Sherpath Unit 1 Lesson questions & quiz

An 18-month-old patient has been started on chemotherapy. Which means are used to adjust the drug dosages?

Therapeutic response
Plasma drug concentrations

Which family-centered education techniques would the nurse use when teaching the parents of a 12-month-old infant how to administer oral antibiotics?

Have parent soothe the 12-month-old patient
Use an oral syringe to administer the drug
Allow the 12-month-old patient to suck on a pacifier

Which factors increase the incidence of older adults experiencing adverse drug effects (ADEs) from drug therapy?

Polypharmacy
Cognitive impairment
Kidney dysfunction

To reduce the incidence of polypharmacy, on which factors would the nurse educate an older adult?

Side effects of their drugs
Interactions of each drug
The name and appearance of their drugs
Therapeutic effects of their drugs

Which considerations would the nurse use to promote drug adherence in older adults?

Recommend simple drug regimens
Recommend keeping a drug list in purse or wallet
Ask the pharmacy to provide containers that are easy to open

In which ways are pharmacokinetic components altered due to liver immaturity in young children?

-Decreased protein binding
(Protein binding is decreased because of decreased production of protein by the immature liver.)
-Reduced first-pass elimination
(First-pass elimination by the liver is reduced because of the immaturity of the liver.)

If the body eliminates a drug more slowly than the drug enters the body, which conditions can occur?

Toxic concentration
Increased side effects

When monitoring for therapeutic response in a patient prescribed a new drug, it is important for the nurse to understand it takes about how many
half-lives for a drug to reach steady state?

4

Which type of drug can mimic or block the actions of receptors?

Partial agonists

Which term describes the most likely cause of orthostatic hypotension that occurs in a patient who is taking six different drugs?

Drug-drug interaction

Patients may experience reduced effectiveness of which drugs when taken with St. John's wort?

Digoxin
Warfarin
Oral contraceptives

Which patients are more vulnerable to adverse effects?

Pediatric patients
Older adult patients
Patients with chronic illness

Nurses understand patients taking which narrow therapeutic index (TI) drugs require close monitoring of blood levels to adjust dosing?

Digoxin
Lithium
Warfarin
Phenytoin

Explains why oral drugs are formulated to be absorbed from small intestine

surface area

Drug that easily crosses membranes that separate it from the blood are

lipid soluble

Process where drug accumulates on side of membrane favoring its ionization is called

pH partitioning

Solutions have a faster onset than capsules due to this factor

rate of dissolution

Which route of administration provides rapid onset of delivery to enhance safety and efficacy?

intravenous

Which statements regarding the rectal administration of drugs are accurate?

Rectal drugs are rapidly absorbed.
Absorption of rectal drugs is unpredictable.
Defecation can interrupt absorption of rectal drugs.

Which factors affect drug distribution?

Blood flow to tissues
Ability of drug to enter cells
Ability of drug to exit blood vessels

Which statements about protein binding are accurate?

The portion of drug that remains unbound is active.
The portion of drug that is bound cannot exit blood vessels.
Only unbound drugs can exert pharmacologic responses.

Which drugs are able to cross the blood-brain barrier (BBB)?

Highly lipid-soluble drugs
Low molecular weight drugs
Drugs bound to transport proteins

The liver metabolizes drugs into which component for renal excretion?

water- soluble substance

Only how many of the 12 closely related cytochrome P450 enzyme families metabolize drugs?

3

Which factors decrease drug metabolism?

Malnutrition
Kidney disease
Cardiovascular disease

Drugs are excreted by which routes?

Feces
Lungs
Breastmilk

Which route of drug administration is most likely to be reversible?

oral

Which route of drug administration delivers drugs directly to the tissue where they exert their actions?

inhalational

Which factors may affect drug absorption?

surface area
lipid solubility
rate of dissolution

Which conditions decrease blood flow to tissues, thereby reducing the effectiveness of drug therapy?

abscess
solid tumor

The nurse knows that warfarin is 99% protein bound, whereas bupropion is 84% protein bound. If both of these drugs are administered concurrently, which events could occur?

Warfarin could displace bupropion from its binding site.
Bupropion could accumulate to toxic levels.

To safely administer drugs, nurses must understand that only certain drugs can cross the blood-brain barrier (BBB), including those that are highly lipid soluble and of low molecular weight. Which drug can cross the BBB?

Diazepam

Which routes of administration can be used to avoid the first-pass effect?

Topical
Intranasal
Intravenous
Inhalational

Which factors alter drug metabolism in older adults?

Decreased liver mass
Decreased hepatic blood flow

Kidney stones and urinary obstruction alter which pharmacokinetic principle?

Excretion

Certain drugs must undergo which process before enterohepatic recirculation can occur?

Glucuronidation

Drugs with which property are excreted in breast milk?

Lipid soluble

How does a medical diagnosis differ from a nursing diagnosis?

A medical diagnosis identifies a disease process.
A medical diagnosis identifies results of procedures.
A medical diagnosis identifies results of diagnostic tests.