Pharmacology & Substance Use
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1) All drugs that are considered safe to administer to adults are safe for administration to pediatric patients if the dose is adjusted appropriately for size.
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2) The majority of drugs used in pediatrics have never been tested on children
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Approximating safe doses of drugs for children is most accurate when calculated based on body surface area.
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When a patient takes a drug for a long time and becomes tolerant, the nurse would expect the prescriber would need to the dose to achieve the desired effect.
5) This specific kind of drug tolerance known as is a reduction in drug responsiveness brought on by repeated dosing of the drug over a short period of time.
6) Based on pharmacokinetics, drugs are most likely to pass through the placenta and into fetal circulation if they are
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Determining the effect of exposure to teratogens during pregnancy depends on timing and amount. Match the following terms to the correct period of pregnancy
| This is the time when the fetus is most vulnerable to teratogens, so the mother must be taught to avoid exposure to teratogens at this time | |
| During this time, exposure usually results in death of the conceptus or full recovery and is usually related to exposure dose | |
| Exposure to teratogens during this period tends to affect function rather than gross anatomy | |
| First trimester (first 3 months of preganancy) | |
| This period is the 2nd and 3rd trimester of pregnancy | |
| Exposure to teratogens during this period is especially important to brain function and can result in problems with learning and behavior | |
| Is the time when internal organs and structures are formed and established | |
| Conception through week 2 | |
| Exposure to teratogens during this period generally results in gross malformations |
8) A woman is admitted to labor and delivery and receives an opioid for pain early in labor. Her labor progresses more rapidly than expected and she delivers shortly after the medication has been given. The nurse will expect assessment of the newborn to include
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Which instruction should be included in patient teaching regarding breast-feeding and drug therapy?
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A 52 y/o man is admitted with uncontrolled hypertension. He has been prescribed 3 medications, but admits he does not take the medications as prescribed. He does not think he needs the drugs because he cannot “feel” his high blood pressure and he does not have insurance for drugs.
Identify 3 interventions specific to this patient that may help the patient increase adherence to his medication. This means looking at the data and coming up with 3 different ideas that address the “why” he doesn’t take the medications.
You must give a reference for this question (APA formatted reference is required).
11) The same name is never used for more than one medication.
12) Most drugs enter cells through channels or pores.
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Cell membranes are composed of fat with phosphate
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P-glycoprotein transports many drugs out of cells
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A transport system is needed for a water-soluble drug to enter a cell
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Ionization is a process that allows a drug to enter a cell.
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If a quaternary ammonium compound drug is injected into a vein, it will produce effects, but it will not produce effects if it is taken orally
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Adding a new drug to a patient’s current drug regimen might cause the other drugs to be metabolized more rapidly or more slowly.
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A drug with extensive first-pass metabolism (or effect) may be given sublingually to allow the drug to be absorbed directly into the systemic circulation.
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First pass effect means that most of the drug is activated by the liver, so it must be administered orally.
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Enteric coated drugs should not be crushed because crushing can cause stomach distress or cause the acid in the stomach to alter the drug.
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Drugs that are currently bound to protein are not able to exert any action at the cellular level.
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Digoxin is a drug that has a narrow therapeutic range. When administering this drug, what does the nurse need to do? Select all that apply.
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Grapefruit juice inhibits the cytochrome P450 CYP3A4 drug metabolizing enzyme and inhibits P-glycoprotein in the intestines for days after ingestion. This especially affects calcium channel blockers, benzodiazepines, cyclosporine, and statin drugs. The nurse should teach the patient who is prescribed any of these drugs that drinking grapefruit juice can cause what problem?
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A patient stopped taking a drug 3 days ago. The drug has a half-life of 7 days. The patient tells the nurse that the drug must not have been necessary because he does not feel any different. What is the basis of the explanation of why the patient has not noticed any change in how he feels?
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Maximal efficacy is defined as the largest effect that a drug can produce
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Two drugs in the same therapeutic class with different recommended doses can have equal effects.
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A drug that is selective for specific receptors will produce more unintended effects than a nonselective drug.
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Affinity is the strength of attraction between a drug and its receptor Pharmacology & Substance Use
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Drugs with high intrinsic activity cause an intense response
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An agonist drug blocks the simulation of a receptor
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32) If a receptor is constantly bombarded by a drug, the cell can down-regulate and decrease the response to the drug.
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False
33) The ED 50 is usually the recommended dose for the drug
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When the therapeutic index of a drug is narrow, what should the nurse expect?
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A prescriber may prescribe a drug solely because of its interaction with another drug.
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The nurse should consult with the prescriber regarding adequate blood levels of oral drugs when a patient has persistent diarrhea.
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The nurse is teaching the patient being treated with a drug known to cause a disulfiram-type side effect to avoid what substance while taking the medication.
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The nurse is caring for a 92 y/o patient who was admitted yesterday for pneumonia. The patient’s medical history includes hypertension and heart failure. The patient is agitated, cannot tell the nurse her name or the date, and is complaining of seeing people outside her 3rd floor window.
The nurse wonders if this behavior is due to the drugs the patient is receiving.
What information should the nurse collect to help determine what the cause of the patient’s behavior is?
Withdrawl syndrome occurs when a drug is stopped and the person is on the drug
. (Answer is 2 words)
42) Genetic differences can cause uncommon drug responses, called reactions
43) is the detrimental physiologic effect caused by excessive drug dosing.
44) The student is studying the difference between an adverse effect and a toxic effect of a drug. Which of the following would be called an adverse effect as defined by the World Health Organization?
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A nurse has incorrectly administered an excessive dose of a prescribed drug to a patient. Which intervention would be the least likely to be beneficial in this situation? Pharmacology & Substance Use
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In attempting to reduce the exposure to of the developing baby to teratogens, match the appropriate teaching or intervention to the risk. Each answer is only used once
| Exposure to medications during pregnancy can negatively impact the developing baby | |
| Belief that over the counter drugs, including vitamins and supplements are safe because they do not require a prescription | |
| Patient is taking a known teratogen | |
| An untreated disease process is more dangerous than the use of medications |