Question1. 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 affectedThe solubility of the drug will not match the site of absorptionThere will be less free drug available to generate an effectDrugs bound to albumin are readily excreted by the kidneyQuestion 2. Drugs that have a significant first-pass effect:Must be given by the enteral (oral) route onlyBypass the hepatic circulationAre rapidly metabolized by the liver and may have little if any desired actionAre converted by the liver to more active and fat-soluble formsQuestion 3. An advantage of prescribing a sublingual medication is that the medication is:Absorbed rapidlyExcreted rapidlyMetabolized minimallyDistributed equallyQuestion 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 kidneysThe lungsThe bile and fecesThe skinQuestion 6. The time required for the amount of drug in the body to decrease by 50% is called:Steady stateHalf-lifePhase II metabolismReduced bioavailability timeQuestion 7. The elderly are at high risk of ADRs due to:Having greater muscle mass than younger adults, leading to higher volume of distributionThe extensive studies that have been conducted on drug safety in this age groupThe blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effectAge-related decrease in renal functionQuestion 8. Patient education regarding prescribed medication includes:Instructions written at the high school reading levelDiscussion of expected ADRsHow to store leftover medication such as antibioticsVerbal instructions always in EnglishQuestion 9. Pharmacokinetic factors that affect prescribing include:Therapeutic indexMinimum effective concentrationBioavailabilityEase of titrationQuestion 10. Drugs that use CYP3A4 isoenzymes for metabolism may:Induce the metabolism of another drugInhibit the metabolism of another drugBoth A and BNeither A nor BQuestion 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 effectRequires several dosage titrations so that missed doses can be replaced with lower doses to keep costs downHas a tolerability profile with less of the adverse effects that are considered “irritating,” such as nausea and dizzinessMust be taken no more than twice a dayQuestion 12. A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is:A cytotoxic hypersensitivity reactionAn immune complex hypersensitivityAn immediate hypersensitivity reactionA delayed hypersensitivity reactionQuestion 13. Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?Complexity of the drug regimenPatient’s perception of the potential adverse effects of the drugsBoth A and BNeither A nor BQuestion 14. The first step in the prescribing process according to the World Health Organization is:Choosing the treatmentEducating the patient about the medicationDiagnosing the patient’s problemStarting the treatmentQuestion 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 medicationsHis hiding information regarding his inappropriate use of aspirin from youA common misconception that intermittently taken OTC medications are not an important part of his drug historyA common misuse of OTC aspirinQuestion 16. Herbs and supplements are tested for safety by the FDA.TrueFalseQuestion 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 upDecreased response to warfarinIncreased risk for significant drug interactions with warfarinLess risk of drug interactions with warfarinQuestion 19. Common OTC pain relievers such as acetaminophen or ibuprofen:Are always safer for the patient than prescription pain medicationAre harmful if taken in higher-than-recommended amountsHave minimal interaction with prescription medicationsShould never be given to children unless recommended by their providerQuestion 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 curveIn oral formulations that are more easily takenThat do not require frequent monitoringCombined with patient education about the need to adhere even when symptoms are absent
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