NR 508/NR508 Midterm Quiz 1,2,3 Review. Chamberlain College Of Nursing.

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1) When taking acyclovir, patients should be educated regarding the Need to drink lots of water during treatment 2) Precautions that should be taken when prescribing controlled substances include U si... ng tamper-proof paper for all prescriptions written for controlled drugs 3) Medication agreements or “Pain medication Contracts” are recommended to be used: Universally for all prescribing for chronic pain 4) Clinical judgment in prescribing include Factoring the cost to the patient of the medication prescribed 5) Vitamin B12 deficiency may lead to: Numbness and tingling on the hands 6) Behaviors predictive of addiction to controlled substances include: Stealing or borrowing another patient’s drugs 7) Isoniazid (INH) may induce a deficiency of which vitamin: C 8) There is often cross-sensitivity and cross-resistance between penicillin and cephalosporins because: Both drugs contain a beta-lactam ring that is vulnerable to the beta-lactamase-producing organism 9) An 82 y/o pt who has herpes zoster (shingles)and would benefit from an anti-viral such as acyclovir. Prior to prescribing valacyclovir, she will need an assessment ofthe Renal function 10) According to the 2003-2006 National Health and Nutrition Examination Survey study of dietary intake, the group at risk for inadequate calcium was: Teenage females Quiz #2 1) Pt with c/o vaginal discharge that when tested meets the criteria for bacteria vaginosis. Tx of bacterial vaginosis in nonpregnant symptomatic women would be: Metronidazole 500 mg PO bid x 7 days 2) If a woman presents with recurrent vulvovaginal candidiasis she may be treated with: Intravaginal tioconazole x 14 days 3) Besides prescribing microbial therapy, pts with bacterial vaginosis require education regarding the fact that: alcohol should not be consumed during and 1 day after metronidazole is taken 4) Tx for chancroid in a nonpregnant pt would be: Oral azithromycin; ceftriaxone; oral ciprofloxacin 5) Dysmenorrhea is one the most common gynecological complaints in young women. The first line drug for this disorder is: NSAIDS 6) Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be warned about the risk for: fatal hypotension if combined with nitrates 7) The drug of choice for tx of primary or secondary syphyllis is: Benzathine penicciliin G IM 8) A contraindication to the use of combined contraceptives is: A hx of clotting factors 9) Patients who are prescribed exogenous androgens need to be warned that decreased libido: May occur with androgen therapy 10) Long-term use of androgens requires specific laboratory monitoring of: calcium, testosterone, PSA, liver function, glucose, and lipids Quiz #3 1) Pt teaching r/t amlodipine includes: Rise slowly from a supine position to reduce orthostatic hypotension 2) The NP orders a thyroid panel for a pt on amiodarone. The pt tells the NP that he does not have thyroid disease and wants to know why the test is ordered: Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism 3) Which of the foll. AE may occur due to a dihydropyridine-type CCB? Edema of hands and feet 4) Rodrigo has been prescribed procainamide after a MI. He is monitored for dyspnea, jugular venous distention, and peripheral edema bcuz they may indicate: Onset of CHF 5) Patrick is 10 y/o pt who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10 y/0 child would be: Bisacodyl (Dulcolax) suppository 6) All pts with HTN benefits from diuretic therapy, but those who benefit the most are: African Americans 7) Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for diarrhea. Loperamide: Slows gastric motility and reduces fluid and electrolyte loss from diarrhea 8) Angiotensin-converting enzyme inhibitors are the drug of choice in treating htn in diabetic pts bcuz they: All of the above 9) Colestipol come in powder form. The pt is taught to: Mix the powder with 4-6 oz of milk or juice 10) Pts at high risk for developing significant coronary heart disease are those with: Class III angina Midterm Outline Chapter 1: The Role of the Advanced Practice Nurse as Prescriber Roles and responsibilities of APRN prescribers Clinical judgement in Prescribing: use tamper proof paper for all prescriptions written for controlled substance Collaboration with other providers Autonomy and Prescriptive authority Chapter 2: Review of Basic Principles of Pharmacology Metabolism: Metabolism & Half Life Metabolism is related to drug concentration so that a fixed fraction of the drug is metabolized per hour. This is called first-order metabolism and is characterized by a half-life, the time period over which the drug concentration will decrease by half. How Drugs are Developed: drugs were developed by accident, this involves designing and synthesizing compounds based on the known structure of a specific target molecule Drug Responses: Receptors: agonists cause an action; antagonists: opposes the action of the agonist Antagonists occupy a receptor site and prevent other molecules, such as agonists, from occupying the same site and producing a response. Antagonists produce no direct response Pharmacokinetics: The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body. Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body. Absorption: is the movement of a drug from its site of administration into the bloodstream for distribution to the tissues. Distribution: refers to the transport of a drug by the bloodstream to its site of action, first to those areas with extensive blood supply. Areas of rapid distribution include the heart, liver, kidneys, and brain; while areas of slower distribution include muscle, skin, and fat Protein Binding: Protein binding may lead to an unpredictable drug response called a drug-drug interaction. A drug-drug interaction occurs when the presence of one drug decreases or increases the actions of another drug that is administered concurrently (i.e., given at the same time). Metabolism: Metabolism of drugs occurs mostly in the smooth endoplasmic reticulum of cells in the liver. A drug that is absorbed from the intestine must first pass through the liver before it reaches the systemic circulation. If a large proportion of a drug is chemically changed into inactive metabolites in the liver, then a much smaller amount of drug will pass into the circulation (i.e., will be bioavailable) thus creating a first-past effect that reduces drug bioavailability. Hepatic metabolism involves the activity of a very large class of enzymes known as cytochrome P-450 enzymes First Pass Routes: Hepatic, arterial, Oral, Portal, venous, Rectal Phase I: It begins with preclinical testing phases, which include in vitro studies (using tissue samples and cell cultures) and animal studies, healthy people without the disease. Phase I studies is to determine the optimal dosage range and the pharmacokinetics of the drug and to ascertain if further testing is needed. II: Clinical (human) studies follow the preclinical phase. This phase involves small numbers of volunteers who have the disease that the drug is designed to diagnose or treat and are closely monitored for the effectiveness of treatment Cytochrome P450 metabolism: the family of enzymes that metabolizes drugs; CYP P450 (mixed-function oxidase reaction) catalyzes the metabolism of a large number of diverse drugs and chemicals that are highly lipid soluble (lipophilic) [Show More]

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