NSG 6005 WEEK 9 CONCEPT REVIEW GUIDE
2026 CARE MANAGEMENT AND ADVANCED
CLINICAL DECISION MAKING
◉ Drugs that have a significant first pass effect:
o Must be given by enteral (oral) route only
o Bypass the hepatic circulation
o Are rapidly metabolized by the liver and may have little if any
desired action
o Are converted by the liver to more active in fat-soluble forms.
Answer: o Are rapidly metabolized by the liver and may have little if
any desired action
◉ 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:
o His appropriately only telling you about his regularly prescribed
medications
o His hiding information regarding his inappropriate use of aspirin
from you
,o His common misconception that intermittently taking OTC
medications are not an important part of his drug history
o A common misuse of OTC aspirin.
Answer: o His common misconception that intermittently taking
OTC medications are not an important part of his drug history
◉ Drugs that use CYP3A4 isoenzymes for metabolism may:
o Induce the metabolism of another drug
o Inhibit the metabolism of another drug
o Both A and B
o Neither A nor B.
Answer: o Both A and B
◉ A twenty four year old male received multiple fractures in a motor
vehicle accident that required significant amounts of opioid
medication to treat his pain. He is at risk for Type ____ ADR when he
no longer requires the opioids.
oA
oC
oE
o G.
,Answer: o E
◉ Infants and young children are at higher risk of ADRs due to:
o Immature renal function in schoolage children
o Lack of safety and efficacy studies in the pediatric population
o Children's skin being thicker than adults, requiring higher dosages
of topical medication
o Infant boys having a higher proportion of muscle mass, leading to a
higher volume of distribution.
Answer: o Lack of safety and efficacy studies in the pediatric
population
◉ The type of ADR that is the result of an unwanted but otherwise
normal pharmacological action of a drug given in the usual
therapeutic dose is:
o Type A
o Type B
o Type C
o Type D.
Answer: o Type A
, ◉ A nurse practitioner would prescribe the liquid form of ibuprofen
for a six-year-old because:
o Drugs given in liquid form are less irritating to the stomach.
o A six-year-old may have problems swallowing a pill.
o Liquid forms of medication eliminate the concern for first-pass
effect.
o Liquid ibuprofen does not have to be dosed as often as tablet form..
Answer: o A six-year-old may have problems swallowing a pill.
◉ The role of the nurse practitioner in the use of herbal medication
is to:
o Maintain competence in the prescribing of common herbal
remedies.
o Recommend common OTC herbs to patients.
o Educate patients and guide them to appropriate sources of care.
o Encourage patients to not use herbal therapy due to the
documented dangers..
Answer: o Educate patients and guide them to appropriate sources
of care.
◉ Genetic polymorphisms account for differences in metabolism,
including:
2026 CARE MANAGEMENT AND ADVANCED
CLINICAL DECISION MAKING
◉ Drugs that have a significant first pass effect:
o Must be given by enteral (oral) route only
o Bypass the hepatic circulation
o Are rapidly metabolized by the liver and may have little if any
desired action
o Are converted by the liver to more active in fat-soluble forms.
Answer: o Are rapidly metabolized by the liver and may have little if
any desired action
◉ 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:
o His appropriately only telling you about his regularly prescribed
medications
o His hiding information regarding his inappropriate use of aspirin
from you
,o His common misconception that intermittently taking OTC
medications are not an important part of his drug history
o A common misuse of OTC aspirin.
Answer: o His common misconception that intermittently taking
OTC medications are not an important part of his drug history
◉ Drugs that use CYP3A4 isoenzymes for metabolism may:
o Induce the metabolism of another drug
o Inhibit the metabolism of another drug
o Both A and B
o Neither A nor B.
Answer: o Both A and B
◉ A twenty four year old male received multiple fractures in a motor
vehicle accident that required significant amounts of opioid
medication to treat his pain. He is at risk for Type ____ ADR when he
no longer requires the opioids.
oA
oC
oE
o G.
,Answer: o E
◉ Infants and young children are at higher risk of ADRs due to:
o Immature renal function in schoolage children
o Lack of safety and efficacy studies in the pediatric population
o Children's skin being thicker than adults, requiring higher dosages
of topical medication
o Infant boys having a higher proportion of muscle mass, leading to a
higher volume of distribution.
Answer: o Lack of safety and efficacy studies in the pediatric
population
◉ The type of ADR that is the result of an unwanted but otherwise
normal pharmacological action of a drug given in the usual
therapeutic dose is:
o Type A
o Type B
o Type C
o Type D.
Answer: o Type A
, ◉ A nurse practitioner would prescribe the liquid form of ibuprofen
for a six-year-old because:
o Drugs given in liquid form are less irritating to the stomach.
o A six-year-old may have problems swallowing a pill.
o Liquid forms of medication eliminate the concern for first-pass
effect.
o Liquid ibuprofen does not have to be dosed as often as tablet form..
Answer: o A six-year-old may have problems swallowing a pill.
◉ The role of the nurse practitioner in the use of herbal medication
is to:
o Maintain competence in the prescribing of common herbal
remedies.
o Recommend common OTC herbs to patients.
o Educate patients and guide them to appropriate sources of care.
o Encourage patients to not use herbal therapy due to the
documented dangers..
Answer: o Educate patients and guide them to appropriate sources
of care.
◉ Genetic polymorphisms account for differences in metabolism,
including:
