NSG6005 Week 2 Quiz Bank Ch: 2, 5, 6, 10, 13 Latest Guide 2025

Chapter 2: Review of Basic Principles of Pharmacology 1. A patient’s nutritional intake and lab work reflects hypoalbuminemia. This is critical to prescribing because: A. Distribution of drugs to target tissue may be affected 2. Drugs that have a significant first-pass effect: C. Are rapidly metabolized by the liver and may have little if any desired action 3. The route of excretion of a volatile drug will likely be: B. The lungs 4. Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage reservoir of the drug. Storage reservoirs: C. Increase the length of time a drug is available and active 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s: B. Biological half-life 6. Azithromycin dosing requires the first day’s dose be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose: A. Rapidly achieves drug levels in the therapeutic range 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: C. Onset of action 8. Phenytoin requires a trough level be drawn. Peak and trough levels are done: D. To determine if a drug is in the therapeutic range 9. A laboratory result indicates the peak level for a drug is above the minimum toxic concentration. This means that the: B. Concentration will produce an adverse response 10. Drugs that are receptor agonists may demonstrate what property? C. Desensitization or down-regulation with continuous use 11. Drugs that are receptor antagonists, such as beta blockers, may cause: B. An exaggerated response if abruptly discontinued 12. Factors that affect gastric drug absorption include: C. Lipid solubility of the drug 13. Drugs administered via intravenous (IV) route: B. Begin distribution into the body immediately 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is: B. Greater than the sum of the effects of each drug individually 15. Which of the following statements about bioavailability is true? A. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained release mechanisms. 16. Which of the following statements about the major distribution barriers (blood-brain or fetal placental) is true? B. The blood-brain barrier slows the entry of many drugs into and from brain cells. 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: C. Change drug molecules to a form that an excretory organ can excrete 18. Once they have been metabolized by the liver, the metabolites may be: A. More active than the parent drug B. Less active than the parent drug C. Totally “deactivated” so that they are excreted without any effect D. All of the above 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: D. Unbinding a nonvolatile drug from plasma proteins 20. Steady state is: B. When the amount of drug in the body remains constant 21. Two different pain meds are given together for pain relief. The drug-drug interaction is: D. Additive 22. Actions taken to reduce drug-drug interaction problems include all of the following EXCEPT: C. Prescribing a third drug to counteract the adverse reaction of the combination 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process? A. Protein malnutrition B. Iron deficiency anemia C. Both A and B D. Neither A nor B 24. The time required for the amount of drug in the body to decrease by 50% is called: B. Half-life 25. An agonist activates a receptor and stimulates a response. When given frequently over time the body may: D. Down-regulate the numbers of that specific receptor 26. Drug antagonism is best defined as an effect of a drug that: B. Is modified by the concurrent administration of another drug 27. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements? D. “To achieve best effect, take the tablet with at least 8 ounces of fluid.” 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: B. Toxicity 29. Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach? A. Sodium bicarbonate 30. Which of the following variables is a factor in drug absorption? B. A rich blood supply to the area of absorption leads to better absorption. 31. An advantage of prescribing a sublingual medication is that the medication is: A. Absorbed rapidly 32. Drugs that use CYP 3A4 isoenzymes for metabolism may: A. Induce the metabolism of another drug B. Inhibit the metabolism of another drug C. Both A and B 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state: B. After four to five half-lives 34. Up-regulation or hypersensitization may lead to: C. An exaggerated response if the drug is withdrawn Chapter 5: Adverse Drug Reactions 1. Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs): C. A 3-month-old female 2. Infants and young children are at higher risk of ADRs due to: B. Lack of safety and efficacy studies in the pediatric population 3. The elderly are at high risk of ADRs due to: D. Age-related decrease in renal function 4. The type of adverse drug reaction that is the result of an unwanted but otherwise normal pharmacological action of a drug given in the usual therapeutic doses is A. Type A 5. Digoxin may cause a Type A adverse drug reaction due to: B. Its narrow therapeutic index 6. Changes in the individual pharmacokinetic parameters of adsorption, distribution, or elimination may result in high concentrations of the drug in the body, leading to which type of adverse drug reaction? A. Type A 7. According to the World Health Organization Classification, Type B adverse reactions are: D. An allergic or idiosyncratic response 8. Sarah developed a rash after using a topical medication. This is a Type allergic drug reaction. D. IV 9. A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n): A. Cytotoxic hypersensitivity reaction 10. Anaphylactic shock is a: A. Type I reaction, called immediate hypersensitivity reaction 11. James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction? B. Type C 12. The treatment for a patient who experiences hypothalamic-pituitary-adrenal axis suppression while taking the corticosteroid prednisone, a Type C adverse drug reaction, is to: C. Slowly taper the patient off of the prednisone 13. The ACE inhibitor lisinopril is a known teratogen. Teratogens cause Type adverse drug reaction. D. D 14. Cardiac defects are a known Type D adverse drug reaction to lithium. Lithium causes a Type D adverse drug reaction because it is: C. A teratogen 15. Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a Type D reaction because they are known: B. Carcinogens 16. 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 Type adverse drug reaction when he no longer requires the opioids. C. E 17. Drugs that may cause a Type E adverse drug reaction include: A. Beta blockers 18. Unexpected failure of drug therapy is a Type adverse drug reaction, commonly caused by . D. F; drug-drug interaction 19. Clopidogrel treatment failure may occur when it is co-administered with omeprazole, known as a Type adverse drug reaction. D. F 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? D. Sexual practices 2. Elena Vasquez’ 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? C. Use a professional interpreter or a reliable staff member who can interpret 3. Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug? D. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds 4. Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen? A. Complexity of the drug regimen B. Patient perception of the potential adverse effects of the drugs C. Both A and B D. Neither A nor B 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? A. Increasing copayments for care 6. Adverse drug reactions and patients’ perceptions of them are likely to produce non- adherence. Which of the following ADRs are least likely to produce non-adherence? A. Severe hypotension and anaphylaxis 7. 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? A. Ralph states that he always takes the drug “when I feel my pressure is going up.” 8. Non-adherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of non-adherence to these drugs is to prescribe a drug that: C. Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness. 9. Factors in chronic conditions that contribute to non-adherence include: A. The complexity of the treatment regimen B. The length of time over which it must be taken C. Breaks in the usual daily routine, such as vacations and weekends D. All of the above 10. 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: B. Their concerns and specific area of knowledge deficit were addressed 11. Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs: A. With a longer half-life so that missed doses produce a longer taper on the drug curve 12. 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? D. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug. 13. Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include: A. Older adults and those on fixed incomes 14. 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: D. None of the above guarantee adherence