Pharmacology- Exam 1
Age-related changes to the liver affects drug _______.
metabolism
A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that the client has been prescribed. What topic should the nurse address?
The effect of the drug on the client's body.
The commonly used system of measurement is the _______ system.
metric
One of the phases of drug development is the post-marketing surveillance phase. Which activity is carried out during this phase?
Health care providers report adverse effects to FDA.
Phase _____ studies help to determine whether the potential benefits for the drug outweigh the risks.
III
When prevention or cure is not a reasonable goal, relief of symptoms can do what?
Improve a client's quality of life, improve ability to function in activities of daily living.
________ injections are avoided in pediatric patients because of the associated pain and unpredictable absorption.
Intramuscular (IM)
__________ are used in clinical drug trials to compare the medication being tested with a "dummy" medication.
Placebos
The care provider has prescribed intravenous hydromorphone, an opioid, for a client using client-controlled analgesia (PCA) pump. The nurse is aware that this drug has a high abuse potential. Under which category would hydromorphone be classified?
Schedule II
A nurse is administering a Schedule II drug to a patient. What most concerns the nurse about this medication therapy?
Schedule II drugs have a high potential to become addictive and be abused
The Drug Enforcement Agency regulates the manufacture, prescription, and distribution of psychoactive medications through a classification system known as the Schedule of Controlled Substances. At which level would anabolic steroids be placed?
Schedule III
Since 1962, newly developed drugs have been extensively tested before being marketed for general use. What do drug companies do to test drugs initially?
Test the drugs with animals
A nurse is questioning safe procedures for administering "late" medications. Where is the best place for the nurse to find information on the time frame of when medication can be administered?
The Institute for Safe Medical Practices (ISMP) Website
The nurse shares with a client that some controlled substances can lead to psychological dependency, and would cause which signs or symptoms?
The client is compelled to take the medication for a pleasurable experience
Once a drug is patented, which statement is true?
The drug may not be manufactured by other companies until the patent expires
As a nurse about to administer a medication tells the patient about the ordered drug, the patient states, "I am not going to take that medication." What is the nurse's best response?
"I am going to document that you refused the medication."
A patient states, "I have to go through so much to get my medication to treat my cancer!" What is the nurse's best response?
"I realize it can be frustrating, but these laws and guidelines are in place for your protection."
Discharging planning for clients leaving the hospital should include instructions on the use of OTC drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
"OTC drugs are thought to be safe when taken as directed."
A nurse is teaching the client about the use of OTC drugs. Which statement best informs the client about their safe use?
"OTC drugs need to be taken with caution; they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy."
By the age of _______, children have developed pharmacokinetic responses that resemble those of adults.
12
A nurse is about to administer a drug to a client. The drug is used medically and has a high potential for abuse. What is the drug's schedule?
2
A nurse is preparing to administer medications. Which of the following orders would the nurse not administer?
20 u of insulin now, 20,000 IU Vitamin K QD, MS 40mg PO 10am
__________ is the process that occurs from the time a drug enters the body to the time it enters the bloodstream to be circulated.
Absorption
For which patient will the nurse need to consult the Beers Criteria prior to administering medications?
An elderly patient who has been prescribed new medications for pain control
Physical activity in the older adult has no effect on drug response.
False
The Harrison Narcotic Act prohibits fraudulent claims of drug effectiveness.
False
___________ may play a casual role in inducing suicide in pediatric patients.
Antidepressants
A licensed nurse in a long-term care facility is in charge of the narcotics cabinet. Which of the following must the nurse ensure when going off duty?
Ask the oncoming and outgoing nurse to count the number of remaining drugs.
In 1997, the ______ ________ was developed as a way to identify potentially inappropriate medications used by the older adult.
Beers Criteria
A nurse is caring for a patient receiving medication synthesized from DNA. What is the appropriate terminology for this type of therapy?
Biotechnology
A nurse is preparing to administer morphine. The nurse understands that this drug is categorized as which schedule of a controlled substance?
C-II
A nurse reviews the pregnancy risk categories for several drugs. The nurse would identify a drug belonging to which category as being safest to administer to a pregnant woman?
Category A
A nurse working for a drug company is involved in phase III drug evaluation studies. What might the nurse be responsible for during this stage of drug development?
Collecting records of symptoms that participants experience while taking a drug and determining whether they are caused by the disease or the drug.
The fact that a physician wrote an erroneous order excuses the nurse from legal liability if he or she carries out that order.
False
A client asks a nurse whether OTC drugs have any disadvantages. What would the nurse cite as potential disadvantages?
Developing adverse drug reactions, inaccurate self-diagnosis, choosing an incorrect drug, delaying treatment by a health care provider
The trade or brand name is related to the chemical or official name and is independent of the manufacturer.
False
Total body water, fat stores, and protein amounts have no effect on drugs administered to the pediatric population.
False
Which agency is responsible for the enforcement of controlled substances?
Drug Enforcement Agency
Controlled-release tablets can be crushed or chewed for slow absorption.
False
It is safer and quicker to utilize abbreviations for drug names and routes of administration.
False
Hyperthyroidism slows metabolism, which shortens drug action and hastens elimination.
False - Hypothyroidism
The desired or ordered dose and the available or labeled dose must be in the same units of measurement.
False - can convert
In children over the age of 2, immature liver function limits the amount of protein binding by drugs.
False - infants
Distribution is the method by which drugs are inactivated or biotransferred by the body.
False - metabolism/biotransformation
People less than 65 years old are the largest health care consumer group.
False - older than 65
Having drugs available OTC has potential advantages and disadvantages for consumers. What is one of the advantages?
Faster and more convenient access to effective treatment.
The nurse is aware that a client at what stage of pregnancy is at most risk for teratogenic effects from a drug?
First trimester
Which agency is responsible for the approval of new drugs in the United States?
Food and Drug Administration
The law requiring that official drugs must meet standards of purity and strength as determined by chemical analysis or by animal response to specified doses is known as the
Food, Drug, and Cosmetic Act of 1938
What is a major disadvantage of using OTC medications?
People may choose an OTC that interacts with another medication
A nurse working in radiology administers iodine to a client who is having a CAT scan. The nurse working on the oncology unit administers chemotherapy to clients who have cancer. At the Public Health Department, a nurse administers an MMR to a 14 month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
Pharmacotherapeutics
A nurse is teaching a patient about drug therapy for a disease process. What is the appropriate terminology for this therapy?
Pharmacotherapy
The FDA approves drugs for OTC status, including the transfer of drugs from prescription to OTC status. What are characteristics of prescription drugs that are delegated to OTC status?
They may require additional clinical trials to determine the safety and effectiveness of the OTC use, they may be used for different indications than the original prescription medication, they may be administered at a lower dosage than the prescription.
The nurse counsels a group of teenagers that synergistic drug reactions (such as mixing alcohol and a hypnotic drug) can be fatal because of what drug-drug interaction?
This interaction occurs when drugs interact with each other and produce an effect that is greater than the sum of their separate actions.
What is the manufacturer's responsibility during phase IV of a drug trial?
To continue to monitor the drug's effects while the drug is in general use.
An example of a transdermal formulation includes nitroglycerin.
True
Controlled drugs are categorized according to therapeutic usefulness and potential for abuse.
True
In drugs with a longer half-life, doses should be decreased.
True
Ingesting tyramine-containing foods with MAO inhibitors may produce severe hypertension.
True
Injections in infants should be administered in the vastus lateralis.
True
Naloxene is used to relieve respiratory depression associated with morphine
True
Pediatric drug doses are determined strictly using the child's weight.
True
Prescriptions for Schedule II drugs cannot be refilled.
True
The FDA is responsible for assuring that new drugs are safe and effective before approving the drugs and allowing them to be marketed.
True
The Food and Drug Administration regulates the development and sale of drugs.
True
The risk of CNS effects related to drugs is higher in infants than in adults because of the immature blood-brain barrier.
True
Toxic concentrations may stem from a single large dose or repeated small doses.
True
Water-soluble drugs such as antibiotics are distributed in smaller volumes due to the decrease in total body fluid volume.
True
Which of the following are examples of drugs with local effects? Select all that apply
cold sore medicine, sunscreen, wart remover
In determining why a medication error occurred, what is an effective strategy for nurses to implement?
root-cause analysis
Generic drugs are required to be
bioequivalent and less expensive than trade-name drugs.
Due to an immature __________, drugs and other chemicals may more easily affect the CNS in young infants.
blood-brain barrier
How may drugs be prescribed and dispensed?
by generic or trade name
Activated _________ is considered the "universal" antidote.
charcoal
Drugs are classified according to their effects on particular body systems, their therapeutic uses, and their __________ characteristics.
chemical
Body weight affects drug action mainly in relation to ________.
dose
The goals of most pharmacoeconomic research is to identify _______ therapy regimens that provide the desired benefits at the least cost.
drug
The nurse is administering a medication to a client for treatment of insomnia. Approximately 30 minutes after receiving the medication, the client complains of nervousness and inability to fall asleep. The nurse knows that the client is most likely experiencing what type of drug reaction?
drug idiosyncrasy
One key to increased medication adherence is ______ the patient regarding administration and adverse effects.
educating
After teaching a group of students about the responsibilities of the FDA related to drugs, the instructor determines that the students need additional teaching when they identify what as a major responsibility?
enforcement of control of substances with a high abuse potential
FDA approval of a drug for OTC availability includes
evaluation of evidence that the consumer can use the drug safely, using information on the product label.
Drugs related to the chemical or official name and are independent of the manufacturer are
generic name drugs.
Enteric-coated tablets and capsules are coated with a substance that is _______ in stomach acid.
insoluble
Milliequivalents express the _____ activity of a drug.
ionic
The main goal of current drug laws and standards is to ensure that drugs
marketed for therapeutic purposes are safe and effective
An example of an opioid analgesic prototype drug is
morphine
Which drug is considered the prototype of opioid analgesics?
morphine
A nurse is teaching a patient about medications. The patient states that "I get all my medications in the drugstore off the shelf." The nurse teaches the patient that this refers to what type of medication?
over the counter (OTC)
Decreased circulation means that ______ medications are slowly absorbed.
parenteral
Which phase of drug development is associated with continual evaluation of a drug?
phase IV
A drug has been approved by the Food and Drug Administration. What study phase would occur next?
phase IV study
During pregnancy, drugs cross the ______ and may harm the fetus.
placenta
The treatment of chronic illnesses and associated comorbidities results in ________.
polypharmacy
Individual drugs that represent groups of drugs are called _________.
prototype
People and companies that are legally empowered to handle controlled substances must follow what procedures?
provide for secure storage of controlled substances, be registered with the DEA, and keep accurate records of all transactions.
Nurses' responsibilities relative to working with controlled substances include all of the following except
renewing expired prescriptions for controlled substance.
Drugs may be given for local or ___________ effects.
systemic
Drugs are classified according to
their effects on particular body systems, therapeutic uses, and chemical characteristics and potential for abuse.
Drugs are classified according to what features?
therapeutic uses
A drug being tested is removed from testing during a phase II study. What would be the most likely reason for the drug being removed from testing?
unacceptable adverse effects