TEST BANK FOR PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE PRESCRIBERS 5TH EDITION WOO ROBINSON ALL CHAPTERS

Chapter 2. Review of the Basic Principles of Pharmacology Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to prescribing because: 1. Distribution of drugs to target tissue may be affected. 2. The solubility of the drug will not match the site of absorption. 3. There will be less free drug available to generate an effect. 4. Drugs bound to albumin are readily excreted by the kidneys. 2. Drugs that have a significant first-pass effect: 1. Must be given by the enteral (oral) route only 2. Bypass the hepatic circulation 3. Are rapidly metabolized by the liver and may have little if any desired action 4. Are converted by the liver to more active and fat-soluble forms 3. The route of excretion of a volatile drug will likely be the: 1. Kidneys 2. Lungs 3. Bile and feces 4. Skin 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs: 1. Assure that the drug will reach its intended target tissue 2. Are the reason for giving loading doses 3. Increase the length of time a drug is available and active 4. Are most common in collagen tissues 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s: 1. Propensity to go to the target receptor 2. Biological half-life 3. Pharmacodynamics 4. Safety and side effects 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: 1. Rapidly achieves drug levels in the therapeutic range 2. Requires four- to five-half-lives to attain 3. Is influenced by renal function 4. Is directly related to the drug circulating to the target tissues 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: 1. Minimum adverse effect level 2. Peak of action 3. Onset of action 4. Therapeutic range 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done: 1. When the drug has a wide therapeutic range 2. When the drug will be administered for a short time only 3. When there is a high correlation between the dose and saturation of receptor sites 4. To determine if a drug is in the therapeutic range 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the: 1. Concentration will produce therapeutic effects 2. Concentration will produce an adverse response 3. Time between doses must be shortened 4. Duration of action of the drug is too long 10. Drugs that are receptor agonists may demonstrate what property? 1. Irreversible binding to the drug receptor site 2. Upregulation with chronic use 3. Desensitization or downregulation with continuous use 4. Inverse relationship between drug concentration and drug action 11. Drugs that are receptor antagonists, such as beta blockers, may cause: 1. Downregulation of the drug receptor 2. An exaggerated response if abruptly discontinued 3. Partial blockade of the effects of agonist drugs 4. An exaggerated response to competitive drug agonists 12. Factors that affect gastric drug absorption include: 1. Liver enzyme activity 2. Protein-binding properties of the drug molecule 3. Lipid solubility of the drug 4. Ability to chew and swallow 13. Drugs administered via IV: 1. Need to be lipid soluble in order to be easily absorbed 2. Begin distribution into the body immediately 3. Are easily absorbed if they are nonionized 4. May use pinocytosis to be absorbed 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is: 1. The sum of the effects of each drug individually 2. Greater than the sum of the effects of each drug individually 3. Less than the effect of each drug individually 4. Not predictable, as it varies with each individual 15. Which of the following statements about bioavailability is true? 1. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. 2. All brands of a drug have the same bioavailability. 3. Drugs that are administered more than once a day have greater bioavailability than drugs given once daily. 4. Combining an active drug with an inert substance does not affect bioavailability.