Pharmacology Exam 1 Test Exam with 174 Questions and Answers, Exams of Nursing

Download Pharmacology Exam 1 Test Exam with 174 Questions and Answers and more Exams Nursing in PDF only on Docsity! PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ ADME - CORRECT ANSWERS absorption, distribution, metabolism, excretion Absorption - CORRECT ANSWERS Movement of a drug from site of administration into the blood Factors affecting absorption - CORRECT ANSWERS rate of dissolution, surface area, blood flow, lipid solubility, pH partitioning Routes of Administration - CORRECT ANSWERS •Enteral - via GI tract; Oral (PO), NG tube, gastrostomy tube, Tablets/capsules, Enteric Coated, Sustained/Extended release, sublingual, Liquids/solutions •Parenteral - "by injection"; Intravenous (IV), Intramuscular (IM), Subcutaneous (subQ or SQ) •Other routes: Topical, Transdermal, Inhaled, Suppository (rectal or vaginal), Direct injection (heart, joints, nerves, CNS) What determines drug action? (rate/amount) - CORRECT ANSWERS absorption Distribution - CORRECT ANSWERS Movement of drugs throughout the body after absorption What 3 factors determine drug distribution? - CORRECT ANSWERS 1. blood flow to tissues 2. exiting the vascular system PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ 3. entering cells What drugs would low albumin affect? - CORRECT ANSWERS Protein bound drugs. Albumin is the main drug binding protein, if levels are low it may cause free active drug in the plasma due to their inability to find receptors to bond to. This can result in elevated drug levels, more rapid hepatic metabolism, or both. Can be toxic. Metabolism - CORRECT ANSWERS Alters structure and function of drugs, nutrients, vitamins, & minerals Primary site of metabolism - CORRECT ANSWERS the liver Therapeutic consequences of drug metabolism - CORRECT ANSWERS •Accelerated renal drug excretion •Drug inactivation •Increased therapeutic action •Activation of prodrugs •Increased / Decreased toxicity Pro-drugs - CORRECT ANSWERS drugs that are administered in an inactive form, which is metabolized into an active form in the liver; the resulting metabolites produce the desired therapeutic effects What enzymes in the liver metabolize drugs? - CORRECT ANSWERS •Hepatic microsomal enzymes PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ plateau - CORRECT ANSWERS point at which repeated drug dosing causes a steady level of drug to be achieved Pharmacodynamics - CORRECT ANSWERS what the drug does to the body Pharmacokinetics - CORRECT ANSWERS what the body does to the drug Maximal Efficacy - CORRECT ANSWERS the largest effect that a drug can produce relative potency - CORRECT ANSWERS the amount of drug that must be given to elicit an effect Receptor Theory - CORRECT ANSWERS most drugs produce their actions by activating or inhibiting specific cellular receptors agonists - CORRECT ANSWERS drugs which mimic/increase the activity of receptors antagonists - CORRECT ANSWERS drugs which block or reduce a cell's response to the action of other chemicals or receptors. competitive antagonists - CORRECT ANSWERS •Compete with agonists for receptor binding •Bind reversibly to receptors •Equal affinity PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ •Receptor occupied by whichever agent is present in the highest concentration EX: narcan is antagonist to opioids Adverse Drug Reactions (ADRs) - CORRECT ANSWERS •Side Effects •Nearly unavoidable •Predictable, usually not serious •Toxicity •ADR caused by excessive dosing •May occur with normal dosing •Many drugs toxic to specific organs •Allergic •Immune response Very few drugs cause severe allergic reactions ADRs cont. - CORRECT ANSWERS •Idiosyncratic •Uncommon response due to genetic predisposition •Pardoxical •Opposite effect •Iatrogenic disease •Drug-induced disease •Dependence •Develops over long-term use - body adapts to use •Carcinogenic PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Teratogenic Prevention of ADRs - CORRECT ANSWERS •Obtain thorough medical Hx •Assess the patient & diagnostic data •Help avoid med errors, question unusual orders •Know your patients' drugs & usual side effects Reporting of ADRs - CORRECT ANSWERS •Serious events - reported per organizational policy •MedWatch - in US, voluntary reporting of adverse effects Drug Interactions - CORRECT ANSWERS •A substance increases or decreases a drug's actions •Inhibition •Enhancement •Changes response drug-drug drug-food drug-herbal - CORRECT ANSWERS types of drug interactions Geriatric patient considerations/risk factors - CORRECT ANSWERS •High prevalence of prescription drug use •Polypharmacy - multiple medications PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Indications - CORRECT ANSWERS •Conditions for which a drug is approved. •All prescription drugs must have some degree of effectiveness. •Every drug has at least one indication. •Many drugs have multiple indications. Unapproved indications are unlabeled or off-label off-label use - CORRECT ANSWERS a drug proven effective for a disease that differs from the one involved in original testing and FDA approval Therapeutic usefulness - CORRECT ANSWERS •What is being treated by the drug •Layman's terms EX: lowers blood pressure Therapeutic classification - CORRECT ANSWERS how the drug acts EX: antihypertensive Pharmacologic classification - CORRECT ANSWERS How the drug produces its effect on the body EX: diuretic Prototype - CORRECT ANSWERS the drug to which all others in a class are compared PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Generic drug name - CORRECT ANSWERS Assigned by the US Adopted Names Council Less complicated than chemical names Many organizations use generic names to describe and identify Easy for students to memorize one name Ex: acetaminophen chemical drug name - CORRECT ANSWERS Standard nomenclature established by IUPAC Each drug has only one chemical name Clear, concise meaning of the nature of the drug Often difficult to remember & pronounce Ex: N-acetyl-para-aminophenol Trade drug name - CORRECT ANSWERS Also known as brand or proprietary name. Given by the pharmaceutical company marketing the drug Attempt to be short and easy to remember Each drug receives a period of exclusivity Ex: Tylenol (or Acephen, Aminophen, Apap, Cetafen, Ed-Apap, Children's Feverall, etc...) Nurse's Role: the "Rights" - CORRECT ANSWERS •Five Rights of Drug Administration •Right drug PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ •Right patient •Right dose •Right route •Right time •ALSO •Right assessment •Right documentation •Right evaluation •Right of patient to education Right of patient to refuse- always remember to ask pt why Nurse's role in medication administration; what you must know - CORRECT ANSWERS Classification of the Drug Action of the drug Pharmacotherapeutics (why it is used) Adverse effects Lab values to be monitored Patient assessment parameters specific to the medication What assessment parameters must be monitored prior to administering the medication? How do you know the drug is effective? How do you know the drug is not effective? What will you include in a teaching plan for the patient related to this medication? PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ hypotonic solution - CORRECT ANSWERS Solute concentration is less than that inside the cell; cell gains water 0.45% NaCl hypertonic solution - CORRECT ANSWERS Solute concentration is greater than that inside the cell; cell loses water 3% NaCl if incorrectly ordered/hung and given to pt can be very dangerous. For HYPOnatremia or HYPOtonicity Ringer's lactate solution (isotonic) - CORRECT ANSWERS Also known as sodium lactate solution, Lactated Ringer's, and Hartmann's solution A mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. Used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure Often used for pt's with severe burns or blood loss osmosis - CORRECT ANSWERS •Water moves from areas of low solute concentration to areas of high solute concentration Why is dextrose added to IV solutions? - CORRECT ANSWERS pt may have low blood sugar or may not be eating PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Overall fluid balance is regulated primarily by: - CORRECT ANSWERS hormones acting upon the kidneys Antidiuretic hormone (ADH) - CORRECT ANSWERS triggered by hypothalamus when it senses ECF is hypertonic (makes you thirsty) tells kidneys to increase water reabsorption Aldosterone - CORRECT ANSWERS Secreted by the adrenal cortex Hormone that stimulates the kidney to retain sodium ions and water and excrete potassium Isotonic contraction - CORRECT ANSWERS •Sodium and water are lost in isotonic proportions •Decrease in total volume, but no change in osmolality causes of isotonic contraction - CORRECT ANSWERS vomiting, diarrhea, kidney disease, misuse of diuretics treatment of isotonic contraction - CORRECT ANSWERS Fluids that are isotonic to plasma 0.9% NS Replenish slowly to prevent pulmonary edema hypertonic contraction - CORRECT ANSWERS Loss of water exceeds loss of sodium PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Reduced extracellular fluid volume and increase in osmolality causes of hypertonic contraction - CORRECT ANSWERS Excessive sweating, osmotic diuresis, concentrated food given to infants Secondary to extensive burns or CNS disorders that interfere with thirst treatment of hypertonic contractions - CORRECT ANSWERS •Hypotonic fluids (0.45% sodium chloride) or fluids that contain no solutes at all (D5W) •Initial therapy: Drink water hypotonic contraction - CORRECT ANSWERS Loss of sodium exceeds loss of water Both volume and osmolality of extracellular fluid are reduced causes of hypotonic contraction - CORRECT ANSWERS •Excessive loss of sodium through the kidney (diuretic therapy, chronic renal insufficiency, lack of aldosterone) treatment of hypotonic contraction - CORRECT ANSWERS •Mild: Infusing isotonic solution (0.9%) NaCL for injection •Severe: Hypertonic solution (3%) NaCl •Watch for signs of fluid overload volume expansion - CORRECT ANSWERS •Increase in total volume of body fluid PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ causes of metabolic alkalosis - CORRECT ANSWERS •Excessive loss of gastric acid (vomiting, excessive gastric suctioning, diuretics) •Administration of alkalinizing salts treatment of metabolic alkalosis - CORRECT ANSWERS •Solution of sodium chloride plus potassium chloride •Severe: Dilute hydrochloric acid (central line); Acid forming salt - i.e. ammonium chloride causes of metabolic acidosis - CORRECT ANSWERS •Chronic renal failure •Loss of bicarbonate during severe diarrhea •Metabolic disorders •Poisoning by methanol and certain medications treatments for metabolic acidosis - CORRECT ANSWERS •Correction of the underlying cause of acidosis Alkalinizing salt if severe (i.e. sodium bicarbonate) Interpreting ABGs: RO-ME - CORRECT ANSWERS •Respiratory Opposite •pH up, PaCO2 down Alkalosis •pH down, PaCO2 up Acidosis •Metabolic Equal •pH up, HCO3 up Alkalosis PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ •pH down, HCO3 down Acidosis Interpreting ABDs: Compensation - CORRECT ANSWERS •pH NORMAL •PaCO2 AND HCO3 Abnormal Compensated •pH ABNORMAL •PaCO2 AND HCO3 Abnormal Partially Compensated •PaCO2 OR HCO3 abnormal Uncompensated Sodium - CORRECT ANSWERS Normal: 135-145 mEq/L •Major electrolyte in extracellular fluid •Sodium & water balance closely connected hypernatremia - CORRECT ANSWERS •Serum sodium level > 145 mEq/L •Due to kidney pathology or excessive intake Symptoms: S(skin flushed) A(agitation) L(low grade fever) T(thirst) hyponatremia - CORRECT ANSWERS •Most common electrolyte abnormality in hospitalized patients •Serum sodium level < 135 mEq/L •Caused by dilution of plasma or sodium loss symptoms: nausea, headache, confusion, and fatigue. Sodium Chloride (NaCL) Classifications - CORRECT ANSWERS •Therapeutic - Agent for hyponatremia PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ •Pharmacologic - Electrolyte, sodium supplement Sodium Chloride (NaCL) mechanism of action - CORRECT ANSWERS •Replacement solution for lost sodium Sodium Chloride (NaCL) adverse effects - CORRECT ANSWERS •Hypernatremia, Lethargy, Confusion, Muscle tremor/rigidity, Hypotension, Restlessness, Pulmonary edema Sodium Chloride (NaCL) Contraindications/precautions - CORRECT ANSWERS •Hypernatremia •Congestive Heart Failure (CHF) •Impaired renal function •No clinically significant drug interactions •Overdose - Diuretics to remove excess sodium ion and water to reduce pulmonary or peripheral edema Potassium (K+) - CORRECT ANSWERS •Most abundant intracellular cation •normal range: Extracellular (serum) 3.5 - 5 mEq/L •Major role in: Conducting nerve impulses & maintaining electrical excitability of muscle; Regulating acid-base balance Potassium (K+) Regulation - CORRECT ANSWERS primarily by kidneys •Aldosterone increases excretion of K+ •Excretion of K+ increased by most diuretics (except potassium-sparing diuretics) PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Causes of Hyperkalemia - CORRECT ANSWERS •Severe tissue trauma, untreated Addison's dz, Acute acidosis, Misuse of K+ sparing diuretics, OD IV K+ cardiac symptoms of hyperkalemia - CORRECT ANSWERS •Disruption of electrical activity of the heart •Earliest sign patient is in danger: Mild elevation (5-7 mEq/L) - should be taking action; T wave heightens; PR interval prolonged •Severe elevation (8-9 mEq/L) - REALLY take action; Cardiac arrest can occur non-cardiac signs of hyperkalemia - CORRECT ANSWERS •Confusion, anxiety, dyspnea, weakness or heaviness of legs, numbness/tingling of hands/feet/lips Treatment of Hyperkalemia - CORRECT ANSWERS •Withhold foods that contain potassium •Withhold medicines that promote potassium accumulation: Potassium-sparing diuretics, potassium supplements •Counteract potassium-induced cardiotoxicity •Lower extracellular levels of potassium by: •Calcium salt (eg, calcium gluconate) counteract ekg changes •Infusion of glucose and insulin (glucose covers insulin - insulin forces potassium back into cells emergently and quickly; for diabetic and non-diabetic pts) •If acidosis is present: Infusion of sodium bicarbonate •Oral / rectal sodium polystyrene sulfonate; [Kayexalate, Kionex] •Peritoneal or extracorporeal dialysis PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Magnesium (Mg 2+) - CORRECT ANSWERS •2nd most abundant intracellular cation (~40mEq/L) •Normal serum range: 1.8 - 3 mEq/L •Required for the activity of many enzymes •Binding of messenger RNA to ribosomes •Helps regulate neurochemical transmission and the excitability of muscle causes of hypomagnesemia - CORRECT ANSWERS •Diarrhea, hemodialysis, renal disease, prolonged IV feeding, chronic EtOH(alcohol) abuse, diabetes, pancreatitis how does hypomagnesemia affect cardiac & skeletal muscle? - CORRECT ANSWERS •increased acetylcholine release can cause muscle excitability •increased CNS neuron excitability can cause disorientation, psychoses, seizures Hypermagnesemia - CORRECT ANSWERS >3mEq/L magnesium serum level hypomagnesemia - CORRECT ANSWERS <1.8 mEq/L magnesium serum level causes of hypermagnesemia - CORRECT ANSWERS Increased magnesium intake ~Magnesium-containing antacids and laxatives ~Excessive admin of magnesium by IV Decreased renal excretion of magnesium as a result of renal insufficiency Most common in patients with renal insufficiency - esp when they use magnesium-containing antacids or cathartics PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ symptoms of hypermagnesemia - CORRECT ANSWERS •Mild - Muscle weakness, hypotension, sedation, and ECG changes •Respiratory paralysis (12 - 15 mEq/L) •Cardiac arrest (>25 mEq/L) Magnesium Sulfate (MgSO4) administration modes - CORRECT ANSWERS •Oral: for prophylaxis •Adverse effects: diarrhea •IV or IM: for treating hypomagnesemia •IM 0.5 - 1 gm 4 times a day •IV 10% solution - 1.5 mL/min or less •Always have injectable calcium available! What does the nurse need to monitor when Magnesium Sulfate (MgSO4) is being administered to the patient? - CORRECT ANSWERS •Assess vitals every 10-15 min when giving IV •Monitor serum magnesium levels •Test patellar reflex before each repeated parenteral dose •Assess for early indicators of magnesium toxicity •Notify if respiratory rate falls below 12 breaths/min •Assess baseline & periodic urine output - discontinue if output less than 100 mL in preceding 4 hours. PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ •furosemide (Lasix) •Thiazide diuretics •Hydrochlorothiazide (HCTZ) •Osmotic diuretics •mannitol •Potassium-sparing diuretics (broken into 2 categories) •aldosterone antagonists: spironolactone •nonaldosterone antagonists: triamterene Loop Diuretics- Furosemide (Lasix) - CORRECT ANSWERS prototype drug for loop diuretics class most effective; WORKS EVEN WITH RENAL IMPAIRMENT "powerhouse diuretic" loop diuretics- Furosemide administration - CORRECT ANSWERS •PO - onset 1 hr lasts 8 hrs •IV - onset 5 min lasts 2 hrs loop diuretics- Furosemide: used for? - CORRECT ANSWERS •pulmonary edema in CHF •edema (hepatic, cardiac, renal) •HTN PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ loop diuretics- Furosemide: mechanism of action - CORRECT ANSWERS acts in the thick segment of the ascending limb of Henle's loop to block reabsorption of sodium and chloride. interference with reabsorption here produces profound diuresis loop diuretics- Furosemide: Adverse Effects - CORRECT ANSWERS •Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia •Ototoxicity, hyperglycemia, hyperuricemia, pregnancy complications loop diuretics- Furosemide: drug interactions - CORRECT ANSWERS •Digoxin, ototoxic drugs, K+ sparing diuretics, Lithium, antihypertensives, NSAIDs Other loop diuretics - CORRECT ANSWERS •ethacrynic acid [Edecrin], bumetanide, torsemide [Demadex] Thiazide Diuretics- Hydrochlorothiazide (HCTZ) - CORRECT ANSWERS prototype of thiazide diuretics drug class •Most used •Function like loop diuretics, BUT, WILL NOT WORK WITH RENAL IMPAIRMENT "gentle diruetic" patients often sent home on this diuretic, gentler but still keeps the kidneys pushing Thiazide Diuretics- Hydrochlorothiazide (HCTZ): Mechanism of action - CORRECT ANSWERS promotes urine production by blocking the reabsorption of sodium and chloride in the early segment of the distal convoluted tubule. PHARMACOLOGY EXAM 1 TEST EXAM WITH 174QUESTIONS AND ANSWERS ALL ANSWERS GUARANTEED SUCCESS BEST EXAM SOLUTION LATEST UPDATE 2024/2025 RATED A+ Because of less reabsorption at site of action, the maximum urine flow these drugs can produce is lower than with the loop diuretics. Thiazide Diuretics- Hydrochlorothiazide (HCTZ): Administration - CORRECT ANSWERS •PO - onset 2 hrs, peak 4-6, lasts up to 12 hrs Thiazide Diuretics- Hydrochlorothiazide (HCTZ): Used for? - CORRECT ANSWERS •HTN, edema in HF, diabetes insipidus, postmenopausal osteoporosis prevention Thiazide Diuretics- Hydrochlorothiazide (HCTZ): Adverse effects - CORRECT ANSWERS •similar to loop diuretics Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia •hyperglycemia, hyperuricemia, pregnancy complications •No ototoxicity Thiazide Diuretics- Hydrochlorothiazide (HCTZ): Drug interactions - CORRECT ANSWERS same as loop diuretics •Digoxin, ototoxic drugs, K+ sparing diuretics, Lithium, antihypertensives, NSAIDs other thiazide diuretics - CORRECT ANSWERS chlorothiazide [Diuril], methylclothiazide [Enduron], chlorthalidone [Thalitone], indapamide, metolazone Potassium-Sparing Diuretics - CORRECT ANSWERS •Limited diuretic effect •substantially decrease K+ excretion often used to counteract potassium loss caused by thiazide and loop diuretics