MSN 571 Nursing Exam with Solutions Latest Update 2023/2024

Prescriptive authority - ANSWERlegal authority granted to advanced practice nurses to prescribe medication; DETERMINED BY STATE LAW Rational Drug Selection - ANSWERbased on individual patient and addresses disease specific information: ONLY A GUIDELINE Drug Selection - ANSWERincludes analysis of cost, guidelines, avaibalbility, interactions, side effects, allergies, hepatic and renal function, need for monitoring, special precautions i.e elderly medication education basic components - ANSWERmedication name purpose dosing regimen administration adverse effects any storage needs associated labs testing food & drug interactions duration of therapy medication adherence - ANSWERbarriers to adherence= forgetfulness lack of planning cost dissatisfaction altered dosing Phamacokinetics - ANSWERstudy of drug movement throughout body principles of pharmacokinetics - ANSWERabsorption distribution metabolism excretion Passage of drugs across membranes - ANSWER- channels and pores - transport systems (P-glycoprotein) - direct penetration of the membrane Absorption of drugs - ANSWERTransfer of drugs from site of administration across cell membrane into the blood stream factors that affect absorption of drugs - ANSWERrate of dissolution- how easy dissolves surface area- surface area moves faster blood flow- blood flow moves faster lipid solubility - lipid easily cross membrane ph partitioning - Distribution of drugs - ANSWERmovement of drugs from systemic circulation to site of drug action factors that determine drug flow - ANSWERblood flow to tissues ability to exit vascular system ability to enter cell Drug ability to exit vascular system - ANSWERcapillary bed- typical blood brain barreier placenta drug transfer protein binding - albumin drug ability to enter cell - ANSWERbinds with receptors on external surface of cell membrane drug metabolism - ANSWERthe enzymatic biotransformation of a drug structure most occur in liver by P450 system first pass effect - ANSWERrapid hepatic inactivation of drug on its first pass through liver drug excretion - ANSWERelimination of a drug from the body Drug Excretion Routes - ANSWERrenal breast milk bile lungs sweat saliva therapeutic drug range - ANSWERrange of drug between minimum effective dose and toxic dose. larger index - safer dose smaller index- harmful dose drug half life - ANSWERthe time required for the amount of drug in the body to decrease by 50% Phamacodynamics - ANSWERbiochemical and physiological effects of drugs on body dose-response relationship - ANSWERthe relationship between the size of an administered dose and the intensity it produces Drug selectivity - ANSWERdrug is effective in intended use w/out harmful effects but causes undesired effects (BP but nausea) ease of administration - ANSWERincreases convenience and adherence and decreases administration efforts Drug affinity - ANSWERstrength of attraction between a drug and its receptor Drug intrinsic activity - ANSWERability of drug to activate receptor upon binding. Agonist - ANSWEReverts effects by activating receptor sites ; can make process so faster or slower Antagonist - ANSWERproduce effects by preventing receptor activation partial agonist - ANSWERhas only moderate intrinsic activity can act as agonist or antagonist