Practice quiz questions - Pharm

When obtaining a patient's health history, which assessment data would the nurse identify as having the most effect on drug metabolism? A. History of liver disease B. Intake of a vegetarian diet C. Sedentary lifestyle D. Teacher as an occupation

A. History of liver disease RATIONAL: Liver enzyme systems are the primary site for metabolism of drugs. Intake of a vegetarian diet may affect absorption but not metabolism. Sedentary lifestyle and occupations could affect metabolism (exposure to environmental pollutants), but these do not have the most significant effect on metabolism.

What effect will occur if a patient being treated with naltrexone (ReVia) for substance abuse ingests opioids or alcohol? A. Increased euphoria B. Nausea, vomiting, and diarrhea C. Deep sedation D. An absence of the "high" associated with drugs

An absence of the "high" associated with drugs RATIONAL: Naltrexone is an opioid antagonist prescribed to block the pharmacologic effects of the "high" associated with opioids and alcohol. Studies report less alcohol craving and fewer drinking days, especially when naltrexone is combined with psychosocial treatment. Naltrexone prevents the euphoria associated with taking drugs like opioids and alcohol. These are symptoms of taking alcohol in combination with disulfiram (Antabuse). Naltrexone is not sedating.

Which patient, when compared with the general population, would require a larger dose or more frequent administration of a drug to attain a therapeutic response? A. A 29 year old who has been diagnosed with kidney failure B. A 35 year old obese male who is being evaluated for an exercise program C. A 52 year old diagnosed with hypothyroidism and decreased metabolic rate D. A 72 year old with decreased circulatory status

B. A 35 year old obese male who is being evaluated for an exercise program RATIONAL: An obese individual would require a larger dose of a drug to attain a therapeutic response. An individual with kidney failure would require less medication because of decreased excretory ability. Individuals with decreased metabolic rate would metabolize drugs more slowly and require smaller doses or less frequent administration. Individuals with decreased circulation would require less medication.

What is the process by which a drug is transported by circulating body fluids to receptor sites? A. Osmosis B. Distribution C. Absorption D. Biotransformation

B. Distribution RATIONAL: Distribution refers to the ways in which drugs are transported by the circulating body fluids to the sites of action (receptors), metabolism, and excretion. Osmosis is the process of moving solution across a semipermeable membrane to equalize the dilution on each side. Absorption is the process by which a drug is transferred from its site of entry into the body to the circulating fluids for distribution. Biotransformation, also called metabolism, is the process by which the body inactivates drugs.

Which food(s) containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy? (Select all that apply.) A. Beer b. Red meat C. Aged cheeses D. Green vegetables E. Bananas

BEER AGED CHEESES BANANAS RATIONAL:

What is the priority nursing diagnosis for an older adult with diabetes who is hospitalized for pneumonia? A. Deficient knowledge related to lack of information about diabetic medication B. Risk for falls related to weakness C. Impaired gas exchange related to decreased pulmonary ventilation D. Imbalanced nutrition: more than body requirements related to obesity

C. Impaired gas exchange related to decreased pulmonary ventilation RATIONAL: Airway is the first priority in a needs assessment (ABCs = airway, breathing, circulation). Medication, weakness, and nutrition are less of a priority than the patient's respiratory status.

For what conditions are benzodiazepines prescribed? A. Chronic amnesia B. Chronic insomnia C. Preoperative sedation D. Psychotic episodes

Correct Answer Preoperative sedation RATIONAL: The sedative hypnotic effect of benzodiazepines facilitates surgical sedation. Short acting benzodiazepines are administered intramuscularly for preoperative sedation. They are also given intravenously for conscious sedation before short diagnostic procedures or for the induction of general anesthesia. Benzodiazepines are not recommended for long term use and do not affect amnesia. Benzodiazepines are a poor choice for the treatment of chronic insomnia because of their risk for habituation. Benzodiazepines do not have an antipsychotic effect.

Which adverse effect(s) may occur as a result of antipsychotic drug therapy? (Select all that apply.) A. Acute dystonia B. Akathisia C. Weight loss D. Neuroleptic malignant syndrome E. Hypoglycemia F. Tardive dyskinesia

Correct! Acute dystonia Correct! Akathisia Correct Answer Neuroleptic malignant syndrome Hypoglycemia Correct! Tardive dyskinesia

The nurse is preparing to administer Lanoxin to a patient on the telemetry unit. In addition to understanding the patient's diagnosis, the nurse must also know which characteristic(s) of the medication? (Select all that apply.) Chemical composition Adverse effects Expected actions Contraindications for use Usual dosing

Correct! Adverse effects Correct! Expected actions Correct! Contraindications for use Correct! Usual dosing RATIONAL: The nurse must understand the individual patient's diagnosis and symptoms that correlate with the rationale for drug use. The nurse should also know why a medication is ordered, expected actions, usual dosing, proper dilution, route and rate of administration, adverse effects, and contraindications for the use of a particular drug. It is not required that the nurse know the chemical composition of the medication prior to administration.

Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.) A. Dizziness B. Orthostatic hypotension C. Respiratory depression D. Confusion E. Diarrhea F. Urinary urgency

Correct! Dizziness Correct! Orthostatic hypotension Correct! Respiratory depression Correct Answer Confusion

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease? A. Dopamine does not cross the blood-brain barrier when administered orally. B. Levodopa is much less expensive. C. The half life of dopamine is too short. D. Dopamine has too many reactions with other medications.

Correct! Dopamine does not cross the blood-brain barrier when administered orally. RATIONAL: When administered orally, dopamine does not enter the brain. Levodopa does cross into the brain and is metabolized into dopamine. Dopamine is not available as an oral medication. The half life of levodopa is approximately 50 minutes; the half life of dopamine is approximately 4 days. Dopamine does not react with medications.

Which statement(s) is/are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply.) A. MAOIs block the effects of dopamine in the CNS. B. SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft. C. Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS. D. Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action. E. SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.

Correct! SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft. Correct Answer Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action. Correct! SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.

The nurse is preparing a patient's prescribed medications. In order to ensure patient safety, the nurse will perform which intervention(s)? (Select all that apply.) Select the correct supplies. Administer the medication by the correct route. Use room number to identify correct patient. Educate patient regarding medications prescribed. Document in chart all aspects of medication administration.

Correct! Select the correct supplies. Correct! Administer the medication by the correct route. Correct! Educate patient regarding medications prescribed. Correct! Document in chart all aspects of medication administration. RATIONAL: The nurse prepares prescribed medications using procedures to ensure patient safety, including selecting correct supplies, administering medication by the correct route, educating patients regarding medications prescribed, and documenting in chart all aspects of medication administration. To improve the accuracy of patient identification, it is now recommended that two patient identifiers, neither of which is the room number, be used when administering medications. Best practice would be to look at the patient's name band for identity and to request that the patient state his or her name and birth date.

A female patient is admitted to the adult psychiatric floor with a diagnosis of generalized anxiety disorder. Anxiolytic medications and group therapy have been prescribed. Evaluation of therapeutic outcomes related to her acute stay can be measured by which assessment(s)? (Select all that apply.) A. She is able to sleep 5 hours during the night. B. The tremor and pacing she exhibited on admission are reduced. C. She is able to attend and actively participate in group sessions. D. She is eating only 10% of her meals. E. She complains of chest pain before group therapy.

Correct! She is able to sleep 5 hours during the night. Correct! The tremor and pacing she exhibited on admission are reduced. Correct! She is able to attend and actively participate in group sessions.

Which is/are extrapyramidal adverse effect(s) of antipsychotic agents? (Select all that apply.) A. Spasmodic movements of muscle groups B. Masklike expression C. Lip smacking D. Inability to sit in one place for an extended period E. Weight gain

Correct! Spasmodic movements of muscle groups Correct! Masklike expression Correct! Lip smacking Correct Answer Inability to sit in one place for an extended period

The nurse is preparing to instruct a patient and his wife on technique and importance of assessing pulse prior to taking heart medication. Which principle(s) of learning would be appropriate in this situation? (Select all that apply.) The learning environment The patient's and wife's learning styles The objectives/goal statements listed on the patient's care plan The patient's financial ability to purchase the medication The patient's understanding of the seriousness of his illness

Correct! The learning environment Correct! The patient's and wife's learning styles Correct! The objectives/goal statements listed on the patient's care plan Correct Answer The patient's understanding of the seriousness of his illness

When is the ideal time for a nursing mother to take her own medications? A. Before the infant latches on to begin to breastfeed B. As soon as the mother wakes up in the morning C. Right before the mother goes to sleep at night D. As soon as the infant finishes breastfeeding

D. As soon as the infant finishes breastfeeding. RATIONAL: Taking medications after breastfeeding reduces the amount of the medication that will reach the baby. Medications taken directly before breastfeeding may have a high concentration in the milk and possibly pass on to the baby. The mother must take into consideration when her medications are ordered to be taken, and schedule them around breastfeeding.

What do drug blood levels indicate? A. They confirm if the patient is taking a generic form of a drug. B. They determine if the patient has sufficient body fat to metabolize the drug. C. They verify if the patient is taking someone else's medications. D. They determine if the amount of drug in the body is in a therapeutic range.

D. They determine if the amount of drug in the body is in a therapeutic range. RATIONAL: The amount of drug present may vary over time and the blood level must remain in a therapeutic range in order to obtain the desired result. Generic drugs do not necessarily produce a different drug blood level than proprietary medications. Body fat is not measured by drug blood levels. Drug blood levels only measure the amount of drug in the body; they do not determine the source of the medication.

Which are routes of drug excretion? (Select all that apply.) GI tract; feces Genitourinary (GU) tract; urine Lymphatic system Circulatory system; blood/plasma Respiratory system; exhalation

GI tract; feces Genitourinary (GU) tract; urine Respiratory system; exhalation

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? A. Cognitive impairments B. Rigidity C. Tremors and drooling D. Postural abnormalities

Tremors and drooling RATIONAL: Anticholinergic drugs will reduce the severity of tremors and drooling in patients with Parkinson's disease. Anticholinergics are most useful when used in combination with levodopa. Anticholinergic drugs do not affect cognitive impairments. Anticholinergics have little effect on rigidity or on postural abnormalities.