NR 565 ADVANCED PHARMACOLOGY FUNDAMENTALS MIDTERM / FINAL EXAM OVER 200 QUESTIONS WITH 100% VERIFIED ANSWERS. LATEST 2020/2021

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Chapter 2. Review of Basic Principles of Pharmacology Question 1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because: Qu... estion 2. Drugs that have a significant first-pass effect: Question 3. The route of excretion of a volatile drug will likely be the: Question 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir Question 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s: Question 6. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose: Question 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: Question 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done: Question 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the: Question 10. Drugs that are receptor agonists may demonstrate what property? Question 11. Drugs that are receptor antagonists, such as beta blockers, may cause: Question 12. Factors that affect gastric drug absorption include: Question 13. Drugs administered via IV: Question 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is: Question 15. Which of the following statements about bioavailability is true? Question 16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true? Question 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: Question 18. Once they have been metabolized by the liver, the metabolites may be: Question 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by: Question 20. Steady state is: Question 21. Two different pain medications are given together for pain relief. The drug—drug interaction Question 22. Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT: Question 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process? Question 24. The time required for the amount of drug in the body to decrease by 50% is called: Question 25. An agonist activates a receptor and stimulates a response. When given frequently over time, the body may: Question 26. Drug antagonism is best defined as an effect of a drug that: Question 27. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements? Question 28. The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly result in: Question 29. Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach? Question 30. Which of the following variables is a factor in drug absorption? Question 31. An advantage of prescribing a sublingual medication is that the medication is: Question 32. Drugs that use CYP 3A4 isoenzymes for metabolism may: Question 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state: Question 34. Upregulation or hypersensitization may lead to: Chapter 7. Cultural and Ethnic Influences in Pharmacotherapeutics Question 1. Cultural factors that must be taken into account when prescribing include(s): Question 2. Ethnic differences have been found in drug: Question 3. The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all: Question 4. According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care: Question 5. According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to: Question 6. The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are: Question 7. Pharmacokinetics among Asians are universal to all the Asian ethnic groups. Question 8. Alterations in drug metabolism among Asians may lead to: Question 9. Asians from Eastern Asia are known to be fast acetylators. Fast acetylators: Question 10. Hispanic native healers (curanderas): Chapter 8. An Introduction to Pharmacogenomics Question 1. Genetic polymorphisms account for differences in metabolism, including: Question 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to: Question 3. Rifampin is a nonspecific CYP450 inducer that may: Question 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to: Question 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to: Question 6. Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin. Question 7. Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing: Question 8. Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to: Question 9. A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to: Question 10. Patients who have a poor metabolism phenotype will have: Question 11. Ultra-rapid metabolizers of drugs may have: Question 12. A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: Chapter 1. The Role of the Nurse Practitioner Question 1. Nurse practitioner prescriptive authority is regulated by: Question 2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include: Question 3. Clinical judgment in prescribing includes: Question 4. Criteria for choosing an effective drug for a disorder include: Question 5. Nurse practitioner practice may thrive under health-care reform because of: Chapter 4. Legal and Professional Issues in Prescribing Question 1. The U.S. Food and Drug Administration regulates: Question 2. The U.S. Food and Drug Administration approval is required for: Question 3. An Investigational New Drug is filed with the U.S. Food and Drug Administration: Question 4. Phase IV clinical trials in the United States are also known as: Question 5. Off-label prescribing is: Question 6. The U.S. Drug Enforcement Administration: Question 7. Drugs that are designated Schedule II by the U.S. Drug Enforcement Administration: Question 8. Precautions that should be taken when prescribing controlled substances include: Question 9. Strategies prescribers can use to prevent misuse of controlled prescription drugs include: Question 10. Behaviors predictive of addiction to controlled substances include: Question 11. Medication agreements or “Pain Medication Contracts” are recommended to be used: Question 12. A prescription needs to be written for: Chapter 13. Over-the-Counter Medications Question 1. Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must: Question 2. In the United States, over-the-counter drugs are regulated by: Question 3. As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to: Question 4. New over-the-counter drug ingredients must undergo the U.S. Food and Drug Administration New Drug Application process, just as prescription drugs do. Question 5 . The ailment that generates the greatest over-the-counter annual drug sales is: Question 6. Common over-the-counter pain relievers such as acetaminophen or ibuprofen: Question 7. When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of: Question 8. The Combat Methamphetamine Epidemic Act, which is part of the 2006 U.S. Patriot Act: Question 9. When prescribing a tetracycline or quinolone antibiotic it is critical to instruct the patient: Chapter 25. Drugs Used in Treating Inflammatory Processes Question 1. Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry? Question 2. Patient education when prescribing colchicine includes: Question 3. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes: Question 4. Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes: Question 5 . Sallie has been taking 10 mg per day of prednisone for the past 6 months. She should be assessed for: Question 6 . Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for: Question 7. Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to discontinue the prednisone. How is prednisone discontinued? Question 8. Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need co-treatment with which medications to prevent further adverse effects? Question 9. Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of: Question 10. Patients who are on chronic long-term corticosteroid therapy need education regarding: Question 11. All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding: Question 12. Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes: Question 13. When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs: Question 14. Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen? Question 15. Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to “get going” each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry? Question 16. The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is: Question 17. Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: Question 18. Monitoring a patient on a high-dose aspirin level includes: Question 19. Patients who are on long-term aspirin therapy should have ______ annually. Chapter 52. Pain Management: Acute and Chronic Pain Question 1. Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence the: Question 2. Patients need to be questioned about all pain sites because: , Question 3. The chemicals that promote the spread of pain locally include: Question 4. Narcotics are exogenous opiates. They act by: Question 5. Age is a factor in different responses to pain. Which of the following age-related statements about pain is NOT true? Question 6. Which of the following statements is true about acute pain? Question 7. One of the main drug classes used to treat acute pain is NSAIDs. They are used because: Question 8. Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs? Question 9. If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use? Question 10. The goal of treatment of acute pain is: Question 11. Which of the following statements is true about age and pain? Question 12. Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to: Question 13. Pathological similarities and differences between acute pain and chronic pain include: Question 14. A treatment plan for management of chronic pain should include: Question 15 .Chronic pain is a complex problem. Some specific strategies to deal with it include: Question 16. Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency? 17. The Pain Management Contract is appropriate for: Chapter 14. Drugs Affecting the Autonomic Nervous System Question 1. Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it: Question 2. To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT: Question 3. John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should Question 4. Clonidine has several off-label uses, including: Question 5. Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by: Reducing vascular smooth muscle tone Question 6. Which of the following adverse effects are less likely in a beta1-selective blocker? Question 7. Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol? 8. Beta blockers are the drugs of choice for exertional angina because they: 9. Adherence to beta blocker therapy may be affected by their: 10. Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the: Question 11. Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious consequences of rapid withdrawal are those with: Question 12. To prevent life-threatening events from rapid withdrawal of a beta blocker: Question 13. Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose? Question 14. Combined alpha-beta antagonists are used to reduce the progression of heart failure because they: Question 15. Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes? Question 16. Alpha-beta blockers are especially effective to treat hypertension for which ethnic group? Question 17. Bethanechol: Question 18. Clinical dosing of Bethanechol: Question 19. Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects? Question 20. Anticholinesterase inhibitors are used to treat: Question 21. Which of the following drugs used to treat Alzheimer’s disease is not an anticholinergic? Question 22. Taking which drug with food maximizes it bioavailability? Question 23. Which of the following drugs should be used only when clearly needed in pregnant and breastfeeding women? Question 24. There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include: Question 25. Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily? Question 26. Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine? Question 27. Nicotine gum products are: Question 28. Nicotine replacement therapy (NRT): [Show More]

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