NURS 615 PHARM EXAM 1 MARYVILLE | COMPLETE QUESTIONS
WITH EXPERT SOLUTIONS | 2026 LATEST UPDATED | GET A+
What factors are associated with clinical judgment when prescribing medications? -
(answer)Prescribing a drug is based on a thorough assessment of the patient and the patient's
environment. The determination of potential medical and nursing diagnoses, a review of the
potential alternative therapies, specific knowledge about the drug chosen, and the disease process
it is going to treat, known as patient centered care. The best therapy is usually the least invasive,
least expensive, and the least likely to cause adverse reactions
What are the criteria for choosing an effective drug? - (answer)Multiple drugs may be able to
treat a specific condition. You must consult nationally recognized guidelines for disease
management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - (answer)Many drugs that carry
an electric charge are bound to albumin in the blood. The distribution of the drug to target tissues
may be affected if hypoalbuminemia is present.
What is the drug's half-life? - (answer)In clinical practice it takes about four to five times the
half-life for a drugs concentration to read steady state after a drug is started, stopped or changed.
Hal life is the amount of time for a drug to be half cleared.
What is meant by the onset of action, peak of action, duration of action of medications? -
(answer)The onset of action is the time between the drug administration and the time that you see
the drugs minimum effect. Onset is the first sign of a drugs therapeutic effect. Peak of action is
the time of the maximum concentration of the drug in the blood. Duration of action is the onset
of action and the metabolism of the drug below the dose needed for an effect.
Explain first pass metabolism. - (answer)This occurs when the concentration of the drug is
greatly reduced before it reaches the systemic circulation. It is the portion of the drug lost during
absorption. Generally, occurs in the liver or gut wall. After a drug is swallowed it is absorbed by
the digestive system and enters the hepatic system. It is then carried by the portal vein to the liver
before it reaches the rest of the body. The liver metabolizes many drugs to such an extent that
only a small portion of the drug reaches the rest of the body. bioavailability of the drug thus is
greatly reduced by the liver. Sublingual administration can bypass the first pass system plus it is
also faster than oral route.
,What is a steady state? - (answer)The overall intake of a drug is fairly and dynamic equilibrium
with its elimination. Steady state is reached when the time of four to five times the half-life is
reached since the drug had been started.
What factors affect the drug's absorption? - (answer)Absorption involves several steps. First the
drug must be introduced via route of administration and the form of medication like tablet or
capsule. In IV or IM administration the absorption is less variable and bioavailability is near
100%. IV administration is considered to lose no portion of the drug. The fastest route of
absorption is inhalation. Drugs must pass through the epithelial cells of the GI tract to be
absorbed by the circulatory system. Cell membranes may affect the absorption of some drugs
because they are made of lipid bilayers that are semi permeable. This means only small
uncharged solutes can pass through the membrane. Whether or not a molecule is ionized affects
the absorption, since ionic molecules are charged. Solubility favors charged species.
Permeability favors neutral species. Some molecules have special channels to facilitate
movement from the lumen into the circulation. The Henderson Hasselbeck equation offers a way
to determine the portion that is ionized in a given pH. Weak acids will be present in their
nonionic form in the stomach because of the acidic pH and bases will be in their ionic form.
Nonionic species diffuse easier through cell membranes. Weak acids have a higher absorption
rate in the stomach. The opposite is true in the basic environment of the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. - (answer)CYPs are
the major enzymes in drug metabolism. Must drugs undergo deactivation by CYPs are directly
facilitated secretion from the body. Many substances are bioactivated by CYPs to form their
active compound. Many drugs increase or decrease the activity of CYPs isoenzymes either by
inducing biosynthesis of an isozyme, which is enzyme induction or by directly inhibiting the
activity of CYP which is enzyme inhibition. This is a major source of adverse drug reactions
since changes in CYPs activity may affect the metabolism and clearance of certain drugs. When
two drugs are both metabolized by the CYP450 system the drugs should be administered at
separate times to prevent toxic effects.
What is the efficacy of the drug? - (answer)Efficacy is the maximum response achievable from a
drug. Intrinsic activity is a term used to describe the efficacy of a drug relative to a drugs highest
observed efficacy. Effectiveness refers to the ability of a drug to produce the wanted effect.
On the drug concentration curve what is the first sign of a therapeutic effect? - (answer)The onset
of action.
, What is the purpose of a peak and trough level? - (answer)To determine if the drug is within
therapeutic range. Which is either dosage range or blood plasma or serum concentration usually
expected to affect desired effects. Some patients require doses or concentrations above or below
this range and some patients have toxicity within this range.
Describe the purpose of the blood brain barrier and the fetal placental barrier. - (answer)The
blood brain barrier is a highly selective permeability barrier that separates circulating blood from
the brain and ECF in nervous system. Formed by brain endothelial cells which are formed by
tight junction with an extremely high electrical reductivity of at least 0.1 micron. The blood brain
barrier allows passage of water, some gases and lipid soluble molecules by passage diffusion. As
well as the selective transport of molecules like glycose and amino acids which are essential to
neruo function. The placental barrier impedes certain chemicals however it allows fat soluble
chemicals to cross. Drugs that are more water soluble and drugs with a higher molecular weight
tend to not cross the placenta. If a drug binds to a large protein like albumin it is even less likely
to cross the placenta.
What is the difference in distribution for each medication route? - (answer)Absorption has a
many steps drug must be introduced via some route in order to be absorbed then distributed.
How will renal insufficiency affect drug elimination? - (answer)Kidney is primary excretion
organ of drugs. General theme of metabolism is to produce a more water soluble and more easily
removed by the kidneys. The rate at which a drug is excreted by the kidneys depends on several
factors. Renal blood flow influences GFR glomerular filtration rate which is how much plasma is
filtered per minute by the glomerulus. Renal excretion of drugs is usually well characterized it is
the patients renal function that is variable. It is common to monitor renal function and adjust
dosages based on renal function. Typically assessed by serum creatinine. Patients with poor renal
function may have high levels of drugs secondary to decreased excretion metabolites.
Describe the effects of drugs based on the route of administration. - (answer)Absorption has a
many steps drug must be introduced via some route in order to be absorbed then distributed.
Describe the role of the isoenzymes. - (answer)CYPs are the major enzymes in drug metabolism.
Must drugs undergo deactivation by CYPs are directly facilitated secretion from the body. Many
substances are bioactivated by CYPs to form their active compound. Many drugs increase or
decrease the activity of CYPs isoenzymes either by inducing biosynthesis of an isozyme, which
is enzyme induction or by directly inhibiting the activity of CYP which is enzyme inhibition.
This is a major source of adverse drug reactions since changes in CYPs activity may affect the
WITH EXPERT SOLUTIONS | 2026 LATEST UPDATED | GET A+
What factors are associated with clinical judgment when prescribing medications? -
(answer)Prescribing a drug is based on a thorough assessment of the patient and the patient's
environment. The determination of potential medical and nursing diagnoses, a review of the
potential alternative therapies, specific knowledge about the drug chosen, and the disease process
it is going to treat, known as patient centered care. The best therapy is usually the least invasive,
least expensive, and the least likely to cause adverse reactions
What are the criteria for choosing an effective drug? - (answer)Multiple drugs may be able to
treat a specific condition. You must consult nationally recognized guidelines for disease
management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - (answer)Many drugs that carry
an electric charge are bound to albumin in the blood. The distribution of the drug to target tissues
may be affected if hypoalbuminemia is present.
What is the drug's half-life? - (answer)In clinical practice it takes about four to five times the
half-life for a drugs concentration to read steady state after a drug is started, stopped or changed.
Hal life is the amount of time for a drug to be half cleared.
What is meant by the onset of action, peak of action, duration of action of medications? -
(answer)The onset of action is the time between the drug administration and the time that you see
the drugs minimum effect. Onset is the first sign of a drugs therapeutic effect. Peak of action is
the time of the maximum concentration of the drug in the blood. Duration of action is the onset
of action and the metabolism of the drug below the dose needed for an effect.
Explain first pass metabolism. - (answer)This occurs when the concentration of the drug is
greatly reduced before it reaches the systemic circulation. It is the portion of the drug lost during
absorption. Generally, occurs in the liver or gut wall. After a drug is swallowed it is absorbed by
the digestive system and enters the hepatic system. It is then carried by the portal vein to the liver
before it reaches the rest of the body. The liver metabolizes many drugs to such an extent that
only a small portion of the drug reaches the rest of the body. bioavailability of the drug thus is
greatly reduced by the liver. Sublingual administration can bypass the first pass system plus it is
also faster than oral route.
,What is a steady state? - (answer)The overall intake of a drug is fairly and dynamic equilibrium
with its elimination. Steady state is reached when the time of four to five times the half-life is
reached since the drug had been started.
What factors affect the drug's absorption? - (answer)Absorption involves several steps. First the
drug must be introduced via route of administration and the form of medication like tablet or
capsule. In IV or IM administration the absorption is less variable and bioavailability is near
100%. IV administration is considered to lose no portion of the drug. The fastest route of
absorption is inhalation. Drugs must pass through the epithelial cells of the GI tract to be
absorbed by the circulatory system. Cell membranes may affect the absorption of some drugs
because they are made of lipid bilayers that are semi permeable. This means only small
uncharged solutes can pass through the membrane. Whether or not a molecule is ionized affects
the absorption, since ionic molecules are charged. Solubility favors charged species.
Permeability favors neutral species. Some molecules have special channels to facilitate
movement from the lumen into the circulation. The Henderson Hasselbeck equation offers a way
to determine the portion that is ionized in a given pH. Weak acids will be present in their
nonionic form in the stomach because of the acidic pH and bases will be in their ionic form.
Nonionic species diffuse easier through cell membranes. Weak acids have a higher absorption
rate in the stomach. The opposite is true in the basic environment of the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. - (answer)CYPs are
the major enzymes in drug metabolism. Must drugs undergo deactivation by CYPs are directly
facilitated secretion from the body. Many substances are bioactivated by CYPs to form their
active compound. Many drugs increase or decrease the activity of CYPs isoenzymes either by
inducing biosynthesis of an isozyme, which is enzyme induction or by directly inhibiting the
activity of CYP which is enzyme inhibition. This is a major source of adverse drug reactions
since changes in CYPs activity may affect the metabolism and clearance of certain drugs. When
two drugs are both metabolized by the CYP450 system the drugs should be administered at
separate times to prevent toxic effects.
What is the efficacy of the drug? - (answer)Efficacy is the maximum response achievable from a
drug. Intrinsic activity is a term used to describe the efficacy of a drug relative to a drugs highest
observed efficacy. Effectiveness refers to the ability of a drug to produce the wanted effect.
On the drug concentration curve what is the first sign of a therapeutic effect? - (answer)The onset
of action.
, What is the purpose of a peak and trough level? - (answer)To determine if the drug is within
therapeutic range. Which is either dosage range or blood plasma or serum concentration usually
expected to affect desired effects. Some patients require doses or concentrations above or below
this range and some patients have toxicity within this range.
Describe the purpose of the blood brain barrier and the fetal placental barrier. - (answer)The
blood brain barrier is a highly selective permeability barrier that separates circulating blood from
the brain and ECF in nervous system. Formed by brain endothelial cells which are formed by
tight junction with an extremely high electrical reductivity of at least 0.1 micron. The blood brain
barrier allows passage of water, some gases and lipid soluble molecules by passage diffusion. As
well as the selective transport of molecules like glycose and amino acids which are essential to
neruo function. The placental barrier impedes certain chemicals however it allows fat soluble
chemicals to cross. Drugs that are more water soluble and drugs with a higher molecular weight
tend to not cross the placenta. If a drug binds to a large protein like albumin it is even less likely
to cross the placenta.
What is the difference in distribution for each medication route? - (answer)Absorption has a
many steps drug must be introduced via some route in order to be absorbed then distributed.
How will renal insufficiency affect drug elimination? - (answer)Kidney is primary excretion
organ of drugs. General theme of metabolism is to produce a more water soluble and more easily
removed by the kidneys. The rate at which a drug is excreted by the kidneys depends on several
factors. Renal blood flow influences GFR glomerular filtration rate which is how much plasma is
filtered per minute by the glomerulus. Renal excretion of drugs is usually well characterized it is
the patients renal function that is variable. It is common to monitor renal function and adjust
dosages based on renal function. Typically assessed by serum creatinine. Patients with poor renal
function may have high levels of drugs secondary to decreased excretion metabolites.
Describe the effects of drugs based on the route of administration. - (answer)Absorption has a
many steps drug must be introduced via some route in order to be absorbed then distributed.
Describe the role of the isoenzymes. - (answer)CYPs are the major enzymes in drug metabolism.
Must drugs undergo deactivation by CYPs are directly facilitated secretion from the body. Many
substances are bioactivated by CYPs to form their active compound. Many drugs increase or
decrease the activity of CYPs isoenzymes either by inducing biosynthesis of an isozyme, which
is enzyme induction or by directly inhibiting the activity of CYP which is enzyme inhibition.
This is a major source of adverse drug reactions since changes in CYPs activity may affect the
