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Pharmacy 1 > Chapter 1-7 exam 1 > Flashcards

Chapter 1-7 exam 1 Flashcards

1
Q

Define Pharmacology

A

study of all interactions between drugs and living things

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2
Q

5 things pharmacology study’s?

A 
1. drug origin
2 nature
3. chemistry
4. effects
5 uses
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3
Q

what does the nurse need to know regarding drugs (12)

A
  1. drug name/classification
  2. action/kinetics
  3. uses
  4. contraindication
  5. special concerns
  6. side effects
  7. lab test considerations
  8. drug interactions
    9 overdose management
  9. how supplied
  10. dosage
  11. nursing actions
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4
Q

What is the general concept of pharmacology

A

no medication has a single action

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5
Q

all medications have the potential to alter more than ___ ___ ____

A

one body function

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6
Q

The 3 things the nurse must know when applying pharmacology to nursing practice (think drug)

A
  1. what medications are appropriate for the pt.
  2. what drugs are contraindicated for the pt.
  3. the probable consequences of the interaction between drug and pt.
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7
Q

5 identifiers for high-risk patients

A
  1. liver and kidney impairment
  2. drug allergies
  3. pregnancy
  4. elderly and pediatrics
  5. tools: pt. history, physical exam, and lab results
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8
Q

Other than prescribed medications what other things does the nurse need to know from her/his pt.

A

what OTC drugs and what herbs. Allergies/reactions

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9
Q

what are the 8 rights

A
  1. right route
  2. right client
  3. right drug
  4. right rationale,
  5. right dose
  6. right time
  7. right documentation
  8. right know/refuse
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10
Q

Before giving a medication other than the 8 rights what does the nurse need to know

A

pre-assessment information, vital signs etc

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11
Q

How far from the medication administration is the pre-assessment

A

30 minutes not any later.

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12
Q

4 types of drug names

A
  1. chemical name
  2. generic name
  3. trade name
  4. molecular formula
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13
Q

What is the chemical name (definition)

A

it is the name of the medication in chemical terms IE N-acetyl-para-aminopheno

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14
Q

What is the generic name of medication (definition)

A

name the drug is known as other than trade name IE acetaminophen

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15
Q

what is the trade name of the medication (definition)

A

the manufacturer name for the drug IE Tylenol

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16
Q

What is the molecular formula of the medication (definition)

A

the actual molecular structure of the drug IE C34H40N20O10S

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17
Q

What is the purpose of the federal drug laws and standards

A

to ensure safety

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18
Q

How did federal drug laws and standards come into being

A

occured after numerous drug-induced catastrophes

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19
Q

4 things that the controlled substance ACT does

A
  1. provides for increase research into an4.d prevention of drug abuse and drug dependence
  2. provides for treatment and rehab of drug abusers and drug-dependent persons
  3. strengthened law enforcement
  4. controlled substance schedule
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20
Q

When did the controlled substance act come into law

A

1970

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21
Q

What are the 4 categories of controlled substances - scheduled

A

C-1
C-2
C-3
C-4

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22
Q

What is the abuse potential for C-1

A

High

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23
Q

What are the dispensing restrictions with schedule C-1

A

only with protocol

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24
Q

3 examples of Schedule C-1

A

heroin
LSD
Marijuana

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25
Q

What is the abuse potential for C-2

A

High

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26
Q

What is the dispensing restrictions of C-2

A
  1. Written by prescription only.
  2. no refills
  3. Must have warning label
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27
Q

What is the abuse potential of C-3

A

Less than C-2

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28
Q

4 examples of Schedule C-2

A

Codeine, cocaine morphine, meperidine

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29
Q

what are the dispensing restrictions of C-3

A
  1. written or oral prescriptions
  2. max refill 5 refills in 6 months
  3. must have a warning label
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30
Q

What are some examples of schedule C-3

A

hydrocodone

ketamine

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31
Q

what is the abuse potential C-4

A

less than C-3

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32
Q

What are the dispensing restrictions of C-4

A
  1. written or oral prescriptions
  2. max 5 refills in 6 months
  3. must have a warning label
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33
Q

examples of C-4

A

lorazepam, phentermine, phenobarbital

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34
Q

what is the abuse potential of C-V

A

less than C-4

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35
Q

What are the dispensing restrictions of C-v

A

written prescription or over the counter depending on the state

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36
Q

what is an example of C-V

A

lomotil

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37
Q

How long does the FDA drug approval process take

A

about 10 years

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38
Q

In phase 1, of the FDA process, what is that process looking for

A

Phase 1 is on healthy people and is used to find the metabolization of the drug

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39
Q

In phase 2 of the FDA process, what is that process looking for

A

Phase 2 is on the person with the disease for effects generally administered with a placebo

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40
Q

In Phase 3 of the FDA process, what is the process looking for

A

Generally this phase is after the completion phase 2 and is more about legal paperwork than anything else

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41
Q

In phase 4 of the FDA process, what is the process lookingfor

A

this phase is generally used for marketing

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42
Q

in the FDA process what is IND

A

investigational new drug

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43
Q

In FDA process what is NDA

A

new drug application

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44
Q

in the FDA process what is clinical phase I, II, and III

A

to determine safety, dose, and eficacy

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45
Q

in the FDA process what is experimental phases

A

INDA phase I, II, and III; put on market if NDA approved by FDA

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46
Q

What is pharmacokinetics

A

used to explain a drug’s action in the body, such as its onset, peak and duration

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47
Q

Define Peak

A

maximum drug relief/action

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48
Q

Define onset

A

When it starts working

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49
Q

Define duration

A

how long it will last

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50
Q

3 Parenteral dosage forms

A

administered directly into the circulation IM, IV, subq

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51
Q

In parenteral dosage forms solutions must be similar to _____ to be safe

A

blood

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52
Q

The advantages of Parenteral dosage forms of medication is

A

do not have to be dissolved and adsorbed to the site of action

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53
Q

what are 6 routes of administration of medications

A
  1. enteral po
  2. NG tube
  3. sublingual
  4. topical
  5. transdermal
  6. inhaled
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54
Q

From slowest to fastest drug absorption for oral preparations

A
  1. enteric-coasted tablets
  2. coated tablets
  3. tablets
  4. capsules
  5. powders
  6. suspension solutions
  7. liquids, elixirs, and syrups
  8. oral disintegration, buccal tablets, and oral soluble wafers
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55
Q

What are two complications of absorption in GI motility

A

diarrhea

constipation

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56
Q

First pass effect ..it effects only what type of drugs

A

Oral

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57
Q

What is first pass effect

A

a phenomenon that occurs after giving an oral drug. A large amount of the drug becomes inactive in the liver after going through the GI tract

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58
Q

How long does the FDA drug approval process take

A

about 10 years

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59
Q

In phase 1, of the FDA process, what is that process looking for

A

Phase 1 is on healthy people and is used to find the metabolization of the drug

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60
Q

In phase 2 of the FDA process, what is that process looking for

A

Phase 2 is on the person with the disease for effects generally administered with a placebo

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61
Q

In Phase 3 of the FDA process, what is the process looking for

A

Generally this phase is after the completion phase 2 and is more about legal paperwork than anything else

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62
Q

In phase 4 of the FDA process, what is the process lookingfor

A

this phase is generally used for marketing

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63
Q

in the FDA process what is IND

A

investigational new drug

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64
Q

In FDA process what is NDA

A

new drug application

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65
Q

in the FDA process what is clinical phase I, II, and III

A

to determine safety, dose, and eficacy

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66
Q

in the FDA process what is experimental phases

A

INDA phase I, II, and III; put on market if NDA approved by FDA

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67
Q

What is pharmacokinetics

A

used to explain a drug’s action in the body, such as its onset, peak and duration

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68
Q

Define Peak

A

maximum drug relief/action

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69
Q

Define onset

A

When it starts working

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70
Q

Define duration

A

how long it will last

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71
Q

3 Parenteral dosage forms

A

administered directly into the circulation IM, IV, subq

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72
Q

In parenteral dosage forms solutions must be similar to _____ to be safe

A

blood

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73
Q

The advantages of Parenteral dosage forms of medication is

A

do not have to be dissolved and adsorbed to the site of action

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74
Q

what are 6 routes of administration of medications

A
  1. enteral po
  2. NG tube
  3. sublingual
  4. topical
  5. transdermal
  6. inhaled
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75
Q

From slowest to fastest drug absorption for oral preparations

A
  1. enteric-coasted tablets
  2. coated tablets
  3. tablets
  4. capsules
  5. powders
  6. suspension solutions
  7. liquids, elixirs, and syrups
  8. oral disintegration, buccal tablets, and oral soluble wafers
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76
Q

What are two complications of absorption in GI motility

A

diarrhea

constipation

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77
Q

First pass effect ..it effects only what type of drugs

A

Oral

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78
Q

What is first pass effect

A

a phenomenon that occurs after giving an oral drug. A large amount of the drug becomes inactive in the liver after going through the GI tract

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79
Q

Distribution is:

A

Transport of a drug by the bloodstream to its site of action.

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80
Q

What does distribution depend on:

A

blood circulation

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81
Q

Regarding distribution, what organs get the drug first:

A

The organs with the largest blood supply. Liver, heart, kidneys

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82
Q

Distribution is effected by

A

how protein bound the drug is

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83
Q

Protein binding is the equivalent of:

A

storage

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84
Q

When two drugs that are highly protein bound are given together, the one with the ____ ____ will be more abundant in its free form

A

lesser affinity

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85
Q

what is the most abundant form of protein

A

albumin

86
Q

another name for metabolism is

A

biotrasformation

87
Q

____ is the primary organ for metabolism

A

liver

88
Q

if you have a poor liver function it can cause an accumulation of drug meaning

A

prolonged response

89
Q

_____ metabolism can cause decreased drug effect

A

stimulated

90
Q

Define excretion

A

elimination of drugs from the body

91
Q

Primary organ responsible for excretion

A

Kidney

92
Q

Primary organ for water soluble drugs

A

kidneys

93
Q

____ function and ___ flow to the kidneys contribute to drug clearance

A

Renal function and blood flow

94
Q

Define serum half-life

A

time required for the amount of the drug in the body to decrease by 50%

95
Q

the half life of morphine is

A

3 hours

96
Q

Define Pharmacokinetic

A

used to describe drug effects

97
Q

Define onset

A

time to get a therapeutic response

98
Q

Define peak

A

time to reach maximum

99
Q

Define duration

A

time the drug is giving a therapeutic response

100
Q

Peak is ___ after first dose.

A

1.5 hours

101
Q

Trough is ___ prior to next dose

A

30 minutes

102
Q

Peak and Trough determines

A

therapeutic level of the drug

103
Q

What is the onset of Ibuprofen

A

30 minutes for analgesia one week for anti-inflammatory effect

104
Q

what is the peak of ibuprofen

A

1-2 hours

105
Q

What is the duration of ibuprofen

A

4-6 hours for analgesia or 1-2 weeks for anti-inflammatory effects

106
Q

Define pharmacodynamics

A

what drugs does to body and how… also effects of drugs in the body both biochemical and physical

107
Q

10 factors affecting drug effects

A
  1. weight
  2. age
  3. gender
  4. drug-drug interactions
  5. drug-food interactions
  6. genetics
  7. psychological factors
  8. dosage
  9. route of administration
  10. physiologic factors
108
Q

a skin woman or a muscled man needs a higher dose?

A

Man

109
Q

Drugs which are extensively metabolized through the ____ liver enzyme system is lots of drug interactions

A

CYP450

110
Q

Define agonists

A

mimic the body’s own regulatory molecules

111
Q

Define antagonists

A

drugs that block actions of endogenous regulators

112
Q

Antagonists ___ ___ to help treat overdose

A

block actions

113
Q

Protagonist is drugs/actions/ interactions that increase the effect (agonist)

A

additive

114
Q

Antagonist is drugs/ actions/ interactions that block the effect

A

block

115
Q

Therapeutic index is

A

drugs with low therapeutic index are not safe.. measures the drugs safety

116
Q

Define adverse drug reactions

A

unintended effect that occurs at normal drug dose

117
Q

Adverse drug reactions can be ___ to ___ threatening

A

Mild to life

118
Q

Define side effect

A

unavoidable drug effect at a therapeutic dose (predictable)

119
Q

Define allergic reactions

A

an immune response.

120
Q

5 geriatric considerations for gastric

A
  1. gastric pH less acidic
  2. gastric emptying slowed
  3. GI motility slowed
  4. blood flow decreased by 40-50%
  5. surface area of villi decreased, thus decreasing absorption
121
Q

Cardiac response in geriatrics

A

decreased cardiac output is decreased absoprtion

122
Q

Gastrointestinal responses in geriatric considerations

A

altered absorption so increase pH(alkaline gastric secretions also decreased peristalsis so delayed gastric emptying

123
Q

Hepatic metabolism in geriatric considerations

A

decreased enzyme production so metabolism is decreased

124
Q

Renal response to geriatric considerations

A

decrease blood flow means decrease enzyme

125
Q

5 geriatric considerations regarding protein

A
  1. total body weight decreases
  2. fat content increases
  3. protein binding sites decrease making highly water soluble drugs will be in higher concentration
  4. drugs distributed in fat will have prolonged effect
  5. drugs highly protein bound will need dosage adjusted
126
Q

Geriatric considerations regarding metabolism (3)

A
  1. decreased liver enzymes
  2. decreased liver metabolism due to decreased liver blood flow meaning prolonged drug half-life making prolonged drug action
  3. will require drug interval adjustments
127
Q

Geriatric considerations regarding excretion (3)

A
  1. Decreased glomerular filtration rate
  2. decreased nephrons
  3. results in adjustment of doses.
128
Q

Polypharmacy define, concerns and who is likely to have them

A

the prescription of multiple medications
increases the risk of drug interactions, adverse reactions, and hospitalization
a pt. receiving 5 medications has 50% chance of a drug interaction
a large concern in the elderly of those with multiple dose.

129
Q

5 factors affecting pediatric drug dosages

A
  1. skin is thin and permeable
  2. stomach lacks acid to kill bacteria
  3. lungs have weaker mucus barriers
  4. body temperatures less well regulated, and dehydration occurs easily
  5. liver and kidneys are immature, impairing drug metabolism and excretion
130
Q

In pediatrics medications are given by ____

A

weight

131
Q

always use weight in ____ not lbs.

A

kilograms

132
Q

body weight dosage calculations uses:

A

mg/kg

133
Q

5 catagories of pregnancy safety categories

A
  1. Cat. A
  2. Cat B
  3. cat. C
  4. Cat D
  5. Cat X
134
Q

Category A in pregnancy means

A

studies indicate no risk to the human fetus

135
Q

Category B in pregnancy means

A

Studies indicate no risk to the animal fetus; information for humans is not available

136
Q

Category C in pregnancy means

A

Adverse effects reported in the animal fetus; information for humans is not available

137
Q

Category D in pregnancy means

A

Possible fetal risk in humans has been reported: however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women

138
Q

Category X in pregnancy means

A

Fetal abnormalities have been reported, and positive evidence of fetal risk in humans is available from animal and /or human studies. These drugs are not to be used in pregnant women.

139
Q

“Which phase of the nursing process requires the nurse to establish a comprehensive baseline of data concerning a particular patient?

a. Assessment
b. Planning
c. Implementation
d. Evaluation”

A

a

140
Q

“The nurse monitors the fulfillment of goals, and may revise them, during which phase of the nursing process?

a. Assessment
b. Planning
c. Implementation
d. Evaluation”

A

d

141
Q

The nurse prepares and administers prescribed medications during which phase of the nursing process? a. Assessment

b. Planning
c. Implementation
d. Evaluation”

A

c

142
Q

When developing a plan of care, which nursing action ensures the goal statement is patient-centered?

a. Considering family input
b. Involving the patient
c. Developing the goal first, and then sharing it with the patient
d. Including the physician

A

b

143
Q

The nurse includes which information as part of a complete medication profile? (Select all that apply.)

a. Use of “street” drugs
b. Current laboratory work
c. History of surgeries
d. Use of alcohol
e. Use of herbal products
f. Family history

A

a,d,e

144
Q

During which phase of the nursing process does the nurse prioritize the nursing diagnoses?

a. Assessment
b. Planning
c. Implementation
d. Evaluation

A

b

145
Q

The nurse is preparing to administer morning doses of medications to a patient and has just checked the patient’s name on the identification band. The patient has stated his name. Which is the nurse’s next appropriate action?

a. Administer the medications.
b. Ask the patient’s wife to verify the patient’s identity.
c. Ask the patient to verify his date of birth.
d. Check the chart for the patient’s date of birth

A

c

146
Q

The nurse is administering a medication and the order reads: Give 250 mcg PO now. The tablets in the medication dispensing cabinet are in milligram strength. What is the right dose of the drug in milligrams? _______

A

0.25 mg

147
Q

The nurse is administering a medication and the order reads: Give 0.125 mg PO now. The tablets in the medication dispensing cabinet are in microgram strength. What is the right dose of the drug in micrograms?

A

125 mcg

148
Q

Placethestepsofthenursingprocessinorder,with (1) being the first step and (5) being the last step.

\_\_\_\_\_ a.Implementation
 \_\_\_\_\_ b. Planning 
\_\_\_\_\_ c.Evaluation 
 \_\_\_\_\_ d.Assessment
\_\_\_\_\_\_ e. Formulation of nursing diagnoses
A
  1. D
  2. E
  3. B
  4. A
  5. C
149
Q

State if the following is either Objective or Subjective:
___ Ms. B. tells the nurse that she smokes a pack of cigarettes a day.
___ She is 5 feet 5 inches tall and weighs 135 pounds.
___ The nurse finds that Ms. B.’s pulse rate is 68 beats/min and her blood pressure is 128/72 mm Hg.
___ Her stool was tested for occult blood by a laboratory technician; the results were negative.
___ Ms. B. says that she does not experience nausea, but she reports pain and heartburn, especially after eating popcorn—something she and her husband have always done while watching TV before bedtime.
___ She experiences occasional increases in stomach pain, a “feeling of heat” in her abdomen and chest at night when she lies down, and increased incidents of heartburn

A 
S
O
O
O
S
S
150
Q

Identify the “Six Rights” of drug administration and specify ways to ensure that each of these rights is addressed

A

Right drug: Compare drug orders and medication
labels. Consider whether the drug is appropriate for that patient. Obtain information about the patient’s medical history and a thorough, updated medication history, including over-the-counter medications taken.
• Right dose: Check the order and the label on the medication, and check the “rights” at least three times before administering the medication. Re- check the math calculations for dosages and contact the physician when clarification is needed. Check the dose and confirm that it is appropriate for the patient’s age and size, and also check the prescribed dose against the available drug stocks and against the normal dosage range.
• Right time: Assess for a conflict between the pharmacokinetic and pharmacodynamic properties of the drugs prescribed and the patient’s lifestyle and likelihood of compliance.
• Right route: Never assume the route of administration or change it; always check with the physi- cian or prescriber.
• Right patient: Check the patient’s identity before administering a medication. Ask for the patient’s name, and check the identification band or bracelet to confirm the patient’s name, identification number, and allergies. The Joint Commission requires the use of two patient identifiers, such as name and birthday, Social Security number, or medical record number.
• Right documentation: Record the date and time of medication administration, name of medication, dose, route, and site of administration. Don’t forget to document the patient’s response to the medication.

151
Q

The following items will help in reviewing the nursing process:
Data are collected during the (a) ________________ phase of the nursing process.
Data can be classified as (b) _________________ or (c) _________________.
To formulate the nursing diagnosis, the nurse must first (d) ______________ the information collected.
The planning phase includes identification of (e) ________________ and (f) ________________.
The (g) _________________ phase consists of carrying out the nursing care plan.
The (h) _________________ phase is ongoing and includes monitoring the patient’s response to medication and determining the status of goals.

A

a. assessment
b. objective
c. subjective
d. analyze
e. goals
f .outcome criteria
g.implementation
h. evaluation

152
Q 
Number the following drug forms in order of speed of dissolution and absorption, with (1) being the fastest and (5) being the slowest:
 \_\_\_\_\_ a. Capsules
\_\_\_\_\_	b.Enteric-coated tablets 
\_\_\_\_\_ c. Elixirs 
\_\_\_\_\_ d. Powders
 \_\_\_\_\_	e.Orally disintegrating tablets
A
  1. C
  2. C
  3. D
  4. A
  5. B
153
Q

When considering the various routes of drug elimination, the nurse is aware that elimination occurs mainly by which routes?

a. Renal tubules and skin
b. Skin and lungs
c. Bowel and renal tubules
d. Lungs and gastrointestinal tract

A

C

154
Q

The nurse is aware that excessive drug dosages, impaired metabolism, or inadequate excretion may result in which drug effect?

a. Tolerance
b. Cumulative effect
c. Incompatibility
d. Antagonistic effect

A

B

155
Q

Drug half-life is defined as the amount of time re- quired for 50% of a drug to:

a. be absorbed by the body.
b. reach a therapeutic level.
c. exert a response.
d. be removed by the body

A

D

156
Q

The nurse recognizes that drugs given by which route will be altered by the first-pass effect? (Select all that apply.)

a. Oral
b. Sublingual
c. Subcutaneous
d. Intravenous
e. Rectal

A

A,C

157
Q

If a drug binds with an enzyme and thereby prevents the enzyme from binding to its normal target cell, it will produce which effect?

a. Receptor interaction
b. Enzyme affinity
c. Enzyme interaction
d. Nonspecific interaction

A

C

158
Q

The nurse is reviewing a list of a patient’s medica- tions, and notes that one of the drugs is known to have a low therapeutic index. Which statement accurately explains this concept?

a. The difference between a therapeutic dose and toxic dose is large.
b. The difference between a therapeutic dose and toxic dose is small.
c. The dose needed to reach a therapeutic level is small.
d. The drug has only a slight chance of being effective.

A

B

159
Q

The nurse prepares to obtain a patient’s blood sample from a central line for a drug level that is to be drawn just before that medication’s next dose. What is the timing of this blood draw known as?

a. Half-life
b. Therapeutic level
c. Peak level
d. Trough level

A

D

160
Q

A drug has a half-life of 4 hours. If at 0800 the drug level is measured as 200 mg/L, at what time would the drug level be 50 mg/L?

A

1600

161
Q

Which physiologic factor is most responsible for the differences in the pharmacokinetic and pharmacodynamic behavior of drugs in neonates and adults?

a. Infant’s stature
b. Infant’s smaller weight
c. Immaturity of neonatal organs
d. Adult’s longer exposure to toxins

A

c

162
Q

A woman who has just discovered that she is pregnant is asking the nurse about taking medications. The nurse keeps in mind that the greatest risk for drug-induced developmental defects occurs during which trimester of pregnancy?

a. First
b. Second
c. Third
d. The risk is the same throughout pregnancy.

A

a

163
Q

Most drug references provide recommended pediatric dosages based on which of the following?

a. Total body water content
b. Fat-to-lean mass ratio
c. Height
d. Body weighT

A

d

164
Q

The nurse recognizes that drug dosages in older adults are based on which factor(s)?

a. More on age than on height or weight
b. On body weight and organ function
c. On the total body water content
d. On the strength of the drug

A

b

165
Q

When giving medications to older adults, the nurse will keep in mind the changes that occur due to aging. Which statements regarding changes in the older patient are true? (Select all that apply.)

a. Fat content is increased.
b. Gastric pH is less acidic because of reduced hydrochloric acid production.
c. Protein albumin binding sites are reduced because of decreased serum protein.
d. Total body water content increases as body composition changes.
e. The absorptive surface area of the gastrointestinal tract is increased due to flattening and blunting of the villi.

A

a,b,c

166
Q

A child is to receive a medication that is dosed as 8 mg/kg. The child weighs 40 kg. What is the dose of medication that the nurse will administer to this child?

A

320 mg

167
Q

A toddler is to receive a daily dose of digoxin (Lanoxin) 2 mcg/kg/day IV. The toddler weighs 23 pounds. Calculate the amount of medication in milligrams that the toddler will receive.

A

0.21 ml

168
Q

When reviewing drug classifications, the nurse knows that drugs classified as category C-I, which are to be dispensed “only with an approved protocol,” include which drugs?
a. Codeine, cocaine, and meperidine (Demerol)
b. Heroin, LSD, and marijuana
c. Phenobarbital, chloral hydrate, and
benzodiazepines
d. Cough preparations and diarrhea-control drugs

A

b

169
Q

_____9. Category A
_____ 10 Category B
_____ 11. Category C
_____ 12. Category D
_____ 13. Category X
a. Possible fetal risk in humans is reported; however, consideration of potential benefit versus risk may, in selected cases, warrant use of these drugs in pregnant women.
b. Studies indicate no risk to animal fetuses; information for humans is not available.
c. Fetal abnormalities are reported, and positive evi- dence of fetal risk in humans is available from animal and/or human studies.
d. Studies indicate no risk to the human fetus.
e. Adverse effects are reported in animal fetuses; information for humans is not available

A
  1. d
  2. b
  3. e
  4. a
  5. c
170
Q

When a health care provider is writing a prescription for a drug, he or she is not permitted to mark a refill on the prescription if the drug falls into which category?

a. C-II
b. C-III
c. C-IV
d. C-V

A

a

171
Q

The nurse is aware that the ethical principle of “Do no harm” is known by which name?

a. Autonomy
b. Beneficence
c. Confidentiality
d. Nonmaleficence

A

d

172
Q

Which legal act required drug manufacturers to establish the safety and efficacy of a new drug before its approval for use?

a. Federal Food and Drugs Act of 1906
b. Federal Food, Drug, and Cosmetic Act of 1938
c. Kefauver-Harris Amendment of 1962 d. Durham-Humphrey Amendment of 1951

A

c

173
Q

Which is the correct definition for placebo?
a. An investigational drug used in a new drug
study
b. An inert substance that is not a drug c. A legend drug that requires a prescription
d. A substance that is not approved as a drug but is used as an herbal product

A

b

174
Q

The nurse is performing an admission assessment. Which finding is considered part of the cultural assessment?

a. The patient uses aspirin as needed for pain.
b. The patient has a history of hypertension.
c. The patient is allergic to shellfish.
d. The patient does not eat pork products for religious reasons.

A

d

175
Q

While reviewing a newsletter about medications, the nurse notices that one drug has a new black box warning from the Food and Drug Administration (FDA). What does this warning entail? (Select all that apply.)
a. The drug is about to be recalled by the FDA.
b. Serious adverse effects have been reported with
the use of this drug.
c. The drug can still be prescribed, but the warning is present to make sure that the prescriber is aware of the potential risks.
d. The drug manufacturer has refused to recall the medication, despite documented problems.
e. The drug cannot be prescribed.

A

b c

176
Q

The nurse is assessing an unresponsive patient when a visitor enters the room. The visitor asks, “Oh, what happened to him? He was fine yesterday!” Which is the most appropriate response from the nurse?

a. “Sorry, but I am not allowed to tell you.”
b. “He had a stroke yesterday while in church, and there is little hope for him to recover.”
c. “You will need to speak to his physician about his condition.”
d. “Before I can give any information about him, I need to ask who you are. Let’s go outside the room and talk.”

A

d

177
Q

The nurse is to administer ranitidine (Zantac) 150 mg IV. The available medication is ranitidine 25 mg/ mL. How many milliliters will the nurse administer?

A

6 ml

178
Q
  1. _____ Phase I
  2. _____ Phase II
  3. _____ Phase III
  4. _____ Phase IV

a. A study using small numbers of volunteers who have the disease or disorder that the drug is meant to diagnose or treat. Subjects are monitored for drug effectiveness and adverse effects.
b. Postmarketing studies conducted by drug companies to obtain further proof of the drug’s therapeutic and adverse effects.
c. A study that involves a large number of patients at research centers designed to monitor for infrequent adverse effects and to identify any associated risks. Double-blind, placebo-controlled studies eliminate patient and researcher bias.
d. A study that uses small numbers of healthy volunteers, as opposed to volunteers with the target ailment, to determine dosage range and pharmacokinetics

A

d
a
c
b

179
Q

_____ Asian
_____ Hispanic
_____ Native American
_____ African American
a. Some may seek a balance between the body and mind through the use of “cold” remedies or foods for “hot” illnesses, and vice versa.
b. Some may use folk medicine, protective bracelets, and laying on of hands.
c. Some believe that opposing forces lead to illness or health, depending on which force is dominant in the individual and whether the forces are balanced. Balance produces healthy states.
d. Some believe in the need for a balance among body, mind, and environment to maintain health and harmony with nature.

A

c
a
d
b

180
Q

A(n) _________________ is defined as any preventable adverse drug event that involves inappropriate medication use by a patient or health care professional. It may or may not cause harm to the patient.

A

medication error

181
Q

“A(n) _________________ reaction is defined as any abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient.

A

idiosyncratic

182
Q

“A(n) _________________ is an immunologic reaction resulting from an unusual sensitivity of a patient to a particular medication.

A

allergic reaction

183
Q

“A(n) _________________ is a type of adverse drug event that is defined as any unexpected, unintended, or excessive response to a medication given at therapeutic dosages.

A

adverse drug reaction

184
Q

“A(n) _________________ is an undesirable occurrence related to administration of or failure to administer a prescribed medication.

A

adverse drug event

185
Q

“True or false: High-alert medications are involved in more errors than other drugs. Explain your answer.

A

“False. High-alert medications are not necessarily

involved in more errors than other drugs. However, the potential for patient harm is higher with these medications.

186
Q

“True or false: High-alert medications are involved in more errors than other drugs. Explain your answer

A

“False. Adverse drug events include medication errors and adverse drug reactions.

187
Q

Study of all interactions between drugs and living things is the definition of?

A

Pharmacology

188
Q

True or False? All medications have the potential to alter more than one body function.

A

True

189
Q

What is the most prevalent protein plasma and the most important of the proteins to which drugs bind?

A

Albumin

190
Q

A,D,M,E is the abbreviation for?

A

Absorption, distribution, metabolism, excretion

191
Q

Define: Absorption

A

Movement of a drug from its site of administration into the bloodstream from distribution to the tissue

192
Q

Define: Bioavailability

A

measure of the extent of drug absorption for a given drug and route

193
Q

Define: First Pass Effect

A

Initial metabolism in the liver of a drug absorbed from the GI tract before the drug reaches systemic circulation through the blood stream. It reduces the bioavailability of the drug to less than 100% like many oral drugs.

194
Q

True of False, Only injection drugs go through the First pass effect?

A

False, only ORAL drugs go through the first pass effect.

195
Q

Define: Distribution

A

Transport of a drug by the blood stream to its site of action.

196
Q

What are some areas of rapid distribution?

A

Heart, Liver, kidneys, brain

197
Q

What are some areas of slow distribution?

A

Muscle, Skin, Fat

198
Q

Blood brain barrier is?

A

hard for drugs to distribute in the brain due to this

199
Q

Define: Metabolism/Biotransformation

A

Biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite, or a less active metabolite

200
Q

Another word for Warfarin?

A

Coumadin

201
Q

When two drugs that are highly protein bound are given together, __________________?

A

the one with the lesser affinity will be more abundant in its free form.

202
Q

Kidneys are the primary organ of Metabolism. True or False?

A

False, Liver is the primary organ for metabolism, Kidneys are the primary organs for excretion

203
Q

Excretion means?

A

Elimination of drugs from the body

204
Q

Time to get a therapeutic response is?

A

Onset

205
Q

Time to reach maximum is?

A

Peak

206
Q

Time the drug is giving a therapeutic response is?

A

Duration

207
Q

What are the Pharmacokinetic terms to describe drug effects?

A

Onset, Peak, Duration

208
Q

Peak is the ___ blood level and taken after trough ___ minutes before next dose.

A

highest, 30

209
Q

Trough us the ___ blood level and taken ___?

A

Lowest, first

210
Q

Order the drug absorption of various oral preparations from fastest to slowest.

A
  1. Oral disintegration, buccal tablets, oral soluble wafers (Fastest)
  2. Liquids, elixers, syrups
  3. Suspension solutions
  4. Powders
  5. Capsules
  6. Tablets
  7. Coated Tablets
  8. Enteric-coated tablets (Slowest)

Pharmacy 1 (6 decks)

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