Question

1. Question :A patient’s nutritional intake and lab work reflect hypoalbuminemia. This is critical to prescribing because:

Distribution of drugs to target tissue may be affected

The solubility of the drug will not match the site of absorption

There will be less free drug available to generate an effect

Drugs bound to albumin are readily excreted by the kidney

Question 2. Drugs that have a significant first-pass effect:

Must be given by the enteral (oral) route only

Bypass the hepatic circulation

Are rapidly metabolized by the liver and may have little if any desired action

Are converted by the liver to more active and fat-soluble forms

Question 3. An advantage of prescribing a sublingual medication is that the medication is:

Absorbed rapidly

Excreted rapidly

Metabolized minimally

Distributed equally

Question 4. Which one of the following statements about bioavailability is true?

Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained release mechanisms.

All brands of a drug have the same bioavailability.

Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.

Combining an active drug with an inert substance does not affect bioavailability.

Question 5. The route of excretion of a volatile drug will likely be:

The kidneys

The lungs

The bile and feces

The skin

Question 6. The time required for the amount of drug in the body to decrease by 50% is called:

Steady state

Half-life

Phase II metabolism

Reduced bioavailability time

Question 7. The elderly are at high risk of ADRs due to:

Having greater muscle mass than younger adults, leading to higher volume of distribution

The extensive studies that have been conducted on drug safety in this age group

The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect

Age-related decrease in renal function

Question 8. Patient education regarding prescribed medication includes:

Instructions written at the high school reading level

Discussion of expected ADRs

How to store leftover medication such as antibiotics

Verbal instructions always in English

Question 9. Pharmacokinetic factors that affect prescribing include:

Therapeutic index

Minimum effective concentration

Bioavailability

Ease of titration

Question 10. Drugs that use CYP3A4 isoenzymes for metabolism may:

Induce the metabolism of another drug

Inhibit the metabolism of another drug

Both A and B

Neither A nor B

Question 11.Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

Has a short half-life so that missing one dose has limited effect

Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down

Has a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizziness

Must be taken no more than twice a day

Question 12. A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is:

A cytotoxic hypersensitivity reaction

An immune complex hypersensitivity

An immediate hypersensitivity reaction

A delayed hypersensitivity reaction

Question 13. Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?

Complexity of the drug regimen

Patient’s perception of the potential adverse effects of the drugs

Both A and B

Neither A nor B

Question 14. The first step in the prescribing process according to the World Health Organization is:

Choosing the treatment

Educating the patient about the medication

Diagnosing the patient’s problem

Starting the treatment

Question 15. When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare-ups. This is an example of:

His appropriately only telling you about his regularly prescribed medications

His hiding information regarding his inappropriate use of aspirin from you

A common misconception that intermittently taken OTC medications are not an important part of his drug history

A common misuse of OTC aspirin

Question 16. Herbs and supplements are tested for safety by the FDA.

True

False

Question 17. The role of the nurse practitioner in the use of herbal medication is to:

Maintain competence in the prescribing of common herbal remedies.

Recommend common OTC herbs to patients.

Educate patients and guide them to appropriate sources of care.

Encourage patients to not use herbal therapy due to the documented dangers.

Question 18. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:

Toxic levels of warfarin building up

Decreased response to warfarin

Increased risk for significant drug interactions with warfarin

Less risk of drug interactions with warfarin

Question 19. Common OTC pain relievers such as acetaminophen or ibuprofen:

Are always safer for the patient than prescription pain medication

Are harmful if taken in higher-than-recommended amounts

Have minimal interaction with prescription medications

Should never be given to children unless recommended by their provider

Question 20. Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:

With a longer half-life so that missed doses produce a longer taper on the drug curve

In oral formulations that are more easily taken

That do not require frequent monitoring

Combined with patient education about the need to adhere even when symptoms are absent