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TEST BANK - PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE PRESCRIBERS, 6TH EDITION (WOO, 2024), CHAPTER 1-57 | ALL CHAPTER R335,26   Add to cart

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TEST BANK - PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE PRESCRIBERS, 6TH EDITION (WOO, 2024), CHAPTER 1-57 | ALL CHAPTER

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TEST BANK - PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE PRESCRIBERS, 6TH EDITION (WOO, 2024), CHAPTER 1-57 | ALL CHAPTER

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  • August 4, 2024
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TEST BANK - PHARMACOTHERAPEUTICS FOR ADVANCED
PRACTICE NURSE PRESCRIBERS, 6TH EDITION (WOO, 2024),
CHAPTER 1-57 | ALL CHAPTER


Chapter 1. The Role of the Nurse
r r r r r r




PractitionerMultiple Choice
r r r




Identify the choice that best completes the statement or answers the question.
r r r r r r r r r r r




r rr 1. Nurse practitioner prescriptive authority is regulated by:
r r r r r r r

1. The National Council of State Boards of Nursing
r r r r r r r

2. The U.S. Drug Enforcement Administration
r r r r

3. The State Board of Nursing for each state
r r r r r r r

4. The State Board of Pharmacy
r r r r




r rr 2. The benefits to the patient of having an Advanced Practice Registered Nurse
r r r r r r r r r r r r


(APRN) prescriberinclude:
r r r

1. Nurses know more about Pharmacology than other prescribers
r r r r r r r

because they take itboth in their basic nursing program and in
r r r r r r r r r r r r

their APRN program.
r r r

2. Nurses care for the patient from a holistic approach and include the patient in
r r r r r r r r r r r r r

decision making regarding their care. r r r r

3. APRNs are less likely to prescribe narcotics and other controlled substances.
r r r r r r r r r r

4. APRNs are able to prescribe independently in all states,
r r r r r r r r


whereas a physician’sassistant needs to have a physician
r r r r r r r r r


supervising their practice.
r r r



r rr 3. Clinical judgment in prescribing includes:
r r r r r

1. Factoring in the cost to the patient of the medication prescribed
r r r r r r r r r r

2. Always prescribing the newest medication available for the disease process
r r r r r r r r r

3. Handing out drug samples to poor patients r r r r r r

4. Prescribing all generic medications to cut costs r r r r r r



r rr 4. Criteria for choosing an effective drug for a disorder include:
r r r r r r r r r r

1. Asking the patient what drug they think would work best for them
r r r r r r r r r r r

2. Consulting nationally recognized guidelines for disease management r r r r r r

3. Prescribing medications that are available as samples before writing a r r r r r r r r r

prescription r

4. Following U.S. Drug Enforcement Administration guidelines for prescribing
r r r r r r r



r rr 5. Nurse practitioner practice may thrive under health-care reform because of:
r r r r r r r r r r

1. The demonstrated ability of nurse practitioners to control costs
r r r r r r r r

,ASAAS


and improve patientoutcomes
r r r r

2. The rfact rthat rnurse rpractitioners rwill rbe rable rto rpractice rindependently
3. The rfact rthat rnurse rpractitioners rwill rhave rfull rreimbursement
under health-carereform
r r r

4. The ability to shift accountability for Medicaid to the state level
r r r r r r r r r r

,ASAAS

,ASAAS



Chapter 1. The Role of the Nurse
r r r r r r


PractitionerAnswer Section
r r r




MULTIPLE CHOICE r




1. ANS: r r r 3 PTS: r 1
2. ANS: r r r 2 PTS: r 1
3. ANS: r r r 1 PTS: r 1
4. ANS: r r r 2 PTS: r 1
5. ANS: r r r 1 PTS: r 1

Chapter 2. Review of Basic Principles of
r r r r r r




rPharmacologyMultiple Choice r r




Identify the choice that best completes the statement or answers the question.
r r r r r r r r r r r




r rr 1. A patient’s nutritional intake and laboratory results reflect
r r r r r r r r


hypoalbuminemia. This is critical toprescribing because:
r r r r r r r

1. Distribution of drugs to target tissue may be affected. r r r r r r r r

2. The solubility of the drug will not match the site of absorption.
r r r r r r r r r r r

3. There will be less free drug available to generate an effect.
r r r r r r r r r r

4. Drugs bound to albumin are readily excreted by the kidneys.
r r r r r r r r r



r rr 2. Drugs that have a significant first-pass effect:
r r r r r r r

1. Must be given by the enteral (oral) route only
r r r r r r r r

2. Bypass the hepatic circulation r r r

3. Are rapidly metabolized by the liver and may have little if any desired action
r r r r r r r r r r r r r

4. Are converted by the liver to more active and fat-soluble forms
r r r r r r r r r r



r rr 3. The route of excretion of a volatile drug will likely be the:
r r r r r r r r r r r r

1. Kidneys
2. Lungs
3. Bile and feces r r

4. Skin

r rr 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM)
r r r r r r r


to create a storagereservoir of the drug. Storage reservoirs:
r r r r r r r r r r

1. Assure that the drug will reach its intended target tissue
r r r r r r r r r

2. Are the reason for giving loading doses
r r r r r r

3. Increase the length of time a drug is available and active r r r r r r r r r r

4. Are most common in collagen tissues
r r r r r



r rr 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
r r r r r r r r r r r r r r r

1. Propensity to go to the target receptor r r r r r r

2. Biological half-life r

3. Pharmacodynamics
4. Safety and side effects r r r

,ASAAS



r rr 6. Azithromycin dosing requires that the first day’s dosage be twice those of the
r r r r r r r r r r r r r


other 4 days of theprescription. This is considered a loading dose. A loading
r r r r r r r r r r r r r r


dose:
r

1. Rapidly achieves drug levels in the therapeutic range
r r r r r r r

2. Requires four- to five-half-lives to attain r r r r r

3. Is influenced by renal function
r r r r

4. Is directly related to the drug circulating to the target tissues
r r r r r r r r r r




r rr 7. The point in time on the drug concentration curve that indicates the first sign of
r r r r r r r r r r r r r r r


a therapeutic effectis the:
r r r r r

1. Minimum adverse effect level r r r

2. Peak of action r r

,ASAAS



3. Onset rof raction
4. Therapeutic rrange

r rr 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
r r r r r r r r r r r r r r

1. When the drug has a wide therapeutic range
r r r r r r r

2. When the drug will be administered for a short time only
r r r r r r r r r r

3. When there is a high correlation between the dose and saturation of receptor
r r r r r r r r r r r r

sites r

4. To determine if a drug is in the therapeutic range
r r r r r r r r r



r 9. A laboratory result indicates that the peak level for a drug is above the minimum
rr r r r r r r r r r r r r r r r

rtoxic concentration.
r

This means that the:
r r r

1. Concentration will produce therapeutic effects r r r r

2. Concentration will produce an adverse response r r r r r

3. Time between doses must be shortened
r r r r r

4. Duration of action of the drug is too long r r r r r r r r



r 10. Drugs that are receptor agonists may demonstrate what property?
r r r r r r r r r r

1. Irreversible binding to the drug receptor site r r r r r r

2. Upregulation with chronic use r r r

3. Desensitization or downregulation with continuous use r r r r r

4. Inverse relationship between drug concentration and drug action
r r r r r r r



r 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
r r r r r r r r r r r r

1. Downregulation of the drug receptor r r r r

2. An exaggerated response if abruptly discontinued
r r r r r

3. Partial blockade of the effects of agonist drugs
r r r r r r r

4. An exaggerated response to competitive drug agonists
r r r r r r



r 12. Factors that affect gastric drug absorption include:
r r r r r r r r

1. Liver enzyme activity r r

2. Protein-binding properties of the drug molecule r r r r r

3. Lipid solubility of the drug r r r r

4. Ability to chew and swallow r r r r



r 13. Drugs administered via IV:
r r r r r

1. Need to be lipid soluble in order to be easily absorbed
r r r r r r r r r r

2. Begin distribution into the body immediately
r r r r r

3. Are easily absorbed if they are nonionized
r r r r r r

4. May use pinocytosis to be absorbed
r r r r r



r 14. When a medication is added to a regimen for a synergistic effect, the combined
r r r r r r r r r r r r r r r

reffect of the drugs is:
r r r r

1. The sum of the effects of each drug individually
r r r r r r r r

2. Greater than the sum of the effects of each drug individually
r r r r r r r r r r

3. Less than the effect of each drug individually
r r r r r r r

4. Not predictable, as it varies with each individual
r r r r r r r



r 15. Which of the following statements about bioavailability is true?
r r r r r r r r r r

1. Bioavailability issues are especially important for drugs with r r r r r r r

narrow therapeuticranges or sustained-release mechanisms.
r r r r r r

,ASAAS



2. All rbrands rof ra rdrug rhave rthe rsame rbioavailability.
3. Drugs rthat rare radministered rmore rthan ronce ra rday rhave rgreater
bioavailability thandrugs given once daily.
r r r r r r

4. Combining ran ractive rdrug rwith ran rinert rsubstance rdoes rnot raffect rbioavailability.


r 16. Which of the following statements about the major distribution
r r r r r r r r r r


barriers (blood-brain orfetal-placental) is true?
r r r r r r

1. Water soluble and ionized drugs cross these barriers rapidly.
r r r r r r r r

2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
r r r r r r r r r r r r r

3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
r r r r r r r r r r r

4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women. r r r r r r r r r r r r




r 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The
r r r r r r r r r r r r r r r r


purpose of both ofthese types of reactions is to:
r r r r r r r r r r

1. Inactivate prodrugs before they can be activated by target tissues r r r r r r r r r

2. Change the drugs so they can cross plasma membranes r r r r r r r r

3. Change drug molecules to a form that an excretory organ can excrete
r r r r r r r r r r r

4. Make these drugs more ionized and polar to facilitate excretion
r r r r r r r r r



r 18. Once they have been metabolized by the liver, the metabolites may be:
r r r r r r r r r r r r r

1. More active than the parent drug r r r r r

2. Less active than the parent drug r r r r r

3. Totally ―deactivated‖ so they are excreted without any effectr r r r r r r r

4. All of the above r r r




r 19. All drugs continue to act in the body until they are changed or excreted. The
r r r r r r r r r r r r r r r r


ability of the body toexcrete drugs via the renal system would be increased
r r r r r r r r r r r r r r


by: r

1. Reduced circulation and perfusion of the kidney r r r r r r

2. Chronic renal disease r r

3. Competition for a transport site by another drug r r r r r r r

4. Unbinding a nonvolatile drug from plasma proteins r r r r r r



r 20. Steady state is:
r r r r

1. The point on the drug concentration curve when absorption exceeds excretion
r r r r r r r r r r

2. When the amount of drug in the body remains constant r r r r r r r r r


3. When the amount of drug in the body stays below the
r r r r r r r r r r


minimum toxicconcentration
r r r

4. All of the above r r r



r 21. Two different pain medications are given together for pain relief. The drug—drug
r r r r r r r r r r r r r

rinteraction is: r

1. Synergistic
2. Antagonistic
3. Potentiative
4. Additive
r 22. Actions taken to reduce drug—drug interaction problems include all of the
r r r r r r r r r r r r

rfollowing EXCEPT: r

1. Reducing the dosage of one of the drugs r r r r r r r

,ASAAS


2. Scheduling rtheir radministration rat rdifferent rtimes
3. Prescribing ra rthird rdrug rto rcounteract rthe radverse rreaction rof rthe rcombination

,ASAAS



4. Reducing rthe rdosage rof rboth rdrugs

r 23. Phase I oxidative-reductive processes of drug metabolism require certain
r r r r r r r r r r

rnutritional elements.
r

Which of the following would reduce or inhibit this process?
r r r r r r r r r

1. Protein malnutrition r

2. Iron-deficiency anemia r

3. Both 1 and 2 r r r

4. Neither 1 nor 2 r r r



r 24. The time required for the amount of drug in the body to decrease by 50% is called:
r r r r r r r r r r r r r r r r r r

1. Steady state r

2. Half-life
3. Phase II metabolism r r

4. Reduced bioavailability time r r




r 25. An agonist activates a receptor and stimulates a response. When given
r r r r r r r r r r r r


frequently over time,the body may:
r r r r r r

1. Upregulate the total number of receptors r r r r r

2. Block the receptor with a partial agonist
r r r r r r

3. Alter the drug’s metabolism r r r

4. Downregulate the numbers of that specific receptor r r r r r r



r 26. Drug antagonism is best defined as an effect of a drug that:
r r r r r r r r r r r r r

1. Leads to major physiological and psychological dependence
r r r r r r

2. Is modified by the concurrent administration of another drug
r r r r r r r r

3. Cannot be metabolized before another dose is administered
r r r r r r r

4. Leads to a decreased physiological response when combined with another drug
r r r r r r r r r r




r 27. Instructions to a client regarding self-administration of oral enteric-coated
r r r r r r r r r r


tablets should includewhich of the following statements?
r r r r r r r r

1. ―Avoid any other oral medicines while taking this drug.‖
r r r r r r r r

2. ―If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice.‖
r r r r r r r r r r r r r

3. ―The tablet may be crushed if you have any difficulty taking it.‖
r r r r r r r r r r r

4. ―To achieve best effect, take the tablet with at least 8 ounces of fluid.‖
r r r r r r r r r r r r r




r 28. The major reason for not crushing a sustained-release capsule is that, if
r r r r r r r r r r r r r


crushed, the coated beads ofthe drugs could possibly result in:
r r r r r r r r r r r

1. Disintegration
2. Toxicity
3. Malabsorption
4. Deterioration

r 29. Which of the following substances is the most likely to be absorbed in the
r r r r r r r r r r r r r r r


intestines rather than inthe stomach?
r r r r r r

1. Sodium bicarbonate r

2. Ascorbic acid r

3. Salicylic acid r

4. Glucose

, ASAAS



r 30. Which of the following variables is a factor in drug absorption?
r r r r r r r r r r r r

1. The smaller the surface area for absorption, the more rapidly the drug is
r r r r r r r r r r r r

absorbed.r

2. A rich blood supply to the area of absorption leads to better absorption.
r r r r r r r r r r r r

3. The less soluble the drug, the more easily it is absorbed.
r r r r r r r r r r

4. Ionized drugs are easily absorbed across the cell membrane.
r r r r r r r r



r 31. An advantage of prescribing a sublingual medication is that the medication is:
r r r r r r r r r r r r r

1. Absorbed rapidly r

2. Excreted rapidly r

3. Metabolized minimally r

4. Distributed equally r



r 32. Drugs that use CYP 3A4 isoenzymes for metabolism may:
r r r r r r r r r r

1. Induce the metabolism of another drug r r r r r

2. Inhibit the metabolism of another drug r r r r r

3. Both 1 and 2 r r r

4. Neither 1 nor 2 r r r



r 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach
r r r r r r r r r r r r r r

rsteady state:
r

1. After the second dose r r r

2. After four to five half-lives r r r r

3. When the patient feels the full effect of the drug
r r r r r r r r r

4. One hour after IV administration
r r r r



r 34. Upregulation or hypersensitization may lead to:
r r r r r r r

1. Increased response to a drug r r r r

2. Decreased response to a drug r r r r

3. An exaggerated response if the drug is withdrawn
r r r r r r r

4. Refractoriness or complete lack of response r r r r r

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