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NSG 6005 ADV PHARM FINAL EXAM TEST BANK
QUESTIONS AND ANSWERS LATEST 2023
Chapter 1. The Role of the Nurse Practitioner

1. Nurse practitioner prescriptive authority is regulated by:
1 The National Council of State Boards of Nursing
.
2 The U.S. Drug Enforcement Administration
.
3 The State Board of Nursing for each state
.
4 The State Board of Pharmacy
.

2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
1 Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing
. program & in their APRN program.
2 Nurses care for the patient from a holistic approach & include the patient in decision making regarding their
. care.
3 APRNs are less likely to prescribe narcotics & other controlled substances.
.
4 APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a
. physician supervising their practice.

3. Clinical judgment in prescribing includes:
1 Factoring in the cost to the patient of the medication prescribed
.
2 Always prescribing the newest medication available for the disease process
.
3 H&ing out drug samples to poor patients
.
4 Prescribing all generic medications to cut costs
.

4. Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing

5. Nurse practitioner practice may thrive under health-care reform because of:
1 The demonstrated ability of nurse practitioners to control costs & improve patient outcomes
.
2 The fact that nurse practitioners will be able to practice independently
.
3 The fact that nurse practitioners will have full reimbursement under health-care reform
.
4 The ability to shift accountability for Medicaid to the state level
.



Chapter 2. Review of Basic Principles of Pharmacology

1. A patient’s nutritional intake & laboratory results reflect hypoalbuminemia. This is critical to prescribing because:
1 Distribution of drugs to target tissue may be affected.
.
2 The solubility of the drug will not match the site of absorption.
.
3 There will be less free drug available to generate an effect.
.
4 Drugs bound to albumin are readily excreted by the kidneys.
.

2. Drugs that have a significant first-pass effect:
1 Must be given by the enteral (oral) route only
.

,2 Bypass the hepatic circulation
.

, 2 ADV Pharm | TextBook | StudyGuide
3 Are rapidly metabolized by the liver & may have little if any desired action
.
4 Are converted by the liver to more active & fat-soluble forms
.

3. The route of excretion of a volatile drug will likely be the:
1 Kidneys
.
2 Lungs
.
3 Bile & feces
.
4 Skin
.

4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
1 Assure that the drug will reach its intended target tissue
.
2 Are the reason for giving loading doses
.
3 Increase the length of time a drug is available & active
.
4 Are most common in collagen tissues
.

5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
1 Propensity to go to the target receptor
.
2 Biological half-life
.
3 Pharmacodynamics
.
4 Safety & side effects
.

6. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading
dose. A loading dose:
1 Rapidly achieves drug levels in the therapeutic range
.
2 Requires four- to five-half-lives to attain
.
3 Is influenced by renal function
.
4 Is directly related to the drug circulating to the target tissues
.

7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
1 Minimum adverse effect level
.
2 Peak of action
.
3 Onset of action
.
4 Therapeutic range
.

8. Phenytoin requires that a trough level be drawn. Peak & trough levels are done:
1 When the drug has a wide therapeutic range
.
2 When the drug will be administered for a short time only
.
3 When there is a high correlation between the dose & saturation of receptor sites
.
4 To determine if a drug is in the therapeutic range
.

9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:
1 Concentration will produce therapeutic effects
.
2 Concentration will produce an adverse response
.

, 3 ADV Pharm | TextBook | StudyGuide
3 Time between doses must be shortened
.
4 Duration of action of the drug is too long
.

10. Drugs that are receptor agonists may demonstrate what property?
1 Irreversible binding to the drug receptor site
.
2 Upregulation with chronic use
.
3 Desensitization or downregulation with continuous use
.
4 Inverse relationship between drug concentration & drug action
.

11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1 Downregulation of the drug receptor
.
2 An exaggerated response if abruptly discontinued
.
3 Partial blockade of the effects of agonist drugs
.
4 An exaggerated response to competitive drug agonists
.

12. Factors that affect gastric drug absorption include:
1 Liver enzyme activity
.
2 Protein-binding properties of the drug molecule
.
3 Lipid solubility of the drug
.
4 Ability to chew & swallow
.

13. Drugs administered via IV:
1 Need to be lipid soluble in order to be easily absorbed
.
2 Begin distribution into the body immediately
.
3 Are easily absorbed if they are nonionized
.
4 May use pinocytosis to be absorbed
.

14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
1 The sum of the effects of each drug individually
.
2 Greater than the sum of the effects of each drug individually
.
3 Less than the effect of each drug individually
.
4 Not predictable, as it varies with each individual
.

15. Which of the following statements about bioavailability is true?
1 Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release
. mechanisms.
2 All brands of a drug have the same bioavailability.
.
3 Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
.
4 Combining an active drug with an inert substance does not affect bioavailability.
.
16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
1 Water soluble & ionized drugs cross these barriers rapidly.
.
2 The blood-brain barrier slows the entry of many drugs into & from brain cells.
.
3 The fetal-placental barrier protects the fetus from drugs taken by the mother.
.

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