NCLEX - Week 3 Flashcards
A nurse is caring for a patient with liver disease who is receiving a medication that is extensively metabolized by the liver. The nurse understands that this patient is at increased risk for which of the following?
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A. Decreased drug levels
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B. Increased drug levels and potential toxicity
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C. Enhanced drug metabolism
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D. Rapid drug excretion
B. Increased drug levels and potential toxicity
Rationale: Liver disease can impair drug metabolism, leading to a buildup of the drug in the body and potentially toxic effects.
A nurse is administering a medication to a patient who is known to be a “slow metabolizer” of this drug. The nurse understands that this patient may require:
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A. Higher doses of the medication
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B. Lower doses of the medication
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C. More frequent dosing
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D. A different route of administration
B. Lower doses of the medication
Rationale:
Slow metabolizers break down drugs more slowly, leading to higher drug levels in the body.
To prevent toxicity, lower doses may be needed.
A patient is receiving a drug that has a high affinity for plasma proteins. The nurse understands that this means the drug:
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A. Is likely to have a longer duration of action
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B. Is rapidly excreted by the kidneys
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C. Has a limited ability to reach target tissues
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D. Is less likely to cause side effects
A. Is likely to have a longer duration of action
Rationale:
When a drug binds to plasma proteins, it becomes inactive and stays in the bloodstream longer.
This can extend the duration of action.
A patient is prescribed a loading dose of an antibiotic. The nurse understands that the purpose of a loading dose is to:
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A. Maintain a steady-state drug level
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B. Reduce the risk of side effects
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C. Prolong the drug’s half-life
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D. Achieve therapeutic drug levels quickly
D. Achieve therapeutic drug levels quickly
Rationale:
A loading dose is a larger initial dose given to rapidly reach the desired therapeutic concentration of the drug in the bloodstream.
A drug that has a narrow therapeutic index:
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A. Is considered very safe
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B. Requires careful monitoring to ensure patient safety
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C. Can be administered in large doses without concern
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D. Has a wide margin between therapeutic and toxic doses
B. Requires careful monitoring to ensure patient safety
Rationale: A narrow therapeutic index means that the difference between the dose that produces a therapeutic effect and the dose that produces toxicity is small.
Which of the following routes of administration has the fastest onset of action?
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A. Oral
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B. Intramuscular
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C. Subcutaneous
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D. Intravenous
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D. Intravenous
Rationale: Intravenous administration delivers the drug directly into the bloodstream, bypassing the absorption process and leading to immediate effects
A nurse is educating a patient about the difference between generic and brand-name medications. Which of the following statements by the nurse is correct?
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A. “Generic medications are less effective than brand-name medications.”
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B. “Generic medications are typically less expensive than brand-name medications.”
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C. “Generic medications have different active ingredients than brand-name medications.”
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D. “Brand-name medications are always preferred over generic medications.”
B. “Generic medications are typically less expensive than brand-name medications.”
Rationale: Generic medications contain the same active ingredients as brand-name medications but are typically sold at lower prices
A patient is asking the nurse about reliable sources of drug information. Which of the following resources would the nurse recommend?
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A. MedlinePlus
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B. Unverified online forums
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C. Advertisements from pharmaceutical companies
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D. Personal anecdotes from friends and family
A. MedlinePlus
Rationale: MedlinePlus, a website maintained by the National Library of Medicine, provides accurate and trustworthy drug information for the public
The nurse is reviewing a drug order for a medication that is highly protein-bound. The nurse understands that the patient’s albumin level is low. The nurse anticipates which of the following?
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A. An increased risk of drug toxicity
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B. A decreased therapeutic effect
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C. The need for a higher drug dose
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D. A longer drug half-life
A. An increased risk of drug toxicity
Rationale: If a drug is highly protein-bound and the patient has low albumin levels (a protein that binds to drugs), there will be more free drug circulating in the bloodstream, potentially leading to higher-than-expected drug levels and an increased risk of side effects or toxicity.
Which of the following factors can affect drug distribution throughout the body?
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A. Blood flow to tissues
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B. Patient’s age
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C. Route of administration
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D. Drug metabolism rate
A. Blood flow to tissues
Rationale: Organs with high blood flow, like the heart, liver, and kidneys, receive higher concentrations of drugs compared to tissues with less blood flow
A nurse is caring for a patient who has been taking a medication for a long time. The patient reports that the medication doesn’t seem to be working as well as it used to. The nurse suspects that the patient may be experiencing:
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A. An allergic reaction
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B. A drug interaction
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C. Drug tolerance
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D. A placebo effect
C. Drug tolerance
Rationale: Drug tolerance occurs when a patient’s response to a drug decreases over time, often requiring higher doses to achieve the same effect.
A drug that activates a receptor and produces the same response as the body’s own chemical messenger is called a(n):
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A. Agonist
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B. Antagonist
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C. Partial agonist
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D. Enzyme inhibitor
A. Agonist
Rationale: Agonists mimic the effects of endogenous ligands by binding to and activating receptors.
Which legislation mandated that drug manufacturers demonstrate drug safety before marketing?
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A. The 1938 Food, Drug, and Cosmetic Act
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B. The 1906 Federal Pure Food and Drug Act
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C. The 1962 Harris-Kefauver Amendments
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D. The 1970 Controlled Substances Act
A. The 1938 Food, Drug, and Cosmetic Act
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Rationale: The 1938 Food, Drug, and Cosmetic Act, enacted after a tragic incident with a toxic elixir, introduced the requirement for pre-marketing proof of drug safety.
The process of chemically altering a drug within the body is known as:
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A. Absorption
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B. Distribution
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C. Metabolism
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D. Excretion
C. Metabolism
Rationale: Metabolism, often occurring in the liver, involves the chemical transformation of drugs, usually into forms that are easier for the body to eliminate.
The primary organ responsible for drug excretion is the:
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A. Liver
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B. Lungs
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C. Kidney
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D. Skin
C. Kidney
Rationale: Kidneys filter waste products from the blood, including drug metabolites, and excrete them in urine.
Which of the following is an advantage of administering a drug via the oral route?
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A. Convenience and ease of administration
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B. Rapid onset of action
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C. Predictable absorption rate
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D. Bypasses first-pass metabolism
A. Convenience and ease of administration
Rationale: Oral administration is often preferred for its convenience and simplicity, especially for patients taking medications at home.
The term “half-life” refers to:
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A. The time it takes for the amount of drug in the body to decrease by 50%
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B. The duration of the drug’s therapeutic effect
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C. The time it takes for the drug to reach peak concentration
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D. The interval between drug doses
A. The time it takes for the amount of drug in the body to decrease by 50%
Rationale: A drug’s half-life is a crucial pharmacokinetic parameter that determines how long it takes for the drug concentration to reduce by half, influencing dosing frequency.
A patient has been taking a medication that is an antagonist. The nurse anticipates that if the medication is stopped abruptly, the patient may experience:
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A. Tolerance to the drug
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B. A decreased therapeutic effect
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C. A reduced risk of side effects
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D. Receptor supersensitivity
D. Receptor supersensitivity
Rationale: When an antagonist is discontinued, the body may have upregulated or become more sensitive to the receptors that the antagonist was blocking. This can lead to an exaggerated response if an agonist for those receptors is then given.
What is the main difference between a competitive antagonist and a non-competitive antagonist?
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A. A competitive antagonist binds reversibly to the receptor, while a non-competitive antagonist binds irreversibly.
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B. A competitive antagonist activates the receptor, while a non-competitive antagonist blocks it.
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C. A competitive antagonist has a higher affinity for the receptor than a non-competitive antagonist.
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D. A competitive antagonist is more likely to cause side effects than a non-competitive antagonist.
A. A competitive antagonist binds reversibly to the receptor, while a non-competitive antagonist binds irreversibly.
Rationale: Understanding the difference in binding between competitive and non-competitive antagonists is key to comprehending how they affect receptor function and the potential for overcoming their effects.
A patient is prescribed a drug that induces the activity of a drug-metabolizing enzyme. What potential effect could this have on the patient’s response to other medications?
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A. Increased therapeutic effects of other drugs
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B. Decreased therapeutic effects of other drugs
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C. Prolonged half-life of other drugs
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D. Enhanced absorption of other drugs
B. Decreased therapeutic effects of other drugs
Rationale: Enzyme induction increases the rate of drug metabolism, which could lead to lower-than-expected drug levels of other medications metabolized by the same enzyme, potentially reducing their effectiveness
A drug that is administered intravenously bypasses which pharmacokinetic process?
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A. Absorption
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B. Distribution
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C. Metabolism
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D. Excretion
A. Absorption
Rationale: Intravenous drugs go directly into the bloodstream, eliminating the need for absorption from the GI tract or other sites.
The term “bioavailability” refers to:
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A. The extent to which a drug reaches systemic circulation
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B. The rate at which a drug is excreted from the body
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C. The drug’s affinity for its receptor
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D. The drug’s ability to cross the blood-brain barrier
A. The extent to which a drug reaches systemic circulation
Rationale: Bioavailability is a crucial concept that describes how much of the administered drug actually makes it into the bloodstream to exert its effects
Which of the following factors would enhance the absorption of an orally administered medication?
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A. The presence of food in the stomach
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B. Increased blood flow to the gastrointestinal tract
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C. Taking the medication with a high-fat meal
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D. A slow rate of drug dissolution
B. Increased blood flow to the gastrointestinal tract
Rationale: Good blood flow to the site of absorption, in this case, the GI tract, facilitates the drug’s entry into the bloodstream.
A patient is prescribed a sustained-release medication. The nurse understands that this type of medication is designed to:
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A. Produce a rapid onset of action
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B. Release the drug over an extended period
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C. Increase the bioavailability of the drug
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D. Minimize the risk of side effects
B. Release the drug over an extended period
Rationale: Sustained-release formulations aim to provide a controlled and prolonged release of the drug, often allowing for once-daily dosing and improving patient adherence.
A nurse is teaching a patient about the importance of taking their medication as prescribed. Which of the following statements best describes the concept of “steady state”?
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A. The point at which the drug’s effects are no longer noticeable
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B. The point at which the amount of drug administered equals the amount eliminated
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C. The maximum concentration of drug in the bloodstream
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D. The time it takes for half of the drug to be eliminated
B. The point at which the amount of drug administered equals the amount eliminated
Rationale: Achieving a steady state is the goal of repeated dosing, ensuring a consistent therapeutic level of the drug in the body.
