304 Final Exam - In Class Quizzes
apoptosis
"programmed" cell death; tidy
Adverse effect
"side effect"
Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct?
"At this stage of drug development, the safety and usefulness of the medication is unknown."
Agonists are molecules that activate receptors. True or false?
True
hypoxemia
low amount of oxygen in the BLOOD
Match the chemical substance with its function/role/description. cytokines
"umbrella term" for signaling molecules (soluble proteins) secreted by cells of both innate and adaptive immunity
Which of the following statements about the "determinants of health" is FALSE? -"Determinants of health" considers a broader range of factors that influence health status than is typically addressed in traditional health care in which the focus is on a specific individual -"Determinants of health" are used by epidemiologists for the purposes of understanding an individual person's health. -In general, "determinants of health" refers to the range of personal, social, economic, and environmental factors that influence health status. -"Determinants of health" fall under several broad categories, such as: Policymaking; Social factors; Health services; Individual behavior; and Biology and genetics.
-"Determinants of health" are used by epidemiologists for the purposes of understanding an individual person's health.
Tolerance
A state of adaptation in which exposure to a drug induces changes that result in diminution (lessening) of one or more effects of the drug over time
Which of the following clients has experienced cellular atrophy as a result of their health condition? -A middle-aged female experiencing menopause due to loss of estrogen stimulation resulting in decreased size of ovaries -A postnephrectomy client whose remaining kidney enlarges to compensate for the loss -A person with long-standing uncontrolled hypertension who has developed a progressive increase in left ventricular mass -A female client with increased size of uterus as a result of pregnancy
-A middle-aged female experiencing menopause due to loss of estrogen stimulation resulting in decreased size of ovaries
Which statement about hypoxia (listed below) is FALSE? -It is the single most common cause of cellular injury -A patient with hypoxia can be cured by administering oxygen. -Ongoing or severe hypoxia can lead to decreased ATP production, impaired cellular function, and eventually cell death -A common cause of hypoxia is lack/insufficient blood flow to organ, as in atherosclerosis
-A patient with hypoxia can be cured by administering oxygen.
In which of the following patients would the use of a muscarinic agonist most likely be indicated? -A patient who has collapsed to the ground with severe asthma attack. He/she needs a drug to dilate the airways/ bronchioles. -A post-operative patient with abdominal distention due to gas accumulation in the intestines. He needs a drug to promote intestinal motility. -A patient in the Emergency Room with symptomatic bradycardia. She is having problems due to excessively slow heart rate. -A patient with a large kidney stone embedded in the wall of the urethra which is causing tremendous pain and urethral obstruction. He needs surgical intervention.
-A post-operative patient with abdominal distention due to gas accumulation in the intestines. He needs a drug to promote intestinal motility.
Cholinergic receptors are acted on by which of the following neurotransmitters? -Epinephrine -Norepinephrine -Acetylcholine -Dopamine
-Acetylcholine
Which of the mechanisms listed below is NOT one of the classic mechanisms of drug interactions? -Direct interaction based on chemical or physical properties -Pharmacokinetic interactions -Pharmacodynamic interactions -Combined Toxicity -All of the above are mechanisms by which drugs interact.
-All of the above are mechanisms by which drugs interact.
Free radicals may damage cells by several mechanisms including __________________ . -All of these are mechanisms of cell damage from free radicals. -Destroying phospholipids in membranes. -Protein degradation, lost functionality/ decreased activity, possible cessation of critical workflow -DNA fragmentation of both nuclear and mitochondrial DNA
-All of these are mechanisms of cell damage from free radicals.
To evaluate therapeutic and adverse responses to a medication, the nurse must know: -All of these factors are important for a nurse to know in order to evaluate responses to a drug -Reason for treatment -Nature and time course of intended response -Nature and time course of potential adverse effects -Potential Adverse interactions
-All of these factors are important for a nurse to know in order to evaluate responses to a drug
Cholinergic receptor subtypes include all of the following, EXCEPT: -Nicotinic n -Nicotinic m -Muscarinic -Alpha and beta receptors
-Alpha and beta receptors
A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives information about the drug's pharmacologic classification?" Which is the correct response? -Aleve -Motrin -Tylenol -Amoxicillin
-Amoxicillin
Cells that mediate humoral immunity do so because they are capable of producing ___________________ . -T cells (helper T, regulatory T) -Platelets and fibrinogen -Stem cells and progenitors -Antibodies and/or chemical mediators
-Antibodies and/or chemical mediators
Which of the following is not a property of an ideal drug? -Safety -Selectivity -Effectiveness -Catchy advertising
-Catchy advertising
Innate immunity, sometimes referred to as "natural" or "native" immunity, consists of mechanisms that respond to _______________________. -Antibodies -Self-cells -Interferons -Cell injury or invasion
-Cell injury or invasion
A client is diagnosed with liver disease. Surgery is performed to remove a large portion of his liver. During the weeks after surgery, which type of adaptation occurs in the remaining liver cells? -Compensatory hyperplasia -Atrophy -Physiologic hypertrophy -Metaplasia
-Compensatory hyperplasia
Which of the terms below describes the following condition: the presence and reproduction of a microorganism in a location of the human body where the organism should not be -INFECTION -IMMUNOLOGY -IMMUNITY -IMMUNE
-INFECTION
Which of the following routes of administration are NOT affected by the 'first pass' effect? -Intramuscular -Nasogastric tube (NG tube) -Percutaneous endogastric (feeding) tube (PEG tube) -Rectal
-Intramuscular
Of the descriptions listed below, which best describes the complement system? -It is a chemical a chemical agent that induces movement of chemotactic cells (attracts) in the direction of its highest concentration -Any substance (e.g. antibody) that binds to the surface of a particle (e.g. antigen) to enhance the uptake of the particle by a phagocyte (e.g. macrophage) -It is a small molecule. It acts as a tag that signals the protein-transport machinery to ferry the protein to the proteosome for degradation. -It is part of the immune system; consists of a series of proteins that interact with one another in a highly regulated manner, in order to eliminate pathogens. It helps antibodies and phagocytic cells to clear pathogens and damaged cells; promote inflammation and attack the pathogen's plasma membrane
-It is part of the immune system; consists of a series of proteins that interact with one another in a highly regulated manner, in order to eliminate pathogens. It helps antibodies and phagocytic cells to clear pathogens and damaged cells; promote inflammation and attack the pathogen's plasma membrane
During a lecture on inflammation, the physiology instructor discusses the major cellular components involved in the inflammation response. The instructor asks, "Which of the following cells arrive early and in great numbers?" The student with the correct response states _____________________ . -Lymphocytes -Monocytes -Neutrophils -Basophils
-Neutrophils
The cell types that play the central role related to the innate immune response to an infectious microorganism are _________________ . -Neutrophils and macrophages -B lymphocytes and erythrocytes -T lymphocytes and stem cells -Antibodies and interleukins
-Neutrophils and macrophages
An older adult client has just sheared a flap of skin from her elbow while attempting to boost herself up in bed. This event has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the client's inflammation? -Migration of fibroblasts into the wound -Formation of a "platelet plug" stabilized by cross-linked fibrin strands at the lacerated blood vessel -Outpouring of exudate into interstitial spaces leading to swelling -Phagocytosis of cellular debris
-Outpouring of exudate into interstitial spaces leading to swelling
Food interactions can lead to treatment failure(s) or toxicity. Which drug-food interaction listed below is INCORRECT? -Grapefruit Juice Inhibits the metabolism of drugs that are metabolized by the CYP3A4 family. -Pts who take mono-amine-oxidase inhibitors need to avoid tyramine-rich foods. -People who take potassium-sparing diuretics and potassium-containing salt substitutes are at risk for hypokalemia. -People taking warfarin are advised to eat consistent amounts of vitamin K-containing foods on a day-to-day (week-to-week) basis.
-People who take potassium-sparing diuretics and potassium-containing salt substitutes are at risk for hypokalemia.
Socioeconomic factors MAY influence disease development due to all of the following factors, EXCEPT: -genetics -exposure to environmental toxins. -overcrowding -nutrition. -access to sanitary waste disposal and washing -facilities
-genetics
Which of the pts listed below is at LOWEST RISK of a drug interaction? -Pts who take several drugs -Pts with renal or liver dysfunction -Pts taking high-risk drugs -Pts taking opioids; insulin or oral hypoglycemic agents; or antiplatelet or anticoagulants -Pts who are usually healthy and only take occasional medications prn
-Pts who are usually healthy and only take occasional medications prn
A baseball player slid into home base and developed huge scratches and abrasions on his hip and thigh. On physical examination at the health clinic, which of the following assessment findings would be considered a cardinal sign of acute inflammation? -Temperature of 101°F -Redness and edema at the injured site -Fatigue with listlessness -Urine output of less than 500 mL/24 hours (low)
-Redness and edema at the injured site
A client with long-standing diabetes has impaired sensation, reduced circulation, and poor oxygenation of his feet. He steps on a piece of glass: the wound does not heal, and some tissue becomes necrotic. Necrosis of cells is characterized by ___________________ . -Rapid apoptosis -Shrinkage and collapse -Rupture of cell membranes and acute inflammation
-Rupture of cell membranes and acute inflammation
Which cell or structure listed below is NOT part of the innate immune system? -mucous membranes -T- helper cells -tears -flow of urine, "washout" of the urethra -skin -several plasma proteins, including the proteins of the complement system -stomach acid -specialized lymphocytes (the natural killer cells) -coughing, sneezing -phagocytic leukocytes (mainly neutrophils and macrophages) -mucous, mucociliary escalator, and ciliated epithelium
-T- helper cells
Which of the following types of drug interactions is least important? -Drug-Drug Interactions -Drug-Food Interactions -Drug-Supplement Interactions -Drug-Disease Interactions -The answer cannot be determined: all of the above-mentioned drug interactions are important.
-The answer cannot be determined: all of the above-mentioned drug interactions are important.
Which of the following statements is true of half-life? -The half-life of a drug is the same whether it is administered IV or IM. -A drug with a long half-life will need to be administered more frequently than a drug with a short half-life. -Toxicity has developed with drug Y; it will be easier to manage this situation clinically if drug Y has a long half-life rather than a short half-life.
-The half-life of a drug is the same whether it is administered IV or IM.
Which statement about commonly ordered diagnostic tests is FALSE? -The nurse should never use the "Reference Range" provided by the facility/lab that processed the specimen -An M7 or "Chem 7" is also known as a basic chemistry panel, or basic metabolic panel, this frequently ordered blood test measures the concentration of seven key components in the blood -A CBC determines the number of red blood cells, white blood cells, and platelets per unit of blood -Tests are done for a variety of reasons, including screening, diagnosing, evaluating severity of a disorder, and monitoring response to treatment.
-The nurse should never use the "Reference Range" provided by the facility/lab that processed the specimen
Which statement about plasma proteins (if any) is FALSE? -Plasma proteins are primarily produced by the liver -The term "thrombocyte" is interchangeable with "plasma protein." These words are synonyms. -The main plasma proteins are albumin, globulins and fibrinogen -Albumin comprises the largest portion of the plasma proteins
-The term "thrombocyte" is interchangeable with "plasma protein." These words are synonyms. (thrombocyte = platelet)
Which description below best describes the entire immune system (in general)? -focused recognition of each unique type of foreign agent followed, in days, by an amplified and effective response. -a complex nonspecific response to tissue injury intended to minimize the effects of injury or infection, remove the damaged tissue, generate new tissue, and facilitate healing -the physical, chemical, molecular, and cellular defenses that are in place before infection and can function immediately as an effective barrier to microbes -a complex network comprised of molecular and cellular elements.
-a complex network comprised of molecular and cellular elements.
Muscarinic agonists can be used to treat all of the health problems listed below, except _________________________ . -bradycardia (heart rate is slow) -urinary retention -gastroesophageal reflux disease -paralytic ileus (ie bowel is much too hypoactive) -Post-operative abdominal distention
-bradycardia (heart rate is slow)
Which of the physiologic variables listed below IS NOT A COMPONENT of the standard Basic Metabolic Panel (common blood test)? -potassium -glucose -carbon dioxide -chloride -sodium -creatinine -blood urea nitrogen (BUN) -hematocrit
-hematocrit
Describe the only known function of peripheral dopamine receptors... At low doses, dopamine
-dilates renal blood vessels
Which characteristic of the INNATE immune system, listed below, is FALSE? -response is rapid, usually within minutes to hours -able to distinguish self from nonself -effector responses to eliminate the microbes are very different for different classes of microorganisms -prevents the establishment of infection and deeper tissue penetration of microorganisms
-effector responses to eliminate the microbes are very different for different classes of microorganisms
Major histocompatibility complex (MHC) molecules are proteins embedded in cell membranes that have an important role in the ____________________ . -suppressing viral replication -identification of self vs nonself -cell membrane transport -DNA transcription, translation and modification
-identification of self vs non-self
Three cell types listed below comprise the phagocytic cells of the immune system. Which cell type is NOT (usually) considered phagocytic (although in some diseases it might be)? -dendritic cells -macrophages -plasma cells -granulocytes
-plasma cells
Local manifestations of acute inflammation, which are determined by severity of the reaction, its specific cause, and the site of involvement, can range from mild to severe. Which of the signs/symptoms listed below identifies the "cardinal signs of inflammation"? -nausea, vomiting, diarrhea abdominal cramps -Skin rash, hives; itching. Swelling of the lips, tongue or throat. Shortness of breath, trouble breathing, wheezing (whistling sound during breathing). Dizziness and/or fainting. Stomach pain, vomiting or diarrhea. Feeling like something awful is about to happen. -redness, warmth in the local area, swelling, loss of function, pain -elevated body temperature; shivering, shakes or chills; achiness in muscles or joints; headache; flushing of skin, hot skin
-redness, warmth in the local area, swelling, loss of function, pain
Muscarinic antagonists can be used for all of the reasons listed below, EXCEPT _________________________ . -used to block sympathetic effects on skeletal muscle -used to block parasympathetic effects on heart rate -used to block parasympathetic effects on salivary secretions -used to block parasympathetic effects on bronchi
-used to block sympathetic effects on skeletal muscle
Which of the following best describes cellular adaptation? -occurs if the cell is unable to maintain homeostasis in the face of injurious stimuli or stress. Function is impaired; cell death may occur. -refers to increased work/demands, chemical, physical, thermal, radiation, immunologic, infectious and other changes that induce cellular "stress" -refers to reversible structural and functional changes made in response to stress -Examples include cells with inadequate oxygen; invasion by virus; exposure to severe toxins, acids or high energy radiation; prolonged exposure to freezing temperatures
-refers to reversible structural and functional changes made in response to stress
Which description below best describes an individual person's genome? -Humans have 23 pairs of chromosomes -refers to the entire set of genetic and regulatory material in the nucleus as well as in the mitochondria -Refers to an individual's observable traits, such as height or eye color -Either XX (biologic female) or XY (biologic male)
-refers to the entire set of genetic and regulatory material in the nucleus as well as in the mitochondria
Target cells of post-ganglionic neurons in the autonomic nervous system include all of the following, EXCEPT: -heart -glands -smooth muscle -skeletal muscle
-skeletal muscle
The plasma membrane is _______________________. (Select all that apply) -a membrane composed of tiny shelves or cristae. -a double-layered membrane surrounding the mitochondria of the cell. -the plasma membrane is another term for cell membrane -a phospholipid bilayer that separates the interior of the cell from the extracellular environment -a single-layer of molecules enclosing the plasma. -the membrane surrounding the cell.
-the plasma membrane is another term for cell membrane -a phospholipid bilayer that separates the interior of the cell from the extracellular environment -the membrane surrounding the cell.
Synaptic transmission consists of basic steps: put the steps below into the proper sequence. -transmitter release -transmitter reuptake or degradation -transmitter storage -dissociation of transmitter from the receptor -binding of transmitter to its receptors -termination of transmitter action -transmitter synthesis
-transmitter synthesis -transmitter storage -transmitter release -binding of transmitter to its receptors -termination of transmitter action -dissociation of transmitter from the receptor -transmitter reuptake or degradation
Which of the following factors is LEAST RELEVANT in determining an individual person's ability to adapt (or respond) to a physiologic stressor? -which hemisphere of the planet the person lives in (ie northern hemisphere or southern hemisphere) -age -pre-existing health status -the rapidity with which the need to adapt occurs (ie, rapidity of onset of the stressor)
-which hemisphere of the planet the person lives in (ie northern hemisphere or southern hemisphere)
Imaging is a general "umbrella" term that refers to which type of tests? -Chemical analysis of a body fluid -electrical activity of an organ is measured -Tissue samples are removed and examined -When a viewing tube is placed into the body to directly observe the inside of body organs or spaces -x-rays, ultrasonography, radioisotope (nuclear) scanning, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography.
-x-rays, ultrasonography, radioisotope (nuclear) scanning, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography.
Drugs that stimulate or mimic the parasympathetic branch of the autonomic nervous system are called adrenergic agonists. True or false?
False
It takes between ________ doses of medications, administered at proper intervals of time, for a drug to reach plateau.
4-5
Physical Dependence
A state in which the body has adapted to drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued.
Adverse event
A noxious, undesirable occurrence that happens (but which cannot be reasonably determined to be caused by a specific drug).
Adverse drug reaction
A response to a drug which is a noxious, unintended and undesired effect that occurs at normal drug doses. Causal relationship with drug is assumed, highly likely.
All postganglionic neurons of the parasympathetic NS release ___ as their neurotransmitter
Acetylcholine
Which neurotransmitter stimulates muscarinic receptors?
Acetylcholine
Name the enzyme that degrades acetylcholine
Acetylcholinesterase
In simple terms, explain how neuropharmacologic drugs exert their effects.
All neuro-pharmacologic drugs exert their effects by directly or indirectly altering receptor activity on target cells. Neuro-pharmacologic drugs modify receptor function in one of two ways: by increasing receptor activation or by decreasing receptor activation.
Which of the following statements about anaphylaxis is FALSE? -Anaphylaxis typically presents with the sudden onset of signs and symptoms, usually in more than one body system, within minutes to a few hours after the last administered dose (ie exposure to trigger.) -The time to onset of signs/symptoms of anaphylaxis is influenced by the route of administration -Anaphylaxis is the most severe presentation of an IgE-mediated (allergic) drug reaction (potentially life-threatening) -Classic signs of anaphylaxis include: Hives, itching or flushing of the skin; swelling of mucosal tissue lips, tongue, uvula; Dyspnea, bronchospasm, wheezing, laryngeal edema, hoarse voice; Precipitous drop in blood pressure! Collapse, syncope, incontinence -All of the above are true
All of the above are true
Statements about normality: Which of the statements below is FALSE? (*If all statements are true, then pick, "All of the statements are true.") -Approximately 2.5% of values will be above the normal range and 2.5% will be below it. -The "normal range" is typically suggested as the mean plus or minus 2 standard deviations -"There is a range of normal" -Most physiologic variables occur in the population according to a "bell curve" or normal distribution -All of the statements are true
All of the statements are true
In an extremely dark setting, where there is very little light, these receptors are stimulated and cause the pupils of your eyes to dilate.
Alpha-1
A patient is scheduled for a procedure that requires a local anesthetic. The nurse remembers that a local anesthetic __________.
Blocks axonal conduction
Match the drug with its pharmacologic class. propranolol
Blocks beta-1 and beta-2 receptors (non-selective)
Match the drug with its pharmacologic class. metoprolol
Blocks beta-1 receptors (ie "Cardioselective")
Match the class of antibody with its basic function IgG
Displays antiviral, antitoxin, and antibacterial properties; only Ig that crosses the placenta and thus partially responsible for protection of newborn; activates complement and binds to macrophages; prominent in the secondary immune system
Effects of a drug that blocks beta-1 receptors will cause/ lead to ___________.
Decreased heart rate, decreased force of ventricular contraction, and decreased velocity of conduction through the AV node.
In the peripheral nervous system, this neurotransmitter causes the renal arteries to dilate
Dopamine
Which component of a correctly written medication order is missing from the following order? Regular insulin 30 subcut x 1 now
Dosage units
A(n) _____ drug is one that elicits the therapeutic responses for which it is given.
Effective
_______________ is the study of factors affecting the health and illness of populations.
Epidemiology
What substance is released by the adrenal medulla into the bloodstream when the adrenal medulla is stimulated?
Epinephrine
The FDA Amendments Act (FDAAA) was passed in 2007 to address which aspect of drug safety?
Evaluating drug safety information that emerges after a drug has been approved and is in use
What errors are made in the medication orders? Fentanyl SL spray .025 mg Q hour prn breakthrough pain in opioid-tolerant adult receiving around-the-clock opioid therapy
Failure to use a leading zero (sometimes called the "naked decimal point")
A carcinogen is a chemical or environmental factor that has the ability to induce birth defects. True or false?
False
Drugs are absorbed more slowly from sites where blood flow is high. True or false?
False
Intensity of the allergic reaction is determined by the drug dosage. True or false?
False
The likelihood of drug interactions decreases as the number of drugs in a person's drug regimen increases. True or false?
False
The parasympathetic nervous system dilates the pupil of the eyes, whereas effects of the sympathetic nervous system cause the pupil of the eyes to constrict. True or false?
False
When muscarinic receptors are stimulated, it promotes skeletal muscle contraction. True or false?
False
When nicotinic m receptors are stimulated, it causes gastric secretions to increase. True or false?
False
Match the class of antibody with its basic function IgM
Forms the natural antibodies such as those for ABO blood antigens; prominent in early immune responses; activate complement
Match the class of antibody with its basic function IgD
Found on B lymphocytes; needed for maturation of B cells
Addiction
Hallmark is craving; impaired control over drug use, compulsive drug use despite harm; complex multi-faceted concept involving genetic, psychosocial and environmental factors.
In which organs are cells with beta1 receptors located?
Heart and kidneys
Match the route of administration with its corresponding abbreviation intramuscular
IM
Match the route of administration with its corresponding abbreviation intravenous
IV
In the year 2000, the number of new cases (__________) and the rate of existing cases of syphilis (______________) in the U.S. population reached historic lows. Unfortunately, there has been a resurgence in the disease since then.
Incidence, Prevalence
Match the class of antibody with its basic function IgE
Involved in immediate hypersensitivity rxs, parasitic infections; binds to mast cells and basophils
Match the branch of the peripheral nervous system with its description sympathetic nervous system
MOST post-ganglionic neurons release norepinephrine onto adrenergic receptors on effector cells
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:
Metabolism of drugs
Name the enzyme that degrades norepinephrine
Monoamine oxidase
Macrophages
Monocytes mature into this cell type; resident in almost all tissues; relatively long-lived cells with different functions during the innate and adaptive immune responses
Dendritic cells
Named for their long finger-like processes; most are immature cells under epithelial tissue and in most organs, where they are poised to capture foreign agents and transport them to peripheral lymphoid organs
The prototype for a cholinesterase inhibitor is _______________ .
Neostigmine
Match the drug with its pharmacologic class. Phentolamine
Non-selective - produces alpha-1 and alpha-2 blockade
What neurotransmitter is released by all postganglionic neurons of the sympathetic NS (except those neurons that terminate on sweat glands)?
Norepinephrine
Match the route of administration with its corresponding abbreviation by mouth
PO
Before administering a medication to a patient, what patient-specific baseline assessment data would be important to collect?
Patient's Medical Conditions and Drug Allergies
A nurse administers the same medication, in the same formulation, in the same dose, to several patients. The nurse observes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon?
Pharmacogenomic difference among individuals
Match the class of antibody with its basic function IgA
Predominant Ig in body secretions, such as saliva, nasal and respiratory secretions, and breast milk; protects mucous membranes
The forty year old survivor of a severe trauma suffered a setback on his chronic alcoholism disorder when something in the news media reminded him of his original traumatic event. He experienced a ____________ of his alcoholism and went on a drinking binge.
Relapse
A(n) ________ drug is one that cannot produce harmful effects even if given in high doses.
Safe
secondary prevention
Screen for disease in its early stages in order to stop the disease while still curable and less invasive, less expensive to treat Example: Pap smears, dental x-rays, mammograms, testicular self-checks, PPD/Mantoux test, etc.
A(n) _____ drug is one that elicits only the responses for which it is given; it would not produce side effects.
Selective
Match the drug with its pharmacologic class. Prazosin
Selective - produces alpha-1 blockade
A patient asks a nurse why drugs that have been approved by the FDA still have unknown side effects. What will the nurse tell the patient?
Subjects in drug trials do not always represent the full spectrum of possible patients.
The nurse in the Emergency Department administers naloxone [Narcan; an opioid antagonist] to a patient who has overdosed on morphine and is experiencing respiratory suppression. Remembering the pharmacodynamics of an antagonist drug, the nurse understands that the naloxone is effective because __________ ?
The antagonist competes with morphine for binding to opioid receptors, thereby reducing the effect of morphine.
Therapeutic effect
The intended effect of the drug
tertiary prevention
The person has disease, but there are opportunities to prevent further deterioration and reduce complications of the disease.
A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings (also known as black box warnings)?
They alert prescribers to measures to mitigate potential harm from side effects.
A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names?
They are assigned by the U.S. Adopted Names Council.
A nursing student asks a nurse about pharmaceutical research and wants to know the purpose of randomization in drug trials. The nurse explains that randomization is used to do what?
To ensure that differences in outcomes are the result of treatment and not differences in subjects
"˜Therapeutic Index" is defined as the ratio of the drug's LD50 (average lethal dose to 50% of the animals treated) to its ED50 (the dose that will produce a predefined intensity of response in 50% of the population.) True or false?
True
A drug that has effects purely as a muscarinic agonist would cause effects similar to those of stimulation by the parasympathetic nervous system. Although sweat glands are under control of the sympathetic nervous system, the sweat glands also have muscarinic receptors. Sweat glands are oddities. True or false?
True
A potent drug is simply a drug that produces its effects at low doses. True or false?
True
A very few organs dually innervated by the sympathetic and parasympathetic nervous systems have effects that are complementary. Examples include the male and female sexual organs. True or false?
True
About 10 to 15 percent of ADR are hypersensitivity reactions, mediated by immunologic or other types of mechanisms. True or false?
True
Activation of muscarinic receptors on the heart decreases heart rate. True or false?
True
Administering a beta2 receptor agonist might be desirable for your patient in unwanted premature labor. True or false?
True
An absolute contraindication is a situation which makes a particular treatment or procedure absolutely inadvisable. NEVER. True or false?
True
Antagonists do not cause receptor activation. Instead, antagonists have pharmacologic effects because they prevent activation of receptors by agonists. True or false?
True
As defined by the World Health Organization, health is "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." True or false?
True
Concept of Normality and the Reference Range: Many physiologic variables are normally distributed within the population, so the mean ±2 standard deviations include 95% of the normal values in the sample. Approximately 2.5% of values will be above the normal range and 2.5% will be below it. True or false?
True
Do not confuse the terms mortality and morbidity; mortality refers to death or lethality of something whereas morbidity refers to detrimental effects of an illness on a person's life True or false?
True
Drugs are absorbed more slowly from a tablet than from a liquid solution. True or false?
True
Essential, cooperative interactions exist between innate and adaptive immunity. The two systems work together in intricate fashion. True or false?
True
For most drugs, as the dosage increases, the response becomes progressively larger (until max effect is reached.) True or false?
True
Health literacy ... is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. True or false?
True
In order to urinate or defecate, alpha-1 receptors must be stimulated. True or false?
True
Incidence is the term that refers to the number of new cases arising in a population at risk during a specified time (usually number of new cases per year). True or false?
True
Liver failure can clinically alter (prolong) a drug's half-life. True or false?
True
Most organs that are innervated by the sympathetic and parasympathetic nervous systems have effects that are opposed. True or false?
True
Multiple receptor types and subtypes allow drugs to act selectively True or false?
True
Neuropharmacologic drugs produce effects equivalent to those produced by excitation or suppression of neuronal activity. True or false?
True
Neutral, uncharged, non-polar drugs have greater lipid solubility than polar drugs. True or false?
True
Nicotinic n (neuronal) receptors are located at all autonomic ganglia and at the adrenal medulla. True or false?
True
Ninety percent of fatal medication errors fall into three categories: human factors, communication mistakes, and name confusion. True or false?
True
No two patients will respond exactly the same to a drug regimen. There are several reasons for this, including age (developmental or lifespan) considerations and genetic differences. True or false?
True
No two people who have ever lived (or will ever live) on this planet are identical genetically (except, perhaps, identical twins). True or false?
True
Pharmacodynamics can be defined as "the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced." In other words, the effect of the drug on the body. True or false?
True
Pharmacogenetics refers to the fact that differences in genetic make-up (particularly differences in genes that determine activity of hepatic enzymes) can lead to significant differences in drug metabolism. Differences in genetic make-up can lead to very significant clinical consequences! True or false?
True
Pharmacokinetics is the study of the effect of the body on the drug: absorption, distribution, metabolism, and excretion. True or false?
True
Pharmacovigilance is defined as "the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem." True or false?
True
Pts older than age 65 years account for > 50% of all ADR cases. True or false?
True
St. John's wort is the dietary supplement that has the most documented interactions with drugs. True or false?
True
The generic name of a drug is the most appropriate name for health care professionals to best identify the drug. True or false?
True
The objective of drug therapy is to provide maximal benefit with minimal harm. True or false?
True
The parasympathetic nervous system decreases heart rate, whereas effects of the sympathetic nervous system lead to increased heart rate, increased conduction velocity, and increased force of contraction. True or false?
True
When an action potential (AP) reaches the axon terminus (synaptic bouton) of a neuron, it causes vesicles containing signaling molecules (neurotransmitter) to be released into synaptic gap. True or false?
True
˜A receptor is the macromolecule in a cell to which a drug binds to produce its effects. ˜The term receptor is generally reserved to refer to the body's own receptors for hormones, neurotransmitters, and other regulatory molecules True or false?
True
What errors are made in the medication orders? MS 1-2 mg IV Q 4 hours as needed for post-operative pain.
Use of a "Do Not Use" abbreviation
What errors are made in the medication orders? Furosemide 20.0 mg PO Q AM for fluid retention. May repeat the same dosage 6 to 8 hours later prn for continued edema.
Use of a trailing zero
What errors are made in the medication orders? Sertraline (Zoloft®) 150 mg qhs for depression
Use of an error-prone abbreviation
prevalence
a measure of exisiting disease in a population at a given point in time; "snapshot"
Match the organelle with its best description endoplasmic reticulum
a network of tubular channels that specialize in the synthesis and transport of proteins and lipid components
The major disadvantage of the oral route of administration is that __________________________ .
absorption can be highly variable
somatic nervous system
acetylcholine is the neurotransmitter that activates skeletal muscle
quaternary prevention
actions taken to prevent overmedicalization, to protect patient from new medical invasion, and to suggest interventions which are ethically acceptable
Match the branch of the peripheral nervous system with its description parasympathetic nervous system
all post-ganglion neurons release acetylcholine onto adrenergic receptors of effectors cells
If a person had a severely congested nose from a cold and wanted a nasal spray with a medication to constrict the blood vessels in their mucous membranes, which type of drug might work?
alpha-1 agonist
Match the drug with its pharmacologic class. Phenylephrine
alpha-1 agonist
Which receptors are located in the following places, and have the following effects when activated? -In certain smooth muscles of eyes - activation causes mydriasis (pupillary dilation) -Bladder neck- activation causes contraction (impaired urination) -In blood vessels of skin, viscera, mucous membranes - activation causes vasoconstriction
alpha-1 receptors
Except for local anesthetics, which suppress axonal conduction, all neuropharmacologic drugs act by ______________________________ .
altering synaptic transmission
Hypertrophy
an increase in cell size by gain of cellular substance
Hyperplasia
an increase in the number of cells in an organ or tissue
secondary prevention
annual exams & Pap smears, mammograms, TB skin test, self-testicular exams, colonoscopy
Since one of the main effects of stimulating the parasympathetic nervous system is to cause increased gastric secretion and motility, a muscarinic ______________ would cause decreased secretions.
antagonist
tertiary prevention
antibiotics, chemotherapy, radiation, rehabilitation to reduce disability and to promote effective functioning
basophils
appear in many specific kinds of inflammatory and hypersensitivity reactions; contain histamine and heparin reactions
The prototype for a muscarinic antagonist is _______________ .
atropine
morbidity
describes the effects an illness has on a person's life
If a person needed a drug that would have the effects listed below, which type of drug would work? -increase heart rate -increase force of contraction (contractility) -speed conduction through the AV node
beta-1 agonist
Match the drug with its pharmacologic class. Dobutamine
beta-1 agonist
If a person needed a drug to prevent the heart from beating too fast, which type of drug might work?
beta-1 antagonist
Which receptors are located in the following places, and have the following effects when activated? -In the heart (SA node and elsewhere) - activation causes: =Increased heart rate =Increased force of contraction =Increased velocity of conduction in AV node -In the kidney- activation stimulates release of renin
beta-1 receptors
Match the drug with its pharmacologic class. Albuterol
beta-2 agonist
Which receptors are located in the following places, and have the following effects when activated? -In the bronchi- activation causes bronchial smooth muscles to relax, thus bronchi DILATE -In the uterus- activation causes smooth -muscles of uterus to relax, thus delays labor -In the liver & skeletal muscle- activation induces glycogenolysis (breakdown of glycogen into glucose) -Certain blood vessels - activation causes dilation, ie increased bloodflow to skeletal muscles, heart, lungs -In skeletal muscle - increased force of contraction
beta-2 receptors
The prototype for a muscarinic agonist is _______________ .
bethanechol
Metabolism
biotransformation; the enzymatic alteration of a drug's structure
reuptake inhibitors
blocks uptake of neurotransmitters into presynaptic cell
Match the cell with its function. cytotoxic T-lymphocyte
destroy virus-infected and malignant cells
agonist
causes receptor activation
necrosis
cell death, membrane ruptures, leads to inflammation
pathogenesis
cellular events, reactions and other pathologic mechanisms occurring in the development/ progression of disease
Match the organelle with its best description cell nucleus
chief functions are cell division and control of genetic information
Match the organelle with its best description mitochondria
contiant eh metabolic machinery necessary for cellular energy metabolism
Binding of drugs to plasma proteins ________________________________ .
decreases the amount of the drug available for having an effect on the patient
If an eyedrop medication was a sympathetic agonist drug, it would cause the eyes to
dilate
If an inhalant medication was a beta2 agonist, it would cause the bronchi to
dilate, widen, lumen get larger
Distribution
drug movement from the blood capillary... into the interstital space... to a cell and then back into the blood
Pharmacodynamics refers to the ________________ .
effect that the drug has on the body
"super" transmitter
enhanced receptor activation
Which substance is discussed below? -This molecule activates alpha1, alpha2, beta1 and beta2 receptors. -This is the drug of choice for anaphylaxis. -As a rescue drug, it is also used to increase blood pressure, increase heart rate, increase force of contraction (ie to reverse or prevent cardiovascular collapse.)
epinephrine
clinical manifestations
evidence of disease such as signs, symptoms, lab results signs or symptoms of illness
Which component of a correctly written medication order is missing from the following order? Valium 5 mg PO
frequency
eosinophils
have several roles, but are particularly important for their anti-parasite role!
primary prevention
immunizations, daily brushing & flossing, nutritious eating habits, physical activity, seatbelts and bike helmets
If a patient was in the hospital received "low dose dopamine" and the therapeutic objective was accomplished, what would the nurse notice when doing her assessment of the patient?
increased urine output
risk factor
increases the likelihood of developing a particular health problem
CQ was recently exposed to group A beta-hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3° F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus. Antibiotics have been prescribed. The etiology of C.Q.'s health problem is ___________ .
infection by streptococcal bacteria
Match the chemical substance with its function/role/description. coagulation proteins
leads to formation of fibrin strand meshwork that stops a blood vessel from bleeding (hemostasis)
hypoxia
low amount of oxygen in the TISSUE
Match the cell with its function. antigen-presenting cells include
macrophages and dendritic cells
The organelle depicted below is important in ____________________________. -suppressing gene transcription -initiating gene transcription -post-translation modifications of protein -maintaining the barrier between intracellular and extracellular compartments
maintaining the barrier between intracellular and extracellular compartments
NK cells
may be the first line of defense against viral infections; also have the ability to recognize and kill tumor cells, abnormal body cells, and cells infected with intracellular pathogens, such as viruses and intracellular bacteria
The terms below are taken from the "pathophysiological framework." treatment implications
medical interventions to restore health to patient who have the disease/illness
The organelle that uses oxygen to produce ATP through oxidative phosphorylation is the ____________________________ .
mitochondria
etiology
molecular, cellular and biological mechanisms responsible for disease onset cause of disease
The terms below are taken from the "pathophysiological framework." etiology
molecular, cellular and ciological mechanisms responsible for disease; CAUSE of the disease
A cholinesterase inhibitor is a particularly useful drug to treat ________________ .
myasthenia gravis
granulocytes
neutrophils, eosinophils, and basophils
Which component of a correctly written medication order is missing from the following medication order? Lisinopril 25 mg PO b.i.d. for 7 days
nothing is missing
Which component of a correctly written medication order is missing from the following order? Digoxin 0.125 mg PO at 0800 x 1 dose only
nothing is missing
Metaplasia
one adult cell type is replaced by another adult cell type of the same tissue
chronic conditions
onset of disease may be sudden, gradual or insidious, but they have a longer duration; may last months to years EXAMPLE: hypertension, diabetes
By which route does the "first pass effect" have the greatest impact on drugs?
oral
The terms below are taken from the "pathophysiological framework." pathogenesis
pathological mechanisms occurring in the development/progression of disease
mortality
pertains to the causes of death in a given population
The processes of drug absorption, distribution, metabolism and excretion (ADME) are considerations relevant to ___________________________ .
pharmacokinetics
The process by which cells "drink" (ingest extracellular fluid) is referred to as __________________________ .
pinocytosis
Match the chemical substance with its function/role/description. complement proteins
potent host defense mechanism; may ultimately form "Membrane Attack Complexes" that lead to lysis of membrane-bound organisms
antagonist
prevents or blocks receptor activation
enzyme inhibitors
prevents/inhibits enzymatic breakdown of neurotransmitter
No matter what the precise mechanism is, neuropharmacologic drugs ultimately work by influencing _________________.
receptor activity on target cells
ischemia
reduction in BLOODFLOW to a certain tissue or organ
Match the cell with its function. mast cells
releases histamines; most important activator of the inflammatory response
primary prevention
removing risk factors, so disease does not occur. Prevent the disease in the first place! Ex: immunizations, fluoridated water, seat belts, bike helmets, etc.
Match the organelle with its best description Golgi complex
responsible for processing, sorting, and packaging proteins into secretory vesicles that migrate to a variety of destinations
cellular adaptations
reversible functions and/or structural responses to severe stress, during which an altered steady state is achieved that allows the cells to survive an continue to function
Match the organelle with its best description lysosomes
saclike structures that contain digestive enzymes
Match the cell with its function. B-lymphocytes
secrete antibodies
The terms below are taken from the "pathophysiological framework." clinical manifestations of disease
signs and symptoms of disease
subacute conditions
somewhere in-between acute and chronic
The terms below are taken from the "pathophysiological framework." clinical course of disease/illness
stages of the illness/disease over time
Match the route of administration with its corresponding abbreviation subcutaneous
subcut
Which branch of the peripheral nervous system has the following characteristics? MOST post-ganglionic neurons release norepinephrine onto adrenergic receptors of effector cells Oddities: -the post-ganglionic neurons that synapse onto sweat glands release acetylcholine onto muscarinic receptors -the neuron that synapses onto the adrenal medulla causes it to release epinephrine
sympathetic nervous system
health literacy
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
diagnosis
the distinctive characterization in precise (or descriptive) terms of a genus, species, or phenomenon the name/identification of the health problem
morbidity
the effects an illness has on a person's life
neutrophils
the most numerous WBC
Absorption
the movement of a drug from its site of administration into the blood
Excretion
the movement of drugs and their metabolites out of the body
incidence
the number of new cases arising in a population at risk during a specified time
Paradoxical Effect
the opposite of the intended drug response
Hematocrit is defined as _________________. -the superficial layer of yellowish or buff coagulated plasma from which the red corpuscles have settled out in slowly coagulated blood -The proportion of the blood that consists of packed red blood cells; expressed as a percentage by volume. -The liquid part of the blood and lymphatic fluid, which makes up about half of the volume of blood -The clear liquid that can be separated from clotted blood
the proportion of the blood that consists of packed red blood cells; expressed as a percentage by volume.
Atrophy
the shrinkage in cell size by loss of cellular substance
epidemiology
the study of disease occurrence in human populations
Neuropharmacology is defined as:
the study of drugs that alter processes controlled by the nervous system.
epidemiology
the study of factors affecting the health and illness of populations
cell injury
this condition may be reversible or irreversible; cell will NOT function normally
Match the chemical substance with its function/role/description. chemokines
type of signaling molecules that stimulates migration and activation of immune cells
acute conditions
typically have a relatively rapid onset (develop quickly); usually of short duration; may have severe manifestation, but not always Example: the common cold; a bout of gastroenteritis (aka "food poisoning")
The MAJOR route by which drugs are excreted (or eliminated) from the body is via ______________________ .
urine
Match the cell with its function. macrophages
very important pahgocytes
