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NR 293 - EXAM 1 QUESTIONS WITH
100% CORRECT ANSWERS!!
Drug - CORRECT ANSWER -Any chemical that affects the physiologic
processes of a living organism
Pharmacology - CORRECT ANSWER -The study or science of drugs
Chemical Name - CORRECT ANSWER -Describes the drug's chemical
composition and molecular structure (not usually used in nursing)
Generic Name - CORRECT ANSWER -Name given by the United States
Adopted Names council. The universal name, like ibuprofen or acetaminophen
Trade Name - CORRECT ANSWER -AKA proprietary name. The drug has a
registered trademark, use of the name is restricted by the drug's patent owner. Ex is Motrin and Advil, they are both ibuprofen
Pharmaceutics - CORRECT ANSWER -The study of how various drug forms
influence the way in which the drug affects the body. Oral, rectal, transdermal, etc.
Pharmacodynamics - CORRECT ANSWER -The study of what the drug does to
the body. The mechanism of drug actions in living tissues and drug-receptor relationships
Pharmacotherapeutics - CORRECT ANSWER -The clinical use of drugs to
prevent and treat disease. Defines principles of drug actions- the cellular processes that change in response to the presence of drug molecules. Drugs are organized into pharmacologic classes, like antihypertensives. Ex: elderly taking baby aspirin to prevent strokes
Pharmacognosy - CORRECT ANSWER -The study of natural drug sources, like
plants, animals and minerals.
Pharmaceutic Properties - CORRECT ANSWER -Different drug dosage forms
have different properties. Dosage form determines the rate of drug dissolution. Enteric- coated tablets protect patients from stomach irritation.
Fastest Route of Oral Drug Absorption - CORRECT ANSWER -1. Oral
disintegration, buccal tabs, and oral soluble wafers
- Liquids, elixirs, and syrups
- Suspension solutions
- Powders
- Capsules
- Tablets
- Coated tablets
- Enteric-coated tabletes
Pharmacokinetics - CORRECT ANSWER -The study of what the body does to
the drug. A drug's time to onset of action, time to peak effect, and duration of action. -Absorption, Distribution, Metabolism, Excretion
Pharmacokinetics: Absorption - CORRECT ANSWER -Movement of a drug from
its site of administration into the bloodstream for distribution to the tissues.
Bioavailability - CORRECT ANSWER -A measure of the extent of drug
absorption for a given drug and route. Giving a med through the IV, you will have 100% of the med in the bloodstream, none is lost.
First-Pass Effect - CORRECT ANSWER -The initial metabolism in the liver of a
drug absorbed from the GI tract before the drug reaches systemic circulation. If you give a PO med, the GI system digests, liver transforms, and then it reaches the bloodstream. Not 100% of the med reaches the bloodstream, you lose some as it travels.
Enteral Route of Drug Administration - CORRECT ANSWER -The drug is
absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine. Types of enteral are oral, sublingual, buccal, and rectal.
Parenteral Route of Drug Administration - CORRECT ANSWER -Though an IV,
IM, subcutaneous, intradermal, intraarterial, intrathecal, and intraarticular
Topical Route of Drug Administration - CORRECT ANSWER -Skin, eyes, ears,
nose, lungs, rectum, vagina
Pharmacokinetics: Distribution - CORRECT ANSWER -The transport of a drug
by the bloodstream to its site of action. Protein-binding, water-soluble vs fat-soluble, blood-brain barrier.
Protein-Binding Drugs - CORRECT ANSWER -After you take the medication, it is
in the blood attached to protein, mainly albumin. When the drug binds to albumin, it works as a slow release, only the free unbound drug is therapeutic. The bound drug is
Trough Level Drug Monitoring - CORRECT ANSWER -The lowest blood level.
Used to make sure kidneys are working before giving the next dose of meds.
Receptor Interactions - CORRECT ANSWER -A molecular structure within or on
the outer surface of a cell. They bind specific substances and one or more corresponding cellular effects occurs.
Enzyme Interactions - CORRECT ANSWER -A medication that blocks an
enzyme, like antihistamines block histamine enzymes
Agonist - CORRECT ANSWER -Drug binds to a receptor, there is a response
Antagonist - CORRECT ANSWER -Drug binds to a receptor, there is no
response. The drugs prevents the binding of agonists.
Competitive Antagonist - CORRECT ANSWER -Drug competes with the agonist
for binding to the receptor. If it binds, there is no response
Noncompetitive Antagonist - CORRECT ANSWER -Drug combines with different
parts of a receptor and inactivates it, agonist then has no effect
Acute Therapy - CORRECT ANSWER -Requires more intensive treatment; used
for critical/very sick patients. Ex: giving nitroglycerin for heart attack
Maintenance Therapy - CORRECT ANSWER -Given to maintain a healthy state
with a chronic disease. Ex: antihypertensive meds
Supplemental Therapy - CORRECT ANSWER -Supplies the body with
something to maintain normal function that the body lacks or cannot produce itself (ex: Insulin)
Palliative Therapy - CORRECT ANSWER -Therapy used to relieve symptoms,
not cure a disease. Usually with chronic, non-curable diseases. Ex: morphine for hospice patient
Supportive Therapy - CORRECT ANSWER -Maintains the integrity of the body
functions while the patient is recovering from illness or trauma. Ex: provision of fluids and electrolytes to prevent dehydration in a patient with influenza who is vomiting and has diarrhea
Prophylactic Therapy - CORRECT ANSWER -Therapy given prior to infectious
signs to prevent the possibility of infection. It is preventative therapy
Empiric Therapy - CORRECT ANSWER -The administration of antibiotics based
on the practitioner's judgment of the pathogens most likely to be causing an apparent infection; it involves the presumptive treatment of an infection to avoid treatment delay before specific culture information has been obtained.
Contraindications - CORRECT ANSWER -Any characteristic of a patient,
especially a disease state, that makes the use of a given medication dangerous for the patient. It is important to assess for contraindications. Ex: pregnancy, allergies, organ failure, etc
Monitoring - CORRECT ANSWER -Evaluating the clinical response of the patient
to the treatment. One must be familiar with a drugs intended therapeutic action, and unintended but potentially adverse effects.
Therapeutic Index - CORRECT ANSWER -The ratio between initial dose and
legal dose. If a drug has a low index, it is a critical drug.
Drug Concentration - CORRECT ANSWER -The level of drug in the blood.
Especially for seizures, you need to maintain drug concentration levels.
Additive Effect - CORRECT ANSWER -Drug interaction in which the effect of a
combination of 2 or more drugs with similar actions is equivalent to the sum of the individual effects of the same drug given alone. 1+1=
Synergistic Effect - CORRECT ANSWER -Drug interaction in which the effect of
a combination of 2 or more drugs with similar actions is greater that the sum of the individual effects the same drugs given alone. 1+1= >
Antagonistic Effect - CORRECT ANSWER -Drug interaction in which the effect of
a combination of 2 or more drugs with similar actions is less than the sum of individual effects of the same drug given alone. 1+1=<
Adverse Drug Reactions - CORRECT ANSWER -Pharmacologic reactions,
including adverse effects.
Idiosyncratic Reaction - CORRECT ANSWER -An abnormal and unexpected
response to a medication, not an allergic reaction, that is peculiar to an individual patient
Category A Drugs in Pregnancy - CORRECT ANSWER -Studies indicate no risk
to the human fetus. Safe for mother and baby
Category B Drugs in Pregnancy - CORRECT ANSWER -Studies indicate no risk
to an animal fetus; information for humans is not available
Category C Drugs in Pregnancy - CORRECT ANSWER -Adverse effects
reported in the animal fetus; information for humans not available
Category D Drugs in Pregnancy - CORRECT ANSWER -Possible fetal risk in
humans has been reported; however in select cases consideration of the potential benefit versus risk may warrant use of the drugs in pregnant women. Ex: if a mother develops leukemia while pregnant, she needs chemotherapy or she'll die, even if it harms the baby
Category X Drugs in Pregnancy - CORRECT ANSWER -Fetal abnormalities
have been reported, and positive evidence of fetal risk in humans is available from animal and/or human studies. These drugs are not to be used on pregnant women
Drug Therapy During Breastfeeding - CORRECT ANSWER -Breastfed infants
are at risk for exposure to drugs consumed by the mother. Consider the risk-to-benefit ratio. It is possible to readjust the schedule, and only breastfeed when the concentration of the medicine is low.
Premature or Preterm Infant Age Range - CORRECT ANSWER -Younger than
38 weeks gestation
Neonate or Newborn Infant Age Range - CORRECT ANSWER -Younger than 1
month
Infant Age Range - CORRECT ANSWER -1 month - 1 year
Child Age Range - CORRECT ANSWER -1 year to 12 years
Absorption of Drugs in Neonatal and Pediatric - CORRECT ANSWER --Gastric
pH less acidic -Gastric emptying slowed -Intramuscular absorption faster and irregular
Distribution of Drugs in Neonatal and Pediatric - CORRECT ANSWER --Greater
total body water means lower fat content -Decreased level of protein binding
-Immature blood-brain barrier, more drugs enter the brain
Metabolism of Drugs in Neonatal and Pediatric - CORRECT ANSWER --Liver
immature, doesn't produce enough microsomal enzymes -Older children may have increased metabolism, requiring higher doses than infants
Excretion of Drugs in Neonatal and Pediatric - CORRECT ANSWER --Kidney
immaturity affects glomerular filtration rate and tubular secretion -Decreased perfusion rate of the kidneys may reduce excretion of drugs
Factors Affecting Pediatric Drug Dosages - CORRECT ANSWER --Skin is thin
and permeable -Stomach lacks acid to kill bacteria -Lungs have weaker mucus barriers -Body temp less well regulated, and dehydration occurs easily -Liver and kidneys are immature, impairing drug metabolism and excretion
Methods of Dosage Calculation for Pediatric Patients - CORRECT ANSWER --
Body surface area method: uses West nomogram, most accurate -Always use weight in kg, not pounds -Body weight dosage calculations use mg/kg
Considerations for Elderly Patients r/t Drugs - CORRECT ANSWER --High use of
medications -Polypharmacy -Noncompliance, non-adherence (don't change their mind easily, like about smoking for ex) -Increased incidence of chronic illnesses -Sensory and motor deficits
Physiological Changes in Elderly Patients - CORRECT ANSWER --↓ cardiac
output = ↓ absorption and distribution -↓ blood flow = ↓ abs & dis -↑ pH = altered absorptions -↓ peristalsis = delayed gastric emptying -↓ hepatic enzyme production = ↓ metabolism -↓ hepatic blood flow = ↓ metabolism -↓ renal blood flow = ↓ excretion -↓ renal function = ↓ excretion
Drug Absorption in Elderly - CORRECT ANSWER --Gastric pH less acidic
-Gastric emptying slowed -Movement through GI tract slowed
Criteria For OTC Medications - CORRECT ANSWER -Must be easy to
understand by the patient, must have a high therapeutic index so there is low potential for OD, and must be easy to monitor (no IV or Coumadin, for example)
Reclassified OTC Drugs - CORRECT ANSWER --ibuprofen (Advil)
-naproxen (Aleve) -diphenhydramine (Benadryl) -loratadine (Claritin) -famotidine (Pepcid AC) -omeprazole (Priolsec OTC)
Use of OTC Drugs: Potential Hazards - CORRECT ANSWER --May postpone
effective treatment of more chronic disease states -May delay treatment of serious and/or life-threatening disorders -May relieve symptoms of a disorder but not the cause -Toxicity -Interactions with current prescription meds -Abuse, not common, but still possible
Dietary Supplement - CORRECT ANSWER -Orally administered alternative
medicine including herbal supplements. Not regulated by FDA
Herbs - CORRECT ANSWER -Plant components, including bark, berries, roots,
leaves, gums, seeds, stems, and flowers, used for their medicinal qualities
Consumer Use of Herbs - CORRECT ANSWER --Therapeutic agents for
treatment and cure of diseases -Prophylactic agents for long-term prevention of disease -Proactive agents to maintain health and wellness and "boost" one's immune system
Conditions Treated with Herbal Products - CORRECT ANSWER -Anxiety, colds
and cough, depression, headache, insomnia, ulcers, premenstrual syndrome, arthritis, constipation, fever, infection, stress, weakness
Commonly Used Herbal Products - CORRECT ANSWER -Aloe, feverfew, ginko,
goldenseal, st. john's wort, valerian, echinacea, garlic, hawthorn, ginseng, saw palmetto
Dietary Supplement Health and Education Act (DSHEA) of 1994 - CORRECT
ANSWER --Herbal products are considered "dietary supplements"
-No proof of efficacy or safety required -No standards for quality control -May claim effect but do not have to promise a specific cure
-Only regulated as a dietary supplement, nothing to do with FDA
Alternative Medicine - CORRECT ANSWER -Use of herbal products and other
nontraditional remedies
Complimentary Medicine - CORRECT ANSWER -Simultaneous use of both
traditional and alternative medicine True or False: Herbal remedies, especially ones derived naturally form plants, are safe
for all patients. - CORRECT ANSWER -False. The general view of the public is
that if a product is "natural" then it is safe. However in the U.S., federal legislation and the FDA still don't provide safeguards for these supplements. A 56 y.o. man is taking OTC antacids for relief of indigestion. He tells the nurse that he drinks at least one bottle a week and has done so for over a month because "it works
for me". The nurses main concern is... - CORRECT ANSWER -The self-
treatment may be delaying treatment of a more serious problem. Normally OTC meds should be used only for a short amount of time for common minor illnesses. Their use may postpone effective management of chronic disease and delay treatment. A patient tells the nurse he wants to stop taking his antilipemic drugs and start taking
garlic to lower cholesterol. The nurse's best reply would be... - CORRECT
ANSWER -"Let's explore the evidence that supports the use of garlic to lower
cholesterol." The nurse can provide patient education regarding potential risks and adverse reactions that are possible with herbal products. True or False: the reclassification of a med from prescription drug status to OTC status
means a direct cost savings for the consumer. - CORRECT ANSWER -False.
When prescription drugs are changed to OTC status, most third-party insurance payers refuse to pay for them, which may increase out-of-pocket costs for many patients.
The Common Cold - CORRECT ANSWER --Most commonly caused by a viral
infection, rhinovirus or influenza virus -Virus invades tissues (mucosa) of upper respiratory tract -Results in excessive mucus production, fluid dripping into pharynx causing cough, sore throat, and upset stomach, sneezing, stuffy nose
Antihistamines - CORRECT ANSWER -Blocks the histamine receptor.
They compete with histamine for specific receptor sites.
Histamine Receptor 1 (H1) - CORRECT ANSWER -Responsible for allergies,
mediates smooth muscle contraction and dilation of capillaries. Benadryl and Claritin target histamine 1.
-Precautions: increased intraoccular pressure, cardiac, renal disease, HTN, asthma, COPD, PUD, BPH, pregnancy
Antihistamine Patient Teaching - CORRECT ANSWER -Report excessive
sedation, confusion, or hypotension. Avoid drinking or operating heavy machinery. Do not take with alcohol or other CNS depressants. Do not take these meds with other prescription or OTC meds until checking with provider.
Antihistamine Administration - CORRECT ANSWER -Best tolerated when taken
with meals, reduces GI irritability. If dry mouth occurs, teach patient to perform frequent mouth care, chew gum, or suck on hard sugarless candy. Monitor for intended therapeutic effects.
Nasal Congestion - CORRECT ANSWER -Excessive nasal secretions. Inflamed
and swollen nasal mucosa. Primarily caused by allergies and upper respiratory tract infections (common cold)
Nasal Decongestants - CORRECT ANSWER -Shrink blood vessels in the nose
to help patient breath easier. Without a decongestant the blood vessels are dilated and leak. Not used in patients with history of HTN
Types of Nasal Decongestants - CORRECT ANSWER -1. Adrenergics: largest
group, stimulates adrenal gland, increased heart rate and BP, sympathomimetics (stimulates system)
- Anticholingerics: less commonly used as decongestant, parasympatholytics
- Corticosteroids: topical, intranasal steroids, rarely used
Oral Decongestants - CORRECT ANSWER -Prolonged onset, less potent than
topical, experiences first-pass effect, no rebound congestion, has systemic effects. Ex: Sudafed
Inhaled Decongestants - CORRECT ANSWER -Prompt onset, potent, limited
systemic effects, rebound congestion can occur.
Topical Decongestants - CORRECT ANSWER --Adrenergic: phenylephrine
(Neo-Synephrine) -Intranasal Steroids: budesonide (Rhinocort), fluticasone (Flonase), triamcinolone (Nasacort) -Intranasal Anticholingeric: ipratropium (Atrovent)
Nasal Decongestant Adrenergic Method of Action - CORRECT ANSWER -
Constricts small blood vessels causing tissues to shrink, relieving congestion
Nasal Decongestant Nasal Steroids Method of Action - CORRECT ANSWER -
Anti-inflammatory effects decrease inflammation and decrease congestion
Why to Take Nasal Decongestants - CORRECT ANSWER -Acute or chronic
rhinitis, common cold, sinusitis, hay fever, other allergies. May also be used for intranasal surgical or diagnostic procedures
Adverse Effects of Decongestant Adrenergics - CORRECT ANSWER -
Nervousness, insomnia, palpitations, tremors, systemic effects caused by adrenergic stimulation of SNS, increased BP, increased heart rate
Adverse Effects of Decongestant Steroids - CORRECT ANSWER -Local
mucosal dryness and irritation
Nasal Decongestant Nursing Implications - CORRECT ANSWER --
Decongestants may cause HTN, palpitations, and CNS stimulation; avoid in patients with these conditions -Patients on medication therapy for HTN and heart disease should check with their prescriber before taking OTC decongestants -Assess for drug allergies -Patients should avoid caffeine products -Report a fever, cough, or other symptoms lasting longer than 1 week
Cough Physiology - CORRECT ANSWER -Respiratory secretions and foreign
objects are naturally removed by the cough reflex. It induces cough and expectoration and is initiation by sensory receptors in respiratory tract.
Productive Cough - CORRECT ANSWER -Congested, removes excessive
secretions, most common reason for coughing
Nonproductive Cough - CORRECT ANSWER -Dry cough, has no benefit
Antitussives - CORRECT ANSWER -Treats a cough by stoping or reducing the
cough. Opioid and nonopijoid. Used only for NONPRODUCTIVE coughs. May be used in cases when coughing is harmful, like hernia repair
Antitussive Opioid Method of Action - CORRECT ANSWER -Suppress the cough
reflex by direct action on the cough center of the medulla. Example is codeine, Robitussin A-C, Dimetane- DC, hydrocodone (narcotic)
Antitussive Nonopioid Method of Action - CORRECT ANSWER -Suppress the
cough reflex by numbing the stretch receptors in the respiratory tract and preventing the cough reflex from being stimulated.
The common cold is treated with empiric therapy, which means.... - CORRECT
ANSWER -The medications only treat symptoms. There is no cure for the common
cold, the efficacy of herbal products is not proven. Treatment rendered can only treat the presenting clinical symptoms. A 58 y.o. patient has an old tracheostomy and has developed pneumonia. He has a productive cough and is producing thick mucus that he is having trouble coughing up.
What drug is best to give him? - CORRECT ANSWER -Guaifenesin (Humibid)
tablets. Expectorants such as guaifenesin aid in the expectoration of excessing mucus that has accumulated in the respiratory tract by breaking down and thinning out secretions.
