NURS 6903 ADVANCED PHARM - QUIZ 1
EXAM 2024-2025
. A nurse is caring for a patient who has been receiving a drug by the intramuscular
route but will receive the drug orally after discharge. How does the nurse explain
the increased dosage prescribed for the oral dose?
A) Passive diffusion
B) Active transport
C) Glomerular filtration
D) First-pass effect - ANSWER D- first-pass effect
The first-pass effect involves drugs that are absorbed from the small intestine
directly into the portal venous system, which delivers the drug molecules to the
liver. After reaching the liver, enzymes break the drug into metabolites, which may
become active or may be deactivated and readily excreted from the body. A large
percentage of the oral dose is usually destroyed and never reaches tissues. Oral
dosages account for the phenomenon of ensuring an appropriate amount of the drug
in the body to produce a therapeutic action. Passive diffusion is the major process
through which drugs are absorbed into the body. Active transport is a process that
uses energy to actively move a molecule across a cell membrane and is often
involved in drug excretion in the kidney. Glomerular filtration is the passage of
water and water-soluble components from the plasma into the renal tubule.
. A nurse is teaching nursing students about pediatric medication administration.
What will the nurse include when discussing pediatric drug research?
Early studies revealed that less than 10% of drugs known to be effective in adults
were effective in children.
Research findings show that drug doses may be safely calculated by extrapolating
adult dosing.
,Studies showed a significant percentage of unanticipated and potentially lethal side
effects in children.
There is no need to continue with pediatric-specific drug research, since early
studies were reassuring. - ANSWER Studies showed a significant percentage of
unanticipated and potentially lethal side effects in children.
In early studies, about 30% of drugs caused unanticipated side effects, some of
them potentially lethal. These same studies revealed that about 20% of drugs were
ineffective in children and that about 20% of drugs required doses different from
those extrapolated from adult dosing. Because the early studies showed that there is
much to learn, the BPCA and PREA were permanently reauthorized by Congress in
2012.
1. An APRN works in a urology clinic under the supervision of a physician who
does not restrict the types of medications the APRN is allowed to prescribe. State
law does not require the APRN to practice under physician supervision. How
would the APRN's prescriptive authority be described?
Full authority
Independent
Without limitation
Limited authority - ANSWER Independent
1. Drugs do not metabolize the same way in all people. For what patient would a
nurse expect to assess for an alteration in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure - ANSWER C) A 50-year-old man
with cirrhosis of the liver
The liver is the most important site of drug metabolism. If the liver is not
functioning effectively, as in patients with cirrhosis, drugs will not metabolize
,normally so that toxic levels could develop unless dosage is reduced. A patient with
cervical cancer or kidney stones would not be expected to have altered ability to
metabolize drugs so long as no liver damage existed. The patient with renal failure
would have altered excretion of the drugs through the renal system
but metabolism would not be impacted.
13. A patient recently prescribed hydrocodone calls t0
reporttheyareunabletofilltheprescription. Which factors could contribute to the
inability to fill the prescription?Select all that apply.
a. DEA number missing from prescription
b-Prescription sent via electronic messenger
c-Dose higher than typically prescribed
d-Prescriber license number not included
e-Patient name and date of birth were handwritten - ANSWER a. DEA number
missing from prescription
b-Prescription sent via electronic messenger
d-Prescriber license number not included
15. A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning?
Recent yeast infection
Family history of cervical cancer
Drinks two glasses of wine every night
Patient is currently unemployed - ANSWER drinking 2 glasses of wine every night
16.
Apatientisusingametered-doseinhalercontainingalbuterolforasthma.Themedicationl
abel instructs the patient to administer "two puffs every 4 hours as needed for
coughing or wheezing." The patient reports feeling jittery sometimes when taking
the medication, and she doesn't feel that the medication is always effective. Which
, action is most appropriate?
Asking the patient to demonstrate use of the inhaler
Assessing the patient's exposure to tobacco smoke
Auscultating lung sounds and obtaining vitalsigns
Suggesting that the patient use one puff to reduce side effects - ANSWER
Auscultating lung sounds and obtaining vitalsigns
19.
ApatientrecentlydiagnosedwithHIVisprescribedseveralmedicationstotreattheconditi
on. Which factors could impact the patient's adherence to the treatment
regimen?Select all that apply.
The patient is uninsured
The patient works three part-time jobs
The medication regimen includes six different pills
Patient has an eighth-grade reading comprehension level
Medication regimen requires medication be taken at regular 4-hour intervals. -
ANSWER The patient is uninsured
The patient works three part-time jobs
The medication regimen includes six different pills
Medication regimen requires medication be taken at regular 4-hour intervals.
2. Which factors increase the need for APRNs to have full prescriptive authority?
More patients will have access to health care.
Enrollment in medical schools is predicted to decrease.
Physician's assistants are being utilized less often.
APRN education is more complex than education for physicians. - ANSWER More
pts will have access to health care
EXAM 2024-2025
. A nurse is caring for a patient who has been receiving a drug by the intramuscular
route but will receive the drug orally after discharge. How does the nurse explain
the increased dosage prescribed for the oral dose?
A) Passive diffusion
B) Active transport
C) Glomerular filtration
D) First-pass effect - ANSWER D- first-pass effect
The first-pass effect involves drugs that are absorbed from the small intestine
directly into the portal venous system, which delivers the drug molecules to the
liver. After reaching the liver, enzymes break the drug into metabolites, which may
become active or may be deactivated and readily excreted from the body. A large
percentage of the oral dose is usually destroyed and never reaches tissues. Oral
dosages account for the phenomenon of ensuring an appropriate amount of the drug
in the body to produce a therapeutic action. Passive diffusion is the major process
through which drugs are absorbed into the body. Active transport is a process that
uses energy to actively move a molecule across a cell membrane and is often
involved in drug excretion in the kidney. Glomerular filtration is the passage of
water and water-soluble components from the plasma into the renal tubule.
. A nurse is teaching nursing students about pediatric medication administration.
What will the nurse include when discussing pediatric drug research?
Early studies revealed that less than 10% of drugs known to be effective in adults
were effective in children.
Research findings show that drug doses may be safely calculated by extrapolating
adult dosing.
,Studies showed a significant percentage of unanticipated and potentially lethal side
effects in children.
There is no need to continue with pediatric-specific drug research, since early
studies were reassuring. - ANSWER Studies showed a significant percentage of
unanticipated and potentially lethal side effects in children.
In early studies, about 30% of drugs caused unanticipated side effects, some of
them potentially lethal. These same studies revealed that about 20% of drugs were
ineffective in children and that about 20% of drugs required doses different from
those extrapolated from adult dosing. Because the early studies showed that there is
much to learn, the BPCA and PREA were permanently reauthorized by Congress in
2012.
1. An APRN works in a urology clinic under the supervision of a physician who
does not restrict the types of medications the APRN is allowed to prescribe. State
law does not require the APRN to practice under physician supervision. How
would the APRN's prescriptive authority be described?
Full authority
Independent
Without limitation
Limited authority - ANSWER Independent
1. Drugs do not metabolize the same way in all people. For what patient would a
nurse expect to assess for an alteration in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure - ANSWER C) A 50-year-old man
with cirrhosis of the liver
The liver is the most important site of drug metabolism. If the liver is not
functioning effectively, as in patients with cirrhosis, drugs will not metabolize
,normally so that toxic levels could develop unless dosage is reduced. A patient with
cervical cancer or kidney stones would not be expected to have altered ability to
metabolize drugs so long as no liver damage existed. The patient with renal failure
would have altered excretion of the drugs through the renal system
but metabolism would not be impacted.
13. A patient recently prescribed hydrocodone calls t0
reporttheyareunabletofilltheprescription. Which factors could contribute to the
inability to fill the prescription?Select all that apply.
a. DEA number missing from prescription
b-Prescription sent via electronic messenger
c-Dose higher than typically prescribed
d-Prescriber license number not included
e-Patient name and date of birth were handwritten - ANSWER a. DEA number
missing from prescription
b-Prescription sent via electronic messenger
d-Prescriber license number not included
15. A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning?
Recent yeast infection
Family history of cervical cancer
Drinks two glasses of wine every night
Patient is currently unemployed - ANSWER drinking 2 glasses of wine every night
16.
Apatientisusingametered-doseinhalercontainingalbuterolforasthma.Themedicationl
abel instructs the patient to administer "two puffs every 4 hours as needed for
coughing or wheezing." The patient reports feeling jittery sometimes when taking
the medication, and she doesn't feel that the medication is always effective. Which
, action is most appropriate?
Asking the patient to demonstrate use of the inhaler
Assessing the patient's exposure to tobacco smoke
Auscultating lung sounds and obtaining vitalsigns
Suggesting that the patient use one puff to reduce side effects - ANSWER
Auscultating lung sounds and obtaining vitalsigns
19.
ApatientrecentlydiagnosedwithHIVisprescribedseveralmedicationstotreattheconditi
on. Which factors could impact the patient's adherence to the treatment
regimen?Select all that apply.
The patient is uninsured
The patient works three part-time jobs
The medication regimen includes six different pills
Patient has an eighth-grade reading comprehension level
Medication regimen requires medication be taken at regular 4-hour intervals. -
ANSWER The patient is uninsured
The patient works three part-time jobs
The medication regimen includes six different pills
Medication regimen requires medication be taken at regular 4-hour intervals.
2. Which factors increase the need for APRNs to have full prescriptive authority?
More patients will have access to health care.
Enrollment in medical schools is predicted to decrease.
Physician's assistants are being utilized less often.
APRN education is more complex than education for physicians. - ANSWER More
pts will have access to health care
