NURS 5334-ADVANCED PHARM-TEST 1 (QUESTIONS AND ANSWERS) LATEST UPDATED 2025

NURS 5334-ADVANCED PHARM-TEST 1 (QUESTIONS
AND ANSWERS) LATEST UPDATED 2025

Pregnancy:KChangesKinKdrugKmetabolismK-KcorrectKanswer--
HepaticKmetabolismKandKGFRKincreaseKduringKpregnancy,KdosagesKofKsomeKdrugsKmayKneedKtoKbeKincrea
sedK
-ForKsomeKdrugs,KhepaticKmetabolismKincreasesKduringKpregnancy--
>KsomeKdrugsKmayKneedKtoKbeKincreased
-ToneKandKmotilityKofKtheKbowelKdecreaseKinKpregnancy,KcausingKintestinalKtransitKtimeKtoKincrease
-->moreKtimeKforKdrugsKtoKbeKabsorbed-->KmightKneedKtoKreduceKdosage
-ProlongationKofKdrugKeffectsKtotalK1-2KlifeKincreases


FetalKdevelopmentKinKpregnancyK(stages)K-KcorrectKanswer--preimplantation/presomite:Kconception-
2Kweeks:KallKorKnothingK
-embryonicKperiod:KweeksK3-8:KgrossKmalformations
-FetalKperiod:KweekK9-Kterm:KexposureKdisruptsKfunctionKnotKgrossKanatomy


PregnancyKLabelingK-KcorrectKanswer--
AsKofK2015,KtheKFoodKandKDrugKAdministrationKhadKaKPregnancyKandKLactationKLabelingKRuleKchange.
-
NoKmoreKletteringKofKtheKcategoriesKofKdrugsKforKpregnancy.KAccordingKtoKtheKletteringKsystem,KdrugsKca
nKbeKputKintoKoneKofKfiveKriskKcategories:KbeKA,KB,KC,KD,KandKX.
-ByK2020,KallKprescriptionsKmustKremoveKletteringKlabelsKaltogether.
-TheKPLLRKrequiresKthreeKsectionsKforKlabeling:
oK(1)Kpregnancy,K(2)Klactation,KandK(3)KfemalesKandKmalesKofKreproductiveKpotential.


HowKdoKyouKdecreaseKriskKinKtheKinfantKduringKbreastfeeding?K-KcorrectKanswer-
oKTakeKtheKdrugsKimmediatelyKafterKbreastfeeding
oKAvoidKdrugsKthatKhaveKlongKhalf-lives
oKChooseKdrugsKthatKtendKtoKbeKexcludedKfromKmilk,KandKthatKareKleastKlikelyKtoKaffectKtheKinfant
oKAvoidKtheKdrugsKthatKareKknownKtoKbeKhazardous

,oKUseKtheKlowestKeffectiveKdosageKforKtheKshortestKpossibleKtime
oKAbandonKplansKtoKbreastfeedKifKaKnecessaryKdrugKisKknownKtoKbeKharmfulKtoKtheKchild.


HowKdoKpediatricKpatientsKdifferKinKtheirKresponseKtoKmedication?KAbsorption?K-KcorrectKanswer-
oKOralKadministration
-GastricKemptyingKtimeKisKprolongedK&KirregularKinKearlyKinfancy
·KAdultKfunctionKatK5-8Kmonths
·KForKdrugsKthatKareKabsorbedKprimarilyKfromKtheKstomach,KdelayedKgastricKemptyingKenhancesKabsorptio
n
·KForKdrugsKthatKareKabsorbedKprimarilyKfromKtheKintestine,KabsorptionKisKdelayed
·KBecauseKgastricKemptyingKtimeKisKirregular,KtheKpreciseKeffectKonKabsorptionKisKnotKpredictable
-KGastricKAcidity
·KVeryKlowK24KhoursKafterKbirth
·KDoesKnotKreachKadultKvaluesKforK2Kyears
·KLowKacidityKabsorptionKofKacid-labileKdrugsKisKincreased
oKIntramuscular
-Slow,KerraticKinKneonates
-KDelayedKabsorptionKasKaKresultKofKlowKbloodKflowKduringKtheKfirstKfewKdaysKofKlife
-KByKearlyKinfancy,KabsorptionKofKIMKdrugsKisKmoreKrapidKthanKinKneonatesKandKadults
oKSkin
-KMoreKrapidKandKcompleteKinKinfantsKthanKinKolderKchildrenKandKadults
-
KTheKstratumKcorneumKofKtheKinfant'sKskinKisKveryKthin,KandKbloodKflowKtoKtheKskinKisKgreaterKinKinfantsKt

hanKinKolderKpatients.KBecauseKofKthisKenhancedKabsorption,KinfantsKareKatKincreasedKriskKforKtoxicityKfro
mKtopicalKdrugs.


HowKdoKpediatricKpatientsKdifferKinKtheirKresponseKtoKmedication?KDistributionKr/tKproteinKbinding?K-
KcorrectKanswer--BindingKofKdrugsKtoKalbuminKandKotherKplasmaKproteinsKisKlimitedKinKtheKinfant



-KAmountKofKserumKalbuminKisKrelativelyKlow
-KEndogenousKcompoundsK(fattyKacids,Kbilirubin)KcompeteKwithKdrugsKforKavailableKbindingKsites
-KLimitedKdrug/proteinKbindingKinKinfantsK--
>KconcentrationKofKfreeKlevelsKofKdrugsKthatKusuallyKundergoKextensiveKproteinKbindingKinKadultsKisKrelati
velyKhighKinKtheKinfantK-->KintensifiedKeffects

,-KReducedKdosageKneeded
-KAdultKproteinKbindingKcapacityKbyK10-12KmonthsKofKage


HowKdoKpediatricKpatientsKdifferKinKtheirKresponseKtoKmedication?KDistributionKr/tKBBB?K-
KcorrectKanswer--KNotKfullyKdevelopedKatKbirth



-KDrugsKandKotherKchemicalsKhaveKrelativelyKeasyKaccessKtoKtheKCNS
-KInfantsKareKespeciallyKsensitiveKtoKdrugsKthatKaffectKCNSKfunction
-
KallKmedicinesKemployedKforKtheirKCNSKeffectsK(e.g.,Kmorphine,Kphenobarbital)KshouldKbeKgivenKinKreduc

edKdosage
-
KDosageKshouldKalsoKbeKreducedKforKdrugsKusedKforKactionsKoutsideKtheKCNSKifKthoseKdrugsKareKcapableK

ofKproducingKCNSKtoxicityKasKaKsideKeffect


HowKdoKpediatricKpatientsKdifferKinKtheirKresponseKtoKmedication?KMetabolismKr/tKHepaticKfunction?K-
KcorrectKanswer-oKTheKdrug-metabolizingKcapacityKofKnewbornsKisKlow



oKNeonatesKareKespeciallyKsensitiveKtoKdrugsKthatKareKeliminatedKprimarilyKbyKhepaticKmetabolism
oKTheKliver'sKcapacityKtoKmetabolizeKmanyKdrugsKincreasedKrapidlyKaboutK1KmonthKafterKbirth
oKTheKabilityKtoKmetabolizeKdrugsKatKtheKadultKlevelKisKreachedKaKfewKmonthsKlater
oKCompleteKliverKmaturationKoccursKbyK1KyearKofKage
oKDosagesKmustKbeKreduced


HowKdoKpediatricKpatientsKdifferKinKtheirKresponseKtoKmedication?KRenalKexcretion?K-KcorrectKanswer-
oKSignificantlyKreducedKatKbirth
oKLowKrenalKbloodKflow,KglomerularKfiltration,KandKactiveKtubularKsecretion
oKDrugsKeliminatedKprimarilyKbyKrenalKexcretionKmustKbeKgivenKinKreducedKdosageKand/orKlongerKdosingK
intervals
oKAdultKlevelsKofKrenalKfunctionKachievedKbyK1Kyear


DefinitionKofKpolypharmacyK-KcorrectKanswer-TreatmentKwithKmultipleKdrugs


BeersKListK-KcorrectKanswer-
aKlistKofKdrugsKforKwhichKmonitoringKisKespeciallyKimportantKandKpossibleKinappropriateKtoKadministerKinK
elderlyKpatients

, -shouldKavoidKtheseKdrugs


GeriatricKpatientKchangesKinKabsorptionK-KcorrectKanswer-
oKAlteredKGIKabsorptionKisKnotKaKmajorKfactorKinKdrugKsensitivity
-OralKdoseKdoesKnotKusuallyKchangeKwithKage
oKRateKofKabsorptionKmayKslowKwithKage
-KD/tKDelayedKgastricKemptyingKandKreducedKsplanchnicKbloodKflowKalsoKoccur
-KDrugKresponsesKmayKbeKdelayed
oKGastricKacidityKisKreducedK-->KmayKalterKtheKabsorptionKofKcertainKdrugs
-someKdrugKformulationsKrequireKhighKacidityKtoKdissolve,KandKhenceKtheirKabsorptionKmayKbeKreduced.


GeriatricKpatientKchangesKinKdistributionK-KcorrectKanswer-(1)KincreasedKpercentageKofKbodyKfat
·KIncreasedKstorageKdepotKforKlipid-solubleKdrugsK(e.g.,Kpropranolol)
·KResultsKinKdecreasedKplasmaKlevelK-->KreductionKinKresponse
(2)KdecreasedKpercentageKofKleanKbodyKmass
(3)KdecreasedKtotalKbodyKwater
·KBecauseKofKtheKdeclineKinKleanKbodyKmassKandKtotalKbodyKwater,Kwater-
solubleKdrugsK(e.g.,Kethanol)KbecomeKdistributedKinKaKsmallerKvolumeKthanKinKyoungerKadultsK--
>KtheKconcentrationKofKtheseKdrugsKisKincreased,KcausingKeffectsKtoKbeKmoreKintense.
(4)KreducedKconcentrationKofKserumKalbumin
·KAlthoughKalbuminKlevelsKareKonlyKslightlyKreducedKinKhealthyKolderKadults,KtheseKlevelsKcanKbeKsignific
antlyKreducedKinKolderKadultsKwhoKareKmalnourishedK-->KreducedKalbuminKlevelsK--
>KsitesKforKproteinKbindingKofKdrugsKdecrease-->KlevelsKofKfreeKdrugKrise


GeriatricKchangesKinKmetabolismK-KcorrectKanswer-oKHepaticKmetabolismKdeclinesKwithKage
oKReducedKhepaticKbloodKflow,KreducedKliverKmass,KandKdecreasedKactivityKofKsomeKhepaticKenzymesKocc
ur
oKTheKhalf-livesKofKsomeKdrugsKmayKincrease,KandKresponsesKareKprolonged
oKResponseKtoKoralKdrugsK(e.g.,KthoseKthatKundergoKextensiveKfirst-
passKeffect)KmayKbeKenhancedKbecauseKfewerKdrugsKareKinactivatedKbeforeKenteringKtheKsystemicKcirculati
on.
oKImportantKtoKnote:KtheKdegreeKofKdeclineKinKdrugKmetabolismKvariesKgreatlyKamongKindividuals.KAsKaKr
esult,KweKcannotKpredictKwhetherKdrugKresponsesKwillKbeKsignificantlyKreducedKinKanyKparticularKpatient.