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NSG 6005 Week 2 Study Guide – Question and Answers

Chapter 2. Review of Basic Principles of Pharmacology

1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because:
2. Drugs that have a significant first-pass effect:
3. The route of excretion of a volatile drug will likely be the:
4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
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:
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:
10. Drugs that are receptor agonists may demonstrate what property?
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
12. Factors that affect gastric drug absorption include:
13. Drugs administered via IV:
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
15. Which of the following statements about bioavailability is true?
16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
17. Drugs are metabolize mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:
18. Once they have been metabolize by the liver, the metabolites may be:
19. All drugs continue to act in the body until they are …… The ability of the body to excrete drugs via the renal system would be increased by:
20. Steady state is:
21. Two different pain medications are ….together for pain relief. The drug—drug interaction is:
22. Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process?
24. The time ….for the amount of drug in the body to decrease by 50% is called:
25. An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:
26. Drug antagonism is best ….as an effect of a drug that: nsg 6005 week 2
27. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?
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:
29. Which of the following substances is the most likely to be ….in the intestines rather than in the stomach?
30. Which of the following variables is a factor in drug absorption?
31. An advantage of prescribing a sublingual medication is that the medication is:
32. Drugs that use CYP 3A4 isoenzymes for metabolism may:
33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:
34. Upregulation or hypersensitization may lead to:

Chapter 5. Adverse Drug Reactions

1. Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs):
2. Infants and young children are at higher risk of ADRs due to:
3. The elderly are at high risk of ADRs due to:
4. The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
5. Digoxin may cause a type A adverse drug reaction due to nsg 6005 week 2
6. Sarah developed a rash after using a topical medication. This is a type __ allergic drug reaction.
7. A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n):
8. Anaphylactic shock is a:
9. James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction?
10. Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
11. A 24-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for a _____ adverse drug reaction when he no longer requires the opioids.
12. An example of a first-dose reaction that may occur includes nsg 6005 week 2
13. Drugs that are prone to cause adverse drug effects include:
14. The U.S. Food and Drug Administration MedWatch system is activated when:
15. The Vaccine Adverse Events Reporting System is:

Chapter 6. Factors That Foster Positive Outcomes

1. A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
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?
3. Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
4. Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?
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?
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?
7. Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:
8. Factors in chronic conditions that contribute to nonadherence include:
9. While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:
10. Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:
11. Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?
12. Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:
13. Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who:
14. Monitoring adherence can take several forms, including:
15. Factors that explain and predict medication adherence include:

Chapter 10. Herbal Therapy and Nutritional Supplements

1. A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.
2. A potential harmful effect on patients who take some herbal medication is:
3. A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
4. Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is …..a time of imbalance, therefore the Chinese herbalist would prescribe:
5. According to traditional Chinese medicine, if a person who has a fever is ….a herb that is yang in nature, such as golden seal, the patient’s illness will:
6. In Ayurvedic medicine, treatment is based on the patient’s dominant dosha, which is referred to as the person’s:
7. Herbs and supplements are …..by the U.S. Food and Drug Administration.
8. When melatonin is …..to induce sleep, the recommendation is that the patient:
9. Valerian tea causes relaxation and can be …..to help a patient fall asleep. Overdosage of valerian (more than 2.5 gm/dose) may lead to:
10. The standard dosage of St John’s wort for the treatment of mild depression is:
11. Patients need to be …..regarding the drug interactions with St John’s wort, including:
12. Ginseng, which is ….to assist with memory, may potentiate:
13. Licorice root is a common treatment for dyspepsia. Drug interactions with licorice include:
14. Patients should be warned about the overuse of topical wintergreen oil to treat muscle strains, as overapplication can lead to:
15. The role of the NP in the use of herbal medication is to:

Chapter 13. Over-the-Counter Medications

1. Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be ……for over-the-counter use the drug must:
2. In the United States, over-the-counter drugs are …….
3. As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
4. New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do.
5. The ailment that generates the greatest over-the-counter annual drug sales is:
6. Common over-the-counter pain relievers such as acetaminophen or ibuprofen:
7. When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
8. The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act:
9. When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient: