WGU D116 Unit 2
A patient receives a drug that has a narrow therapeutic range. What is the nurse
administering this medication expected to do? - ANSWER Monitor plasma drug
levels
Narrow therapeutic range is more difficult to administer safely because the difference
between MEC and toxic concentration is small
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels.
The dosing is correct, and this medication has been tolerated by this patient in the
past.
What is a probable cause of the test result? - ANSWER The pt is taking another
medication that binds to serum albumin
BGentamicin binds to albumin but weakly. In presence of another drug that binds to
albumin, gentamicin can rise to toxic levels in blood stream
What are the components of pharmacokinetics? - ANSWER Absorption, distribution,
metabolism, excretion
Does the volume of distribution increase or decrease as the concentration of a drug
in the blood plasma increases? - ANSWER DECREASES
A patient reports becoming "immune" to a medication because it no longer works to
alleviate symptoms.
The provider recognizes that this decreased effectiveness is likely caused by what? -
ANSWER Desensitization of receptor sites by continual exposure to the drug
Continual exposure to an agonist would cause the cell to become less responsive or
desensitized
What occurs when a drug binds to a receptor in the body? - ANSWER It increases or
decreases the activity of that receptor
Which pharmacodynamic principle is most correlated with drug toxicity? - ANSWER
Therapeutic index
Which is calculated by dividing the median toxic dose by the median efficacious dose
A patient who is taking morphine for pain asks the nurse how a pain medication can
also cause constipation.
What is the nurse's response? - ANSWER It is selective to receptors that regulate
more than one body process
Which statement about food and drug interactions is true? - ANSWER Some foods
can inhibit CYP isoenzymes and alter drug metabolism
, Grapefruit inhibits which lowers metabolism of drugs, leading to toxic effects of drugs
With respect to the cytochrome P450 (CYP) system, what will result in a higher
concentration of a drug? - ANSWER Inhibition of the enzyme
Decreasing enzyme activity leads to decreased metabolism of the drug, leading to
toxic effects of drug
An advanced practice registered nurse (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? - ANSWER Independent
because the prescriptive authority does not require the APRN work under physician
supervision
Which drug requires registration with the Drug Enforcement Administration (DEA) to
prescribe? - ANSWER Chlordiazepoxide
Schedule IV substance
All scheduled substances require the prescriber to be registered with the DEA
True or False
Your DEA registration allows you to prescribe Schedule II and Schedule III controlled
substances for addiction. - ANSWER FALSE
Special waiver is required
A patient with diabetes reports losing their job and an inability to purchase the
required medications.
As the FNP, which action is most appropriate? - ANSWER Contact a different
pharmacy-it could decrease the cost of the medication
A nurse is preparing to administer a drug. After reading the medication guide, the
nurse notes that the drug has been linked to symptoms of Parkinson disease in
some patients.
What should the nurse do? - ANSWER Observe the patient closely for such
symptoms and prepare to tx them if needed
A drug that causes disease-like s/s is known to be iatrogenic
Iatrogenic effects are not typically expected side effects
True or False
Macrolide antibiotics are classic inducers of common cytochrome enzymes. -
ANSWER False
Macrolide antibiotics are inhibitors
A patient receives a drug that has a narrow therapeutic range. What is the nurse
administering this medication expected to do? - ANSWER Monitor plasma drug
levels
Narrow therapeutic range is more difficult to administer safely because the difference
between MEC and toxic concentration is small
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels.
The dosing is correct, and this medication has been tolerated by this patient in the
past.
What is a probable cause of the test result? - ANSWER The pt is taking another
medication that binds to serum albumin
BGentamicin binds to albumin but weakly. In presence of another drug that binds to
albumin, gentamicin can rise to toxic levels in blood stream
What are the components of pharmacokinetics? - ANSWER Absorption, distribution,
metabolism, excretion
Does the volume of distribution increase or decrease as the concentration of a drug
in the blood plasma increases? - ANSWER DECREASES
A patient reports becoming "immune" to a medication because it no longer works to
alleviate symptoms.
The provider recognizes that this decreased effectiveness is likely caused by what? -
ANSWER Desensitization of receptor sites by continual exposure to the drug
Continual exposure to an agonist would cause the cell to become less responsive or
desensitized
What occurs when a drug binds to a receptor in the body? - ANSWER It increases or
decreases the activity of that receptor
Which pharmacodynamic principle is most correlated with drug toxicity? - ANSWER
Therapeutic index
Which is calculated by dividing the median toxic dose by the median efficacious dose
A patient who is taking morphine for pain asks the nurse how a pain medication can
also cause constipation.
What is the nurse's response? - ANSWER It is selective to receptors that regulate
more than one body process
Which statement about food and drug interactions is true? - ANSWER Some foods
can inhibit CYP isoenzymes and alter drug metabolism
, Grapefruit inhibits which lowers metabolism of drugs, leading to toxic effects of drugs
With respect to the cytochrome P450 (CYP) system, what will result in a higher
concentration of a drug? - ANSWER Inhibition of the enzyme
Decreasing enzyme activity leads to decreased metabolism of the drug, leading to
toxic effects of drug
An advanced practice registered nurse (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? - ANSWER Independent
because the prescriptive authority does not require the APRN work under physician
supervision
Which drug requires registration with the Drug Enforcement Administration (DEA) to
prescribe? - ANSWER Chlordiazepoxide
Schedule IV substance
All scheduled substances require the prescriber to be registered with the DEA
True or False
Your DEA registration allows you to prescribe Schedule II and Schedule III controlled
substances for addiction. - ANSWER FALSE
Special waiver is required
A patient with diabetes reports losing their job and an inability to purchase the
required medications.
As the FNP, which action is most appropriate? - ANSWER Contact a different
pharmacy-it could decrease the cost of the medication
A nurse is preparing to administer a drug. After reading the medication guide, the
nurse notes that the drug has been linked to symptoms of Parkinson disease in
some patients.
What should the nurse do? - ANSWER Observe the patient closely for such
symptoms and prepare to tx them if needed
A drug that causes disease-like s/s is known to be iatrogenic
Iatrogenic effects are not typically expected side effects
True or False
Macrolide antibiotics are classic inducers of common cytochrome enzymes. -
ANSWER False
Macrolide antibiotics are inhibitors
