NSG 6005 WEEK 2 STUDY GUIDE
Chapter 2. Review of Basic Principles of Pharmacology
____ 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. Drugs that have a significant first-pass effect:
3. Are rapidly metabolized by the liver and may have little if any desired action
____ 3. The route of excretion of a volatile drug will likely be the:
2. Lungs
____ 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage
reservoir of the drug. Storage reservoirs:
3. Increase the length of time a drug is available and active
____ 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
2. Biological half-life
____ 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
____ 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect
is the:
3. Onset of action
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
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.
____ 16. Which of the following statements about the major distribution barriers (blood-brain or fetal-
placental) is true?
1. Water soluble and ionized drugs cross these barriers rapidly.
2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
____ 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of
these types of reactions is to:
1. Inactivate prodrugs before they can be activated by target tissues
2. Change the drugs so they can cross plasma membranes
3. Change drug molecules to a form that an excretory organ can excrete
4. Make these drugs more ionized and polar to facilitate excretion
____ 18. Once they have been metabolized by the liver, the metabolites may be:
1. More active than the parent drug
2. Less active than the parent drug
3. Totally “deactivated” so they are excreted without any effect
4. All of the above
, ____ 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to
excrete drugs via the renal system would be increased by:
1. Reduced circulation and perfusion of the kidney
2. Chronic renal disease
3. Competition for a transport site by another drug
4. Unbinding a nonvolatile drug from plasma proteins
____ 20. Steady state is:
1. The point on the drug concentration curve when absorption exceeds excretion
2. When the amount of drug in the body remains constant
3. When the amount of drug in the body stays below the minimum toxic
concentration
4. All of the above
____ 21. Two different pain medications are given together for pain relief. The drug—drug interaction is:
1. Synergistic
2. Antagonistic
3. Potentiative
4. Additive
____ 22. Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
1. Reducing the dosage of one of the drugs
2. Scheduling their administration at different times
3. Prescribing a third drug to counteract the adverse reaction of the combination
4. Reducing the dosage of both drugs
____ 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements.
Which of the following would reduce or inhibit this process?
1. Protein malnutrition
2. Iron-deficiency anemia
3. Both 1 and 2
4. Neither 1 nor 2
____ 24. The time required for the amount of drug in the body to decrease by 50% is called:
1. Steady state
2. Half-life
3. Phase II metabolism
4. Reduced bioavailability time
____ 25. An agonist activates a receptor and stimulates a response. When given frequently over time, the
body may:
1. Upregulate the total number of receptors
2. Block the receptor with a partial agonist
3. Alter the drug’s metabolism
4. Downregulate the numbers of that specific receptor
____ 26. Drug antagonism is best defined as an effect of a drug that:
1. Leads to major physiological and psychological dependence
Chapter 2. Review of Basic Principles of Pharmacology
____ 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. Drugs that have a significant first-pass effect:
3. Are rapidly metabolized by the liver and may have little if any desired action
____ 3. The route of excretion of a volatile drug will likely be the:
2. Lungs
____ 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage
reservoir of the drug. Storage reservoirs:
3. Increase the length of time a drug is available and active
____ 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
2. Biological half-life
____ 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
____ 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect
is the:
3. Onset of action
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
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.
____ 16. Which of the following statements about the major distribution barriers (blood-brain or fetal-
placental) is true?
1. Water soluble and ionized drugs cross these barriers rapidly.
2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
____ 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of
these types of reactions is to:
1. Inactivate prodrugs before they can be activated by target tissues
2. Change the drugs so they can cross plasma membranes
3. Change drug molecules to a form that an excretory organ can excrete
4. Make these drugs more ionized and polar to facilitate excretion
____ 18. Once they have been metabolized by the liver, the metabolites may be:
1. More active than the parent drug
2. Less active than the parent drug
3. Totally “deactivated” so they are excreted without any effect
4. All of the above
, ____ 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to
excrete drugs via the renal system would be increased by:
1. Reduced circulation and perfusion of the kidney
2. Chronic renal disease
3. Competition for a transport site by another drug
4. Unbinding a nonvolatile drug from plasma proteins
____ 20. Steady state is:
1. The point on the drug concentration curve when absorption exceeds excretion
2. When the amount of drug in the body remains constant
3. When the amount of drug in the body stays below the minimum toxic
concentration
4. All of the above
____ 21. Two different pain medications are given together for pain relief. The drug—drug interaction is:
1. Synergistic
2. Antagonistic
3. Potentiative
4. Additive
____ 22. Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
1. Reducing the dosage of one of the drugs
2. Scheduling their administration at different times
3. Prescribing a third drug to counteract the adverse reaction of the combination
4. Reducing the dosage of both drugs
____ 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements.
Which of the following would reduce or inhibit this process?
1. Protein malnutrition
2. Iron-deficiency anemia
3. Both 1 and 2
4. Neither 1 nor 2
____ 24. The time required for the amount of drug in the body to decrease by 50% is called:
1. Steady state
2. Half-life
3. Phase II metabolism
4. Reduced bioavailability time
____ 25. An agonist activates a receptor and stimulates a response. When given frequently over time, the
body may:
1. Upregulate the total number of receptors
2. Block the receptor with a partial agonist
3. Alter the drug’s metabolism
4. Downregulate the numbers of that specific receptor
____ 26. Drug antagonism is best defined as an effect of a drug that:
1. Leads to major physiological and psychological dependence
