Sentinel N521 Advanced Pharmacology Progress Test 1
The CNP orders the patient a tetracycline antibiotic and instructs him to avoid taking the medication with foods, beverages, or drugs that contain calcium, iron, or magnesium. The patient takes the antibiotic along with a daily multivitamin, not realizing that the vitamin contains iron. What effect may this have on the tetracycline?
- Increased distribution
- Decreased metabolism
- Impaired excretion
- Impaired absorption
During completion of the exam and review of the patient’s most recent medical record notes, it is noted by the CNP that the patient has a malignant brain tumor. What pharmacokinetic phase may be affected by the presence of the tumor?
The patient requires a drug to be prescribed by the CNP that is known to be completely metabolized by the first-pass effect. During the prescribing process the CNP knows that due to this requirement:
- The drug must be given by a non-oral route.
- The drug must be given in higher doses.
- The drug must be given in a lipid-soluble form.
- The drug must be given more frequently.
A patient with cirrhosis of the liver exhibits decreased metabolic activity. This will require the CNP to make what possible changes in the patient’s pharmacotherapeutic regimen? (Select all that apply.) Select one or more:
- More frequent monitoring for adverse drug effects
- A reduction in the dosage of the drugs
- A change in the timing of medication administration
- An increased dose of prescribed drugs
- Giving all prescribed drugs by intramuscular injection
A patient who is in renal failure may have a diminished capacity to excrete medications. During the course of drug therapy, the CNP must assess the patient more frequently for what development?
- Increased risk of allergy
- Increased risk for drug toxicity
- Increased absorption of the drug from the intestines
- Decreased therapeutic drug effects
A patient experiences profound drowsiness when a normal or low dose of a stimulant drug is given. This is an unusual reaction for this drug, a reaction that has not been associated with that particular drug. What is the term for this type of drug reaction?
- Unaltered reaction
- Enzyme-specific reaction
- Allergic reaction
- Idiosyncratic reaction
The CNP has ordered atropine, a drug that will prevent the patient’s own chemical, acetylcholine, from causing parasympathetic effects. What type of drug would atropine be considered?
- A protagonist
- An agonist
- A partial agonist
- An antagonist
The CNP explains to the patient that the drug he is prescribing has a “narrow therapeutic index,” and what this means. The provider knows the patient has correctly understood the meaning of his explanation when the patient tells him that the drug has what properties?
- It has a narrow range of effectiveness and may not give him the desired therapeutic results.
- It has a narrow range of conditions or diseases that the drug will be expected to treat successfully.
- It has a narrow segment of the population for whom the drug will work as desired.
- It has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects.
The CNP instructs her nursing student that 10 mg of morphine is considered to provide the same pain relief as 200 mg of codeine, and tells the student that this indicates that the morphine would be considered more Select one:
- potent than codeine.
- toxic than codeine.
- likely to cause an adverse event than codeine.
- likely to require dosing beyond once per day, than codeine..
What is the term used to describe the magnitude of maximal response that can be produced from a particular drug?
The CNP prescribes butorphanol (Stadol), a partial agonist. This term “partial agonist” reminds the CNP that Stadol:
- is a drug that will occupy a receptor and prevent the endogenous chemical from acting.
- is a drug that produces the same type of response as the endogenous substance.
- is a drug that produces a weaker, or less efficacious, response than an agonist drug.
- is a drug that causes unpredictable and unexplained drug reactions.
Nonlinear kinetics or zero-order kinetics describes a process whereby drug elimination does not depend on its:
- Both a and b
- Neither a nor b
Which herbal supplement should be taken with caution by people on Plavix(clopidogrel) due to its impact on platelet activity?
Which supplement increases bulk in stool but should be taken with a space of one to two hours from other medications?
- St John Wort
The following medication has a lower potential for abuse than schedule 1 and it is considered a schedule 3.
- Tylenol #3
- Hydromorphone Feedback
When prescribing drugs for an older adult, what factor affecting elimination of drugs should the practitioner consider?
- The kidney is the major organ of drug metabolism for older adults.
- Aging produces an increase in hepatic blood flow.
- Increased oxidation of drugs occurs with aging.
- Phase II metabolism of drugs by conjugation is not affected by age..
Which statement accurately describes the structure and function of a P&T Committee?
- It creates and implements medication use policies.
- It is composed of pharmacists and insurance company CFOs.
- It licenses pharmacists to practice in hospital settings.
- It helps to develop and manufacture safe, effective generic medications..
A health care practitioner is caring for an older patient diagnosed with dementia. Which measure is appropriate for this patient?
- Periodically assessing a patient who is taking a cholinesterase inhibitor
- Ordering antipsychotic medication for BPSD as first-line therapy
- Treating insomnia with benzodiazepines
- Ordering physical restraints to prevent falls
When prescribing doses for pediatric patients the NP must consider Select one:
- Height in centimeters
- Body Surface Area (BSA)
- Age in months
- Weight in kilograms
When prescribing doses for geriatric patients the NP must consider Select one:
- Age in years
- Weight in Kilograms
- Renal function
- Visual acuity