,Chapter 1 Issues for the Practitioner in Drug Therapy
kr kr kr kr kr kr kr kr
MULTIPLE CHOICE kr
1. Nurse practitioner prescriptive authority is regulated by:
kr kr kr kr kr kr
A. The National Council of State Boards of Nursing
kr kr kr kr kr kr kr
B. The U.S. Drug Enforcement Administration
kr kr kr kr
C. The State Board of Nursing for each state
kr kr kr kr kr kr kr
D. The State Board of Pharmacy
kr kr kr kr
ANS: k r C PTS: k r k r 1
2. Physician Assistant (PA) prescriptive authority is regulated by:
kr kr kr kr kr kr kr
A. The National Council of State Boards of Nursing
kr kr kr kr kr kr kr
B. The U.S. Drug Enforcement Administration
kr kr kr kr
C. The State Board of Nursing
kr kr kr kr
D. The State Board of Medical Examiners
kr kr kr kr kr
ANS: k r D PTS: k r k r 1
3. Clinical judgment in prescribing includes:
kr kr kr kr
A. Factoring in the cost to the patient of the medication prescribed
kr kr kr kr kr kr kr kr kr kr
B. Always prescribing the newest medication available for the disease process
kr kr kr kr kr kr kr kr kr
C. Handing out drug samples to poor patients kr kr kr kr kr kr
D. Prescribing all generic medications to cut costs kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
4. Criteria for choosing an effective drug for a disorder include:
kr kr kr kr kr kr kr kr kr
A. Asking the patient what drug they think would work best for them
kr kr kr kr kr kr kr kr kr kr kr
B. Consulting nationally recognized guidelines for disease management
kr kr kr kr kr kr
C. Prescribing medications that are available as samples before writing a prescription
kr kr kr kr kr kr kr kr kr kr
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for
kr kr kr kr kr kr kr
prescribing
kr
ANS: k r B PTS: k r k r 1
5. Nurse practitioner practice may thrive under health-care reform due to:
kr kr kr kr kr kr kr kr kr
A. The demonstrated ability of nurse practitioners to control costs and improve patient
kr kr kr kr kr kr kr kr kr kr kr
kr outcomes
B. The fact that nurse practitioners will be able to practice independently
kr kr kr kr kr kr kr kr kr kr
C. The fact that nurse practitioners will have full reimbursement under health-care
kr kr kr kr kr kr kr kr kr kr
reform
kr
D. The ability to shift accountability for Medicaid to the state level
kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
,Chapter 2.Pharmacokinetic Basis of Therapeutics and Pharmacodynamic
kr kr kr kr kr kr
MULTIPLE CHOICE kr
1. A patient's nutritional intake and lab work reflects hypoalbuminemia. This is critical
kr kr kr kr kr kr kr kr kr kr kr
to prescribing because:
kr kr kr
A. Distribution of drugs to target tissue may be affected kr kr kr kr kr kr kr kr
B. The solubility of the drug will not match the site of absorption
kr kr kr kr kr kr kr kr kr kr kr
C. There will be less free drug available to generate an effect
kr kr kr kr kr kr kr kr kr kr
D. Drugs bound to albumin are readily excreted by the kidney
kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
2. Drugs that have a significant first-pass effect:
kr kr kr kr kr kr
A. Must be given by the enteral (oral) route only
kr kr kr kr kr kr kr kr
B. Bypass the hepatic circulation kr kr kr
C. Are rapidly metabolized by the liver and may have little if any desired action
kr kr kr kr kr kr kr kr kr kr kr kr kr
D. Are converted by the liver to more active and fat-soluble forms
kr kr kr kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
3. The route of excretion of a volatile drug will likely be:
kr kr kr kr kr kr kr kr kr kr
A. The kidneys kr
B. The lungs kr
C. The bile and feces kr kr kr
D. The skin kr
ANS: k r B PTS: k r k r 1
4. Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage reservoir of the kr kr kr kr kr kr kr kr kr kr kr kr
kr drug. Storage reservoirs:
kr kr
A. Assure that the drug will reach its intended target tissue
kr kr kr kr kr kr kr kr kr
B. Are the reason for giving loading doses
kr kr kr kr kr kr
C. Increase the length of time a drug is available and active kr kr kr kr kr kr kr kr kr kr
D. Are most common in collagen tissues
kr kr kr kr kr
ANS: k r C PTS: k r k r 1
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
A. Propensity to go to the target receptor kr kr kr kr kr kr
B. Biological half-life kr
C. Pharmacodynamics
D. Safety and side effects kr kr kr
ANS: k r B PTS: k r k r 1
6. Azithromycin dosing requires the first day's dose be twice those of the other 4 days of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
the prescription. This is considered a loading dose. A loading dose:
kr kr kr kr kr kr kr kr kr kr kr
A. Rapidly achieves drug levels in the therapeutic range kr kr kr kr kr kr kr
B. Requires four to five half-lives to attain kr kr kr kr kr kr
C. Is influenced by renal function
kr kr kr kr
, D. Is directly related to the drug circulating to the target tissues
kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
effect is the:
kr kr kr
A. Minimum adverse effect level kr kr kr
B. Peak of action kr kr
C. Onset of action kr kr
D. Therapeutic range kr
ANS: k r C PTS: k r k r 1
8. Phenytoin requires a trough level be drawn. Peak and trough levels are done:
kr kr kr kr kr kr kr kr kr kr kr kr
A. When the drug has a wide therapeutic rangekr kr kr kr kr kr kr
B. When the drug will be administered for a short time only
kr kr kr kr kr kr kr kr kr kr
C. When there is a high correlation between the dose and saturation of receptor sites
kr kr kr kr kr kr kr kr kr kr kr kr kr
D. To determine if a drug is in the therapeutic range
kr kr kr kr kr kr kr kr kr
ANS: k r D PTS: k r k r 1
9. A laboratory result indicates the peak level for a drug is above the minimum toxic
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
concentration. This means that the:
kr kr kr kr kr
A. Concentration will produce therapeutic effects kr kr kr kr
B. Concentration will produce an adverse response kr kr kr kr kr
C. Time between doses must be shortened
kr kr kr kr kr
D. Duration of action of the drug is too long kr kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
10. Drugs that are receptor agonists may demonstrate what property?
kr kr kr kr kr kr kr kr
A. Irreversible binding to the drug receptor site kr kr kr kr kr kr
B. Up-regulation with chronic use kr kr kr
C. Desensitization or down-regulation with continuous use kr kr kr kr kr
D. Inverse relationship between drug concentration and drug action
kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
kr kr kr kr kr kr kr kr kr kr
A. Down-regulation of the drug receptor kr kr kr kr
B. An exaggerated response if abruptly discontinued
kr kr kr kr kr
C. Partial blockade of the effects of agonist drugs
kr kr kr kr kr kr kr
D. An exaggerated response to competitive drug agonists
kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
12. Factors that affect gastric drug absorption include:
kr kr kr kr kr kr
A. Liver enzyme activity kr kr
B. Protein-binding properties of the drug molecule kr kr kr kr kr
C. Lipid solubility of the drug kr kr kr kr
D. Ability to chew and swallow kr kr kr kr
ANS: k r C PTS: k r k r 1
, 13. Drugs administered via intravenous (IV) route:
kr kr kr kr kr
A. Need to be lipid soluble in order to be easily absorbed
kr kr kr kr kr kr kr kr kr kr
B. Begin distribution into the body immediately kr kr kr kr kr
C. Are easily absorbed if they are nonionized
kr kr kr kr kr kr
D. May use pinocytosis to be absorbed kr kr kr kr kr
ANS: k r B PTS: k r k r 1
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
drugs is:
kr kr
A. The sum of the effects of each drug individually
kr kr kr kr kr kr kr kr
B. Greater than the sum of the effects of each drug individually
kr kr kr kr kr kr kr kr kr kr
C. Less than the effect of each drug individually
kr kr kr kr kr kr kr
D. Not predictable, as it varies with each individual
kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
15. Which of the following statements about bioavailability is true?
kr kr kr kr kr kr kr kr
A. Bioavailability issues are especially important for drugs with narrow therapeutic kr kr kr kr kr kr kr kr kr
ranges or sustained release mechanisms.
kr kr kr kr kr
B. All brands of a drug have the same bioavailability.
kr kr kr kr kr kr kr kr
C. Drugs that are administered more than once a day have greater bioavailability than
kr kr kr kr kr kr kr kr kr kr kr kr
drugs given once daily.
kr kr kr kr
D. Combining an active drug with an inert substance does not affect bioavailability. kr kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
16. Which of the following statements about the major distribution barriers (blood-brain or
kr kr kr kr kr kr kr kr kr kr kr
kr fetal-placental) is true? kr kr
A. Water soluble and ionized drugs cross these barriers rapidly.
kr kr kr kr kr kr kr kr
B. The blood-brain barrier slows the entry of many drugs into and from brain cells.
kr kr kr kr kr kr kr kr kr kr kr kr kr
C. The fetal-placental barrier protects the fetus from drugs taken by the mother.
kr kr kr kr kr kr kr kr kr kr kr
D. Lipid soluble drugs do not pass these barriers and are safe for pregnant women.
kr kr kr kr kr kr kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
17. Drugs are metabolized mainly by the liver via Phase I or Phase II reactions. The purpose of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
both of these types of reactions is to:
kr kr kr kr kr kr kr kr
A. Inactivate prodrugs before they can be activated by target tissues kr kr kr kr kr kr kr kr kr
B. Change the drugs so they can cross plasma membranes kr kr kr kr kr kr kr kr
C. Change drug molecules to a form that an excretory organ can excrete
kr kr kr kr kr kr kr kr kr kr kr
D. Make these drugs more ionized and polar to facilitate excretion
kr kr kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
18. Once they have been metabolized by the liver, the metabolites may be:
kr kr kr kr kr kr kr kr kr kr kr
A. More active than the parent drug kr kr kr kr kr
B. Less active than the parent drug kr kr kr kr kr
C. Totally “deactivated” so that they are excreted without any effect
kr kr kr kr kr kr kr kr kr
D. All of the above kr kr kr
ANS: k r D PTS: k r k r 1
kr kr kr kr kr kr kr kr
MULTIPLE CHOICE kr
1. Nurse practitioner prescriptive authority is regulated by:
kr kr kr kr kr kr
A. The National Council of State Boards of Nursing
kr kr kr kr kr kr kr
B. The U.S. Drug Enforcement Administration
kr kr kr kr
C. The State Board of Nursing for each state
kr kr kr kr kr kr kr
D. The State Board of Pharmacy
kr kr kr kr
ANS: k r C PTS: k r k r 1
2. Physician Assistant (PA) prescriptive authority is regulated by:
kr kr kr kr kr kr kr
A. The National Council of State Boards of Nursing
kr kr kr kr kr kr kr
B. The U.S. Drug Enforcement Administration
kr kr kr kr
C. The State Board of Nursing
kr kr kr kr
D. The State Board of Medical Examiners
kr kr kr kr kr
ANS: k r D PTS: k r k r 1
3. Clinical judgment in prescribing includes:
kr kr kr kr
A. Factoring in the cost to the patient of the medication prescribed
kr kr kr kr kr kr kr kr kr kr
B. Always prescribing the newest medication available for the disease process
kr kr kr kr kr kr kr kr kr
C. Handing out drug samples to poor patients kr kr kr kr kr kr
D. Prescribing all generic medications to cut costs kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
4. Criteria for choosing an effective drug for a disorder include:
kr kr kr kr kr kr kr kr kr
A. Asking the patient what drug they think would work best for them
kr kr kr kr kr kr kr kr kr kr kr
B. Consulting nationally recognized guidelines for disease management
kr kr kr kr kr kr
C. Prescribing medications that are available as samples before writing a prescription
kr kr kr kr kr kr kr kr kr kr
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for
kr kr kr kr kr kr kr
prescribing
kr
ANS: k r B PTS: k r k r 1
5. Nurse practitioner practice may thrive under health-care reform due to:
kr kr kr kr kr kr kr kr kr
A. The demonstrated ability of nurse practitioners to control costs and improve patient
kr kr kr kr kr kr kr kr kr kr kr
kr outcomes
B. The fact that nurse practitioners will be able to practice independently
kr kr kr kr kr kr kr kr kr kr
C. The fact that nurse practitioners will have full reimbursement under health-care
kr kr kr kr kr kr kr kr kr kr
reform
kr
D. The ability to shift accountability for Medicaid to the state level
kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
,Chapter 2.Pharmacokinetic Basis of Therapeutics and Pharmacodynamic
kr kr kr kr kr kr
MULTIPLE CHOICE kr
1. A patient's nutritional intake and lab work reflects hypoalbuminemia. This is critical
kr kr kr kr kr kr kr kr kr kr kr
to prescribing because:
kr kr kr
A. Distribution of drugs to target tissue may be affected kr kr kr kr kr kr kr kr
B. The solubility of the drug will not match the site of absorption
kr kr kr kr kr kr kr kr kr kr kr
C. There will be less free drug available to generate an effect
kr kr kr kr kr kr kr kr kr kr
D. Drugs bound to albumin are readily excreted by the kidney
kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
2. Drugs that have a significant first-pass effect:
kr kr kr kr kr kr
A. Must be given by the enteral (oral) route only
kr kr kr kr kr kr kr kr
B. Bypass the hepatic circulation kr kr kr
C. Are rapidly metabolized by the liver and may have little if any desired action
kr kr kr kr kr kr kr kr kr kr kr kr kr
D. Are converted by the liver to more active and fat-soluble forms
kr kr kr kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
3. The route of excretion of a volatile drug will likely be:
kr kr kr kr kr kr kr kr kr kr
A. The kidneys kr
B. The lungs kr
C. The bile and feces kr kr kr
D. The skin kr
ANS: k r B PTS: k r k r 1
4. Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage reservoir of the kr kr kr kr kr kr kr kr kr kr kr kr
kr drug. Storage reservoirs:
kr kr
A. Assure that the drug will reach its intended target tissue
kr kr kr kr kr kr kr kr kr
B. Are the reason for giving loading doses
kr kr kr kr kr kr
C. Increase the length of time a drug is available and active kr kr kr kr kr kr kr kr kr kr
D. Are most common in collagen tissues
kr kr kr kr kr
ANS: k r C PTS: k r k r 1
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
A. Propensity to go to the target receptor kr kr kr kr kr kr
B. Biological half-life kr
C. Pharmacodynamics
D. Safety and side effects kr kr kr
ANS: k r B PTS: k r k r 1
6. Azithromycin dosing requires the first day's dose be twice those of the other 4 days of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
the prescription. This is considered a loading dose. A loading dose:
kr kr kr kr kr kr kr kr kr kr kr
A. Rapidly achieves drug levels in the therapeutic range kr kr kr kr kr kr kr
B. Requires four to five half-lives to attain kr kr kr kr kr kr
C. Is influenced by renal function
kr kr kr kr
, D. Is directly related to the drug circulating to the target tissues
kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
effect is the:
kr kr kr
A. Minimum adverse effect level kr kr kr
B. Peak of action kr kr
C. Onset of action kr kr
D. Therapeutic range kr
ANS: k r C PTS: k r k r 1
8. Phenytoin requires a trough level be drawn. Peak and trough levels are done:
kr kr kr kr kr kr kr kr kr kr kr kr
A. When the drug has a wide therapeutic rangekr kr kr kr kr kr kr
B. When the drug will be administered for a short time only
kr kr kr kr kr kr kr kr kr kr
C. When there is a high correlation between the dose and saturation of receptor sites
kr kr kr kr kr kr kr kr kr kr kr kr kr
D. To determine if a drug is in the therapeutic range
kr kr kr kr kr kr kr kr kr
ANS: k r D PTS: k r k r 1
9. A laboratory result indicates the peak level for a drug is above the minimum toxic
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
concentration. This means that the:
kr kr kr kr kr
A. Concentration will produce therapeutic effects kr kr kr kr
B. Concentration will produce an adverse response kr kr kr kr kr
C. Time between doses must be shortened
kr kr kr kr kr
D. Duration of action of the drug is too long kr kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
10. Drugs that are receptor agonists may demonstrate what property?
kr kr kr kr kr kr kr kr
A. Irreversible binding to the drug receptor site kr kr kr kr kr kr
B. Up-regulation with chronic use kr kr kr
C. Desensitization or down-regulation with continuous use kr kr kr kr kr
D. Inverse relationship between drug concentration and drug action
kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
kr kr kr kr kr kr kr kr kr kr
A. Down-regulation of the drug receptor kr kr kr kr
B. An exaggerated response if abruptly discontinued
kr kr kr kr kr
C. Partial blockade of the effects of agonist drugs
kr kr kr kr kr kr kr
D. An exaggerated response to competitive drug agonists
kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
12. Factors that affect gastric drug absorption include:
kr kr kr kr kr kr
A. Liver enzyme activity kr kr
B. Protein-binding properties of the drug molecule kr kr kr kr kr
C. Lipid solubility of the drug kr kr kr kr
D. Ability to chew and swallow kr kr kr kr
ANS: k r C PTS: k r k r 1
, 13. Drugs administered via intravenous (IV) route:
kr kr kr kr kr
A. Need to be lipid soluble in order to be easily absorbed
kr kr kr kr kr kr kr kr kr kr
B. Begin distribution into the body immediately kr kr kr kr kr
C. Are easily absorbed if they are nonionized
kr kr kr kr kr kr
D. May use pinocytosis to be absorbed kr kr kr kr kr
ANS: k r B PTS: k r k r 1
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
drugs is:
kr kr
A. The sum of the effects of each drug individually
kr kr kr kr kr kr kr kr
B. Greater than the sum of the effects of each drug individually
kr kr kr kr kr kr kr kr kr kr
C. Less than the effect of each drug individually
kr kr kr kr kr kr kr
D. Not predictable, as it varies with each individual
kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
15. Which of the following statements about bioavailability is true?
kr kr kr kr kr kr kr kr
A. Bioavailability issues are especially important for drugs with narrow therapeutic kr kr kr kr kr kr kr kr kr
ranges or sustained release mechanisms.
kr kr kr kr kr
B. All brands of a drug have the same bioavailability.
kr kr kr kr kr kr kr kr
C. Drugs that are administered more than once a day have greater bioavailability than
kr kr kr kr kr kr kr kr kr kr kr kr
drugs given once daily.
kr kr kr kr
D. Combining an active drug with an inert substance does not affect bioavailability. kr kr kr kr kr kr kr kr kr kr kr
ANS: k r A PTS: k r k r 1
16. Which of the following statements about the major distribution barriers (blood-brain or
kr kr kr kr kr kr kr kr kr kr kr
kr fetal-placental) is true? kr kr
A. Water soluble and ionized drugs cross these barriers rapidly.
kr kr kr kr kr kr kr kr
B. The blood-brain barrier slows the entry of many drugs into and from brain cells.
kr kr kr kr kr kr kr kr kr kr kr kr kr
C. The fetal-placental barrier protects the fetus from drugs taken by the mother.
kr kr kr kr kr kr kr kr kr kr kr
D. Lipid soluble drugs do not pass these barriers and are safe for pregnant women.
kr kr kr kr kr kr kr kr kr kr kr kr kr
ANS: k r B PTS: k r k r 1
17. Drugs are metabolized mainly by the liver via Phase I or Phase II reactions. The purpose of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
both of these types of reactions is to:
kr kr kr kr kr kr kr kr
A. Inactivate prodrugs before they can be activated by target tissues kr kr kr kr kr kr kr kr kr
B. Change the drugs so they can cross plasma membranes kr kr kr kr kr kr kr kr
C. Change drug molecules to a form that an excretory organ can excrete
kr kr kr kr kr kr kr kr kr kr kr
D. Make these drugs more ionized and polar to facilitate excretion
kr kr kr kr kr kr kr kr kr
ANS: k r C PTS: k r k r 1
18. Once they have been metabolized by the liver, the metabolites may be:
kr kr kr kr kr kr kr kr kr kr kr
A. More active than the parent drug kr kr kr kr kr
B. Less active than the parent drug kr kr kr kr kr
C. Totally “deactivated” so that they are excreted without any effect
kr kr kr kr kr kr kr kr kr
D. All of the above kr kr kr
ANS: k r D PTS: k r k r 1
