1. Nurse practitioner prescriptive authority is regulated by:
1
. The National Council of State Boards of Nursing
2
. The U.S. Drug Enforcement
... [Show More] Administration
3
. The State Board of Nursing for each state
4
. The State Board of Pharmacy
2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
1
.
Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing
program & in their APRN program.
2
.
Nurses care for the patient from a holistic approach & include the patient in decision making regarding their
care.
3
. APRNs are less likely to prescribe narcotics & 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 practice.
3. Clinical judgment in prescribing includes:
1
.
Factoring in the cost to the patient of the medication prescribed
2
. Always prescribing the newest medication available for the disease process
3
.
H&ing out drug samples to poor patients
4
. Prescribing all generic medications to cut costs
4. Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing
5. Nurse practitioner practice may thrive under health-care reform because of:
1 The demonstrated ability of nurse practitioners to control costs & improve patient outcomes
.
2
. The fact that nurse practitioners will be able to practice independently
3
.
The fact that nurse practitioners will have full reimbursement under health-care reform
4
. The ability to shift accountability for Medicaid to the state level
Chapter 2. Review of Basic Principles of Pharmacology
1. A patient’s nutritional intake & laboratory results reflect hypoalbuminemia. This is critical to prescribing because:
1 Distribution of drugs to target tissue may be affected.
.
2
. The solubility of the drug will not match the site of absorption.
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 significant first-pass effect:
1
. Must be given by the enteral (oral) route only
2
. Bypass the hepatic circulation
2
3
. Are rapidly metabolized by the liver & may have little if any desired action
4
. Are converted by the liver to more active & fat-soluble forms
3. The route of excretion of a volatile drug will likely be the:
1
. Kidneys
2
. Lungs
3
. Bile & 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 tissue
2
. Are the reason for giving loading doses
3
. Increase the length of time a drug is available & active
4
. Are most common in collagen tissues
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 & side effects
6. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading
dose. A loading dose:
1
. Rapidly achieves drug levels in the therapeutic range
2
.
Requires four- to five-half-lives to attain
3
. Is influenced by renal function
4
. Is directly related to the drug circulating to the target tissues
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
1
.
Minimum adverse effect level
2
.
Peak of action
3
. Onset of action
4
. Therapeutic range
8. Phenytoin requires that a trough level be drawn. Peak & trough levels are done:
1
.
When the drug has a wide therapeutic range
2
.
When the drug will be administered for a short time only
3
. When there is a high correlation between the dose & saturation of receptor sites
4
.
To determine if a drug is in the therapeutic range
9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:
1
. Concentration will produce therapeutic effects
2
.
Concentration will produce an adverse response
3
3
. Time between doses must be shortened
4
. Duration of action 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
. Upregulation with chronic use
3
. Desensitization or downregulation with continuous use
4
. Inverse relationship between drug concentration & drug action
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1
. Downregulation of the drug receptor
2
. An exaggerated response if abruptly discontinued
3
. Partial blockade of the effects of agonist drugs
4
. An exaggerated response to competitive drug agonists
12. Factors that affect gastric drug absorption include:
1
. Liver enzyme activity
2
. Protein-binding properties of the drug molecule
3
. Lipid solubility of the drug
4
.
Ability to chew & swallow
13. Drugs administered via IV:
1
. Need to be lipid soluble in order to be easily absorbed
2
. Begin distribution into the body immediately
3
. Are easily absorbed if they are nonionized
4
. May use pinocytosis to be absorbed
14. When a medication is added to a regimen for a synergistic 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 therapeutic 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 active drug with an inert substance does not affect bioavailability.
16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
1
.
Water soluble & ionized drugs cross these barriers rapidly.
2
. The blood-brain barrier slows the entry of many drugs into & from brain cells.
3
. The fetal-placental barrier protects the fetus from drugs taken by the mother [Show Less]