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