NURS 5334 TESTBANK
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
3 stages of teratogenesis development
Correct Answer: 1. conception through week 2
2. embryonic period week 3-8 = gross malformations
3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure
Question 2.
physiologic changes during pregnancy & drug impact
Correct Answer: - 3rd trimester = renal blood doubles, renal excretion
accelerated - tone and mobility of bowel decreases -> prolongation of drug
effects
Question 3.
placental drug transfer
Correct Answer: all drugs can cross the placenta, some cross more easily than
others
Question 4.
adverse reactions during pregnancy
Correct Answer: can adversely affect both pregnant pt and fetus - heparin ->
osteoporosis - prostaglandins -> stimulate uterine contraction - some pain
relievers can be used during delivery can cause respiratory depression in baby
Question 5.
teratogenesis birth defects
Correct Answer: gross malformations = cleft palate, clubfoot, hydrocephalus
neurobehavioral & metabolic anomalies
Question 6.
responding to teratogen exposure
Correct Answer: Determine when the drug was taken
Determine when the pregnancy began -Weeks 3-8 (organogenesis) is most
crucial time
Determine type of malformation expected
Conduct 2 US and consult FDA to determine severity
• how to decrease risk of drug effects during breastfeeding -✓✓- take drugs
,immediately after breastfeeding - avoid drugs w/ long half-lives - choose
drugs that tend to be excluded from milk, least likely to affect infant - avoid
hazardous drugs
Question 7.
pediatric response to drugs
Correct Answer: - more sensitive to drugs - greater individual variation -
sensitivity d/t organ system immaturity - increased risk for adverse rxns
Question 8.
determining the intensity of duration of drug response in neonates & infants
Correct Answer: - elevated drug levels = more intense response - delayed
elimination = prolonged response - immaturity of organs = risk for both^
Question 9.
comparison of plasma drug levels in adults and infants
Correct Answer:
Question 10.
increased sensitivity in infants caused by immature state of...
Correct Answer: absorption, protein binding of drugs, BBB, hepatic
metabolism, renal drug excretion
Question 11.
infant absorption: oral administration
Correct Answer: prolonged and irregular gastric adult function at 6-8 months
Question 12.
infant absorption: gastric acidity
Correct Answer: - very low 24 hours after birth - does not reach adult values
for 2 years - low acidity = absorption of acid-labile drugs is increased
Question 13.
infant absorption: intramuscular admin
Correct Answer: slow, erratic, delayed absorption as results of low blood flow
in 1st few days of life
in early infancy, absorption of IM drugs more rapid than neonates & adults
, Question 14.
infant absorption: transdermal
Correct Answer: more rapid & complete for infants than older children &
adults - stratum corneum of infant's skin is thin - blood flow to skin is greater
in infants than older patients - infants increased risk for toxicity from topical
drugs
Question 15.
infant distribution: BBB
Correct Answer: - not fully developed at birth - drugs have easy access to CNS
- infants especially sensitive to drugs that affect CNS function - dosage should
be reduced for drug actions outside the CNS if those drugs are capable of
producing toxicity as a side effect
Question 16.
infant hepatic metabolism
Correct Answer: - drug-metabolizing capability of newborns is low - liver's
capability to metabolize drugs increases fast @ 1mo - complete liver
maturation occurs at 1yr
Question 17.
infant renal excretion
Correct Answer: - low renal blood flow, glomerular filtration, & active tubular
secretion - drugs eliminated by renal excretion must have reduced dosing
and/or longer dosing intervals - adult level renal function occurs at 1yr
Question 18.
pharmacokinetics in children
Correct Answer: metabolize drugs faster than adults till 2yrs, then gradual
decline
sharp decline at puberty
may need to increase or decrease interval between doses
Question 19.
adverse drug reactions in children
Correct Answer: - glucocorticoids -> growth suppression - tetracyclines ->
discoloring of teeth - sulfonamides -> kernicterus - fluoroquinolones ->
musculoskeletal d/o's - SSRIs - > black box increased SI - OTC cough and cold
meds not recommended in kids <2yrs
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
3 stages of teratogenesis development
Correct Answer: 1. conception through week 2
2. embryonic period week 3-8 = gross malformations
3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure
Question 2.
physiologic changes during pregnancy & drug impact
Correct Answer: - 3rd trimester = renal blood doubles, renal excretion
accelerated - tone and mobility of bowel decreases -> prolongation of drug
effects
Question 3.
placental drug transfer
Correct Answer: all drugs can cross the placenta, some cross more easily than
others
Question 4.
adverse reactions during pregnancy
Correct Answer: can adversely affect both pregnant pt and fetus - heparin ->
osteoporosis - prostaglandins -> stimulate uterine contraction - some pain
relievers can be used during delivery can cause respiratory depression in baby
Question 5.
teratogenesis birth defects
Correct Answer: gross malformations = cleft palate, clubfoot, hydrocephalus
neurobehavioral & metabolic anomalies
Question 6.
responding to teratogen exposure
Correct Answer: Determine when the drug was taken
Determine when the pregnancy began -Weeks 3-8 (organogenesis) is most
crucial time
Determine type of malformation expected
Conduct 2 US and consult FDA to determine severity
• how to decrease risk of drug effects during breastfeeding -✓✓- take drugs
,immediately after breastfeeding - avoid drugs w/ long half-lives - choose
drugs that tend to be excluded from milk, least likely to affect infant - avoid
hazardous drugs
Question 7.
pediatric response to drugs
Correct Answer: - more sensitive to drugs - greater individual variation -
sensitivity d/t organ system immaturity - increased risk for adverse rxns
Question 8.
determining the intensity of duration of drug response in neonates & infants
Correct Answer: - elevated drug levels = more intense response - delayed
elimination = prolonged response - immaturity of organs = risk for both^
Question 9.
comparison of plasma drug levels in adults and infants
Correct Answer:
Question 10.
increased sensitivity in infants caused by immature state of...
Correct Answer: absorption, protein binding of drugs, BBB, hepatic
metabolism, renal drug excretion
Question 11.
infant absorption: oral administration
Correct Answer: prolonged and irregular gastric adult function at 6-8 months
Question 12.
infant absorption: gastric acidity
Correct Answer: - very low 24 hours after birth - does not reach adult values
for 2 years - low acidity = absorption of acid-labile drugs is increased
Question 13.
infant absorption: intramuscular admin
Correct Answer: slow, erratic, delayed absorption as results of low blood flow
in 1st few days of life
in early infancy, absorption of IM drugs more rapid than neonates & adults
, Question 14.
infant absorption: transdermal
Correct Answer: more rapid & complete for infants than older children &
adults - stratum corneum of infant's skin is thin - blood flow to skin is greater
in infants than older patients - infants increased risk for toxicity from topical
drugs
Question 15.
infant distribution: BBB
Correct Answer: - not fully developed at birth - drugs have easy access to CNS
- infants especially sensitive to drugs that affect CNS function - dosage should
be reduced for drug actions outside the CNS if those drugs are capable of
producing toxicity as a side effect
Question 16.
infant hepatic metabolism
Correct Answer: - drug-metabolizing capability of newborns is low - liver's
capability to metabolize drugs increases fast @ 1mo - complete liver
maturation occurs at 1yr
Question 17.
infant renal excretion
Correct Answer: - low renal blood flow, glomerular filtration, & active tubular
secretion - drugs eliminated by renal excretion must have reduced dosing
and/or longer dosing intervals - adult level renal function occurs at 1yr
Question 18.
pharmacokinetics in children
Correct Answer: metabolize drugs faster than adults till 2yrs, then gradual
decline
sharp decline at puberty
may need to increase or decrease interval between doses
Question 19.
adverse drug reactions in children
Correct Answer: - glucocorticoids -> growth suppression - tetracyclines ->
discoloring of teeth - sulfonamides -> kernicterus - fluoroquinolones ->
musculoskeletal d/o's - SSRIs - > black box increased SI - OTC cough and cold
meds not recommended in kids <2yrs
