NSG 6005 FINAL EXAM TEST BANK (PHARM)

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 . ...

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. n 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 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: 2 ADV Pharm | TextBook | StudyGuide NSG 6005final question bank pharm 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 receptorsites 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 . Time between doses must be shortened 4 . Duration of action of the drug is too long 3 ADV Pharm | TextBook | StudyGuide NSG 6005final question bank pharm 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 orsustained-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 . Watersoluble & 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. 4 Lipid-soluble drugs do not pass these barriers & are safe for pregnant women. . 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: 1 . Inactivate prodrugs before they can be activated by target tissues 2 . Change the drugs so they can cross plasma membranes 3 . Change drug molecules to a form that an excretory organ can excrete 4 . Make these drugs more ionized & polar to facilitate excretion 18. Once they have been metabolized by the liver, the metabolites may be: 1. More active than the parent drug 2. Less active than the parent drug 3. Totally ―deactivated‖ so they are excreted without any effect 4. All of the above 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by: 1 . Reduced circulation & perfusion of the kidney 2 . Chronic renal disease 3 . Competition for a transport site by another drug 4 Unbinding a nonvolatile drug from plasma proteins . 20. Steady state is: 1. The point on the drug concentration curve when absorption exceeds excretion 2. When the amount of drug in the body remains constant 3. When the amount of drug in the body stays below the minimum toxic concentration 4. All of the above