ISSA EXAM SCRIPT 2026 COMPLETE
QUESTIONS AND ANSWERS
▶ Side effects? Answer:Types of drug effects that are predictable and
which may occur even at therapeutic doses. Less serious than adverse
effects
▶ What constitutes a serious adverse drug effect?? Answer:o Result in a
patient's death, hospitalization, or disability
o Cause a congenital abnormality
o Cause a life-threatening event
o Require an intervention to prevent permanent damage
o Ex: impairment or failure of entire organs, such as cardiac, hepatic, or
renal failure or loss of vision or hearing, Anaphylaxis, Stevens-Johnson
syndrome (SJS), cancer, and birth defects.
▶ Common side effects? Answer:Nausea, vomiting, and headache.
▶ Nursing knowledge and behaviors to help prevent/minimize side effects?
Answer:o Take a thorough medical history
o Thoroughly assess the patient and all diagnostic data
o Prevent medication errors
o Monitor pharmacotherapy carefully
o Know the drugs
o Be prepared for the unusual
o Question unusual orders
o Teach patients about adverse effects
▶ Adverse event reporting system? Answer:A voluntary program that
encourages health care providers and consumers to report suspected
adverse effects directly to the FDA or the product manufacturer.
▶ Drug allergy? Answer:Common events, comprising 6% to 10% of all
adverse drug effects.
o All are caused by a hyper-response of body defenses.
o Signs and symptoms of drug allergies are non-specific
,▶ Teratogen? Answer:a drug that causes birth defects
▶ Drug interaction? Answer:Occurs when a substance increases or
decreases a drugs action. Potential outcomes for such interactions...
o The actions of the drug can be inhibited, resulting in less therapeutic
action.
o The actions of the drug may be enhanced, causing a greater therapeutic
response.
o The drug interaction my produce a totally new and different response.
▶ Additive effect? Answer:The pharmacodynamics drug interaction that is
easiest to visualize. In this reaction two drugs from a similar therapeutic
class produce a combined summation response. Using lower doses of two
drugs compared to a high dosage of one drug helps avoid adverse side
effects.
▶ Synergistic effect? Answer:The effect of the two drugs is greater than
would be expected from simply adding the two individual drugs response.
Used extensively in treating infections.
▶ Antagonist effect? Answer:Occurs when adding a second drug results in
a diminished pharmacologic response. This effect can result in drug actions
being cancelled. Can be used to treat symptoms of a drug overdose.
▶ Interactions between grapefruit juice and medications? Answer:o
Grapefruit juice contains substances that increase the absorption of certain
oral drugs. This occurs because grapefruit juice inhibits the enzyme
CYP3A4 in the wall of the intestinal tract. As drugs are absorbed, they are
not inactivated by CYP3A4, and higher amounts reach the circulation.
o This can last up to 3 days after drinking the juice
o The medications that cause this interaction are benzodiazepine, certain
calcium channel blockers, and statins.
▶ Black box warning? Answer:In some drug inserts, a requirement by the
FDA that warns prescribers that the drug carries a risk for serious or fetal
adverse effects.
, ▶ Medication error? Answer:is "any preventable event that may cause or
lead to inappropriate medication use or patient harm while the medication
is in the control of the health care professional, patient, or consumer."
▶ How to prevent medication errors? Answer:o Implement a process for
obtaining and documenting a complete list of all the patient's current
medications on the patient's admission.
o Communicate a complete list of the patient's medications to the next
provider of service.
o When discharging from the facility, provide a complete list of medications
for the patient.
o Educate patients on knowing the names, side effects, how to read labels,
and contact information for a pharmacist.
o Agencies can store medications in proper conditions, avoid overstocking,
removed outdated reference books, and avoid administration of expired
drugs.
▶ Addiction? Answer:an overwhelming compulsion that drives someone to
repeat drug-taking behavior, despite serious health and social
consequences.
▶ Physical dependence? Answer:Occurs when the body adapts to
repeated use of the substance by altering normal physiology.
▶ Physiological dependence? Answer:Produces no signs of physical
discomfort after the agent is discontinued.
▶ Tolerance? Answer:a biologic condition that occurs when the body
adapts to a substance after repeated administration.
▶ Withdrawal syndrome? Answer:Once a patient becomes physically
dependent and the substance is abruptly discontinued.
▶ Controlled substance? Answer:A drug whose use is restricted by the
Comprehensive Drug Abuse Prevention and Control Act of 1970 and later
revisions. Title II of this law, known as the Controlled Substances Act
(CSA), is the legal basis for regulating drugs of abuse. The CSA created
five categories or schedules for drugs of abuse. These scheduled drugs are
classified according to their potential for abuse and toxicity.
QUESTIONS AND ANSWERS
▶ Side effects? Answer:Types of drug effects that are predictable and
which may occur even at therapeutic doses. Less serious than adverse
effects
▶ What constitutes a serious adverse drug effect?? Answer:o Result in a
patient's death, hospitalization, or disability
o Cause a congenital abnormality
o Cause a life-threatening event
o Require an intervention to prevent permanent damage
o Ex: impairment or failure of entire organs, such as cardiac, hepatic, or
renal failure or loss of vision or hearing, Anaphylaxis, Stevens-Johnson
syndrome (SJS), cancer, and birth defects.
▶ Common side effects? Answer:Nausea, vomiting, and headache.
▶ Nursing knowledge and behaviors to help prevent/minimize side effects?
Answer:o Take a thorough medical history
o Thoroughly assess the patient and all diagnostic data
o Prevent medication errors
o Monitor pharmacotherapy carefully
o Know the drugs
o Be prepared for the unusual
o Question unusual orders
o Teach patients about adverse effects
▶ Adverse event reporting system? Answer:A voluntary program that
encourages health care providers and consumers to report suspected
adverse effects directly to the FDA or the product manufacturer.
▶ Drug allergy? Answer:Common events, comprising 6% to 10% of all
adverse drug effects.
o All are caused by a hyper-response of body defenses.
o Signs and symptoms of drug allergies are non-specific
,▶ Teratogen? Answer:a drug that causes birth defects
▶ Drug interaction? Answer:Occurs when a substance increases or
decreases a drugs action. Potential outcomes for such interactions...
o The actions of the drug can be inhibited, resulting in less therapeutic
action.
o The actions of the drug may be enhanced, causing a greater therapeutic
response.
o The drug interaction my produce a totally new and different response.
▶ Additive effect? Answer:The pharmacodynamics drug interaction that is
easiest to visualize. In this reaction two drugs from a similar therapeutic
class produce a combined summation response. Using lower doses of two
drugs compared to a high dosage of one drug helps avoid adverse side
effects.
▶ Synergistic effect? Answer:The effect of the two drugs is greater than
would be expected from simply adding the two individual drugs response.
Used extensively in treating infections.
▶ Antagonist effect? Answer:Occurs when adding a second drug results in
a diminished pharmacologic response. This effect can result in drug actions
being cancelled. Can be used to treat symptoms of a drug overdose.
▶ Interactions between grapefruit juice and medications? Answer:o
Grapefruit juice contains substances that increase the absorption of certain
oral drugs. This occurs because grapefruit juice inhibits the enzyme
CYP3A4 in the wall of the intestinal tract. As drugs are absorbed, they are
not inactivated by CYP3A4, and higher amounts reach the circulation.
o This can last up to 3 days after drinking the juice
o The medications that cause this interaction are benzodiazepine, certain
calcium channel blockers, and statins.
▶ Black box warning? Answer:In some drug inserts, a requirement by the
FDA that warns prescribers that the drug carries a risk for serious or fetal
adverse effects.
, ▶ Medication error? Answer:is "any preventable event that may cause or
lead to inappropriate medication use or patient harm while the medication
is in the control of the health care professional, patient, or consumer."
▶ How to prevent medication errors? Answer:o Implement a process for
obtaining and documenting a complete list of all the patient's current
medications on the patient's admission.
o Communicate a complete list of the patient's medications to the next
provider of service.
o When discharging from the facility, provide a complete list of medications
for the patient.
o Educate patients on knowing the names, side effects, how to read labels,
and contact information for a pharmacist.
o Agencies can store medications in proper conditions, avoid overstocking,
removed outdated reference books, and avoid administration of expired
drugs.
▶ Addiction? Answer:an overwhelming compulsion that drives someone to
repeat drug-taking behavior, despite serious health and social
consequences.
▶ Physical dependence? Answer:Occurs when the body adapts to
repeated use of the substance by altering normal physiology.
▶ Physiological dependence? Answer:Produces no signs of physical
discomfort after the agent is discontinued.
▶ Tolerance? Answer:a biologic condition that occurs when the body
adapts to a substance after repeated administration.
▶ Withdrawal syndrome? Answer:Once a patient becomes physically
dependent and the substance is abruptly discontinued.
▶ Controlled substance? Answer:A drug whose use is restricted by the
Comprehensive Drug Abuse Prevention and Control Act of 1970 and later
revisions. Title II of this law, known as the Controlled Substances Act
(CSA), is the legal basis for regulating drugs of abuse. The CSA created
five categories or schedules for drugs of abuse. These scheduled drugs are
classified according to their potential for abuse and toxicity.
