NR508 Final Exam Test Bank completed by chapters
Chapter 1. The Role of the Nurse Practtoner
Multple Choice
Identfy the choice that best completes
... [Show More] the statement or answers the queston.
____ 1. Nurse practtoner prescriptve authority is regulated by:
1. The Natonal Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administraton
3. The State Board of Nursing for each state
4. The State Board of Pharmacy
____ 2. The benefts to the patent of having an Advanced Practce Registered Nurse (APRN)
prescriber include:
1. Nurses know more about Pharmacology than other prescribers because they take it both in their
basic nursing program and in their APRN program.
2. Nurses care for the patent from a holistc approach and include the patent in decision making
regarding their care.
3. APRNs are less likely to prescribe narcotcs and other controlled substances.
4. APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to
have a physician supervising their practce.
____ 3. Clinical judgment in prescribing includes:
1. Factoring in the cost to the patent of the medicaton prescribed
2. Always prescribing the newest medicaton available for the disease process
3. Handing out drug samples to poor patents
4. Prescribing all generic medicatons to cut costs
____ 4. Criteria for choosing an effectve drug for a disorder include:
1. Asking the patent what drug they think would work best for them
2. Consultng natonally recognized guidelines for disease management
3. Prescribing medicatons that are available as samples before writng a prescripton
4. Following U.S. Drug Enforcement Administraton guidelines for prescribing
____ 5. Nurse practtoner practce may thrive under health-care reform because of:
1. The demonstrated ability of nurse practtoners to control costs and improve patent outcomes
2. The fact that nurse practtoners will be able to practce independently
3. The fact that nurse practtoners will have full reimbursement under health-care reform
4. The ability to shif accountability for Medicaid to the state level
Chapter 2. Review of Basic Principles of Pharmacology
Multple Choice
Identfy the choice that best completes the statement or answers the queston.____ 1. A patent’s nutritonal intake and laboratory results reflect hypoalbuminemia. This is
critcal to prescribing because:
1. Distributon of drugs to target tssue may be affected.
2. The solubility of the drug will not match the site of absorpton.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys.
____ 2. Drugs that have a signifcant frst-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatc circulaton
3. Are rapidly metabolized by the liver and may have litle if any desired acton
4. Are converted by the liver to more actve and fat-soluble forms
____ 3. The route of excreton of a volatle drug will likely be the:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin
____ 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a
storage reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tssue
2. Are the reason for giving loading doses
3. Increase the length of tme a drug is available and actve
4. Are most common in collagen tssues
____ 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects
____ 6. Azithromycin dosing requires that the frst day’s dosage be twice those of the other 4
days of the prescripton. This is considered a loading dose. A loading dose:
1. Rapidly achieves drug levels in the therapeutc range
2. Requires four- to fve-half-lives to atain
3. Is influenced by renal functon
4. Is directly related to the drug circulatng to the target tssues
____ 7. The point in tme on the drug concentraton curve that indicates the frst sign of a
therapeutc effect is the:1. Minimum adverse effect level
2. Peak of acton
3. Onset of acton
4. Therapeutc range
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutc range
2. When the drug will be administered for a short tme only
3. When there is a high correlaton between the dose and saturaton of receptor sites
4. To determine if a drug is in the therapeutc range
____ 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic
concentraton. This means that the:
1. Concentraton will produce therapeutc effects
2. Concentraton will produce an adverse response
3. Time between doses must be shortened
4. Duraton of acton of the drug is too long
____ 10. Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Upregulaton with chronic use
3. Desensitzaton or downregulaton with contnuous use
4. Inverse relatonship between drug concentraton and drug acton
____ 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1. Downregulaton of the drug receptor
2. An exaggerated response if abruptly discontnued
3. Partal blockade of the effects of agonist drugs
4. An exaggerated response to compettve drug agonists
____ 12. Factors that affect gastric drug absorpton include:
1. Liver enzyme actvity
2. Protein-binding propertes of the drug molecule
3. Lipid solubility of the drug
4. Ability to chew and swallow
____ 13. Drugs administered via IV:
1. Need to be lipid soluble in order to be easily absorbed
2. Begin distributon into the body immediately
3. Are easily absorbed if they are nonionized
4. May use pinocytosis to be absorbed____ 14. When a medicaton is added to a regimen for a synergistc effect, the combined effect of
the drugs is:
1. The sum of the effects of each drug individually
2. Greater than the sum of the effects of each drug individually
3. Less than the effect of each drug individually
4. Not predictable, as it varies with each individual
____ 15. Which of the following statements about bioavailability is true?
1. Bioavailability issues are especially important for drugs with narrow therapeutc ranges or
sustained-release mechanisms.
2. All brands of a drug have the same bioavailability.
3. Drugs that are administered more than once a day have greater bioavailability than drugs given
once daily.
4. Combining an actve drug with an inert substance does not affect bioavailability.
____ 16. Which of the following statements about the major distributon barriers (blood-brain or
fetal-placental) is true?
1. Water soluble and ionized drugs cross these barriers rapidly.
2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
____ 17. Drugs are metabolized mainly by the liver via phase I or phase II reactons. The purpose
of both of these types of reactons is to:
1. Inactvate prodrugs before they can be actvated by target tssues
2. Change the drugs so they can cross plasma membranes
3. Change drug molecules to a form that an excretory organ can excrete
4. Make these drugs more ionized and polar to facilitate excreton
____ 18. Once they have been metabolized by the liver, the metabolites may be:
1. More actve than the parent drug
2. Less actve than the parent drug
3. Totally “deactvated” so they are excreted without any effect
4. All of the above
____ 19. All drugs contnue to act in the body untl they are changed or excreted. The ability of
the body to excrete drugs via the renal system would be increased by:
1. Reduced circulaton and perfusion of the kidney
2. Chronic renal disease
3. Competton for a transport site by another drug
4. Unbinding a nonvolatle drug from plasma proteins____ 20. Steady state is:
1. The point on the drug concentraton curve when absorpton exceeds excreton
2. When the amount of drug in the body remains constant
3. When the amount of drug in the body stays below the minimum toxic concentraton
4. All of the above
____ 21. Two different pain medicatons are given together for pain relief. The drug—drug
interacton is:
1. Synergistc
2. Antagonistc
3. Potentatve
4. Additve
____ 22. Actons taken to reduce drug—drug interacton problems include all of the following
EXCEPT:
1. Reducing the dosage of one of the drugs
2. Scheduling their administraton at different tmes
3. Prescribing a third drug to counteract the adverse reacton of the combinaton
4. Reducing the dosage of both drugs
____ 23. Phase I oxidatve-reductve processes of drug metabolism require certain nutritonal
elements. Which of the following would reduce or inhibit this process?
1. Protein malnutriton
2. Iron-defciency anemia
3. Both 1 and 2
4. Neither 1 nor 2
____ 24. The tme required for the amount of drug in the body to decrease by 50% is called:
1. Steady state
2. Half-life
3. Phase II metabolism
4. Reduced bioavailability tme
____ 25. An agonist actvates a receptor and stmulates a response. When given frequently over
tme, the body may:
1. Upregulate the total number of receptors
2. Block the receptor with a partal agonist
3. Alter the drug’s metabolism
4. Downregulate the numbers of that specifc receptor
____ 26. Drug antagonism is best defned as an effect of a drug that:1. Leads to major physiological and psychological dependence
2. Is modifed by the concurrent administraton of another drug
3. Cannot be metabolized before another dose is administered
4. Leads to a decreased physiological response when combined with another drug
____ 27. Instructons to a client regarding self-administraton of oral enteric-coated tablets should
include which of the following statements?
1. “Avoid any other oral medicines while taking this drug.”
2. “If swallowing this tablet is difcult, dissolve it in 3 ounces of orange juice.”
3. “The tablet may be crushed if you have any difculty taking it.”
4. “To achieve best effect, take the tablet with at least 8 ounces of fluid.”
____ 28. The major reason for not crushing a sustained-release capsule is that, if crushed, the
coated beads of the drugs could possibly result in:
1. Disintegraton
2. Toxicity
3. Malabsorpton
4. Deterioraton
____ 29. Which of the following substances is the most likely to be absorbed in the intestnes
rather than in the stomach?
1. Sodium bicarbonate
2. Ascorbic acid
3. Salicylic acid
4. Glucose
____ 30. Which of the following variables is a factor in drug absorpton?
1. The smaller the surface area for absorpton, the more rapidly the drug is absorbed.
2. A rich blood supply to the area of absorpton leads to beter absorpton.
3. The less soluble the drug, the more easily it is absorbed.
4. Ionized drugs are easily absorbed across the cell membrane.
____ 31. An advantage of prescribing a sublingual medicaton is that the medicaton is:
1. Absorbed rapidly
2. Excreted rapidly
3. Metabolized minimally
4. Distributed equally
____ 32. Drugs that use CYP 3A4 isoenzymes for metabolism may:
1. Induce the metabolism of another drug
2. Inhibit the metabolism of another drug
3. Both 1 and 24. Neither 1 nor 2
____ 33. Therapeutc drug levels are drawn when a drug reaches steady state. Drugs reach steady
state:
1. Afer the second dose
2. Afer four to fve half-lives
3. When the patent feels the full effect of the drug
4. One hour afer IV administraton
____ 34. Upregulaton or hypersensitzaton may lead to:
1. Increased response to a drug
2. Decreased response to a drug
3. An exaggerated response if the drug is withdrawn
4. Refractoriness or complete lack of response
Chapter 3. Ratonal Drug Selecton
Multple Choice
Identfy the choice that best completes the statement or answers the queston.
____ 1. An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
1. Drugs given in liquid form are less irritatng to the stomach.
2. A 6-year-old child may have problems swallowing a pill.
3. Liquid forms of medicaton eliminate the concern for frst-pass effect.
4. Liquid ibuprofen does not have to be dosed as ofen as the tablet form.
____ 2. In deciding which of multple drugs used to use to treat a conditon, the NP chooses
Drug A because it:
1. Has serious side effects and it is not being used for a life-threatening conditon
2. Will be taken twice daily and will be taken at home
3. Is expensive, but covered by health insurance
4. None of these are important in choosing a drug
____ 3. A client asks the NP about the differences in drug effects between men and women.
What is known about the differences between the pharmacokinetcs of men and women?
1. Body temperature varies between men and women.
2. Muscle mass is greater in women.
3. Percentage of fat differs between genders.
4. Proven subjectve factors exist between the genders.
____ 4. The frst step in the prescribing process according to the World Health Organizaton is:
1. Choosing the treatment2. Educatng the patent about the medicaton
3. Diagnosing the patent’s problem
4. Startng the treatment
____ 5. Treatment goals in prescribing should:
1. Always be curatve
2. Be patent-centered
3. Be convenient for the provider
4. Focus on the cost of therapy
____ 6. The therapeutc goals when prescribing include(s):
1. Curatve
2. Palliatve
3. Preventve
4. All of the above
____ 7. When determining drug treatment the NP prescriber should:
1. Always use evidence-based guidelines
2. Individualize the drug choice for the specifc patent
3. Rely on his or her experience when prescribing for complex patents
4. Use the newest drug on the market for the conditon being treated
____ 8. Patent educaton regarding prescribed medicaton includes:
1. Instructons writen at the high school reading level
2. Discussion of expected adverse drug reactons
3. How to store lefover medicaton such as antbiotcs
4. Verbal instructons always in English
____ 9. Passive monitoring of drug effectveness includes:
1. Therapeutc drug levels
2. Adding or subtractng medicatons from the treatment regimen
3. Ongoing provider visits
4. Instructng the patent to report if the drug is not effectve
____ 10. Pharmacokinetc factors that affect prescribing include:
1. Therapeutc index
2. Minimum effectve concentraton
3. Bioavailability
4. Ease of ttraton____ 11. Pharmaceutcal promoton may affect prescribing. To address the impact of
pharmaceutcal promoton, the following recommendatons have been made by the Insttute of
Medicine:
1. Conflicts of interest and fnancial relatonships should be disclosed by those providing educaton.
2. Providers should ban all pharmaceutcal representatves from their ofce setng.
3. Drug samples should be used for patents who have the insurance to pay for them, to ensure the
patent can afford the medicaton.
4. Providers should only accept low-value gifs, such as pens and pads of paper, from the
pharmaceutcal representatve.
____ 12. Under new U.S. Food and Drug Administraton labeling, Pregnancy Categories will be:
1. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to
the fetus
2. Changed to incorporate a pregnancy risk summary and clinical consideratons on the drug label
3. Eliminated, and replaced with a link to the Natonal Library of Medicine TOXNET Web site for indepth informaton regarding pregnancy concerns
4. Clarifed to include informaton such as safe dosages in each trimester of pregnancy
Chapter 4. Legal and Professional Issues in Prescribing
Multple Choice
Identfy the choice that best completes the statement or answers the queston.
____ 1. The U.S. Food and Drug Administraton regulates:
1. Prescribing of drugs by MDs and NPs
2. The ofcial labeling for all prescripton and over-the-counter drugs
3. Off-label recommendatons for prescribing
4. Pharmaceutcal educatonal offerings
____ 2. The U.S. Food and Drug Administraton approval is required for:
1. Medical devices, including artfcial joints
2. Over-the-counter vitamins
3. Herbal products, such as St John’s wort
4. Dietary supplements, such as Ensure
____ 3. An Investgatonal New Drug is fled with the U.S. Food and Drug Administraton:
1. When the manufacturer has completed phase III trials
2. When a new drug is discovered
3. Prior to animal testng of any new drug entty
4. Prior to human testng of any new drug entty
____ 4. Phase IV clinical trials in the United States are also known as:
1. Human bioavailability trials2. Postmarketng research
3. Human safety and efcacy studies
4. The last stage of animal trials before the human trials begin
____ 5. Off-label prescribing is:
1. Regulated by the U.S. Food and Drug Administraton
2. Illegal by NPs in all states (provinces)
3. Legal if there is scientfc evidence for the use
4. Regulated by the Drug Enforcement Administraton
____ 6. The U.S. Drug Enforcement Administraton:
1. Registers manufacturers and prescribers of controlled substances
2. Regulates NP prescribing at the state level
3. Sanctons providers who prescribe drugs off-label
4. Provides prescribers with a number they can use for insurance billing
____ 7. Drugs that are designated Schedule II by the U.S. Drug Enforcement Administraton:
1. Are known teratogens during pregnancy
2. May not be reflled; a new prescripton must be writen
3. Have a low abuse potental
4. May be dispensed without a prescripton unless regulated by the state
____ 8. Precautons that should be taken when prescribing controlled substances include:
1. Faxing the prescripton for a Schedule II drug directly to the pharmacy
2. Using tamper-proof paper for all prescriptons writen for controlled drugs
3. Keeping any pre-signed prescripton pads in a locked drawer in the clinic
4. Using only numbers to indicate the amount of drug to be prescribed
____ 9. Strategies prescribers can use to prevent misuse of controlled prescripton drugs include:
1. Use of chemical dependency screening tools
2. Firm limit-setng regarding prescribing controlled substances
3. Practcing “just say no” to deal with patents who are pushing the provider to prescribe
controlled substances
4. All of the above
____ 10. Behaviors predictve of addicton to controlled substances include:
1. Stealing or borrowing another patent’s drugs
2. Requiring increasing doses of opiates for pain associated with malignancy
3. Receiving reflls of a Schedule II prescripton on a regular basis
4. Requestng that only their own primary care provider prescribe for them____ 11. Medicaton agreements or “Pain Medicaton Contracts” are recommended to be used:
1. Universally for all prescribing for chronic pain
2. For patents who have repeated requests for pain medicaton
3. When you suspect a patent is exhibitng drug-seeking behavior
4. For patents with pain associated with malignancy
____ 12. A prescripton needs to be writen for:
1. Legend drugs
2. Most controlled drugs
3. Medical devices
4. All of the above
Chapter 5. Adverse Drug Reactons
Multple Choice
Identfy the choice that best completes the statement or answers the queston.
____ 1. Which of the following patents would be at higher risk of experiencing adverse drug
reactons (ADRs):
1. A 32-year-old male
2. A 22-year-old female
3. A 3-month-old female
4. A 48-year-old male
____ 2. Infants and young children are at higher risk of ADRs due to:
1. Immature renal functon in school-age children
2. Lack of safety and efcacy studies in the pediatric populaton
3. Children’s skin being thicker than adults, requiring higher dosages of topical medicaton
4. Infant boys having a higher proporton of muscle mass, leading to a higher volume of distributon
____ 3. The elderly are at high risk of ADRs due to:
1. Having greater muscle mass than younger adults, leading to higher volume of distributon
2. The extensive studies that have been conducted on drug safety in this age group
3. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutc
effect
4. Age-related decrease in renal functon
____ 4. The type of adverse drug reacton that is idiosyncratc when a drug given in the usual
therapeutc doses is type:
1. A
2. B
3. C4. D
____ 5. Digoxin may cause a type A adverse drug reacton due to:
1. Idiosyncratc effects
2. Its narrow therapeutc index
3. Being a teratogen
4. Being a carcinogen
____ 6. Sarah developed a rash afer using a topical medicaton. This is a type __ allergic drug
reacton.
1. I
2. II
3. III
4. IV
____ 7. A patent may develop neutropenia from using topical Silvadene for burns. Neutropenia
is a(n):
1. Cytotoxic hypersensitvity reacton
2. Immune complex hypersensitvity
3. Immediate hypersensitvity reacton
4. Delayed hypersensitvity reacton
____ 8. Anaphylactc shock is a:
1. Type I reacton, called immediate hypersensitvity reacton
2. Type II reacton, called cytotoxic hypersensitvity reacton
3. Type III allergic reacton, called immune complex hypersensitvity
4. Type IV allergic reacton, called delayed hypersensitvity reacton
____ 9. James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a
cortcosteroid) use. He is at risk for what type of adverse drug reacton?
1. Type B
2. Type C
3. Type E
4. Type F
____ 10. Immunomodulators such as azathioprine may cause a delayed adverse drug reacton
known as a type D reacton because they are known:
1. Teratogens
2. Carcinogens
3. To cause hypersensitvity reactons
4. Hypothalamus-pituitary-adrenal axis suppressants____ 11. A 24-year-old male received multple fractures in a motor vehicle accident that required
signifcant amounts of opioid medicaton to treat his pain. He is at risk for a _____ adverse drug reacton
when he no longer requires the opioids.
1. Rapid
2. First-dose
3. Late
4. Delayed
____ 12. An example of a frst-dose reacton that may occur includes:
1. Orthostatc hypotension that does not occur with repeated doses
2. Purple glove syndrome with phenytoin use
3. Hemolytc anemia from cefriaxone use
4. Contact dermatts from neomycin use
____ 13. Drugs that are prone to cause adverse drug effects include:
1. Diuretcs
2. Inhaled antcholinergics
3. Insulins
4. Stmulants
____ 14. The U.S. Food and Drug Administraton MedWatch system is actvated when:
1. There is an adverse event to a vaccine.
2. The patent has a severe reacton that is noted in the “Severe Reacton” secton in the
medicaton label.
3. A lactatng woman takes a medicaton that is potentally toxic to the breasteeding infant.
4. An adverse event or serious problem occurs with a medicaton that is not already identfed on
the label.
____ 15. The Vaccine Adverse Events Reportng System is:
1. A mandatory reportng system for all health-care providers when they encounter an adverse
vaccine event
2. A voluntary reportng system that health-care providers or consumers may use to report vaccine
adverse events
3. Utlized to send out safety alerts regarding emerging vaccine safety issues
4. Actvated when a vaccine has been proven to cause signifcant adverse effects
Chapter 6. Factors That Foster Positve Outcomes
Multple Choice
Identfy the choice that best completes the statement or answers the queston.____ 1. A comprehensive assessment of a patent should be holistc when trying to determine
competence in drug administraton. Which of the following factors would the NP omit from this type of
assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practces
____ 2. Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which
technique would be appropriate to use in teaching her about a new drug you have just prescribed?
1. Use correct medical terminology because Spanish has a Latn base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an interpreter.
4. Use careful, detailed explanatons.
____ 3. Rod, age 68, has hearing difculty. Which of the following would NOT be helpful in
assuring that he understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
2. Speak in low tones or fnd a provider who has a lower voice.
3. Write down the instructons as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.
____ 4. Which of the following factors may adversely affect a patent’s adherence to a
therapeutc drug regimen?
1. Complexity of the drug regimen
2. Patent percepton of the potental adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2
____ 5. The health-care delivery system itself can create barriers to adherence to a treatment
regimen. Which of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treatng a wider range of disorders
____ 6. Ralph’s blood pressure remains elevated despite increased doses of his drug. The NP is
concerned that he might not be adhering to his treatment regimen. Which of the following events would
suggest that he might not be adherent?
1. Ralph states that he always takes the drug “when I feel my pressure is going up.”
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show that he is adherent to the drug regimen.____ 7. Nonadherence is especially common in drugs that treat asymptomatc conditons, such
as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug
that:
1. Has a short half-life so that missing one dose has limited effect
2. Requires several dosage ttratons so that missed doses can be replaced with lower doses to
keep costs down
3. Has a tolerability profle with fewer of the adverse effects that are considered “irritatng,” such
as nausea and dizziness
4. Must be taken no more than twice a day
____ 8. Factors in chronic conditons that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of tme over which it must be taken
3. Breaks in the usual daily routne, such as vacatons and weekends
4. All of the above
____ 9. While patent educaton about their drugs is important, informaton alone does not
necessarily lead to adherence to a drug regimen. Patents report greater adherence when:
1. The provider spent a lot of tme discussing the drugs with them
2. Their concerns and specifc area of knowledge defcit were addressed
3. They were given writen material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms
____ 10. Patents with psychiatric illnesses have adherence rates to their drug regimen between
35% and 60%. To improve adherence in this populaton, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug curve
2. In oral formulatons that are more easily taken
3. That do not require frequent monitoring
4. Combined with patent educaton about the need to adhere even when symptoms are absent
____ 11. Many disorders require multple drugs to treat them. The more complex the drug
regimen, the less likely the patent will adhere to it. Which of the following interventons will NOT
improve adherence?
1. Have the patent purchase a pill container with compartments for daily or multple tmes-per-day
dosing.
2. Match the clinic appointment to the next tme the drug is to be reflled.
3. Write prescriptons for new drugs with shorter tmes between reflls.
4. Give the patent a clear drug schedule that the provider devises to ft the characteristc of the
drug.____ 12. Pharmacologic interventons are costly. Patents for whom the cost/beneft variable is
especially important include:
1. Older adults and those on fxed incomes
2. Patents with chronic illnesses
3. Patents with copayments for drugs on their insurance
4. Patents on public assistance
____ 13. Providers have a responsibility for determining the best plan of care, but patents also
have responsibilites. Patents the provider can be assured will carry through on these responsibilites
include those who:
1. Are well-educated and afuent
2. Have chronic conditons
3. Self-monitor drug effects on their symptoms
4. None of the above guarantee adherence
____ 14. Monitoring adherence can take several forms, including:
1. Patent reports from data in a drug diary
2. Pill counts
3. Laboratory reports and other diagnostc markers
4. All of the above
____ 15. Factors that explain and predict medicaton adherence include:
1. Social
2. Financial
3. Health system
4. All of the above
Chapter 9. Nutriton and Nutraceutcals
Multple Choice
Identfy the choice that best completes the statement or answers the queston.
____ 1. The most frequent type of drug-food interacton is food:
1. Causing increased therapeutc drug levels
2. Affectng the metabolism of the drug
3. Altering the volume of distributon of drugs
4. Affectng the gastrointestnal absorpton of drugs
____ 2. Food in the gastrointestnal tract affects drug absorpton by:
1. Altering the pH of the colon, which decreases absorpton
2. Competng with the drug for plasma proteins
3. Altering gastric emptying tme4. Altering the pH of urine
____ 3. Food can alter the pH of the stomach, leading to:
1. Enhanced drug metabolism
2. Altered vitamin K absorpton
3. Increased vitamin D absorpton
4. Altered drug bioavailability
____ 4. Fastng for an extended period can:
1. Increase drug absorpton due to lack of competton between food and the drug
2. Alter the pH of the gastrointestnal tract, affectng absorpton
3. Cause vasoconstricton, leading to decreased drug absorpton
4. Shrink the stomach, causing decreased surface area for drug absorpton
____ 5. Tetracycline needs to be given on an empty stomach because it chelates with:
1. Calcium
2. Magnesium
3. Iron
4. All of the above
____ 6. A low-carbohydrate, high-protein diet may:
1. Increase drug-metabolizing enzymes
2. Decrease drug absorpton from the GI tract
3. Alter drug binding to plasma proteins
4. Enhance drug eliminaton
____ 7. Grapefruit juice contains furanocoumarins that have been found to:
1. Alter absorpton of drugs through competton for binding sites
2. Inhibit CYP 3A4, leading to decreased frst-pass metabolism of drugs
3. Alter vitamin K metabolism, leading to prolonged bleeding
4. Enhance absorpton of calcium and vitamin D
____ 8. Cruciferous vegetables may alter drug pharmacokinetcs by:
1. Enhancing absorpton of weakly acidic drugs
2. Altering CYP 3A4 actvity, leading to elevated levels of drugs, such as the statns
3. Inducing CYP 1A2, possibly leading to therapeutc failure of drugs metabolized by CYP 1A2
4. Decreasing frst-pass metabolism of drugs
____ 9. Milk and other foods that alkalinize the urine may:
1. Result in basic drugs being reabsorbed in the renal tubule
2. Increase the eliminaton of basic drugs in the urine3. Decrease the eliminaton of acidic drugs
4. Not alter drug eliminaton due to the minimal change in urine pH
____ 10. Antacids such as calcium carbonate (Tums) can reduce the absorpton of which of the
following nutrients?
1. Protein
2. Calcium
3. Iron
4. Vitamin K
____ 11. Phenytoin decreases folic acid absorpton by:
1. Altering the pH of the stomach
2. Increasing gastric emptying tme
3. Inhibitng intestnal enzymes required for folic acid absorpton
4. Chelaton of the folic acid into inactve ingredients
____ 12. Patents taking warfarin need to be educated about the vitamin K content of foods to
avoid therapeutc failure. Foods high in vitamin K that should be limited to no more than one serving per
day include:
1. Spinach
2. Milk
3. Romaine letuce
4. Cauliflower [Show Less]