2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
An infant who receives a drug that does not produce CNS side effects in
adults exhibits drowsiness and sedation. The nurse understands that
this is because of differences in which physiologic system in infants and
adults?
a. Blood-brain barrier
b. First-pass effect
c. Gastrointestinal absorption
d. Renal filtration - ANSWER-ANS: A
The blood-brain barrier is not fully developed at birth, making infants
much more sensitive to CNS drugs than older children and adults. CNS
symptoms may include sedation and drowsiness. The first-pass effect
and GI absorption affect metabolism and absorption of drugs, and renal
filtration affects elimination of drugs, all of which may alter drug levels.
Which monoamines act as neurotransmitters in the central nervous
system? Select all that apply.
a. Acetylcholine
b. Norepinephrine
c. Serotonin
d. Dopamine
e. Epinephrine
f. Histamine - ANSWER-ANS: B , C , D , E
Acetylcholine and histamines are not monoamines.
,2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
A patient asks a nurse to explain what drug tolerance means. The nurse
responds by telling the patient that when tolerance occurs, it means the
patient:
a. has developed a psychological dependence on the drug.
b. may need increased amounts of the drug over time.
c. will cause an abstinence syndrome if the drug is discontinued
abruptly.
d. will have increased sensitivity to drug side effects. - ANSWER-ANS: B
When tolerance develops, a dose increase may be needed, because a
decreased response may occur with prolonged use. Psychologic
dependence involves cravings for drug effects and does not define
tolerance. Physical dependence occurs when the drug becomes
necessary for the brain to function "normally," meaning the patient
should be weaned from the drug slowly to prevent an abstinence
syndrome. Patients may have a decreased sensitivity to drug side effects
over time as the brain adapts to the medication.
A group of nursing students asks a nurse to explain the blood-brain
barrier. The nurse would be correct to say that the blood-brain barrier:
a. prevents some potentially toxic substances from crossing into the
central nervous system.
b. causes infants to be less sensitive to CNS drugs and thus require
larger doses.
,2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
c. allows only ionized or protein-bound drugs to cross into the central
nervous system.
d. prevents lipid-soluble drugs from entering the central nervous
system. - ANSWER-ANS: A
The blood-brain barrier can prevent some drugs and some toxic
substances from entering the CNS. The blood-brain barrier in infants is
not fully developed, so infants are more sensitive to CNS drugs and
often require lower doses. The blood-brain barrier prevents highly
ionized and protein- bound drugs from crossing into the CNS and allows
lipid-soluble drugs and those that can cross via specific transport
systems to enter.
A nurse is teaching a group of students about how CNS drugs are
developed. Which statement
by a student indicates a need for further teaching?
a. "Central nervous system drug development relies on observations of
their effects on human behavior."
b. "Studies of new central nervous system drugs in healthy subjects can
produce paradoxical
effects."
c. "Our knowledge of the neurochemical and physiologic changes that
underlie mental illness
is incomplete."
, 2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
d. "These drugs are developed based on scientific knowledge of CNS
transmitters and receptors." - ANSWER-ANS: D
The deficiencies in knowledge about how CNS transmitters and
receptors work make systematic development of CNS drugs difficult.
Testing in healthy subjects often leads either to no effect or to
paradoxical effects. Medical knowledge of the neurochemical and
physiologic changes underlying mental illness is incomplete. The
development of CNS drugs depends less on knowledge of how the CNS
functions and how these drugs affect that process and more on how
administering one of these agents leads to changes in behavior.
A nurse is teaching a group of nursing students how the CNS adapts to
psychotherapeutic
medications. Which statement by a nursing student indicates a need for
further teaching?
a. "Adaptation can lead to tolerance of these drugs with prolonged
use."
b. "Adaptation helps explain how physical dependence occurs."
c. "Adaptation often must occur before therapeutic effects develop."
d. "Adaptation results in an increased sensitivity to side effects over
time." - ANSWER-ANS: D
With adaptation of the central nervous system to prolonged exposure
to CNS drugs, many adverse effects diminish and therapeutic effects
remain. Adaptation helps explain how tolerance and physical
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
An infant who receives a drug that does not produce CNS side effects in
adults exhibits drowsiness and sedation. The nurse understands that
this is because of differences in which physiologic system in infants and
adults?
a. Blood-brain barrier
b. First-pass effect
c. Gastrointestinal absorption
d. Renal filtration - ANSWER-ANS: A
The blood-brain barrier is not fully developed at birth, making infants
much more sensitive to CNS drugs than older children and adults. CNS
symptoms may include sedation and drowsiness. The first-pass effect
and GI absorption affect metabolism and absorption of drugs, and renal
filtration affects elimination of drugs, all of which may alter drug levels.
Which monoamines act as neurotransmitters in the central nervous
system? Select all that apply.
a. Acetylcholine
b. Norepinephrine
c. Serotonin
d. Dopamine
e. Epinephrine
f. Histamine - ANSWER-ANS: B , C , D , E
Acetylcholine and histamines are not monoamines.
,2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
A patient asks a nurse to explain what drug tolerance means. The nurse
responds by telling the patient that when tolerance occurs, it means the
patient:
a. has developed a psychological dependence on the drug.
b. may need increased amounts of the drug over time.
c. will cause an abstinence syndrome if the drug is discontinued
abruptly.
d. will have increased sensitivity to drug side effects. - ANSWER-ANS: B
When tolerance develops, a dose increase may be needed, because a
decreased response may occur with prolonged use. Psychologic
dependence involves cravings for drug effects and does not define
tolerance. Physical dependence occurs when the drug becomes
necessary for the brain to function "normally," meaning the patient
should be weaned from the drug slowly to prevent an abstinence
syndrome. Patients may have a decreased sensitivity to drug side effects
over time as the brain adapts to the medication.
A group of nursing students asks a nurse to explain the blood-brain
barrier. The nurse would be correct to say that the blood-brain barrier:
a. prevents some potentially toxic substances from crossing into the
central nervous system.
b. causes infants to be less sensitive to CNS drugs and thus require
larger doses.
,2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
c. allows only ionized or protein-bound drugs to cross into the central
nervous system.
d. prevents lipid-soluble drugs from entering the central nervous
system. - ANSWER-ANS: A
The blood-brain barrier can prevent some drugs and some toxic
substances from entering the CNS. The blood-brain barrier in infants is
not fully developed, so infants are more sensitive to CNS drugs and
often require lower doses. The blood-brain barrier prevents highly
ionized and protein- bound drugs from crossing into the CNS and allows
lipid-soluble drugs and those that can cross via specific transport
systems to enter.
A nurse is teaching a group of students about how CNS drugs are
developed. Which statement
by a student indicates a need for further teaching?
a. "Central nervous system drug development relies on observations of
their effects on human behavior."
b. "Studies of new central nervous system drugs in healthy subjects can
produce paradoxical
effects."
c. "Our knowledge of the neurochemical and physiologic changes that
underlie mental illness
is incomplete."
, 2024 Rosenthal: Lehne's Pharmacotherapeutics for
Advanced Practice Nurses and Physician Assistants Test
With Correct Answers And Rationnalles
d. "These drugs are developed based on scientific knowledge of CNS
transmitters and receptors." - ANSWER-ANS: D
The deficiencies in knowledge about how CNS transmitters and
receptors work make systematic development of CNS drugs difficult.
Testing in healthy subjects often leads either to no effect or to
paradoxical effects. Medical knowledge of the neurochemical and
physiologic changes underlying mental illness is incomplete. The
development of CNS drugs depends less on knowledge of how the CNS
functions and how these drugs affect that process and more on how
administering one of these agents leads to changes in behavior.
A nurse is teaching a group of nursing students how the CNS adapts to
psychotherapeutic
medications. Which statement by a nursing student indicates a need for
further teaching?
a. "Adaptation can lead to tolerance of these drugs with prolonged
use."
b. "Adaptation helps explain how physical dependence occurs."
c. "Adaptation often must occur before therapeutic effects develop."
d. "Adaptation results in an increased sensitivity to side effects over
time." - ANSWER-ANS: D
With adaptation of the central nervous system to prolonged exposure
to CNS drugs, many adverse effects diminish and therapeutic effects
remain. Adaptation helps explain how tolerance and physical
