NURP-424 Exam 2 Questions And Correct Answers Graded A+
How do PDE-5 inhibitors work? -Answer PDE-5 inhibitors block the breakdown of cGMP,
which leads to an increased amount and duration of erections in men with ED.
Pharmacokinetics Pediatrics -Answer -Incomplete blood brain barrier and more
permeable
- Small infants have less protein binding capacity which results in more free drug in the
body
- Kidneys are not matured so excretion and elimination is slowed
- Skin is thin and more permeable so it absorbs quicker
- Oral bioavailability of weak bases compounds is increased.
( e.g. Beta-lactams)
- Oral bioavailability of weak organic acids is decreased.
(e.g. Phenobarbital and phenytoin)
Which form of birth control carries a Black Box Warning because it causes a significant
loss of bone mineral density in teens? - Answer Medroxyprogesterone acetate (Depo
shot)
A mother asks the APN to use an OTC medication for her child because the label states,
"Consult your provider for use instructions as safety and effectiveness have not been
established." Which response by the APN is most appropriate? -Answer "Pediatric
studies have shown this drug to be either unsafe or ineffective in children."
Which of the following would the APN include in teaching for the transmasculine patient
,initiating testosterone replacement therapy? - Answer The patient's menstrual cycles
should cease within 6 months.
A transfeminine patient is preparing to initiate feminizing hormone therapy. Which of the
following would the APN include in teaching about the effects of hormone therapy? -
Answer It may take months, and even up to a year, for the patient to realize the full effect
of the hormones.
Which of the following does testosterone replacement therapy (TRT) cause? - Answer
Decreased fat mass
Normal aging is associated with decreased serum albumin. What does this do to the
distribution of drugs? - Answer There are fewer protein molecules available to bind the
drug, increasing levels of free unbound drug and the risk for drug toxicity.
Normal age-related changes affect the absorption of medications from the GI tract.
Which of the following is due to normal age-related change? - Answer Decreased acid
production
Which of the following is a potential pharmacodynamic difference in children compared
to adults? Select all that apply. - Answers An unexpected side effect different than an
adult
Which of the following would the APN take into account when selecting the best option
for the patient starting testosterone replacement therapy? - Answer Injectable
testosterone is the least expensive.
The APN recognizes that children are frequently more vulnerable to ADRs for which two
reasons? Answer Inattention to weight-based dosing and immature organ function in the
very young makes dosing more complex
Which of the following statements about topical absorption of medications is true?
Answer It is increased in children due to increased body surface relative to size.
,The APN is following a 68-year-old male who had an acute myocardial infarction (MI)
about 4 months ago. He is no longer seeing a cardiologist. He is doing well and has
resumed all his activities without incident. He is tolerating a low dose beta blocker,
initiated post heart attack. He has never had chest pain or exercise intolerance. He has
a prescription for sublingual nitroglycerine when necessary but has never needed it. He
requests a refill on his Viagra. Which action taken by the APN is most appropriate? -
Answer Tell him he has to wait 6 months after his heart attack to use this medication
again.
Gender Differences: Pharmacodynamics - Answer - Opioids have a greater analgesic
effects and side effects in women than men (i.e. N/V)
Aspirin- will decrease the risk for stroke but is less useful if given prophylactically for an
MI in women- opposite is seen in men
Warfarin-less beneficial in women and more prone to adverse effects such as bleeding
Tricyclic antidepressants-longer time to steady state and more adverse effects seen in
women
- Antipsychotics will be more effective but have more side effects in females
- Medication absorption rate is delayed due to higher amount of adipose tissue/ fat,
hence bioavailability is greater among females
Pharmacokinetics in Women - Answer - Gastric emptying time is delayed d/t estrogen
which will give medications more time at the absorption site
- Plasma concentration of alcohol is higher in females with the same quantity of alcohol
consumption
-Womens have more % of body fat so increase the absorption of the lipophilic drugs
, -Women have a harder time with tricyclic antidepressants, which means they have an
increased risk of having SE
-Plasma volume is lower in females drugs with high volumes of distribution will be
concentrated in the plasma
-Pregnancy and lactation risk categories will no longer be used, instead provides a label
before prescribing
Pharmacokinetics in Pregnancy - Answer - Hydrophilic, high molecular weight, ionized,
and high protein binding drugs are required for pregnant women
- Plasma volume is increased in pregnancy hence dilutional anemia occurs which
warrants the need for prenatal vitamins and possibly iron supplementation
- Volume of distribution is affected by increase in plasma volumes
- Caffeine is limited in pregnancy due to the fact that caffeine places additional work on
the heart which is already taxed due to pregnancy
-No smoking or vaping throughout pregnancy as it diminishes the oxygen going to the
fetus
- Drug absorption via skin, lungs and mucous membranes are enhanced due to cardiac
output
- GI motility and gastric emptying times are reduced
Pharmacokinetics in Lactation -Answer- Breastmilk: acidic so a more basic medication
will be more concentrated in the milk than in the plasma
How do PDE-5 inhibitors work? -Answer PDE-5 inhibitors block the breakdown of cGMP,
which leads to an increased amount and duration of erections in men with ED.
Pharmacokinetics Pediatrics -Answer -Incomplete blood brain barrier and more
permeable
- Small infants have less protein binding capacity which results in more free drug in the
body
- Kidneys are not matured so excretion and elimination is slowed
- Skin is thin and more permeable so it absorbs quicker
- Oral bioavailability of weak bases compounds is increased.
( e.g. Beta-lactams)
- Oral bioavailability of weak organic acids is decreased.
(e.g. Phenobarbital and phenytoin)
Which form of birth control carries a Black Box Warning because it causes a significant
loss of bone mineral density in teens? - Answer Medroxyprogesterone acetate (Depo
shot)
A mother asks the APN to use an OTC medication for her child because the label states,
"Consult your provider for use instructions as safety and effectiveness have not been
established." Which response by the APN is most appropriate? -Answer "Pediatric
studies have shown this drug to be either unsafe or ineffective in children."
Which of the following would the APN include in teaching for the transmasculine patient
,initiating testosterone replacement therapy? - Answer The patient's menstrual cycles
should cease within 6 months.
A transfeminine patient is preparing to initiate feminizing hormone therapy. Which of the
following would the APN include in teaching about the effects of hormone therapy? -
Answer It may take months, and even up to a year, for the patient to realize the full effect
of the hormones.
Which of the following does testosterone replacement therapy (TRT) cause? - Answer
Decreased fat mass
Normal aging is associated with decreased serum albumin. What does this do to the
distribution of drugs? - Answer There are fewer protein molecules available to bind the
drug, increasing levels of free unbound drug and the risk for drug toxicity.
Normal age-related changes affect the absorption of medications from the GI tract.
Which of the following is due to normal age-related change? - Answer Decreased acid
production
Which of the following is a potential pharmacodynamic difference in children compared
to adults? Select all that apply. - Answers An unexpected side effect different than an
adult
Which of the following would the APN take into account when selecting the best option
for the patient starting testosterone replacement therapy? - Answer Injectable
testosterone is the least expensive.
The APN recognizes that children are frequently more vulnerable to ADRs for which two
reasons? Answer Inattention to weight-based dosing and immature organ function in the
very young makes dosing more complex
Which of the following statements about topical absorption of medications is true?
Answer It is increased in children due to increased body surface relative to size.
,The APN is following a 68-year-old male who had an acute myocardial infarction (MI)
about 4 months ago. He is no longer seeing a cardiologist. He is doing well and has
resumed all his activities without incident. He is tolerating a low dose beta blocker,
initiated post heart attack. He has never had chest pain or exercise intolerance. He has
a prescription for sublingual nitroglycerine when necessary but has never needed it. He
requests a refill on his Viagra. Which action taken by the APN is most appropriate? -
Answer Tell him he has to wait 6 months after his heart attack to use this medication
again.
Gender Differences: Pharmacodynamics - Answer - Opioids have a greater analgesic
effects and side effects in women than men (i.e. N/V)
Aspirin- will decrease the risk for stroke but is less useful if given prophylactically for an
MI in women- opposite is seen in men
Warfarin-less beneficial in women and more prone to adverse effects such as bleeding
Tricyclic antidepressants-longer time to steady state and more adverse effects seen in
women
- Antipsychotics will be more effective but have more side effects in females
- Medication absorption rate is delayed due to higher amount of adipose tissue/ fat,
hence bioavailability is greater among females
Pharmacokinetics in Women - Answer - Gastric emptying time is delayed d/t estrogen
which will give medications more time at the absorption site
- Plasma concentration of alcohol is higher in females with the same quantity of alcohol
consumption
-Womens have more % of body fat so increase the absorption of the lipophilic drugs
, -Women have a harder time with tricyclic antidepressants, which means they have an
increased risk of having SE
-Plasma volume is lower in females drugs with high volumes of distribution will be
concentrated in the plasma
-Pregnancy and lactation risk categories will no longer be used, instead provides a label
before prescribing
Pharmacokinetics in Pregnancy - Answer - Hydrophilic, high molecular weight, ionized,
and high protein binding drugs are required for pregnant women
- Plasma volume is increased in pregnancy hence dilutional anemia occurs which
warrants the need for prenatal vitamins and possibly iron supplementation
- Volume of distribution is affected by increase in plasma volumes
- Caffeine is limited in pregnancy due to the fact that caffeine places additional work on
the heart which is already taxed due to pregnancy
-No smoking or vaping throughout pregnancy as it diminishes the oxygen going to the
fetus
- Drug absorption via skin, lungs and mucous membranes are enhanced due to cardiac
output
- GI motility and gastric emptying times are reduced
Pharmacokinetics in Lactation -Answer- Breastmilk: acidic so a more basic medication
will be more concentrated in the milk than in the plasma
