Pharmacology Final - Posttest Questions
Which of the following are reasons for administering preanesthetic medications before inducing general anesthesia? 1) Decrease anxiety 2) Decrease amount of general anesthetic agent needed 3) Reduce secretions 4) Avoid the need for skeletal muscle relaxants a. 1 and 3 only b. 1, 2, and 3 only c. 2, 3, and 4 only d. 1, 2, 3, and 4
b. 1, 2, and 3 only
A 1% solution has: a. 1 mg solute per mL solution b. 10 mg solute per mL solution c. 100 mg solute per mL solution d. 1 g solute per mL solution.
b. 10 mg solute per mL solution
Which of the following is an appropriate drug and dosage for use as a topical agent before bronchoscopy? a. 4-6 mL of 4% Lidocaine b. 10-15 mL of 1% Lidocaine c. 3-5 mL of 2% Procainamide d. 3 mL of 1% Novocain®
b. 10-15 mL of 1% Lidocaine
Albuterol (0.5% solution) has been ordered via continuous nebulization. The physician wants to provide 7.5 mg/h. How much albuterol will be needed for 8 hours of nebulized therapy? a. 8 mL b. 12 mL c. 24 mL d. 32 mL
b. 12 mL
Adverse reactions of administration of surfactant replacement drugs include: 1. Tachycardia 2. Bradycardia 3. Oxygen desaturation 4. Hyperglycemia a. 1 and 3 only b. 2 and 3 only c. 3 and 4 only d. 2, 3, and 4 only
b. 2 and 3 only
NAC may be administered orally for which of the following conditions? 1. Aspirin overdose 2. Acetaminophen overdose 3. Before cardiac angiography to prevent renal failure 4. Barbiturate overdose a. 1 and 2 only b. 2 and 3 only c. 3 and 4 only d. 1, 2, 3, and 4
b. 2 and 3 only
Sodium bicarbonate may be administered by aerosol in which of the following concentrations? a. 5 and 10% b. 2 and 4.2% c. 10 and 20% d. 5% only
b. 2 and 4.2%
All of the following statements regarding rivaroxaban (Xarelto®) are true, except: a. It is an oral factor Xa inhibitor. b. Doses greater than 10 mg must be taken with food. c. It cannot be used in patients with mechanical heart valves. d. Patients must avoid foods high in vitamin K.
d. Patients must avoid foods high in vitamin K.
Which of the following phases of drug development studies the effectiveness and safety in the largest population of patients against placebo or the current standard of treatment? a. In vitro b. Phase I c. Phase II d. Phase III
d. Phase III
CPR is being performed on a patient; following intubation and ventilation, the cardiac monitor reveals asystole. Which of the following ACLS drugs is appropriate first? a. 1 mL Isoproterenol b. 1 mg Epinephrine c. 1 mg Atropine d. 0.1 mg Digoxin
b. 1 mg Epinephrine
Which of the following are accepted non-FDA-approved uses of exogenous surfactant in preterm infants? a. Acute RDS in adults b. Necrotizing enterocolitis c. Patent ductusarteriosus d. Meconium aspiration syndrome
d. Meconium aspiration syndrome
Which of the following is NOT adverse effect reported with inhaled Epoprostenol use? a. Hypotension b. Flushing c. Jaw pain d. Methemoglobinemia
d. Methemoglobinemia
Which of the following statements is true regarding the use of bronchodilators with dornase alfa in aerosol therapy? a. Only anticholinergic bronchodilators may be mixed with dornase alfa for nebulization. b. Only sympathomimetic bronchodilators may be mixed with dornase alfa for nebulization. c. Both anticholinergic and sympathomimetic bronchodilators may be mixed with dornase alfa for nebulization. d. Neither anticholinergic nor sympathomimetic bronchodilators should be mixed with dornase alfa for nebulization.
d. Neither anticholinergic nor sympathomimetic bronchodilators should be mixed with dornase alfa for nebulization.
Contraindications for the administration of surfactant replacement drugs include: a. Persistent fetal circulation b. Congenital heart disease c. Apgar score of <5 at birth d. None of these is correct
d. None of these is correct
Which of the following drugs should not be recommended for the treatment of status asthmaticus? a. Cromolyn sodium (Intal®) b. Beclomethasone (QVAR®) c. Mometasone (Asmanex®) d. None of these is correct.
d. None of these is correct.
Which of the following phases of drug development is required after marketing of a drug to monitor for safety issues that may result from long-term use? a. Phase I b. Phase II c. Phase III d. Phase IV
d. Phase IV
A respiratory therapist is about to initiate incentive spirometry for a post-op patient. When reviewing the patient's chart and current medications, which of the following medications might cause the therapist to have concerns regarding the patient's ability to follow directions and cooperate with the treatment? a. Theophylline b. Naloxone (Narcan®) c. Beclomethasone (QVAR®) d. Phenobarbital
d. Phenobarbital
A patient is brought to the ER after experiencing SOB, a "tight" feeling in his chest, and tachycardia while swimming at a local pool. It appears to be laryngeal edema. The maintenance crew had added chlorine to the pool by tossing a bucket of solution over the surface just before the patient's symptoms began. Which of the following drugs should the RCP suggest by aerosol? a. Arformoterol (Brovana®) b. Flunisolide (AeroBid®) c. Epinephrine d. Racemic epinephrine (Micronefrin®)
d. Racemic epinephrine (Micronefrin®)
The term bactericidal indicates that a drug slows down the growth of bacteria. True or False?
False
How frequently can racemic epinephrine be safely given? a. Every hour b. Every 4 hours c. Four times per day d. Every 6 hours
a. Every hour
When an antigen-antibody reaction occurs in the body, histamine is released by: a. Plasma cells. b. White blood cells. c. Erythrocytes. d. Mast cells
d. Mast cells
Which of the following organ system are responsible for excretion of drugs from the body? (Select all that apply.) a. Respiratory tract b. GI tract c. Kidney d. Liver
a. Respiratory tract b. GI tract c. Kidney
Drugs in which of the following forms are least readily absorbed? a. Lipid-soluble b. Ionized c. Unionized d. Small molecules
b. Ionized
Which of the following antimicrobials are part of the standard anti-TB treatment regimen? a. Kanamycin and Amikacin b. Isoniazid and Rifampin c. Penicillin and Ribavirin d. Vancomycin and Tobramycin
b. Isoniazid and Rifampin
The following statements describe the mechanism of action of various antiarrhythmic drugs. From the list of drugs on the right, match the appropriate drug with the appropriate mechanism of action. 1. Calcium channel blocker a. Quinidine 2. Beta-blocker b. Metoprolol tartrate (Lopressor®) 3. Potassium channel blocker c. Amiodarone 4. Sodium channel blocker d. Verapamil (Calan®)
Calcium channel blocker: Verapamil (Calan) β-blocker: Metoprolol tartrate (Lopressor) Potassium channel blocker: Amiodarone Sodium channel blocker: Quinidine
What is another name for a drug or substance, such as alcohol, that is known to cause liver cancer or other types of cancer?
Carcinogen
Antihistamines are excellent drugs in treating acute anaphylactic reactions. True or False?
False
Induction should always follow paralysis in RSI. True or False?
False
Theophylline produces bronchodilation by inhibiting PDE enzymes, resulting in an increase in cAMP, and is considered the most effective bronchodilator. True or False?
False
An agonist is a drug that combines with a receptor causing a drug action to occur. True or False?
True
An arrhythmia can cause symptoms ranging from mild palpitations to cardiac arrest. True or False?
True
Dabigatran (Pradaxa®) is an oral factor Xa inhibitor. True or False?
True
Generally, a sedative drug can become a hypnotic by increasing the dose. True or False?
True
In addition to an anatomical relationship between the hypothalamus and the pituitary gland, the hypothalamus controls homeostasis through the autonomic nervous system and the pituitary gland controls homeostasis through the release of hormones. True or False?
True
Patients receiving NMBAs need to be mechanically ventilated. True or False?
True
The most serious side effect of the aminoglycosides is severe renal and ototoxicity. True or False?
True
The neurotransmitter at the neuroeffector site of the parasympathetic nervous system is ACh. True or False?
True
Warfarin, an anticoagulant or blood thinner, when used in pregnancy can lead to mental retardation and blindness and interferes with bone and cartilage formation in newborn babies. Warfarin is considered a teratogen. True or False?
True
If a solution contains 5 mg of solute per mL of solution, the concentration is: a. 0.5% b. 1% c. 2.25% d. 5%
a. 0.5%
Which of the following are advantages of drug administration by aerosol? 1) Fewer systemic side effects than other routes 2) Rapid onset of therapeutic effects of drug 3) Precise amount of drug is given only to target organ 4)Technique is cost-effective because patient effort is not required a. 1 and 2 only b. 2 and 4 only c. 1, 2, and 3 only d. 1, 2, 3, and 4
a. 1 and 2 only (1) Fewer systemic side effects than other routes 2) Rapid onset of therapeutic effects of drug
Which of the following side effects of morphine would a respiratory therapist be required to monitor? 1) Hypotension 2) Bradycardia 3) Respiratory depression 4) Tachypnea 5) Pupillary dilation a. 1 and 3 only b. 2, 4, and 5 only c. 1 and 5 only d. 3 and 5 only
a. 1 and 3 only 1) Hypotension, 3) Respiratory depression
Which of the following drugs has an α-adrenergic effect? 1. Epinephrine 2. Cromolyn sodium 3. Beclomethasone 4. Racemic epinephrine 5. Flunisolide a. 1 and 4 only b. 1, 2, and 4 only c. 2 only d. 3 and 5 only
a. 1 and 4 only
A patient must take 10 mL of albuterol syrup. How many teaspoons should he take? a. 2 teaspoons b. 1 teaspoon c. 2/3 teaspoon d. 1/2 teaspoon
a. 2 teaspoons
When ACLS drugs are to be instilled via endotracheal tube, the dosage should be: a. 2 to 2.5 times the standard IV dosage. b. The same as the standard IV dosage. c. One-half the standard IV dosage. d. Determined by Starling's law.
a. 2 to 2.5 times the standard IV dosage.
A 154-lb patient must take an antibiotic that is prescribed at 0.5 mg/kg for each dose. How many milligrams must be taken each time? a. 35 mg b. 50 mg c. 70 mg d. 77 mg
a. 35 mg
Which of the following is another name for a side effect of a medication? a. Adverse Drug Reaction b. Tolerance c. Therapeutic Effect d. Placebo Effect
a. Adverse Drug Reaction
A drug interacts with its receptor site and causes a similar action as activation of the receptor. This drug is a/an: a. Agonist b. Antagonist c. Placebo d. Phospholipid
a. Agonist
Which of the following antifungals are associated with renal toxicity? a. Amphotericin B b. Voriconazole c. Nystatin d. Micafungin
a. Amphotericin B
Which of the following β-lactams would be safe to use in a patient with a proven anaphylactic shock to penicillin? a. Aztreonam b. Nafcillin c. Cephalexin d. Ampicillin
a. Aztreonam
Side effects of aerosolized NAC may include: a. Bronchospasm, acute airway obstruction, and oropharyngeal irritation. b. Bronchodilation, oropharyngeal irritation, and fluid overload. c. Liver damage, bronchospasm, and renal failure. d. Kidney stones, airway obstruction, and hypernatremia
a. Bronchospasm, acute airway obstruction, and oropharyngeal irritation.
Dornase alfa has been approved for daily use by: a. CF patients only b. Patients with CF or tuberculosis c. Patients with CF, tuberculosis, or purulent bronchiectasis d. Patients with CF or purulent bronchiectasis.
a. CF patients only
Which of the following is a third-generation cephalosporin? a. Cefotaxime (Claforan®) b. Cefaclor (Ceclor®) c. Ceftaroline (Teflaro ®) d. Cephalexin (Keflex ®
a. Cefotaxime (Claforan®)
Which of the following agents, if used with theophylline, may lead to increases in theophylline concentrations and potential toxicity? a. Ciprofloxacin b. Albuterol c. Phenytoin d. Tobacco
a. Ciprofloxacin
Stimulation of the sympathetic nervous system causes: a. Dilation of the pupils, increased rate and contractility of the heart, and decreased GI activity. b. Constriction of the pupils, increased heart rate and contractility, and increased GI activity. c. Vasoconstriction of peripheral arteries, decreased heart rate and contractility, and pupillary constriction. d. No effect on the pupils or GI activity, but an increase in heart rate and contractility.
a. Dilation of the pupils, increased rate and contractility of the heart, and decreased GI activity.
Which of the following drug classes should never be used as monotherapy in the treatment of chronic asthma? a. ICSs b. LABA c. SABA d. Combination ICSs and LABAs
a. ICSs
The purpose of a brief breath-hold at end-inspiration during an aerosol treatment is to: a. Improve treatment effectiveness and drug deposition. b. Prevent hyperventilation during treatment. c. Assure proper drug mixing in nebulizer. d. Assure appropriate treatment length.
a. Improve treatment effectiveness and drug deposition.
The parasympathetic nervous system causes all of the following, except: a. Increase in heart rate b. Increased function in the GI tract c. Contraction of the urinary bladder d. Pupillary constriction.
a. Increase in heart rate
When a patient in an acute asthmatic attack is still experiencing severe bronchospasm after receiving inhaled β-agonists and IV steroids, the drugs to be considered next are: a. Inhaled anticholinergic b. Cromolyn sodium and ICS c. Oral β-agonist and IV xanthine d. Oral xanthines and inhaled anticholinergic
a. Inhaled anticholinergic
Which of the following drugs stabilizes the mast cell? a. Intal® b. QVAR® c. AeroBid® d. Flovent®
a. Intal®
Which of the following is considered a parenteral route of administration? a. Intramuscular b. Transdermal c. Inhalation d. Sublingual
a. Intramuscular
Drying of secretions and mucus plugging may occur as a side effect from the use of which bronchodilator? a. Ipratropium b. Albuterol c. Aminophylline d. Magnesium
a. Ipratropium
Surface tension: a. Is a cohesive force that creates tension at the surface of a liquid b. Is an adhesive force that prevents alveolar collapse c. Always opposes alveolar deflation d. Is the force within a fluid that holds molecules together
a. Is a cohesive force that creates tension at the surface of a liquid
Which of the following statements about propranolol are true? a. It affects both β1 - and β2 -receptors b. It is safe to use in patients with asthma c. It is used in treating low blood pressure d. It is used in treating anaphylactic shock.
a. It affects both β1 - and β2 -receptors
Which of the following agents is used in the management of type 1 diabetes? a. Lantus® b. Metformin c. Glucotrol® d. All of these are correct.
a. Lantus®
What is the mechanism of action of dornase alfa as a mucolytic agent? a. Lysis of DNA in cellular debris of purulent secretions b. Disruption of disulfide bonds c. Altering the pH of mucopolysaccharide chains d. Altering the DNA composition of alveolar type II cells
a. Lysis of DNA in cellular debris of purulent secretions
Which of the following adrenocortical hormones can alter potassium levels? a. Mineralocorticoids b. Glucocorticoids c. Gonadocorticoids d. None of these is correct.
a. Mineralocorticoids
Which of the following statements is true about neurotransmitters? (Select all that apply.) a. Neurotransmitters are chemical substances b. Neurotransmitters are released into a synapse or neuroeffector junction when an impulse is transmitted along the nerve c. Neurotransmitters are produced in the postsynaptic terminal d. Neurotransmitters interact with receptors in the postsynaptic or postjunctional site.
a. Neurotransmitters are chemical substances b. Neurotransmitters are released into a synapse or neuroeffector junction when an impulse is transmitted along the nerve d. Neurotransmitters interact with receptors in the postsynaptic or postjunctional site.
Which nebulizer device is approved for use with nebulized TOBI for this patient? a. PARI-LC PLUS nebulizer device b. Any nebulizer device should be sufficient because this is an FDA-approved medication. c. Small particle aerosol generator (SPAG-2) nebulizing system d. Respirgard II nebulizing System
a. PARI-LC PLUS nebulizer device
Which of the following drugs is appropriately aerosolized in order to prevent PCP? a. Pentamidine b. Ribavirin c. Tobramycin d. Colistin
a. Pentamidine
Which of the following factors are important in distribution of a drug? a. Plasma protein binding b. Metabolism c. Excretion d. Potency
a. Plasma protein binding
Which of the following phrases best describes the action of cromolyn sodium? a. Prevents degranulation of mast cell b. Anti-inflammatory c. Bronchodilator d. Breaks down histamine inside mast cell
a. Prevents degranulation of mast cell
Which of the following medications can be used in addition to an analgesic agent to target a light level of sedation? (Select all that apply.) a. Propofol b. Dexmedetomidine c. Acetaminophen d. Ketamine
a. Propofol & b. Dexmedetomidine
The advantages of administering corticosteroids by aerosol include: a. Rapid absorption at site of action with reduced systemic side effects. b. Prolonged duration with reduced side effects c. Rapid absorption with reduced dosage d. Immediate relief of bronchospasm.
a. Rapid absorption at site of action with reduced systemic side effects.
A patient who has been using a transdermal nicotine patch as part of his smoking cessation program is complaining of insomnia and itching at the site of the patch. He has been using the patch for several weeks and has been weaned to the lowest dose patch. Which of the following is the best suggestion for this patient? a. Rotate the location of the patch more frequently and remove the patch at night. b. Change to the next higher dose patch, rotate it frequently, and remove it at night. c. Place the patch in the lumbar area (just below the waist) during the night. d. Discontinue the patch and concentrate on other smoking cessation techniques.
a. Rotate the location of the patch more frequently and remove the patch at night.
All of the following are known effects of acetylsalicylic acid (aspirin), except: a. Sedation. b. Antiplatelet. c. Anti-inflammatory action. d. Antipyresis.
a. Sedation.
A 68-year-old woman (70kg) presents to the ED. She is hypotensive (90/75) and is complaining of pain on urination for the past 3 days, which indicates a bladder infection. Her laboratory results have come back and are significant for an acute kidney injury and her urinalysis is positive, demonstrating a urinary tract infection. She has already been given 2000 mL of normal saline and remains hypotensive. What kind of shock does this patient have? a. Septic shock b. Cardiogenic shock c. Hemorrhagic shock d. Anaphylactic shock
a. Septic shock
What are three categories of bronchodilators? a. Sympathomimemics, anticholinergics, and methylxanthines b. Parasympathomimetics, cholinergics, and methylxanthines c. Parasympatholytics, cholinergics, and methylxanthines d. Muscarinics, anticholinergics, and methylxanthines
a. Sympathomimemics, anticholinergics, and methylxanthines
Which of the following drugs is a sympathomimetic bronchodilator? (Select all that apply.) a. Terbutaline b. Albuterol c. Theophylline d. Vilanterol e. Ipratropium bromide
a. Terbutaline b. Albuterol d. Vilanterol
Which of the following drugs are methylxanthines? (Select all that apply.) a. Theophylline b. Aminophylline c. Caffeine d. Terbutaline
a. Theophylline b. Aminophylline c. Caffeine
All of the following statements about digoxin are true, except: a. These drugs cause a decrease in intracellular calcium. b. These drugs cause an increase in force of contraction. c. These drugs cause an increase in SV and cardiac output. d. These drugs have a narrow therapeutic index and drug levels must be monitored.
a. These drugs cause a decrease in intracellular calcium.
Which of the following antifungal drugs are used to treat pulmonary aspergillosis? a. Voriconazole b. Fluconazole c. Terconazole d. Nystatin
a. Voriconazole
Which of the following is a brand name of Levalbuterol? a. Xopenex ® b. Serevent® c. Ventolin® d. Atrovent®
a. Xopenex ®
Racemic epinephrine is supplied as a 2.25% concentration solution. How many milliliters must be given to provide 11.25 mg of racemic epinephrine? a. 0.30 mL b. 0.5 mL c. 1.0 mL d. 5 mL
b. 0.5 mL
What is the appropriate dosage of racemic epinephrine? a. 0.30 mL of 1% solution in 3.0 mL of diluent b. 0.50 mL of 2.25% solution in 3.0 mL of diluent c. 0.25 mL of 1:100 solution in 3.0 mL of diluent d. 0.20 mL of 0.5% solution in 2.5 mL of diluent
b. 0.50 mL of 2.25% solution in 3.0 mL of diluent
Drugs are instilled into an artificial airway for which of the following reasons? 1) Provide precise amount of desired drug 2) Utilize pulmonary mucosa for drug absorption in low cardiac output state (i.e., cardiac resuscitation) 3)Minimize systemic effects of drugs 4)Assure drug is not swallowed a. 1 only b. 2 only c. 2 and 3 only d. 2, 3, and 4 only
b. 2 only 2) Utilize pulmonary mucosa for drug absorption in low cardiac output state (i.e., cardiac resuscitation)
What is the minimum length of time during which ETT suctioning should be avoided following administration of surfactant replacement drugs? a. 30 minutes b. 60 minutes c. 90 minutes d. 120 minutes
b. 60 minutes
When using pMDI treatments for pediatric patients: a. A spacer or valved holding chamber is not recommended. b. A valved-holding chamber is recommended. c. The breathing pattern is not important. d. A DPI is preferred.
b. A valved-holding chamber is recommended.
A 12-year-old boy with CF has copious and purulent secretions, and sputum sample analysis confirms a Pseudomonas infection. He is currently receiving dornase alfa (DNase) once a day and 2.5 mg albuterol every 4 hours. Which of the following is an appropriate modification of his care plan? a. Administer 3 mL 10% acetylcysteine (Mucomyst®) every 4 hours. b. Add 300 mg aerosolized tobramycin (TOBI®) twice a day. c. Increase dornase alfa frequency to every 4 hours. d. Increase albuterol dosage to 5 mg per treatment.
b. Add 300 mg aerosolized tobramycin (TOBI®) twice a day.
Which of the following are contraindications for the use of NAC as an aerosol? a. Tylenol® overdose b. Administration to a semicomatose patient without suction equipment and monitoring c. Administration to a patient with bronchiectasis d. Administration in concentrations over 10%
b. Administration to a semicomatose patient without suction equipment and monitoring
Which of the following statements is true regarding the use of skeletal muscle relaxants during mechanical ventilation? a. Most NMBAs provide adequate analgesia. b. Analgesia and sedation must be provided in addition to NMBA. c. Most NMBAs provide adequate sedation but no analgesia.
b. Analgesia and sedation must be provided in addition to NMBA.
Which of the following drugs is an antifungal agent? a. Amphotericin B b. Aztreonam c. Colistin d. Ribavirin
b. Aztreonam
Which of the following is a common side effect associated with aerosolized antibiotics? a. Hypoglycemia b. Bronchospasm c. Sinusitis d. Euphoria
b. Bronchospasm
Surfactant replacement drugs are given: a. By aerosol only b. By intratracheal instillation only c. By aerosol or instillation d. By aerosol or intravenous line
b. By intratracheal instillation only
When an aerosol device produces particle sizes that are very large (>5 µm), the aerosol would most likely: a. Deposit in the oropharynx. b. Deposit in the large upper airways (trachea and bronchi). c. Be exhaled. d. Deposit in the small airways and lung periphery
b. Deposit in the large upper airways (trachea and bronchi).
Neostigmine and pyridostigmine may be used clinically to: a. Treat severe hypovolemic shock b. Diagnose and treat myasthenia gravis c. Stimulate bronchospasm for diagnostic pulmonary function testing d. Treat hypertension and migraine headaches.
b. Diagnose and treat myasthenia gravis
Which of the following drugs works by decreasing reabsorption of glucose at the proximal tubule of the nephron? a. Metformin b. Empagliflozin c. Exenatide d. Januvia
b. Empagliflozin
What is the recommended dosage of methacholine used during bronchial provocation testing? a. Two to three breaths of the strongest solution, followed by measurement of FVC occurs. b. Five breaths of each dilution, beginning with the most dilute solution, followed by measurement of FVC after each dilution until 20% reduction of FEV1 occurs. c. 2-3 mL of each solution, beginning with the most dilute solution; test ends when 20% reduction in FVC occurs. d. None of these is correct.
b. Five breaths of each dilution, beginning with the most dilute solution, followed by measurement of FVC after each dilution until 20% reduction of FEV1 occurs.
Which of the following is the most common side effect seen with injectable insulin therapy? a. Weight loss b. Hypoglycemia c. Fungal infections d. Renal dysfunction
b. Hypoglycemia
Which one of the following are functions of the parasympathetic nervous system? (Select all that apply.) a. Increase in cardiovascular activity b. Increase in gastric motility c. Increase in salivary and respiratory secretions d. Decrease in activity of genitourinary system
b. Increase in gastric motility c. Increase in salivary and respiratory secretions
Which of the following drug mechanisms promote bronchodilation? a. Increase levels of cGMP b. Increase levels of cAMP c. Decrease levels of cAMP d. Increase levels of PDE
b. Increase levels of cAMP
Which of the following statements is true regarding the use of a DPI for medication administration? a. DPI is the preferred method of aerosol medication for infants and children under 5 years old. b. Inspiratory flow rate of 40-120 L/min is needed for effective powder aerosol deposition. c. Breathing pattern and patient cooperation are not important for an effective treatment. d. Use of a spacer or valved holding chamber is recommended when using a DPI.
b. Inspiratory flow rate of 40-120 L/min is needed for effective powder aerosol deposition.
Drugs administered by which of the following routes have the quickest onset of action? a. Oral b. Intravenous c. Rectal d. Subcutaneous
b. Intravenous
A pediatric patient in the ER has a harsh, barking cough, inspiratory stridor, tachypnea, and tachycardia. Wheezing is not heard, and the parents report some improvement because the child has been sitting up and during the ride in the cold night air to the hospital. Which of the following drugs should the RCP recommend by aerosol? a. QVAR® b. Micronefrin® c. Intal® d. Ventolin®
b. Micronefrin®
Mucomyst® is the brand name of: a. Sulfur hydroxide b. N-acetylcysteine (NAC) c. Dornase alfa d. Sodium bicarbonate
b. N-acetylcysteine (NAC)
All of the following general anesthetics agents are volatile liquids, except: a. Sevoflurane. b. Nitrous oxide. c. Methoxyflurane. d. Flurothane
b. Nitrous oxide.
Methacholine can be categorized as a: a. β-agonist. b. Parasympathomimetic. c. Sympathomimetic. d. Xanthine agonist.
b. Parasympathomimetic.
Side effects of aerosolized dornase alfa include: a. Bronchospasm, rash, and fever b. Pharyngitis, laryngitis, and voice alteration c. Headache, nausea, and tachycardia d. Bronchospasm, laryngitis, and headache
b. Pharyngitis, laryngitis, and voice alteration
Which of the following agents used to treat hyperthyroidism can cause liver failure? a. Methimazole b. Propylthiouracil c. Iodine d. Levothyroxine
b. Propylthiouracil
A cell membrane can be termed a fluid mosaic because of: a. A lipid bilayer membrane b. Proteins that change position within the membrane c. Pores d. Lipid solubility
b. Proteins that change position within the membrane
Which of the following agents have activity similar to ACh at the skeletal muscle neuroeffector site? a. Ipratropium b. Pyridostigmine c. Dicyclomine d. Pilocarpine
b. Pyridostigmine
Which of the following terms is synonymous with β-adrenergic? a. Parasympatholytic b. Sympathomimetic c. Anticholinergic d. Antimuscarinic
b. Sympathomimetic
If the LD50 of a drug is 50 mg and the ED50 is 1 mg, which of the following is true? a. The TI is 0.02 and the drug is toxic b. The TI is 50 and the drug is relatively nontoxic c. The TI is 50 and the drug is relatively toxic d. The TI is 0.02 and the drug is nontoxic.
b. The TI is 50 and the drug is relatively nontoxic
Which of the following considerations should be stressed when instructing a new patient in the use of aerosolized steroids? a. The patient should use the MDI steroids only when symptoms (e.g., wheezing) are severe. b. The patient should use steroids by MDI every day regardless of having symptoms. c. The patient should discontinue ICS use when symptoms are controlled for 5 consecutive days. d. MDI steroids are safe for use during pregnancy because they are deposited in the lungs and do not reach fetal circulation.
b. The patient should use steroids by MDI every day regardless of having symptoms.
Which of the following statements is true regarding the nebulization of dornase alfa? a. Most small-volume jet nebulizers currently available are recommended for use with dornase alfa. b. There are specific jet nebulizers recommended for use with dornase alfa. c. There are specific jet and ultrasonic nebulizers that are recommended for use with dornase alfa. d. Ultrasonic nebulizers are ideal for nebulizing dornase alfa
b. There are specific jet nebulizers recommended for use with dornase alfa.
Which of the following side effects may occur with the use of β-agonists? a. Appetite suppression b. Tremor c. Hematemesis d. Seizures
b. Tremor
Which of the following drug classes may cause an increased effect of dry mouth if used concomitantly with ipratropium? a. β-Blockers b. Tricyclic antidepressants c. Adrenergic agents d. Digoxin
b. Tricyclic antidepressants
Which of the following pharmacologic agents used for smoking cessation should be started before the patient quits smoking? a. Nicotine patch and Buproprion b. Varenicline and Buproprion c. Nicotine gum and Varenicline d. All agents should not be used when still smoking
b. Varenicline and Buproprion
A 25-year-old man is found unresponsive and requires intubation and mechanical ventilation. The patient is hypotensive and anxious. Which of the following drugs is the most appropriate agent to facilitate his intubation after pretreatment and induction have been completed? a. Morphine b. Vecuronium (Norcuron) c. Cisatracurium (Nimbex) d. Midazolam (Versed)
b. Vecuronium (Norcuron)
Epinephrine in a 1:1000 solution strength is what concentration? a. 10% b. 1% c. 0.1% d. 0.01%
c. 0.1%
Which of the following drugs are often used to control the inflammation associated with chronic asthma? 1. Fluticasone (Flovent®) 2. Racemic epinephrine 3. Arformoterol (Brovana®) 4. Flunisolide (AeroBid®) 5. Budesonide (Pulmicort®) a. 2 and 3 only b. 1, 2, and 4 only c. 1, 4 and 5 only d. 1 and 4 only
c. 1, 4 and 5 only
Which of the following drugs may be used to control the bronchospasm associated with an acute asthmatic attack? 1. Cromolyn sodium (Intal®) 2. Albuterol (Proventil®) 3. Budesonide (Pulmicort®) 4. Levalbuterol (Xopenex®) 5. Formoterol (Foradil®) a. 1 and 4 only b. 3, 4, and 5 only c. 2 and 4 only d. 2, 4, and 5 only
c. 2 and 4 only
Which of the following is the recommended flow rate to be used to power an SVN? a. 1-4 L/min b. 4-6 L/min c. 6-8 L/min d. 15 L/min
c. 6-8 L/min
A respiratory therapist is caring for a patient with a flail chest who is intubated and receiving mechanical ventilation with PEEP. Which of the following medications is the most appropriate recommendation to provide analgesia for his severe pain? a. Midazolam (Versed®) IV b. Budesonide (Pulmicort®) aerosolized c. Morphine IV d. Hydrocodone (Lortab®) PO
c. Morphine IV
A 9-year-old child who recently had a bone marrow transplant is given an aerosol treatment with 300 mg pentamidine (NebuPent) for the prevention of P. carinii pneumonia. The patient developed some wheezing during the treatment and then experienced some shortness of breath, wheezing, and a dry cough after the treatment. Which of the following should the respiratory therapist recommend? a. Change to ribavirin (Virazole) for the next treatment, given 4 weeks later. b. Reduce the dosage of pentamidine to 100 mg and give the next treatment in 2 weeks. c. Administer two puffs of albuterol before the next 300 mg pentamidine treatment, given 4 weeks later. d. Administer two puffs of albuterol before the next treatment and change to tobramycin (TOBI), wait 2 weeks before the next treatment
c. Administer two puffs of albuterol before the next 300 mg pentamidine treatment, given 4 weeks later.
Which of the following medications would be the most appropriate firstline agent used to treat bronchospasm associated with an acute asthmatic attack? a. Atropine b. Magnesium c. Albuterol d. Ipratropium
c. Albuterol
Which of the following antiarrhythmics may cause pulmonary fibrosis? a. Quinidine (Quinaglute®) b. Propafenone (Rythmol®) c. Amiodarone (Cordarone®) d. Dofetilide (Tykosyn®)
c. Amiodarone (Cordarone®)
Which of the following drugs may be useful in treating colonized Pseudomonas in the CF patient? a. Ribavirin and Pentamidine b. Colistin and Amphotericin B c. Aztreonam and Tobramycin d. Ribavirin and Tobramycin
c. Aztreonam and Tobramycin
Stimulation of the β2 -receptors by epinephrine causes: a. Constriction of the uterus b. Bronchoconstriction c. Bronchodilation d. Vasoconstriction of the blood vessels of the skeletal muscle
c. Bronchodilation
Salmeterol is a long-acting, highly specific β-agonist effective in the treatment of: a. Both acute and chronic asthmatic symptoms. b. Acute status asthmaticus. c. Chronic asthmatic symptoms. d. Asthma when anticholinergics have failed.
c. Chronic asthmatic symptoms.
The overall function of the ANS includes all of the following, except: a. Controls bladder b. Controls heart rate c. Controls skeletal muscle d. Controls digestion
c. Controls skeletal muscle
A patient is started on Ceftriaxone to treat severe pharyngitis. The culture comes back to reveal the causative organism is S. pyogenes and susceptibilities show it is sensitive to penicillin. The ceftriaxone is changed to penicillin VK. This is considered what part of the approach to infectious disease is described? a. Empiric b. Prophylaxis c. Definitive d. Resistance
c. Definitive
Respiratory failure secondary to surfactant deficiency in the newborn primarily is because of: a. Ventilation-perfusion mismatching b. Diffusion barrier c. Fatigue due to excessive work of breathing d. Persistent fetal circulation
c. Fatigue due to excessive work of breathing
All of the following are drugs that are considered first-line agents for hypertension, except: a. Lisinopril (Zestril®). b. Amlodipine (Norvasc®). c. Hydralazine (Apresoline®). d. Chlorthalidone (Hygroton®).
c. Hydralazine (Apresoline®).
Adverse effects of the nitrates include all of the following, except: a. Severe headache. b. Dizziness. c. Hypertension. d. Hypotension.
c. Hypertension.
All of the following are side effects of dulaglutide (Trulicity®), except: a. Nausea. b. Vomiting. c. Hypoglycemia. d. Pancreatitis.
c. Hypoglycemia.
The usual first-line drugs used in the management of chronic asthma symptoms include: a. Inhaled and oral SABAs and anticholinergics. b. Inhaled LABAs and oral xanthines. c. ICSs. d. nhaled and oral β-agonists, xanthines, and oral corticosteroids.
c. ICSs.
Which of the following would be potential consequences of improper administration procedures causing environmental exposure, when using aerosolized ribavirin in a hospitalized patient? a. Increases the risk of infection to the patient b. Increases risk of bronchospasms to the patient c. Increases the risk of a pregnant nurse giving birth to a baby with a birth defect d. Decreases the effectiveness of the drug
c. Increases the risk of a pregnant nurse giving birth to a baby with a birth defect
The recommended procedure for administration of exogenous surfactant to a newborn requires: a. Using a PARI LC nebulizer and scavenger system b. Using a small-volume nebulizer with an aerosol mask c. Instillation of two to four equal aliquots with specific positioning for each portion d. Instillation of first dosage as one bolus before intubation
c. Instillation of two to four equal aliquots with specific positioning for each portion
Which of the following statement regarding drugs used for the management of hypothyroidism is correct? a. Cytomel is the preferred thyroid replacement product. b. Doses should be adjusted every 1-2 weeks. c. Levothyroxine should be taken on an empty stomach at least 30 minutes before eating. d. Toxic effects of thyroid hormone include low blood pressure and weight gain.
c. Levothyroxine should be taken on an empty stomach at least 30 minutes before eating.
Which of the following organs are most commonly involved in the process of metabolism or biotransformation of a drug? a. Brain b. Heart c. Liver d. Skin
c. Liver
A respiratory therapist is caring for a patient with a flail chest who is intubated and receiving mechanical ventilation with positive end-expiratory pressure. Which of the following medications is the most appropriate recommendation to provide analgesia for this patient's severe pain? a. Midazolam b. Desflurane c. Morphine d. Haloperidol
c. Morphine
Which of the following pharmacologic agents used for smoking cessation should be avoided in patients with reactive airway disease due to risk of causing bronchospasm? a. Buproprion b. Nicotine patch c. Nicotine inhaler d. Varenicline
c. Nicotine inhaler
Which of the following antivirals are used in the treatment of influenza? a. Acyclovir b. Ganciclovir c. Oseltamivir d. Valganciclovir
c. Oseltamivir
When taking a drug by pMDI, a spacer is used to: a. Concentrate the medication. b. Capture the patient's exhaled air. c. Provide a reservoir and improve drug delivery. d. Eliminate the need for the patient to inhale deeply.
c. Provide a reservoir and improve drug delivery.
Which of the following agents is the drug of choice in the presence of upper airway mucosal edema? a. Terbutaline b. Albuterol c. Racemic epinephrine d. Formoterol
c. Racemic epinephrine
Which of the following side effects of morphine should be monitored by the respiratory therapist? a. Hypertension b. Tachycardia c. Respiratory depression d. Tachypnea
c. Respiratory depression
In which of the following patients should the RCP consider diluting the bronchodilator with sterile distilled water rather than NS for an SVN treatment given every 3 hours? a. Postacute myocardial infarction b. Diabetic coma c. Severe salt restriction d. Acetaminophen overdose
c. Severe salt restriction
Which of the following is the recommended breathing pattern for maximal deposition of medication by aerosol? a. Normal breathing b. Normal breathing with a 3-second pause at end-inspiration c. Slow, deep breathing with a 10-second pause at end-inspiration d. Rapid inspiration with a 3- to 5-second pause at end-inspiration
c. Slow, deep breathing with a 10-second pause at end-inspiration
Which of the following is a brand name of Tiotropium? a. Serevent® b. Atrovent® c. Spiriva® d. Combivent®
c. Spiriva®
Which of the following is a likely explanation for why a CF patient on PERT would develop fibrosing colonopathy? a. A pancreatic enzyme capsule was chewed. b. An allergic reaction has developed. c. The dose of lipase is too high. d. It is a sign the enzyme is ineffective.
c. The dose of lipase is too high.
All of the following statements about benzodiazepines are true, except: a. These agents have relatively few side effects in comparison to barbiturates. b. The main clinical use of these drugs is the treatment of anxiety. c. The overall mechanism of action is to block the inhibitory effect of GABA neurotransmitters. d. They can create additive effects when administered with alcohol and other CNS depressants.
c. The overall mechanism of action is to block the inhibitory effect of GABA neurotransmitters.
Which of the following drugs may be used to stimulate respiration in a newborn with episodes of apnea? a. Varenicline and Acetazolamide b. Caffeine and Prostacyclin c. Theophylline and Caffeine d. Mannitol and Acetazolamide
c. Theophylline and Caffeine
Bronchial provocation testing is performed: a. To determine which allergens cause bronchospasm in a specific patient. b. To determine the degree of bronchospasm caused by a specific allergen in a given patient. c. To determine if an asthma attack or bronchospasm can be provoked by external stimuli. d. To diagnose reactive airway disease in patients who do not have clinically apparent asthma.
c. To determine if an asthma attack or bronchospasm can be provoked by external stimuli.
It is important for a respiratory therapist to have a general knowledge of drugs: a. To administer the proper dose b. To treat a specific disease c. To predict a drug effect d. To prevent side effects.
c. To predict a drug effect
Which of the following symptoms are not associated with long-term glucocorticoid use? a. Poor wound healing b. Edema c. Weight loss d. Cushing syndrome
c. Weight loss
An unexplained drug effect is called: a. Potency b. Allergic Reaction c. Hypersensitivity d. Idiosyncratic Reaction
d. Idiosyncratic Reaction.
Which of the following drugs has a general anti-inflammatory effect? 1. QVAR®(beclomethasone) 2. Nasalcrom® (cromolyn sodium) 3. Flovent® (fluticasone) 4. Pulmicort® (budesonide) 5. Singulair® (montelukast) a. 2 and 5 only b. 3 only c. 1, 2, and 4 only d. 1, 3, and 4 only
d. 1, 3, and 4 only
Stage II hypertension is classified as a BP greater than or equal to: a. 120/80 mm Hg. b. 140/90 mm Hg. c. 150/90 mm Hg. d. 160/100 mm Hg
d. 160/100 mm Hg
Mucomyst (acetylcysteine) is supplied in a 20% solution. How many milligrams of acetylcysteine are contained in 4 mL of the 20% solution? a. 200 mg b. 400 mg c. 600 mg d. 800 mg
d. 800 mg
An RCP is providing incentive spirometry for a post-op patient and notes that the patient is febrile. What is the most appropriate medication the therapist should recommend to treat this patient's fever? a. Albuterol b. Thorazine c. Lorazepam d. Acetaminophen
d. Acetaminophen
Which of the following bronchodilators can be used in the treatment of acute bronchospasms? (Select all that apply.) a. Umeclidinium b. Ipratropium c. Theophylline d. Albuterol e. Formoterol f. Levalbuterol
d. Albuterol e. Formoterol f. Levalbuterol
Which of the following drugs stimulate production of cAMP by stimulating β2 -adrenergic receptors? a. Metaproterenol b. Formoterol c. Albuterol d. All of the above stimulate β2 -adrenergic receptors
d. All of the above stimulate β2 -adrenergic receptors
Pulmonary surfactant: a. Is made of phospholipids and proteins b. Reduces surface tension c. Is produced by alveolar type II cells d. All of these are correct
d. All of these are correct
Which of the following is not a penicillin? a. Nafcillin b. Amoxicillin c. Ampicillin d. All of these are correct
d. All of these are correct
Which of the following drug information references would be a good resource to use to determine the appropriate dose of inhaled epinephrine for stridor? a. AHFS Drug Information b. Drug Information Handbook c. Micromedex d. All of these are correct.
d. All of these are correct.
Which of the following are appropriate indications for use of the inhaled vasodilators, Nitric Oxide, and Epoprostenol? A. Pulmonary hypertension b. Acute respiratory distress syndrome c. Right-sided heart failure d. All of these are correct.
d. All of these are correct. Pulmonary hypertension Acute respiratory distress syndrome Right-sided heart failure
When using a pMDI without a spacer or chamber, the patient should be instructed to squeeze the canister: a. At end-inspiration. b. At end-exhalation. c. During the middle of inspiration. d. At the beginning of inspiration.
d. At the beginning of inspiration.
All of the following are adverse effects of valsartan, except: a. Hyperkalemia. b. Angioedema. e c. Elevated serum creatinine. d. Cough.
d. Cough.
What is the mechanism of action of NAC in promoting mucolysis? a. Lysis of proteins in mucus b. Increasing alkalinity of mucus c. Hygroscopic properties d. Disrupting disulfide bonds in mucus molecule
d. Disrupting disulfide bonds in mucus molecule
A respiratory therapist is caring for a patient with COPD and HFrEF. The patient's current BP is 145/98 mm Hg. The patient's HR is 102 beats/min, and breath sounds reveal moist crackles bilaterally. Which of the following medications should be suggested? a. Beta-agonist b. Anticholinergic c. Ipratropium and Albuterol (Combivent®) d. Diuretic
d. Diuretic
All of the following anticoagulants can place a patient in an increased risk of developing HIT, except: a. Enoxaparin (Lovenox ®). b. Dalteparin (Fragmin®). c. UFH. d. Fondaparinux (Arixtra ®)
d. Fondaparinux (Arixtra ®)
Which of the following is considered an expectorant? a. Normal saline b. Hypertonic saline c. Mucomyst® d. Guaifenesin
d. Guaifenesin
Which of the following would put a patient at risk of fatal lung toxicity from aerosolized Colistin? a. Administration using the PARI-LC PLUS nebulizer b. Administering albuterol before administration c. Administering 160 mg every 12 hours d. Reconstitution of the Colistin solution more than 24 hours before administration
d. Reconstitution of the Colistin solution more than 24 hours before administration
Which of the following is not a bland aerosol? a. Half-NS b. Sterile distilled water c. 0.9%NaCl d. Sodium bicarbonate
d. Sodium bicarbonate
The dose-response curve represents all of the following, except: a. The ceiling effect b. The relationship between the drug effect and dose c. The relative potency of one drug compared with another drug d. Therapeutic effect.
d. Therapeutic effect.
With regard to β-agonists, aerosolized steroids have which of the following effects? a. They block the effects of bronchodilators. b. They have no effect on bronchodilating. c. They reduce systemic side effects of dilators. d. They potentiate (increase) bronchodilating effects
d. They potentiate (increase) bronchodilating effects
A COPD patient has been taking Advair® (Salmeterol and Fluticasone) and continues to complain of dyspnea throughout the day. The respiratory therapist should recommend adding which of the following agents to his or her regimen to control shortness of breath throughout the day? a. Formoterol b. Atropine c. Theophylline d. Tiotropium
d. Tiotropium
Which of the following is not an appropriate clinical indication or rational for the use of an aerosolized antimicrobial? a. To deliver the antimicrobial directly to the respiratory tract (e.g., infected/colonized sputum). b. To reduce the severity of systemic side effects. c. As an adjunct (additional) therapy when systemic administration of antimicrobials has been unsuccessful. d. To avoid the development of drug sensitivity
d. To avoid the development of drug sensitivity
Which of the following agents can be used in the treatment of bipolar disorder and for epilepsy? a. Lithium b. Phenytoin c. Lorazepam d. Valproic acid
d. Valproic acid
The rescue treatment for surfactant replacement drugs is used for infants: a. Whose birth weight is <1250 g b. Whose birth weight is <1350 g c. Who are born at <36 weeks' gestation d. Who develop RDS
d. Who develop RDS
Which of the following agents is/are hypertonic? a. 0.9%NaCl b. 5%NaCl c. 10%NaCl d. b and c
d. b and c
