NR 508 Final Exam Answers \u2013 Chamberlain College Of Nursing
\nNR 508 Final Exam Answers \u2013 Chamberlain College Of Nursing<\/p>\n
Sample Questions:<\/p>\n
Multiple Choice<\/p>\n
Identify the choice that best completes the statement or answers the question.<\/p>\n
____ 1. Nurse practitioner prescriptive authority is regulated by:<\/p>\n
1.\tThe National Council of State Boards of Nursing
\n2.\tThe U.S. Drug Enforcement Administration
\n3.\tThe State Board of Nursing for each state
\n4.\tThe State Board of Pharmacy<\/p>\n
____ 2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:<\/p>\n
1.\tNurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
\n2.\tNurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
\n3.\tAPRNs are less likely to prescribe narcotics and other controlled substances.
\n4.\tAPRNs are able to prescribe independently in all states, whereas a physician\u2019s Helpant needs to have a physician supervising their practice.<\/p>\n
____ 3. Clinical judgment in prescribing includes:<\/p>\n
1.\tFactoring in the cost to the patient of the medication prescribed
\n2.\tAlways prescribing the newest medication available for the disease process
\n3.\tHanding out drug samples to poor patients
\n4.\tPrescribing all generic medications to cut costs<\/p>\n
____ 4. Criteria for choosing an effective drug for a disorder include:<\/p>\n
1.\tAsking the patient what drug they think would work best for them
\n2.\tConsulting nationally recognized guidelines for disease management
\n3.\tPrescribing medications that are available as samples before writing a prescription
\n4.\tFollowing U.S. Drug Enforcement Administration guidelines for prescribing<\/p>\n
____ 5. Nurse practitioner practice may thrive under health-care reform because of:<\/p>\n
1.\tThe demonstrated ability of nurse practitioners to control costs and improve patient outcomes
\n2.\tThe fact that nurse practitioners will be able to practice independently
\n3.\tThe fact that nurse practitioners will have full reimbursement under health-care reform
\n4.\tThe ability to shift accountability for Medicaid to the state level<\/p>\n
Multiple Choice<\/p>\n
Identify the choice that best completes the statement or answers the question.<\/p>\n
____ 1. A patient\u2019s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because:<\/p>\n
1.\tDistribution of drugs to target tissue may be affected.
\n2.\tThe solubility of the drug will not match the site of absorption.
\n3.\tThere will be less free drug available to generate an effect.
\n4.\tDrugs bound to albumin are readily excreted by the kidneys.<\/p>\n
____ 2. Drugs that have a significant first-pass effect:<\/p>\n
1.\tMust be given by the enteral (oral) route only
\n2.\tBypass the hepatic circulation
\n3.\tAre rapidly metabolized by the liver and may have little if any desired action
\n4.\tAre converted by the liver to more active and fat-soluble forms<\/p>\n
____ 3. The route of excretion of a volatile drug will likely be the:<\/p>\n
1.\tKidneys
\n2.\tLungs
\n3.\tBile and feces
\n4.\tSkin<\/p>\n
____ 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:<\/p>\n
1.\tAssure that the drug will reach its intended target tissue
\n2.\tAre the reason for giving loading doses
\n3.\tIncrease the length of time a drug is available and active
\n4.\tAre most common in collagen tissues<\/p>\n
____ 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug\u2019s:<\/p>\n
1.\tPropensity to go to the target receptor
\n2.\tBiological half-life
\n3.\tPharmacodynamics
\n4.\tSafety and side effects<\/p>\n
____ 6. Azithromycin dosing requires that the first day\u2019s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:<\/p>\n
1.\tRapidly achieves drug levels in the therapeutic range
\n2.\tRequires four- to five-half-lives to attain
\n3.\tIs influenced by renal function
\n4.\tIs directly related to the drug circulating to the target tissues<\/p>\n
____ 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:<\/p>\n
1.\tMinimum adverse effect level
\n2.\tPeak of action
\n3.\tOnset of action
\n4.\tTherapeutic range<\/p>\n
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:<\/p>\n
1.\tWhen the drug has a wide therapeutic range
\n2.\tWhen the drug will be administered for a short time only
\n3.\tWhen there is a high correlation between the dose and saturation of receptor sites
\n4.\tTo determine if a drug is in the therapeutic range<\/p>\n
____ 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:<\/p>\n
1.\tConcentration will produce therapeutic effects
\n2.\tConcentration will produce an adverse response
\n3.\tTime between doses must be shortened
\n4.\tDuration of action of the drug is too long<\/p>\n
____ 10. Drugs that are receptor agonists may demonstrate what property?<\/p>\n
1.\tIrreversible binding to the drug receptor site
\n2.\tUpregulation with chronic use
\n3.\tDesensitization or downregulation with continuous use
\n4.\tInverse relationship between drug concentration and drug action<\/p>\n
____ 11. Drugs that are receptor antagonists, such as beta blockers, may cause:<\/p>\n
1.\tDownregulation of the drug receptor
\n2.\tAn exaggerated response if abruptly discontinued
\n3.\tPartial blockade of the effects of agonist drugs
\n4.\tAn exaggerated response to competitive drug agonists<\/p>\n
____ 12. Factors that affect gastric drug absorption include:<\/p>\n
1.\tLiver enzyme activity
\n2.\tProtein-binding properties of the drug molecule
\n3.\tLipid solubility of the drug
\n4.\tAbility to chew and swallow<\/p>\n
____ 13. Drugs administered via IV:<\/p>\n
1.\tNeed to be lipid soluble in order to be easily absorbed
\n2.\tBegin distribution into the body immediately
\n3.\tAre easily absorbed if they are nonionized
\n4.\tMay use pinocytosis to be absorbed<\/p>\n
____ 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:<\/p>\n
1.\tThe sum of the effects of each drug individually
\n2.\tGreater than the sum of the effects of each drug individually
\n3.\tLess than the effect of each drug individually
\n4.\tNot predictable, as it varies with each individual<\/p>\n
____ 15. Which of the following statements about bioavailability is true?<\/p>\n
1.\tBioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
\n2.\tAll brands of a drug have the same bioavailability.
\n3.\tDrugs that are administered more than once a day have greater bioavailability than drugs given once daily.
\n4.\tCombining an active drug with an inert substance does not affect bioavailability.<\/p>\n
____ 16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?<\/p>\n
1.\tWater soluble and ionized drugs cross these barriers rapidly.
\n2.\tThe blood-brain barrier slows the entry of many drugs into and from brain cells.
\n3.\tThe fetal-placental barrier protects the fetus from drugs taken by the mother.
\n4.\tLipid-soluble drugs do not pass these barriers and are safe for pregnant women.<\/p>\n
____ 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:<\/p>\n
1.\tInactivate prodrugs before they can be activated by target tissues
\n2.\tChange the drugs so they can cross plasma membranes
\n3.\tChange drug molecules to a form that an excretory organ can excrete
\n4.\tMake these drugs more ionized and polar to facilitate excretion<\/p>\n
____ 18. Once they have been metabolized by the liver, the metabolites may be:<\/p>\n
1.\tMore active than the parent drug
\n2.\tLess active than the parent drug
\n3.\tTotally \u201cdeactivated\u201d so they are excreted without any effect
\n4.\tAll of the above<\/p>\n
____ 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by:<\/p>\n
1.\tReduced circulation and perfusion of the kidney
\n2.\tChronic renal disease
\n3.\tCompetition for a transport site by another drug
\n4.\tUnbinding a nonvolatile drug from plasma proteins<\/p>\n
____ 20. Steady state is:<\/p>\n
1.\tThe point on the drug concentration curve when absorption exceeds excretion
\n2.\tWhen the amount of drug in the body remains constant
\n3.\tWhen the amount of drug in the body stays below the minimum toxic concentration
\n4.\tAll of the above<\/p>\n
____ 21. Two different pain medications are given together for pain relief. The drug\u2014drug interaction is:<\/p>\n
1.\tSynergistic
\n2.\tAntagonistic
\n3.\tPotentiative
\n4.\tAdditive<\/p>\n
____ 22. Actions taken to reduce drug\u2014drug interaction problems include all of the following EXCEPT:<\/p>\n
1.\tReducing the dosage of one of the drugs
\n2.\tScheduling their administration at different times
\n3.\tPrescribing a third drug to counteract the adverse reaction of the combination
\n4.\tReducing the dosage of both drugs<\/p>\n
____ 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process?<\/p>\n
1.\tProtein malnutrition
\n2.\tIron-deficiency anemia
\n3.\tBoth 1 and 2
\n4.\tNeither 1 nor 2<\/p>\n
____ 24. The time required for the amount of drug in the body to decrease by 50% is called:<\/p>\n
1.\tSteady state
\n2.\tHalf-life
\n3.\tPhase II metabolism
\n4.\tReduced bioavailability time<\/p>\n
____ 25. An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:<\/p>\n
1.\tUpregulate the total number of receptors
\n2.\tBlock the receptor with a partial agonist
\n3.\tAlter the drug\u2019s metabolism
\n4.\tDownregulate the numbers of that specific receptor<\/p>\n
____ 26. Drug antagonism is best defined as an effect of a drug that:<\/p>\n
1.\tLeads to major physiological and psychological dependence
\n2.\tIs modified by the concurrent administration of another drug
\n3.\tCannot be metabolized before another dose is administered
\n4.\tLeads to a decreased physiological response when combined with another drug<\/p>\n
____ 27. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?<\/p>\n
1.\t\u201cAvoid any other oral medicines while taking this drug.\u201d
\n2.\t\u201cIf swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice.\u201d
\n3.\t\u201cThe tablet may be crushed if you have any difficulty taking it.\u201d
\n4.\t\u201cTo achieve best effect, take the tablet with at least 8 ounces of fluid.\u201d<\/p>\n
____ 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:<\/p>\n
1.\tDisintegration
\n2.\tToxicity
\n3.\tMalabsorption
\n4.\tDeterioration<\/p>\n
____ 29. Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach?<\/p>\n
1.\tSodium bicarbonate
\n2.\tAscorbic acid
\n3.\tSalicylic acid
\n4.\tGlucose<\/p>\n
____ 30. Which of the following variables is a factor in drug absorption?<\/p>\n
1.\tThe smaller the surface area for absorption, the more rapidly the drug is absorbed.
\n2.\tA rich blood supply to the area of absorption leads to better absorption.
\n3.\tThe less soluble the drug, the more easily it is absorbed.
\n4.\tIonized drugs are easily absorbed across the cell membrane.<\/p>\n
____ 31. An advantage of prescribing a sublingual medication is that the medication is:<\/p>\n
1.\tAbsorbed rapidly
\n2.\tExcreted rapidly
\n3.\tMetabolized minimally
\n4.\tDistributed equally<\/p>\n
____ 32. Drugs that use CYP 3A4 isoenzymes for metabolism may:<\/p>\n
1.\tInduce the metabolism of another drug
\n2.\tInhibit the metabolism of another drug
\n3.\tBoth 1 and 2
\n4.\tNeither 1 nor 2<\/p>\n
____ 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:<\/p>\n
1.\tAfter the second dose
\n2.\tAfter four to five half-lives
\n3.\tWhen the patient feels the full effect of the drug
\n4.\tOne hour after IV administration<\/p>\n
____ 34. Upregulation or hypersensitization may lead to:<\/p>\n
1.\tIncreased response to a drug
\n2.\tDecreased response to a drug
\n3.\tAn exaggerated response if the drug is withdrawn
\n4.\tRefractoriness or complete lack of response<\/p>\n","protected":false},"excerpt":{"rendered":"
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