Test Bank for Advanced Pharmacology for Prescribers 1st Edition by Brent Luu,Gerald Kayingo & Virginia McCoy Hass

Advanced Pharmacology for Prescribers A Comprehensive and Evidence -Based Pharmacology Reference Book for Advanced Practice Students and Clinicians 1ED Brent Luu, Gerald Kayingo, Virginia McCoy Hass Test Bank 2021 ADVANCED PHARMACOLOGY TEST BANK Drone IT Chapter 1. The Role of the Nurse Practitioner 1. Nurse practitioner prescriptive authority is regulated by: 1. The National Council of State Boards of Nursing 2. The U.S. Drug Enforcement 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 A PRN 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 prescr ibe 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 presc ribing 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. n 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 r eform 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 becaus e: 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 3. Are rapidly metabolized by the liver & may have little if any desired action 4. Are con verted 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 cr eate a storage reservoir of the drug. Storage reservoirs: ADVANCED PHARMACOLOGY TEST BANK 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 requ ires 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. 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 c ompetitive 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