| COMPLETE ACTUAL EXAM | QUESTIONS & 100% VERIFIED CORRECT
ANSWERS | OBJECTIVE ASSESSMENT | PRE ASSESSMENT INCLUDED |
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Once you graduate from an NP program, in order to prescribe you'll need: - ANSWER -
Advanced nurse prescriber license
-DEA #
What is the purpose of a DEA #? - ANSWER Needed to prescribed scheduled drugs
Rules for prescribing Schedule II drugs: - ANSWER -Written script needed
1 month supply only
-No refills
What is the PDMP? - ANSWER Prescription Drug Monitoring Program
Used to effectively track patient controlled substance uses across different health facilities (in
the same state)
What are clinical practice guidelines? - ANSWER Recommendations that are intended to
optimize patient care that are informed by a systematic review of the evidence and an
assessment of the benefits/harms of alternative care practices
Ex: sepsis, CAP
Common causes of medication errors: - ANSWER -Illegible writing
,-Drug names that sound alike
-Medications that look alike
-Administering a drug with the wrong route
What is pharmacokinetics? What are its 4 categories? - ANSWER What the body does to
the drug
1. Absorption
2. Metabolism
3. Distribution
4. Excretion
Quickest route of absorption? Slowest? - ANSWER IV = quickest
IM = slowest
What is the most common way drugs pass through cell membranes? - ANSWER Passive
diffusion
What characteristics of a drug allow it to pass most quickly through cell membranes (usually
through passive diffusion)? - ANSWER Small, uncharged (unionized), lipid soluble--pass
through membrane without any energy
What does it mean when a drug is ionized? - ANSWER It means that the drug is stuck in the
compartment it was ionized in and has to be moved to the next compartment (cannot be
absorbed into the bloodstream)
Where do weak acids absorb? - ANSWER Stomach
, Where do weak bases absorb? - ANSWER Small intestine
pH of stomach: - ANSWER 2-4
pH of small intestine: - ANSWER 6-7
pH of large intestine: - ANSWER 6-7
pH of bloodstream: - ANSWER 7.35-7.45
pH of bladder: - ANSWER 5-8
pH of breastmilk: - ANSWER 7.1
Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and lower? - ANSWER
In the small intestine (since the stomach has a pH of 2-4, so the drug will become ionized
and move to the small intestine where it will be able to absorb into the bloodstream)
How can we manipulate the urine pH in cases of overdose? - ANSWER Drugs that are weak
acids (aspirin) can be trapped and excreted through the urine.
We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be
excreted, not reabsorbed through the bloodstream.
What is distribution? - ANSWER How a drug will be transported to the tissues it needs to
go to in order for it to exert its effects
, Drug factors related to distribution: - ANSWER -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - ANSWER -Vascularity (poor perfusion, disruption of
blood flow due to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will
need very high dosing since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein binding for medications? - ANSWER
Albumin
Why do we monitor albumin? - ANSWER Indicative of nutritional status and how well
protein-bound drugs will be transported to their target locations