Pharm Exam 1

A drug given by which route is altered by the first-pass effect? A. Oral B. Sublingual C. Intravenous D. SubQ

Oral

What is the ratio between a drug's therapeutic effects and toxic effects called? A. Cumulative effect B. Therapeutic index C. Tolerance D. Affinity

Therapeutic index

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the nurse's best response to the mother's question? A. "Only certain medications pass to infants while breastfeeding." B. "Drugs can cross from mother to infant in breast milk, so it depends on the drug you are taking." C. "You should not take any medications while breastfeeding." D. "I will leave the health care provider a message to return your call."

"Drugs can cross from mother to infant in breast milk, so it depends on the drug you are taking."

The nurse knows that which factors will affect the absorption of orally administered medications? SATA A. Time of day B. pH of the stomach C. Presence of food in the stomach D. Form of drug preparation E. Patient in high-Fowler's position

Time of day, pH of stomach, presence of food in the stomach, form of drug preparation

A patient who reports chronic pain states that his fentanyl (Duragesic) topical patch is no longer effective for pain relief. The health care professional should suspect which of the following? A. Tolerance to the drug B. Dependence on the drug C. Drug toxicity D. Drug interaction

Tolerance to the drug

Which statement best describes pharmacokinetics? A. Adverse effects and toxic reactions to medications B. Physiologic interaction between a drug and body cells C. What the body does to the drug after it is administered D. Converts medication into its active chemical substance

What the body does to the drug after it is administered

A health care professional administers 2 units of Regular insulin (Humulin R) to a patient by subcutaneous injection at 0700. The package insert included with the Regular insulin bottle states that the onset of action is 30 to 60 min, the peak effect is 1 to 5 hr, and the duration of action is 6 to 10 hr. The health care professional should advise the patient to expect the lowest blood glucose level at which of the following times? A. 0700 B. 0730 C. 0900 D. 1300

0900

A health care professional obtaining a patient's health history discovers that the patient takes loratadine (Claritin), an over-the-counter drug. Which of the following information about over-the-counter drugs is correct? SATA A. They do not require supervision of a health care professional B. They can interact with other drugs C. They should be included in the drug history assessment D. They are less effective than prescription drugs E. They do not cause toxicity

A, B, C

The nurse understands that drugs exert their actions on the body by what process? SATA A. Inhibiting the action of a specific enzyme B. Interacting with receptors C. Altering metabolic chemical processes D. Making the cell perform a new function

A, B, C

When talking to a patient about having vancomycin (Vancocin), the health care professional explains the need to check periodic blood levels of the drug to monitor serum peak and trough. Peak and trough drug levels help monitor for which of the following? SATA A. Drug toxicity B. Minimum effective dose C. Constant therapeutic level D. Biotransformation E. First-pass effect

A, B, C

A patient who is postpartum and is breastfeeding asks a health care professional about what effects taking over-the-counter drugs will have on her newborn. Which of the following should the health care professional consider when recommending a drug for the patient? SATA A. The newborn's weight B. How much breast milk the newborn consumes each day C. Whether or not the benefits to the mother outweigh the risks to the newborn D. The properties of the drug E. The route of administration of the drug

A, B, C, D

A health care professional is preparing to explain to to take care of a newly created colostomy to a patient. The health care professional should recognize that which of the following can decrease the patient's ability to learn? SATA A. Cognitive level B. Language C. Comfort level D. Mild anxiety E. Readiness to learn

A, B, C, E

A health care professional is caring for a patient who arrived at an urgent care center following a bee sting. Which of the following findings indicates an anaphylactic reaction? SATA A. Low blood pressure B. Wheezing C. Bradycardia D. Peripheral edema E. Swallowing difficulty

A, B, E

A health care professional is talking to a patient about giving the correct dose of acetaminophen (Tylenol) to the patient's infant. The health care professional explains that infants can absorb certain drugs at different rates than adults. Which of the following is physiologic characteristic of infants that can alter drug absorption? A. Delayed gastric emptying B. Increased gastric acidity C. Increased first-pass effect D. Greater protein-binding capacity

Delayed gastric emptying

The physiologic changes that normally occur in older adult patients have which implication for drug responses? A. Protein binding is more efficient B. Drug elimination is faster C. Drug half-life is lengthened D. Drug metabolism is quicker

Drug half-life is lengthened

A health care professional is obtaining a patient's health history. The patient states that he has no allergies but developed some mild itching while taking amoxicillin (Amoxil). Which of the following information should the health care professional explain to the patient? A. Itching is an expected side effect of amoxicillin B. Itching can indicate amoxicillin toxicity C. Itching can indicate a hypersensitivity to amoxicillin D. Itching can result from the dry skin often caused by amoxicillin

Itching can indicate a Hypersensitivity to amoxicillin

Which of the following information should health care professionals consider when calculating drug dosages for infants and children compared with adults? A. Percent of body fat is greater in children than in adults B. Infants have a smaller body surface area than adults C. Urine is more concentrated in infants than in adults D. Older children have a faster metabolic rate than adults

Older children have a faster metabolic rate than adults

What is the study of physiochemical properties of drugs and how they influence the body called? A. Pharmacotherapeutics B. Pharmacokinetics C. Pharmacodynamics D. Pharmacology

Pharmacodynamics

A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse's best response to the patient? A. "A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver." B. "Medications given orally bypass the portal circulatory system." C. "Drugs administered intravenously enter the portal system before systemic circulation." D. "Medications given intravenously are not affected by the first-pass effect."

"Medications given intravenously are not affected by the first-pass effect"

A health care professional is talking about drugs that have a small margin of safety to a patient who is taking phenytoin (Dilantin). The health care professional should include which of the following information? SATA A. Periodic laboratory tests are essential to measure serum drug levels B. Monitoring for indications of toxicity is important C. Effects can decrease over an extended period of time D. Taking the smallest effective dose is crucial E. Increasing fluid intake is recommended to avoid toxicity

A, B, D

Infants are at risk for drug toxicity due to which of the following? SATA A. Decreased liver enzymes B. Reduced kidney perfusion C. Increased stomach acid D. Reduced percentage of body water E. Reduced liver perfusion

A, B, E

A health care professional is caring for a patient who is taking acetaminophen (Tylenol), a nonopioid analgesic, and codeine, an opioid agonist, for pain relief. These drugs interact together causing an additive effect. Which of the following are characteristics of additive drug interactions? SATA A. Patients can achieve desired effects with the use of lower dosages B. Taking two drugs together can reduce the effects of one or both drugs C. Taking two drugs together can potentiate the effects of one or both drugs D. The two drugs produce an action neither would have produced alone E. Both drugs have similar actions

A, E

A health care professional is caring for a patient who is hospitalized with chest pain. Patient instruction about drugs and discharge planning should begin A. As soon as possible B. On the day of discharge C. When family members are present D. After the patient has a definitive diagnosis

As soon as possible

Which of the following describes drugs that are in pregnancy risk category D? SATA A. Are safe to take during the first trimester of pregnancy B. Require the use of contraception by women of childbearing age C. Can cause fetal malformation D. Can pass through the umbilical cord or the placenta to the fetus E. Require weighing potential benefits against possible risks

B, C, D, E

Drug half-life is defined as the amount of time required for 50% of a drug to: A. Be absorbed by the body B. Reach a therapeutic level C. Be eliminated by the body D. Exert a response

Be eliminated by the body

While conducting a health history for an older adult patient with heart failure, the patient tells the nurse, "I have chronic constipation." The nurse suspects this gastrointestinal complaint is caused by which class of drugs? A. Nonsteroidal antiinflammatory drugs B. Calcium channel blockers C. Potassium-sparing diuretics D. Anticoagulants

Calcium channel blockers

A health care professional is explaining the adverse effects of digoxin (Lanoxin) to a patient. Which of the following is an adverse effect of the drug? A. Cardiac dysrhythmias B. Increased-cardiac output C. Increased urine output D. Reduced edema

Cardiac dysrhythmias

Knowing that the albumin in neonates and infants has lower binding capacity for medications, the nurse anticipates the health care provider will perform which action to minimize the risk of toxicity? A. Decrease the amount of drug given B. Administer the medication intravenously C. Increase the amount of drug given D. Shorten the time interval between doses

Decrease the amount of drug given

A health care professional is caring for a patient who is receiving nitroglycerin (Nitrostat) IV and is changing to the oral form of the drug. The health care professional should recognize that the oral dose will be higher than the IV dose because of which of the following? A. The IV dose crossing the blood-brain barrier B. Decreased bioavailability because of the first-pass effect C. Decreased half-life of the oral dose D. Increased rate of excretion of the oral dose

Decreased bioavailability because of the first-pass effect

When talking to a patient about taking naproxen (EC-Naprosyn), enteric-coated tablets, which of the following information should the health care professional include? A. Expect drug absorption in the stomach B. Expect immediate drug absorption C. Allow the drug to dissolve in your mouth D. Do not crush or chew the tablet

Do not crush or chew the tablet

When calculating pediatric dosages, the nurse understands which method is MOST accurate for dosing calculation? A. Dosage calculation by body surface area because it takes into account the difference in size for children and neonates B. Use of drug reference recommendation based on mg/kg of body weight C. Medication dosing calculated according to body weight because it is based on maturational growth and development D. Calculated doses based on body weight need to be increased by 10% because of immature renal and hepatic function

Dosage calculation by body surface area because it takes into account the difference in size for children and neonates

A nurse working with older adult patients is concerned about the number of medications prescribed for each patient. Which older adult assessment should be of highest priority related to polypharmacy? A. Schedule of medications B. Cost of medications C. Drug interactions D. No adherence to drug regimen

Drug interactions

The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor? A. Drug properties B. Fetal sex C. Maternal blood type D. Diet of the mother

Drug properties

A health care professional is caring for a patient who has a history of renal insufficiency and is taking lithium carbonate (Lithobid). The health care professional should monitor for which of the following? A. Tolerance to the drug B. Drug toxicity C. Drug interaction D. Dependence on the drug

Drug toxicity

A health care professional is speaking to a patient who is taking carbamazepine (Tegretol) and who reports drinking grapefruit juice. The health care professional explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize certain drugs such as carbamazepine. The health care professional should recognize the patient's risk for which of the following? A. Reduced drug absorption B. Drug dependence C. Altered drug distribution D. Drug toxicity

Drug toxicity

Patients with renal failure would MOST likely have problems with which pharmokinetic process? A. Distribution B. Excretion C. Metabolism D. Absorption

Excretion

A patient is having difficulty remembering to take a prescribed drug three times a day. Which of the following forms of the drug should the health care professional recommend to increase adherence? A. Liquid suspension B. Immediate-release capsule C. Extended-release tablet D. Powder form

Extended-release tablet

A health care professional is talking with a female patient who is taking captopril (Capoten), an ACE inhibitor, for hypertension. The health care professional informs the patient that captopril is a teratogenic drug. Teratogenic Drugs can cause which of the following? A. Maternal bleeding B. Fetal malformation C. Gestational diabetes D. Maternal blood clots

Fetal malformation

The nurse is teaching a pregnant patient about the effects of medication on fetal development. The nurse understands the greatest risk for medication effects on developing fetuses occurs during which time period? A. Third trimester B. Second trimester C. Birthing process D. First trimester

First trimester

A health care professional is caring for a patient who is having cardiac dysrhythmias and is taking digoxin (Lanoxin). The health care professional should recognize that which of the following routes of administration has the fastest rate of absorption? A. Subcutaneous B. IM C. Oral D. IV

IV

To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route? A. IM B. SubQ C. IV D. Intrathecally

IV

When administering two medications that are highly protein bound, the nurse understands to monitor the patient carefully for which effect? A. Hypovolemic shock caused by a low albumin level B. Immediate improvement in the patient's condition C. A short duration of medication action D. Increase in the risk of drug-drug interactions

Increase in the risk of drug-drug interactions

Which nursing action will increase the absorption of a medication administered intramuscularly (IM)? A. Lower the extremity below the level of the heart B. Massage the site after injection C. Administer the medication via the Z-track method D. Apply ice packs to the injection site

Massage the site after injection

What is another term for biotransformation of a drug? A. Absorption B. Excretion C. Metabolism D. Dilution

Metabolism

An older adult patient who has hypertension is prescribed enalapril (Vasotec), a drug that is eliminated by the kidneys. Before the patient begins the drug, the health care professional should assess which of the following blood values? A. Total cholesterol B. Serum creatinine C. Platelet count D. C-reactive protein

Serum creatinine

A health care professional is preparing to administer a Parenteral drug to a patient. Which of the following drugs is he preparing to give? A. Acetaminophen (Tylenol) via rectal suppository B. albuterol (Proventil) via inhaler C. Heparin via subcutaneous injection D. betaxolol (Betoptic) via eye drops

heparin via subcutaneous injection