NNP EXAM QUESTIONS AND 100% CORRECT ANSWERS
Pharmacokinetics refers to "the mathematical relationships between dose and blood
level as a function of time." Pharmacokinetic processes include absorption, distribution,
metabolism - biotransformation, and excretion (Allegaert et al., 2018, pp. 419-421;
Blackburn, 2018; pp. 180-181; Wade, 2015, p. 665).
Phase I drug metabolism reactions are mediated by
A.
Cytochrome P450 enzymes
B.
Hepatic oxidation metabolites
C.
Enzymatic reduction molecules - ANSWER A.
Which of the following would provide the weakest evidence for practice?
A.
Case study
B.
Case-control study
C.
Quasi-experimental study - ANSWER A.
Level Evidence type I meta-analysis and/or systematic review of randomized-controlled
trials (RCT); II single RCT; III quasi-experiment (non-randomized); IV non-experimental
study (casecontrol, cohort, correlational); V systematic reviews of descriptive studies
or qualitative studies; VI single qualitative study or cross-section study (survey); VII
expert opinion, case reports, committee reports (Polit & Beck, 2018, pp. 23-34; Thomas,
2015, p. 840).
,An early manifestation of hyperkalemia related to an EKG is
A.
Tall T waves
B.
Slurring of the QRS
C.
Ventricular fibrillation - ANSWER A.
EKG changes typically are the first manifestation of hyperkalemia. EKG changes are
modified as the serum K + increases, presenting with progressive degrees of peaked T
waves (secondary to enhancement of the repolarization of cardiac tissue), followed by
P-wave flattening and prolongation of the PR intervals secondary to suppression of the
conductivity of the atrium. These are followed by widening and slurring of the QRS
complex- secondary to delay in ventricular conduction as well as delays in myocardial
conduction, with eventual development of supraventricular tachycardia, ventricular
tachycardia, bradycardia, or ventricular fibrillation - Doherty, 2017, p. 308.
The Henderson-Hasselebalch equation is a negative logarithm that calculates the level
of
A.
Bicarbonate ions
B.
Dioxide ions
C.
Hydrogen ions - ANSWER C.
The Henderson-Hasselebalch equation calculates plasma pH. The pH is the negative
logarithm that measures the level of hydrogen ions; thus, there is an inverse relationship
between the pH and H+. For example, the pH decreases as the H+ increases, and pH
increases with a decrease in H+. If there is a balance in the changes of CO2 and HCO3,
then the pH will be within the normal limit.
,The NNP recalls that a peak serum level of any medication is typically indicative of the
infant's:
A.
Rate of excretion of metabolites
B.
Rate of digestion of the medication
C.
Volume of distribution
answer - ANSWER C.
Volume of distribution (Vd) is a function of gestational age because the percentage of
total body water and fluid shifts change with rapid growth. Allegaert K, Olafsdottir E,
Jensen PS. Neonatal Drug Therapy: The Customizing Factors, 2018. p 428; Wade D.
Coming of Age in Pharmacology: Age-Related Changes and Their Effects on Drug Action
in Neonates, Infants, Children, and Adults. J Midwifery Women's Health. 2015. p 666.
Infants have large extracellular fluid volumes, which increase Vd for water-soluble
drugs and may reduce peak drug values and affect drug excretion. (Blackburn, 2018,
p.198).
Less body fat in preterm and intrauterine growth-restricted infants reduces the Vd for
lipophilic drugs. (Blackburn, 2018, p.199).
Pharmacokinetics is the process of drug
A.
Absorption, distribution, biotransformation, and excretion
B.
Adaptations made to physiological systems by the drugs
C.
Changes, metabolism, and excretion in the cellular matrix - ANSWER A.
Phase I metabolism is mediated for the most part by the CYP450 group of enzymes,
which are mainly located in hepatic tissues but can be found in many tissues around the
, body. (Allegaert et al., 2018, pp. 655-657; McClary, 2015b, pp. 420-421).
Translocation of a drug from the site of administration into the systemic circulation is
called
A.
Absorption
B.
Distribution
C.
Drug delivery answer - ANSWER A.
Absorption is the movement of the drug from the administration site (gastrointestinal,
intravenous, intramuscular, intrapulmonary/inhaled, and subcutaneous) across
membranes into the systemic circulation (Allegaert et al., 2018, p. 419; Domonoske,
2015, pp. 220-221; Wade, 2015, p. 665).
8.
The time to delay clamping of the umbilical cord after delivery of a well newborn is
A.
0 to 20 seconds
B.
30 to 60 seconds
C.
90 to 120 seconds - ANSWER B.
Delayed umbilical cord clamping is the time taken, usually 30 to 60 seconds, before
clamping the cord to transfuse blood from the placenta to the infant (Katheria & Finer,
2018, pp. 277-279).
9.
Pharmacokinetics refers to "the mathematical relationships between dose and blood
level as a function of time." Pharmacokinetic processes include absorption, distribution,
metabolism - biotransformation, and excretion (Allegaert et al., 2018, pp. 419-421;
Blackburn, 2018; pp. 180-181; Wade, 2015, p. 665).
Phase I drug metabolism reactions are mediated by
A.
Cytochrome P450 enzymes
B.
Hepatic oxidation metabolites
C.
Enzymatic reduction molecules - ANSWER A.
Which of the following would provide the weakest evidence for practice?
A.
Case study
B.
Case-control study
C.
Quasi-experimental study - ANSWER A.
Level Evidence type I meta-analysis and/or systematic review of randomized-controlled
trials (RCT); II single RCT; III quasi-experiment (non-randomized); IV non-experimental
study (casecontrol, cohort, correlational); V systematic reviews of descriptive studies
or qualitative studies; VI single qualitative study or cross-section study (survey); VII
expert opinion, case reports, committee reports (Polit & Beck, 2018, pp. 23-34; Thomas,
2015, p. 840).
,An early manifestation of hyperkalemia related to an EKG is
A.
Tall T waves
B.
Slurring of the QRS
C.
Ventricular fibrillation - ANSWER A.
EKG changes typically are the first manifestation of hyperkalemia. EKG changes are
modified as the serum K + increases, presenting with progressive degrees of peaked T
waves (secondary to enhancement of the repolarization of cardiac tissue), followed by
P-wave flattening and prolongation of the PR intervals secondary to suppression of the
conductivity of the atrium. These are followed by widening and slurring of the QRS
complex- secondary to delay in ventricular conduction as well as delays in myocardial
conduction, with eventual development of supraventricular tachycardia, ventricular
tachycardia, bradycardia, or ventricular fibrillation - Doherty, 2017, p. 308.
The Henderson-Hasselebalch equation is a negative logarithm that calculates the level
of
A.
Bicarbonate ions
B.
Dioxide ions
C.
Hydrogen ions - ANSWER C.
The Henderson-Hasselebalch equation calculates plasma pH. The pH is the negative
logarithm that measures the level of hydrogen ions; thus, there is an inverse relationship
between the pH and H+. For example, the pH decreases as the H+ increases, and pH
increases with a decrease in H+. If there is a balance in the changes of CO2 and HCO3,
then the pH will be within the normal limit.
,The NNP recalls that a peak serum level of any medication is typically indicative of the
infant's:
A.
Rate of excretion of metabolites
B.
Rate of digestion of the medication
C.
Volume of distribution
answer - ANSWER C.
Volume of distribution (Vd) is a function of gestational age because the percentage of
total body water and fluid shifts change with rapid growth. Allegaert K, Olafsdottir E,
Jensen PS. Neonatal Drug Therapy: The Customizing Factors, 2018. p 428; Wade D.
Coming of Age in Pharmacology: Age-Related Changes and Their Effects on Drug Action
in Neonates, Infants, Children, and Adults. J Midwifery Women's Health. 2015. p 666.
Infants have large extracellular fluid volumes, which increase Vd for water-soluble
drugs and may reduce peak drug values and affect drug excretion. (Blackburn, 2018,
p.198).
Less body fat in preterm and intrauterine growth-restricted infants reduces the Vd for
lipophilic drugs. (Blackburn, 2018, p.199).
Pharmacokinetics is the process of drug
A.
Absorption, distribution, biotransformation, and excretion
B.
Adaptations made to physiological systems by the drugs
C.
Changes, metabolism, and excretion in the cellular matrix - ANSWER A.
Phase I metabolism is mediated for the most part by the CYP450 group of enzymes,
which are mainly located in hepatic tissues but can be found in many tissues around the
, body. (Allegaert et al., 2018, pp. 655-657; McClary, 2015b, pp. 420-421).
Translocation of a drug from the site of administration into the systemic circulation is
called
A.
Absorption
B.
Distribution
C.
Drug delivery answer - ANSWER A.
Absorption is the movement of the drug from the administration site (gastrointestinal,
intravenous, intramuscular, intrapulmonary/inhaled, and subcutaneous) across
membranes into the systemic circulation (Allegaert et al., 2018, p. 419; Domonoske,
2015, pp. 220-221; Wade, 2015, p. 665).
8.
The time to delay clamping of the umbilical cord after delivery of a well newborn is
A.
0 to 20 seconds
B.
30 to 60 seconds
C.
90 to 120 seconds - ANSWER B.
Delayed umbilical cord clamping is the time taken, usually 30 to 60 seconds, before
clamping the cord to transfuse blood from the placenta to the infant (Katheria & Finer,
2018, pp. 277-279).
9.
