Download NURS 617 Pharm Exam 1 2024 LATEST Jean Genzale (100% CORRECT SUMMER) Pharmacotherapeutics and more Exams Nursing in PDF only on Docsity!
NURS 617 Pharm Exam 1 2024 LATEST Jean Genzale (100% CORRECT SUMMER) Pharmacotherapeutics for Advanced Nursing Practice
- A 42 y / o woman is diagnosed with bacteremia in the ED. The NP empirically starts antibiotics and want the first dose of Vancomycin to be given prior to admission to the floor. The hospital has a vancomycin nomogram for 15 mg / kg initial dosing ( rounded to the nearest 250 mg ) , followed by pharmacy dosing / pharmacokinetic service. If the patient weighs 154 pounds , what dose of vancomycin would the patient receive in the ED? Please give your answer as a whole number without units. 1000 The study of pharmacodynamics involves all of the following EXCEPT , CHOOSE ONE ANSWER a. Biological effects of drugs 20 1919 b. Biotransformation of drugs c. Chemical alteration of the cellular environment d. Mechanism of a drug's action b. Biotransformation of drugs
- In regard to pharmacodynamics , " affinity " can be defined as : CHOOSE ONE ANSWER a. The measure of how tightly a drug binds to plasma proteins b. The amount of time that a measurable drug effect persists c. The degree of attraction between a drug and its receptor d. The measure of a drug's bioavailability c. The degree of attraction between a drug and its receptor
- Antagonist drugs prevent the actions of the body's endogenous biomediators on their receptors by which mechanism? CHOOSE ONE ANSWER a. Preventing agonist drugs from binding to antagonist drug b. Binding to the receptor and activating it c. Preventing occupancy of the receptor d. Mimicking the actions of the body's endogenous biomediators c. Preventing occupancy of the receptor What are the two most important sites for drug elimination? CHOOSE ONE ANSWER a. liver and gastrointestinal tract b. kidneys and liver c. lungs and liver d. skin and kidneys b. kidneys and liver ALSY 6. Acetaminophen and codeine are given together for pain relief. The drug - drug interaction is : CHOOSE ONE ANSWER a. Beneficial inhibitory b. Beneficial potentiative c. Harmful inhibitory d. Harmful potentiative b. Beneficial potentiative
Drugs cross the placenta membrane by : CHOOSE ONE ANSWER a. Active transport b. Exocytosis c. Filtration d. Passive diffusion d. Passive diffusion Drugs having a significant first pass effect : CHOOSE ONE ANSWER a. Are converted by the liver to more active and fat soluble forms b. Are rapidly metabolized by the liver and may have little if any action c. Bypass the hepatic circulation d. Must be given by the enteral ( Oral ) route only b. Are rapidly metabolized by the liver and may have little if any action The cytochrome P - 450 enzyme system a. Alters a parent drug by oxidation , hydrolysis , and other chemical reactions b. Is involved in excreting drugs through the kidney c. Mediates Phase II reactions in the liver d. Changes a drug to make it more fat soluble a. Alters a parent drug by oxidation , hydrolysis , and other chemical reactions The most important drug metabolizing enzyme is : CHOOSE ONE ANSWER
a. CYPIA b. CYP2C c. CYP2E d. CYP3A d. CYP3A The initial therapeutic effect on the drug concentration curve can be defined as the : CHOOSE ONE ANSWER a. Minimal adverse effect level b. Onset of action c. Peak of action d. Therapeutic range b. Onset of action An excessive dose of meperidine ( Demerol ) causing respiratory depression and sedation can be classified as what type of adverse drug reaction ( ADR )? CHOOSE ONE ANSWER a. Delayed ADR b. Idiosyncratic ADR c. Cumulative ADR d. Intrinsic ADR d. Intrinsic ADR Example ( s ) of an inhibitory pharmacodynamic drug - drug interaction would include : blocker for congestive heart failure
c. Digoxin binding to Na / K ATPase inhibiting the movement of sodium ions from within the cardiac muscle cells and enhancing the entry of calcium ions into the cell Which drug molecules are readily able to enter and cross the lipid content of the cell membrane? CHOOSE ONE ANSWER a. Fat soluble b. Hydrophilic substances c. Ionized d. Polarized a. Fat soluble Which of the following drugs can be used to form an irreversible chemical bond between themselves and another molecular substance? CHOOSE ONE ANSWER a. Cholestyramine ( Questran ) b. Mannitol c. Sucralfate d. Talcum powder a. Cholestyramine ( Questran ) Biotransformation of a drug results in? CHOOSE ONE ANSWER a. Easier distribution b. Faster urinary excretion c. Higher protein binding
d. Slower urinary excretion b. Faster urinary excretion Which statement is true concerning pharmacokinetic variations in a pediatric patient? CHOOSE ONE ANSWER a. Drugs administered topically to the skin in neonates , infants , and small children will be absorbed faster than the same drug applied to the skin of an adult b. Neonates have a larger percentage of their body weight as fat allowing a wider distribution of fat - soluble drugs c. Because drug metabolic rates are proportional to basal body temperatures , drug metabolism in neonates and infants is generally slower than an adult. d. Glomerular filtration and renal tubular excretion does not change in the lifespan of al patient. a. Drugs administered topically to the skin in neonates , infants , and small children will be absorbed faster than the same drug applied to the skin of an adult Water soluble drugs have good absorption through all the following routes EXCEPT : CHOOSE ONE ANSWER a. Enteral b. Intravenous c. Transdermal d. Transrectal c. Transdermal
Routine monitoring of PT and INR is necessary with which of the following drugs? CHOOSE ONE ANSWER a. Prasugrel ( Effient ) b. Rivaroxaban ( Xarelto ) c. Streptokinase ( Streptase ) d. Warfarin ( Coumadin ) d. Warfarin ( Coumadin ) When treating angina , incorporating ' drug holidays ' in a patient's drug regimen may help prevent tolerance and physical dependence with which drug class? CHOOSE ONE ANSWER a. Angiotensin Receptor blockers b. Diuretics c. Nitrates d. Statins c. Nitrates What patient education would you give when prescribing a nitrate for treatment of angina? CHOOSE ONE ANSWER a. Nitrates should not be used for acute episodes of angina b. Tolerance and physical dependence do not occur with continuous use c. Nitrates commonly cause headaches with initial doses of the drug d. Take this medication with the first meal of the day c. Nitrates commonly cause headaches with initial doses of the drug
Spironolactone ( Aldactone ) is often used in combination with the thiazides because : CHOOSE ONE ANSWER a. The combination improves compliance in long term hypertensive therapy. b. The potassium sparing diuretic offsets the potential for hypokalemia often seen with the thiazides c. The antihypertensive efficacy is increased when the renin - angiotensin - aldosterone mechanism is activated d. The potential risk of reflex tachycardia is reduced. b. The potassium sparing diuretic offsets the potential for hypokalemia often seen with the thiazides Dobutamine in the treatment of acute CHF : CHOOSE ONE ANSWER a. Works as a beta agonist and an alpha agonist b. Increases the force of myocardial contraction c. Reduces systemic vascular resistance and decreases afterload d. Can be given sublingually b. Increases the force of myocardial contraction Treatment for ACC / AHA Stage A heart failure patients includes : CHOOSE ONE ANSWER a. Digoxin ( Lanoxin ) , a cardiac glycoside b. Drugs for hypertension and lipid disorders , if they exist c. No drugs are used in this early stage d. Smoking cessation only b. Drugs for hypertension and lipid disorders , if they exist
Calcium channel blockers : CHOOSE ONE ANSWER a. Decrease calcium movement into the extra - cellular environment b. Block calcium channels in myocardial cells resulting in decreased contraction c. Cause increased heart rate by speeding conductance of electrical cells d. Have negative effects on glucose levels in diabetic patients b. Block calcium channels in myocardial cells resulting in decreased contraction Centrally acting Alpha II ( two ) adrenergic agents : CHOOSE ONE ANSWER a. Interact with Alpha II ( two ) receptors on the peripheral vascular system b. Result in vasodilation leading to a decrease in blood pressure c. Increases venous return ; therefore decreasing heart rate d. result in a mild to moderate increase in cardiac output b. Result in vasodilation leading to a decrease in blood pressure Direct acting vasodilators : CHOOSE ONE ANSWER a. Can be useful in the treatment of hypertensive crisis b. Are teratogenic c. Often cause impotence in men d. Block the action of aldosterone a. Can be useful in the treatment of hypertensive crisis
Drowsiness and dizziness may be adverse effects of some antihypertensive drugs. Of the following , which one is MOST LIKELY to cause this? CHOOSE ONE ANSWER a. The direct - acting vasodilator , minoxidil ( Loniten ) b. Calcium channel blocker , nifedipine ( Procardia ) c. The alpha 2 adrenergic agonist , alpha methyldopa ( Aldomet ) d. The ACE inhibitor , Lisinopril ( Prinivil ) c. The alpha 2 adrenergic agonist , alpha methyldopa ( Aldomet ) The mechanism of action of the ACE Inhibitors includes : CHOOSE ONE ANSWER a. Promoting release of aldosterone b. Reduction of arterial resistance with minimal compensatory volume increase c. Working in both the adrenal gland and the central nervous system d. Promoting the transformation of Angiotensin I into Angiotensin II b. Reduction of arterial resistance with minimal compensatory volume increase Pharmacological management of acute heart failure may include all of the following therapies , EXCEPT? CHOOSE ONE ANSWER a. Morphine Sulfate b. Dopamine ( Intropin ) c. Dobutamine ( Dobutrex ) d. Alpha - methyldopa ( Aldomet ) d. Alpha - methyldopa ( Aldomet )
Which drug results in pharmacological blockade of sodium and chloride co - transport at the distal convoluted tubule : CHOOSE ONE ANSWER a. Bumetanide ( Bumex ) b. Chlorothiazide ( Diuril ) c. Furosemide ( Lasix ) d. Triamterene ( Dyrenium ) b. Chlorothiazide ( Diuril ) Which drug class is teratogenic and toxic in pregnancy? CHOOSE ONE ANSWER a. ACE Inhibitors b. Centrally - Acting Alpha 2 Adrenergic Agents c. Direct acting Vasodilators d. Thiazides a. ACE Inhibitors Which of the following drugs mask the signs of hypoglycemia in patients with diabetes? CHOOSE ONE ANSWER a. ACE Inhibitors b. Alpha blockers c. Beta blockers d. Nitrates c. Beta blockers
Which lab test should be monitored to detect adverse drug reactions common with statins ( HMG CoA reductase inhibitors )? CHOOSE ONE ANSWER a. glucose b. potassium c. white blood cell count d. liver function Test d. liver function Test Which of the following side effects is experienced by patients taking Verapamil? CHOOSE ONE ANSWER a. Chest pain b. Constipation c. Diarrhea d. Nocturnal cough b. Constipation Which of the following lipid lowering agents can be used during pregnancy if medication is required after lifestyle managements has been unsuccessful? CHOOSE ONE ANSWER a. Bile acid binding resins b. Nicotinic Acid c. Omega 3 fatty acids d. Statins a. Bile acid binding resins
An adverse drug reaction characterized by a decreased response to a particular drug dosage when the drug is given repeatedly over time is called a. Dependence b. An idiosyncratic reaction c. Tolerance d. A cumulative reaction c. Tolerance A new drug seeking FDA approval has been studied in pregnant rats , rabbits , and mice and causes birth defects in these fetal animals. There are , however , no studies of this drug in pregnant women. To which pregnancy risk category does this drug belong? a. A b. B c. C d. D c. C Which process explains why the recommended oral dose of some medications is much higher than the parenteral dose of the same medications? a. Hepatic first - pass metabolism b. Competitive antagonism C. Tolerance d. Intrinsic activity a. Hepatic first - pass metabolism
Which of the following conditions can lead to a cumulative type of adverse drug reaction? a. Renal insufficiency b. Diarrhea C. Increased GFR ( glomerular filtration rate ) d. Chronic use of antacids a. Renal insufficiency Which statement is true concerning pharmacokinetic variations in a pediatric patient? A. Drugs administered topically to the skin and neonate's, infants, and small children will be absorbed faster than the same drug applied to the skin of an adult b. Because drug metabolic rates are proportional to basil body temperatures, drug metabolism in neonates and infants is generally slower than an adult C. Neonates have a larger percentage of their body weight as fat allowing a wider distribution of fat soluble drugs d. Glomerular filtration and renal tubular excretion does not change in the lifespan of a patient A. Drugs administered topically to the skin and neonate's, infants, and small children will be absorbed faster than the same drug applied to the skin of an adult Which combination of drugs has the potential of producing a harmful inhibitory drug interaction? a. Concurrent use of aspirin and warfarin for anticoagulation.
