NR 508 Basic Principles of Pharmacology in Advanced Pharmacology Questions with Answers
1. The route of excretion of a volatile drug will likely be the:
c) Bile and feces
Answer. Bile and feces
2. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage reservoir of the drug. Storage reservoirs:
a) Assure that the drug will reach its intended target tissue
b) Are the reason for giving loading doses
c) Increase the length of time a drug is available and active
d) Are most common in collagen tissues
Answer. Increase the length of time a drug is available and active
3. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
a) Propensity to go to the target receptor
b) Biological half-life
d) Safety and side effects
Answer. Biological half-life
4. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. A loading dose:
a) Rapidly achieves drug levels in the therapeutic range
b) Requires four- to five-half-lives to attain
c) Is influenced by renal function
d) Is directly related to the drug circulating to the target tissues
Answer. Rapidly achieves drug levels in the therapeutic range
5. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
a) Minimum adverse effect level
b) Peak of action
c) Onset of action
d) Therapeutic range
Answer. Onset of action
6. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
a) When the drug has a wide therapeutic range
b) When the drug will be administered for a short time only
c) When there is a high correlation between the dose and saturation of receptor sites
d) To determine if a drug is in the therapeutic range
Answer. To determine if a drug is in the therapeutic range
7. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration. This means that the:
a) Concentration will produce therapeutic effects
b) Concentration will produce an adverse response
c) Time between doses must be shortened
d) Duration of action of the drug is too long
Answer. Concentration will produce an adverse response
8. Drugs that are receptor agonists may demonstrate what property?
a) Irreversible binding to the drug receptor site
b) Upregulation with chronic use
c) Desensitization or downregulation with continuous use
d) Inverse relationship between drug concentration and drug action
Answer. Desensitization or downregulation with continuous use
9. Drugs that are receptor antagonists, such as beta blockers, may cause:
a) Downregulation of the drug receptor
b) An exaggerated response if abruptly discontinued
c) Partial blockade of the effects of agonist drugs
d) An exaggerated response to competitive drug agonists
Answer. An exaggerated response if abruptly discontinued
10. Factors that affect gastric drug absorption include:
a) Liver enzyme activity
b) Protein-binding properties of the drug molecule
c) Lipid solubility of the drug
d) Ability to chew and swallow
Answer. Lipid solubility of the drug
11. Drugs administered via IV:
a) Need to be lipid soluble in order to be easily absorbed
b) Begin distribution into the body immediately
c) Are easily absorbed if they are nonionized
d) May use pinocytosis to be absorbed
Answer. Begin distribution into the body immediately
12. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
a) The sum of the effects of each drug individually
b) Greater than the sum of the effects of each drug individually
c) Less than the effect of each drug individually
d) Not predictable, as it varies with each individual
Answer. Greater than the sum of the effects of each drug individually
13. Which of the following statements about bioavailability is true?
a) Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
b) All brands of a drug have the same bioavailability.
c) Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
d) Combining an active drug with an inert substance does not affect bioavailability.
Answer. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
14. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
a) Water soluble and ionized drugs cross these barriers rapidly.
b) The blood-brain barrier slows the entry of many drugs into and from brain cells.
c) The fetal-placental barrier protects the fetus from drugs taken by the mother.
d) Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
Answer. The blood-brain barrier slows the entry of many drugs into and from brain cells.
15. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to:
a) Inactivate prodrugs before they can be activated by target tissues
b) Change the drugs so they can cross plasma membranes
c) Change drug molecules to a form that an excretory organ can excrete
d) Make these drugs more ionized and polar to facilitate excretion
Answer. Change drug molecules to a form that an excretory organ can excrete
16. Once they have been metabolized by the liver, the metabolites may be:
a) More active than the parent drug
b) Less active than the parent drug
c) Totally “deactivated” so they are excreted without any effect
d) All of the above
Answer. All of the above
17. All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by:
a) Reduced circulation and perfusion of the kidney
b) Chronic renal disease
c) Competition for a transport site by another drug
d) Unbinding a nonvolatile drug from plasma proteins
Answer. Unbinding a nonvolatile drug from plasma proteins
18. Steady state is:
a) The point on the drug concentration curve when absorption exceeds excretion
b) When the amount of drug in the body remains constant
c) When the amount of drug in the body stays below the minimum toxic concentration
d) All of the above
Answer. When the amount of drug in the body remains constant
19. Two different pain medications are given together for pain relief. The drug—drug interaction is:
20. Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
a) Reducing the dosage of one of the drugs
b) Scheduling their administration at different times
c) Prescribing a third drug to counteract the adverse reaction of the combination
d) Reducing the dosage of both drugs
Answer. Prescribing a third drug to counteract the adverse reaction of the combination
21. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process?
a) Protein malnutrition
b) Iron-deficiency anemia
c) Both 1 and 2
d) Neither 1 nor 2
Answer. Neither 1 nor 2
22. The time required for the amount of drug in the body to decrease by 50% is called:
a) Steady state
c) Phase II metabolism
d) Reduced bioavailability time
23. An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:
a) Upregulate the total number of receptors
b) Block the receptor with a partial agonist
c) Alter the drug’s metabolism
d) Downregulate the numbers of that specific receptor
Answer. Downregulate the numbers of that specific receptor
24. Drug antagonism is best defined as an effect of a drug that:
a) Leads to major physiological and psychological dependence
b) Is modified by the concurrent administration of another drug
c) Cannot be metabolized before another dose is administered
d) Leads to a decreased physiological response when combined with another drug
Answer. Is modified by the concurrent administration of another drug
25. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements?
a) Avoid any other oral medicines while taking this drug.
b) If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice.
c) The tablet may be crushed if you have any difficulty taking it.
d) To achieve best effect, take the tablet with at least 8 ounces of fluid.
Answer. To achieve best effect, take the tablet with at least 8 ounces of fluid.
26. The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly result in:
27. Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach?
a) Sodium bicarbonate
b) Ascorbic acid
c) Salicylic acid
Answer. Sodium bicarbonate
28. Which of the following variables is a factor in drug absorption?
a) The smaller the surface area for absorption, the more rapidly the drug is absorbed.
b) A rich blood supply to the area of absorption leads to better absorption.
c) The less soluble the drug, the more easily it is absorbed.
d) Ionized drugs are easily absorbed across the cell membrane.
Answer. A rich blood supply to the area of absorption leads to better absorption.
31.An advantage of prescribing a sublingual medication is that the medication is:
a) Absorbed rapidly
b) Excreted rapidly
c) Metabolized minimally
d) Distributed equally
Answer. Absorbed rapidly
32. Drugs that use CYP 3A4 isoenzymes for metabolism may:
a) Induce the metabolism of another drug
b) Inhibit the metabolism of another drug
c) Both 1 and 2
d) Neither 1 nor 2
Answer. Both 1 and 2
33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:
a) After the second dose
b) After four to five half-lives
c) When the patient feels the full effect of the drug
d) One hour after IV administration
Answer. After four to five half-lives
34. Upregulation or hypersensitization may lead to:
1) Increased response to a drug
2) Decreased response to a drug
3) An exaggerated response if the drug is withdrawn
4) Refractoriness or complete lack of response
Answer. An exaggerated response if the drug is withdrawn