, dt dt
lOM oARc PSD|
dt 3013804
lOM dt dt dt
oARc PSD| 3013804
Chapter 1 Issues for the Practitioner in Drug Therapy
dt dt dt dt dt dt dt dt
MULTIPLE CHOICE dt
1. Nurse practitioner prescriptive authority is regulated by:
dt d t d t dt dt d t
A. The National Council of State Boards of Nursing
dt dt dt dt dt dt dt
B. The U.S. Drug Enforcement Administration
dt dt dt d t
C. The State Board of Nursing for each state
dt dt dt dt dt dt dt
D. The State Board of Pharmacy
dt dt dt dt
ANS: C d t PTS: 1 dt
2. Physician Assistant (PA) prescriptive authority is regulated by:
dt d t d t dt dt dt d t
A. The National Council of State Boards of Nursing
dt dt dt dt dt dt dt
B. The U.S. Drug Enforcement Administration
dt dt dt d t
C. The State Board of Nursing
dt dt dt dt
D. The State Board of Medical Examiners
dt dt dt dt dt
ANS: D d t PTS: 1 dt
3. Clinical judgment in prescribing includes:
dt dt d t dt
A. Factoring in the cost to the patient of the medication prescribed
dt dt dt dt dt dt dt dt dt dt
B. Always prescribing the newest medication available for the disease process
dt dt dt dt dt dt dt dt dt
C. Handing out drug samples to poor patientsdt dt dt dt dt dt
D. Prescribing all generic medications to cut costs dt dt dt dt dt d t
ANS: A d t PTS: 1 dt
4. Criteria for choosing an effective drug for a disorder include:
dt dt dt dt dt dt dt dt dt
A. Asking the patient what drug they think would work best for them
dt dt d t dt dt dt dt dt dt dt dt
B. Consulting nationally recognized guidelines for disease management
dt dt d t d t d t d t
C. Prescribing medications that are available as samples before writing a prescription
dt dt dt dt dt dt dt dt dt dt
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for pr
dt dt dt dt dt dt dt d t
escribing
ANS: B d t PTS: 1 dt
5. Nurse practitioner practice may thrive under health-care reform due to:
dt d t d t dt dt dt dt dt dt
A. The demonstrated ability of nurse practitioners to control costs and improve patient ou
dt dt dt dt dt dt dt dt dt dt dt d t
tcomes
B. The fact that nurse practitioners will be able to practice independently
dt dt dt dt dt dt dt dt dt dt
C. The fact that nurse practitioners will have full reimbursement under health-
dt dt dt dt dt dt dt dt dt dt
care reform d t
D. The ability to shift accountability for Medicaid to the state level
dt dt dt dt d t dt dt dt dt dt
ANS: A d t PTS: 1 dt
, dt dt
lOM oARc PSD|
dt 3013804
Chapter 2.Pharmacokinetic Basis of Therapeutics and Pharmacodynamic
dt dt dt dt dt dt
MULTIPLE CHOICE dt
1. A patient’s nutritional intake and lab work reflects hypoalbuminemia. This is critical to pr
dt dt d t dt dt dt dt dt dt dt dt dt dt
escribing because: d t
A. Distribution of drugs to target tissue may be affected dt dt dt dt dt dt dt dt
B. The solubility of the drug will not match the site of absorption
dt dt dt dt dt dt dt dt dt dt dt
C. There will be less free drug available to generate an effect
dt dt dt dt dt dt dt dt dt d t
D. Drugs bound to albumin are readily excreted by the kidney
dt dt dt dt dt dt dt dt dt
ANS: A d t PTS: 1 dt
2. Drugs that have a significant first-pass effect:
dt dt dt dt dt dt
A. Must be given by the enteral (oral) route only
dt dt dt dt dt dt dt dt
B. Bypass the hepatic circulation dt dt dt
C. Are rapidly metabolized by the liver and may have little if any desired action
dt dt dt dt dt dt d t dt dt dt dt dt dt
D. Are converted by the liver to more active and fat-soluble forms
dt dt dt dt dt dt dt dt d t dt
ANS: C d t PTS: 1 dt
3. The route of excretion of a volatile drug will likely be:
dt dt dt dt dt dt dt dt dt d t
A. The kidneys dt
B. The lungs dt
C. The bile and feces dt dt dt
D. The skin dt
ANS: B d t PTS: 1 dt
4. Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage reservoir of the d dt d t d t dt dt dt dt dt d t dt d t dt dt
rug. Storage reservoirs:
dt dt
A. Assure that the drug will reach its intended target tissue
dt dt dt dt dt dt dt dt dt
B. Are the reason for giving loading doses
dt dt dt dt dt dt
C. Increase the length of time a drug is available and active
dt dt dt dt dt dt dt dt dt dt
D. Are most common in collagen tissues
dt dt dt dt dt
ANS: C d t PTS: 1 dt
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
dt dt dt dt dt dt dt d t dt dt dt dt dt dt
A. Propensity to go to the target receptor dt dt dt dt dt dt
B. Biological half-life d t
C. Pharmacodynamics
D. Safety and side effects dt dt dt
ANS: B d t PTS: 1 dt
6. Azithromycin dosing requires the first day’s dose be twice those of the other 4 days of the pre
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
scription. This is considered a loading dose. A loading dose:
dt dt dt d t dt d t d t dt d t
A. Rapidly achieves drug levels in the therapeutic range
dt dt dt dt dt dt dt
B. Requires four to five half-lives to attain dt dt dt dt dt dt
C. Is influenced by renal function
dt dt dt dt
, dt dt
lOM oARc PSD|
dt 3013804
D. Is directly related to the drug circulating to the target tissues
dt dt dt dt dt dt dt dt dt dt
ANS: A d t PTS: d t d t 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic ef
dt dt dt dt dt dt dt d t dt dt dt dt dt dt dt dt dt
fect is the:
dt dt
A. Minimum adverse effect level dt dt dt
B. Peak of action dt dt
C. Onset of action dt dt
D. Therapeutic range d t
ANS: C d t PTS: 1 dt
8. Phenytoin requires a trough level be drawn. Peak and trough levels are done:
dt dt dt dt dt dt dt dt dt dt dt dt
A. When the drug has a wide therapeutic range
dt dt dt dt dt dt dt
B. When the drug will be administered for a short time only
dt dt dt dt dt dt dt dt dt dt
C. When there is a high correlation between the dose and saturation of receptor sites
dt dt dt dt dt dt dt dt dt dt dt dt d t
D. To determine if a drug is in the therapeutic range
dt dt dt dt dt dt dt dt dt
ANS: D d t PTS: 1 dt
9. A laboratory result indicates the peak level for a drug is above the minimum toxic co
dt dt dt dt dt dt dt dt d t dt dt dt dt dt dt
ncentration. This means that the: dt dt dt dt
A. Concentration will produce therapeutic effects d t d t dt d t
B. Concentration will produce an adverse response dt dt dt dt dt
C. Time between doses must be shortened
dt dt dt dt dt
D. Duration of action of the drug is too long dt dt dt dt dt dt dt dt
ANS: B d t PTS: 1 dt
10. Drugs that are receptor agonists may demonstrate what property?
dt dt dt d t dt dt dt dt
A. Irreversible binding to the drug receptor site dt dt dt dt dt d t
B. Up-regulation with chronic use d t d t dt
C. Desensitization or down-regulation with continuous use d t d t d t d t dt
D. Inverse relationship between drug concentration and drug action
dt dt dt dt d t dt dt
ANS: C d t PTS: 1 dt
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
dt dt dt dt dt dt dt dt dt dt
A. Down-regulation of the drug receptor d t dt d t dt
B. An exaggerated response if abruptly discontinued
dt dt dt dt d t
C. Partial blockade of the effects of agonist drugs
dt dt dt dt dt dt dt
D. An exaggerated response to competitive drug agonists
dt dt dt dt dt dt
ANS: B d t PTS: 1 dt
12. Factors that affect gastric drug absorption include:
dt dt dt dt dt dt
A. Liver enzyme activity dt dt
B. Protein-binding properties of the drug molecule dt dt dt dt d t
C. Lipid solubility of the drug dt dt dt dt
D. Ability to chew and swallow dt dt dt dt
ANS: C d t PTS: 1 dt
lOM oARc PSD|
dt 3013804
lOM dt dt dt
oARc PSD| 3013804
Chapter 1 Issues for the Practitioner in Drug Therapy
dt dt dt dt dt dt dt dt
MULTIPLE CHOICE dt
1. Nurse practitioner prescriptive authority is regulated by:
dt d t d t dt dt d t
A. The National Council of State Boards of Nursing
dt dt dt dt dt dt dt
B. The U.S. Drug Enforcement Administration
dt dt dt d t
C. The State Board of Nursing for each state
dt dt dt dt dt dt dt
D. The State Board of Pharmacy
dt dt dt dt
ANS: C d t PTS: 1 dt
2. Physician Assistant (PA) prescriptive authority is regulated by:
dt d t d t dt dt dt d t
A. The National Council of State Boards of Nursing
dt dt dt dt dt dt dt
B. The U.S. Drug Enforcement Administration
dt dt dt d t
C. The State Board of Nursing
dt dt dt dt
D. The State Board of Medical Examiners
dt dt dt dt dt
ANS: D d t PTS: 1 dt
3. Clinical judgment in prescribing includes:
dt dt d t dt
A. Factoring in the cost to the patient of the medication prescribed
dt dt dt dt dt dt dt dt dt dt
B. Always prescribing the newest medication available for the disease process
dt dt dt dt dt dt dt dt dt
C. Handing out drug samples to poor patientsdt dt dt dt dt dt
D. Prescribing all generic medications to cut costs dt dt dt dt dt d t
ANS: A d t PTS: 1 dt
4. Criteria for choosing an effective drug for a disorder include:
dt dt dt dt dt dt dt dt dt
A. Asking the patient what drug they think would work best for them
dt dt d t dt dt dt dt dt dt dt dt
B. Consulting nationally recognized guidelines for disease management
dt dt d t d t d t d t
C. Prescribing medications that are available as samples before writing a prescription
dt dt dt dt dt dt dt dt dt dt
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for pr
dt dt dt dt dt dt dt d t
escribing
ANS: B d t PTS: 1 dt
5. Nurse practitioner practice may thrive under health-care reform due to:
dt d t d t dt dt dt dt dt dt
A. The demonstrated ability of nurse practitioners to control costs and improve patient ou
dt dt dt dt dt dt dt dt dt dt dt d t
tcomes
B. The fact that nurse practitioners will be able to practice independently
dt dt dt dt dt dt dt dt dt dt
C. The fact that nurse practitioners will have full reimbursement under health-
dt dt dt dt dt dt dt dt dt dt
care reform d t
D. The ability to shift accountability for Medicaid to the state level
dt dt dt dt d t dt dt dt dt dt
ANS: A d t PTS: 1 dt
, dt dt
lOM oARc PSD|
dt 3013804
Chapter 2.Pharmacokinetic Basis of Therapeutics and Pharmacodynamic
dt dt dt dt dt dt
MULTIPLE CHOICE dt
1. A patient’s nutritional intake and lab work reflects hypoalbuminemia. This is critical to pr
dt dt d t dt dt dt dt dt dt dt dt dt dt
escribing because: d t
A. Distribution of drugs to target tissue may be affected dt dt dt dt dt dt dt dt
B. The solubility of the drug will not match the site of absorption
dt dt dt dt dt dt dt dt dt dt dt
C. There will be less free drug available to generate an effect
dt dt dt dt dt dt dt dt dt d t
D. Drugs bound to albumin are readily excreted by the kidney
dt dt dt dt dt dt dt dt dt
ANS: A d t PTS: 1 dt
2. Drugs that have a significant first-pass effect:
dt dt dt dt dt dt
A. Must be given by the enteral (oral) route only
dt dt dt dt dt dt dt dt
B. Bypass the hepatic circulation dt dt dt
C. Are rapidly metabolized by the liver and may have little if any desired action
dt dt dt dt dt dt d t dt dt dt dt dt dt
D. Are converted by the liver to more active and fat-soluble forms
dt dt dt dt dt dt dt dt d t dt
ANS: C d t PTS: 1 dt
3. The route of excretion of a volatile drug will likely be:
dt dt dt dt dt dt dt dt dt d t
A. The kidneys dt
B. The lungs dt
C. The bile and feces dt dt dt
D. The skin dt
ANS: B d t PTS: 1 dt
4. Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage reservoir of the d dt d t d t dt dt dt dt dt d t dt d t dt dt
rug. Storage reservoirs:
dt dt
A. Assure that the drug will reach its intended target tissue
dt dt dt dt dt dt dt dt dt
B. Are the reason for giving loading doses
dt dt dt dt dt dt
C. Increase the length of time a drug is available and active
dt dt dt dt dt dt dt dt dt dt
D. Are most common in collagen tissues
dt dt dt dt dt
ANS: C d t PTS: 1 dt
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
dt dt dt dt dt dt dt d t dt dt dt dt dt dt
A. Propensity to go to the target receptor dt dt dt dt dt dt
B. Biological half-life d t
C. Pharmacodynamics
D. Safety and side effects dt dt dt
ANS: B d t PTS: 1 dt
6. Azithromycin dosing requires the first day’s dose be twice those of the other 4 days of the pre
dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt
scription. This is considered a loading dose. A loading dose:
dt dt dt d t dt d t d t dt d t
A. Rapidly achieves drug levels in the therapeutic range
dt dt dt dt dt dt dt
B. Requires four to five half-lives to attain dt dt dt dt dt dt
C. Is influenced by renal function
dt dt dt dt
, dt dt
lOM oARc PSD|
dt 3013804
D. Is directly related to the drug circulating to the target tissues
dt dt dt dt dt dt dt dt dt dt
ANS: A d t PTS: d t d t 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic ef
dt dt dt dt dt dt dt d t dt dt dt dt dt dt dt dt dt
fect is the:
dt dt
A. Minimum adverse effect level dt dt dt
B. Peak of action dt dt
C. Onset of action dt dt
D. Therapeutic range d t
ANS: C d t PTS: 1 dt
8. Phenytoin requires a trough level be drawn. Peak and trough levels are done:
dt dt dt dt dt dt dt dt dt dt dt dt
A. When the drug has a wide therapeutic range
dt dt dt dt dt dt dt
B. When the drug will be administered for a short time only
dt dt dt dt dt dt dt dt dt dt
C. When there is a high correlation between the dose and saturation of receptor sites
dt dt dt dt dt dt dt dt dt dt dt dt d t
D. To determine if a drug is in the therapeutic range
dt dt dt dt dt dt dt dt dt
ANS: D d t PTS: 1 dt
9. A laboratory result indicates the peak level for a drug is above the minimum toxic co
dt dt dt dt dt dt dt dt d t dt dt dt dt dt dt
ncentration. This means that the: dt dt dt dt
A. Concentration will produce therapeutic effects d t d t dt d t
B. Concentration will produce an adverse response dt dt dt dt dt
C. Time between doses must be shortened
dt dt dt dt dt
D. Duration of action of the drug is too long dt dt dt dt dt dt dt dt
ANS: B d t PTS: 1 dt
10. Drugs that are receptor agonists may demonstrate what property?
dt dt dt d t dt dt dt dt
A. Irreversible binding to the drug receptor site dt dt dt dt dt d t
B. Up-regulation with chronic use d t d t dt
C. Desensitization or down-regulation with continuous use d t d t d t d t dt
D. Inverse relationship between drug concentration and drug action
dt dt dt dt d t dt dt
ANS: C d t PTS: 1 dt
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
dt dt dt dt dt dt dt dt dt dt
A. Down-regulation of the drug receptor d t dt d t dt
B. An exaggerated response if abruptly discontinued
dt dt dt dt d t
C. Partial blockade of the effects of agonist drugs
dt dt dt dt dt dt dt
D. An exaggerated response to competitive drug agonists
dt dt dt dt dt dt
ANS: B d t PTS: 1 dt
12. Factors that affect gastric drug absorption include:
dt dt dt dt dt dt
A. Liver enzyme activity dt dt
B. Protein-binding properties of the drug molecule dt dt dt dt d t
C. Lipid solubility of the drug dt dt dt dt
D. Ability to chew and swallow dt dt dt dt
ANS: C d t PTS: 1 dt