pharmacology: prep quiz 1

Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.) a. Affinity and intrinsic activity are dependent properties. b. Drugs with high affinity are strongly attracted to their receptors. c. The affinity of a drug for its receptors is reflected in its potency. d. Affinity refers to the strength of the attraction between a drug and its receptor. e. Drugs with low affinity are strongly attracted to their receptors.

b, c, d

A patient shows the nurse an article in the newspaper about a new black box warning and states, "I take this drug! Is it safe for me to take now?" Which of these statements about black box warnings is true? (Select all that apply.) a. It can still be prescribed as long as the prescriber and patient are aware of the potential risks. b. Serious adverse effects from the drug have been reported. c. Pharmacies will no longer be able to dispense this drug to patients. d. The FDA is asking for a mandatory recall of this drug. e. Serious adverse effects have been reported with this drug, and the patient will not be able to take it again because the risks outweigh the benefits.

a, b

Which groups of people are especially sensitive to medication effects? (Select all that apply.) a. Older Adults b. Infants c. Women d. Caucasians e. Minorities

a, b

Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's physiologic response to the medication? (Select all that apply.) a. Patient's age b. Patient's diagnosis c. Family medical history d. Ease of administration e. Chemical stability of the medication

a, b, c

The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factors puts the neonatal patient at risk with regard to drug therapy? (Select all that apply.) a. Reduced first-pass elimination in the liver b. Immature renal function c. Higher gastric pH d. Decreased protein-binding of medications e. Increased peristalsis in the GI tract

a, b, d

A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statements? (Select all that apply.) a. "Be sure to drink 6 to 8 ounces of water with this tablet." b. "Crush the tablet before swallowing if you have problems with swallowing." c. "Be sure to swallow the tablet whole without chewing it." d. "Avoid taking all other medications with any enteric-coated tablet." e. Take the tablet with 2 to 3 ounces of orange juice."

a, c

What are the properties of an ideal drug? (Select all that apply) a. Ease of administration b. Irreversible action c. Predictability d. Chemical stability

a, c, d

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) a. Plasma levels of free drug will rise. b. Plasma levels of free drug will fall. c. Binding of one or both agents will be reduced. d. The increase in bound drug will intensify effects. e. The increase in free drug will intensify effects.

a, c, d, e

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) a. Plasma levels of free drug will rise. b. Plasma levels of free drug will fall. c. The increase in free drug will intensify effects. d. The increase in bound drug will intensify effects. e. Binding of one or both agents will be reduced.

a, c, e

The nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction? a. A 30-year-old man with kidney disease b. A 75-year-old woman with cystitis c. A 9-year-old boy with an ear infection d. A 50-year-old man with an upper respiratory tract infection

a. A 30-year-old man with kidney disease

Patients can exhibit alterations in the rate and extent of drug absorption because of various factors. All of the following factors might affect the rate and/or extent of drug absorption EXCEPT: a. A generic form of the drug b. The formulation of the drug c. Gastric emptying time d. The presence of food in gut e. Intestinal motility

a. A generic form of the drug

The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. Which of these reflect the correct order of the steps of the nursing process? a. Assessment, planning, implementation, evaluation b. Evaluation, assessment, planning, implementation c. Human needs statement, assessment, planning, implementation, evaluation d. Assessment, planning, human needs statement, implementation, evaluation

a. Assessment, planning, implementation, evaluation

A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? a. The patient is taking another medication that binds to serum albumin. b. The drug was not completely dissolved in the IV solution. c. The medication is being given at a frequency that is longer than its half-life. d. A loading dose was not given.

a. The patient is taking another medication that binds to serum albumin.

Parenteral (Intravenous) administration: a. Usually produces a more rapid response than oral administration b. Cannot be used with unconsciousness patients c. Generally results in a less accurate dosage than oral administration d. Is too slow for emergency use

a. Usually produces a more rapid response than oral administration

The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: a. increase the urinary excretion of aspirin. b. Increase the gastric absorption of aspirin. c. increase the serum protein binding of aspirin. d. decrease the lipid solubility of aspirin.

a. increase the urinary excretion of aspirin.

A patient is receiving Gentamycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? a. 7:00AM b. 7:45AM c. 8:45AM d. 4:00AM

b. 7:45 AM

A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? a. The bioavailability of a drug is determined by the amount of the drug in each dose. b. Brands or generic forms of tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. c. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. d. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical.

b. Brands or generic forms of tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body.

The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers: a. Produce a drug that is tailored to an individual patient's genetic makeup. b. Determine whether a patient is a rapid or slow metabolizer of the drug. c. Identify racial characteristics that affect psychosocial variation in drug response. d. Better establish a drug's therapeutic index.

b. Determine whether a patient is a rapid or slow metabolizer of the drug.

What is a desired outcome when a drug is described as easy to administer? a. It is usually relatively inexpensive to produce. b. It enhances patient adherence to the drug regimen. c. It can be stored indefinitely without need for refrigeration. d. It does not interact significantly with other medications.

b. It enhances patient adherence to the drug regimen.

What occurs when a drug binds to a receptor in the body? a. It prevents the action of the receptor by altering its response to chemical mediators. b. It increases or decreases the activity of that receptor. c. It gives the receptor a new function. d. It alters the receptor to become nonresponsive to its usual endogenous molecules.

b. It increases or decreases the activity of that receptor.

Which route of drug administration is most likely to lead to the first-pass effect? a. Intravenous b. Oral c. Intramuscular d. Sublingual

b. Oral

The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process? a. Evaluation b. Planning c. Assessment d. Implementation

b. Planning

A patient requires a high dose of antihypertensive medication because the medication has a significant first-pass effect. What does this mean? a. The medication must pass through the patient's bloodstream several times to generate a therapeutic effect. b. The medication is extensively metabolized in the patient's liver. c. The medication is ineffective following the first dose and increasingly effective with each subsequent dose. d. The medication passes through the renal tubules and is excreted in large amounts.

b. The medication is extensively metabolized in the patient's liver.

A nursing student is preparing to give a medication that has a "High Alert" or "Black Boxed Warning". The student asks the nurse what this means. What will the nurse explain about boxed warnings? a. They provide detailed information about the adverse effects of the drug. b. They alert prescribers to measures to mitigate potential harm from side effects. c. They indicate that a drug should not be given except in life-threatening circumstances. d. They provide information about antidotes in the event that toxicity occurs.

b. They alert prescribers to measures to mitigate potential harm from side effects

Your pediatric patient(6 years old) is ordered ibuprofen 200 mg, you have enteric-coated tablets, but patient says she can't swallow the pills. What does the RN do? a. Call the pharmacy and ask for the IM form of the medication. b. Encourage the patient to try to swallow the tablets. c. Call the pharmacy and ask for the liquid form of the medication. d. Crush the tablets and mix them with applesauce or pudding.

c. Call the pharmacy and ask for the liquid form of the medication.

A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? a. Teach the patient that maximum drug effects will occur within a short period. b. Administer this medication intravenously. c. Monitor plasma drug levels. d. Administer the drug at intervals longer than the drug half-life.

c. Monitor plasma drug levels.

A provider prescribed phenobarbital for a patient who has seizure disorder. This medication has a long half life of 4 days. How many times per day should the nurse expect to administer this drug? a. Four times daily b. Three times per day c. Once daily d. Twice daily

c. Once daily

The body has developed defense mechanisms that reduce the amount of foreign chemicals, such as drugs, that enter the body. One of the more prominent of these mechanisms is an efflux transport system that pumps some drugs back into the intestinal lumen following absorption into the enterocytes and that is responsible for the lack of complete absorption of some drugs and removing drugs from the kidneys and liver into the urine and bile respectively. This efflux transport system is: a. Pinocytosis b. Cytochrome P450 c. P glycoprotein d. Facilitated diffusion

c. P glycoprotein

The study of drug movement throughout the body is called a. Pharmacology b. Pharmacodynamics c. Pharmacokinetics d. Pharmacotoxicology

c. Pharmacokinetics

What is the definition for therapeutic dose: a. The amount of a substance to accelerate an increase of concentration of medicine in an organism b. The amount of a substance to produce the minimal biological effect c. The amount of a substance to produce the required effect in most patients d. The amount of a substance to produce effects hazardous for an organism

c. The amount of a substance to produce the required effect in most patients

The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply? a. "This drug has a narrow therapeutic range, and the dose must be tightly controlled." b. "This drug causes severe gastric upset if given orally." c. "This drug is absorbed much too quickly in an oral form." d. "This drug would be inactivated by enzymes in the stomach."

d. "This drug would be inactivated by enzymes in the stomach."

A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse? a. "Many people are allergic to penicillin." b. "Drug allergies don't usually occur in older individuals due to built-up resistance to allergic reactions." c. "This allergy is not of major concern because the drug is given so often." d. "What type of reaction did you have when you took penicillin?"

d. "What type of reaction did you have when you took penicillin?"

The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process? a. Monitoring the patient for drug interactions after giving the medication b. Taking the patient's blood pressure throughout the course of treatment c. Asking the prescriber for an order to monitor serum drug levels d. Questioning the patient about over-the-counter medications

d. Questioning the patient about over-the-counter medications

A patient's medical record includes an order that reads as follows: "Atenolol 25 mg once daily at 0900." Which action by the nurse is correct? a. The nurse gives the drug orally b. The nurse gives the drug intravenously. c. The nurse does not give the drug d. The nurse contacts the prescriber to clarify the dosage route.

d. The nurse contacts the prescriber to clarify the dosage route.

Therapeutic index (TI) is: a. A ratio used to evaluate the bioavailability of a drug b. A ratio used to evaluate the elimination of a drug c. A ratio used to evaluate the effectiveness of a drug d. The ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response

d. The ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response

Pharmacokinetics is: a. The study of methods of new drug development b. The study of mechanisms of drug action c. The study of biological and therapeutic effects of drugs d. The study of absorption, distribution, metabolism and excretion of drugs

d. The study of absorption, distribution, metabolism and excretion of drugs

Following oral administration, a drug is absorbed into the body, wherein it can exert its action. For a drug given orally, the primary site of drug absorption is: a. The esophagus b. The stomach c. Liver d. The upper portion of the small intestine

d. The upper portion of the small intestine

If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of the drugs given individually, it is called as: a. Synergism b. Tolerance c. Antagonism d. Additive effect

d. additive effect

The amount of a drug dose that reaches the systemic circulation will affect the plasma concentration and therapeutic effects observed. The fraction of a administered drug that reaches the systemic circulation in the unchanged form (i.e., intact) is defined as: a. Theoretical dose b. Therapeutic dose c. Therapeutic index d. Bioavailability

d. bioavailability

Which of the following is an accurate description of changes taking place in elderly individuals compared to younger adults? a. Diminished body fat as a relative percentage of total body mass b. Increased lean body mass c. Increase in the levels of plasma proteins d. General increase in hepatic drug metabolizing capacity e. Decrease in renal clearance of many drugs

e. Decrease in renal clearance of many drugs