NURS 6015 Exam 1 QUESTIONS WITH 100% COMPLETE SOLUTIONS 2024-2025 LATEST VERSION., Exams of Nursing

Download NURS 6015 Exam 1 QUESTIONS WITH 100% COMPLETE SOLUTIONS 2024-2025 LATEST VERSION. and more Exams Nursing in PDF only on Docsity! NURS 3330- PHARMACOTHERAPEUTICS FOR NURSING CARE - EXAM 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is pharmacology? - ANSWER -The study of the effects of drugs and their interaction with living systems. It is also the study of what drugs do and how they do it. What is clinical pharmacology? - ANSWER -The study of drugs in humans. What is therapeutics mean in terms of nursing care? - ANSWER -The use of drugs to diagnose, cure, treat, or prevent disease. What is a drug? - ANSWER -Any chemical that can affect living processes. What are reasons for studying pharmacology? - ANSWER -1. Safely be able to administer medications. 2. Educate clients and caregivers. 3. Manage a therapeutic drug regimen. What is effectiveness in terms of the properties of an ideal drug? - ANSWER -It elicits the responses for which is given. It is the most important property a drug can have. US law requires all new drugs must prove to be this. What is safety in terms of the properties of an ideal drug? - ANSWER -It cannot produce harmful effects. There is no such thing as a drug which is this. What is intrinsic activity? - ANSWER -This refers to the ability of a drug to activate receptors. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is selectivity in terms of the properties of an ideal drug? - ANSWER -It only elicits the response for which it is given. There is no such thing as a drug which is this because all medications cause side effects. If a drug binds to only one type of receptor, and the receptor with the drug produces the desired effects, than a drug is known to be selective. If a drug responds to multiple receptors, then it is known to be nonselective. What are the Six Rights of Medication Administration? - ANSWER -Right medication Right client Right dosage Right route Right time Right documentation What is patient adherence? - ANSWER -Also known as compliance implementing non-drug measures. It is simply the education of patients of the drugs which they are given. What is a side effect? - ANSWER -Not a desired effect and usually not life threatening. They can be alleviated with specific measures. These may develop soon after a drug is initiated or not until drug has been taken for weeks or months. What is an adverse effect? - ANSWER -These are more severe than a side effect. It is always an undesirable effect and must always be reported to the health care provider. Nurses must know the major kinds of these which a drug can elicit, the time when these reactions are likely to occur (45 min-1 hour), early signs when one is developing, and interventions which can minimize discomfort and harm of these. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is the first-pass effect? - ANSWER -A drug that is absorbed from the small intestine and transported to portal circulation for metabolism. The liver may biotransform much of the drug before is can enter general circulation. It is the process of the loss of effectiveness. What is the rate in terms of absorption? - ANSWER -This determines how soon the effects of a drug will begin. What is the amount in terms of absorption? - ANSWER -This helps us determine how intense the effects of a drug will be. What are different pharmaceutical preparations for oral administration of drugs? - ANSWER -1. Tablets - can be crushed/chewed/cut in half 2. Enteric-coated preparations - do not affect pH balance and are biotransformed in small intestine. 3. Sustained-release preparations - dissolve over a long period of time. EC and SR drugs are NOT crushed. What is metabolism (also known as biotransformation)? - ANSWER -The enzymatic alteration of drug structure. It is the ability of living organism to modify the chemical structure of compounds. The liver is the most important site for biotransformation of drugs. What are the therapeutic consequences of drug metabolism? What are special considerations in drug metabolism? - ANSWER -Acceleration of renal excretion of drugs, drug inactivation, increased therapeutic action, activation of "prodrugs", increased/decreased toxicity are all consequences. A nurse should note patient's age, induction of drug-metabolizing enzymes, first-pass effect, nutritional status (albumin levels), and competition between other drugs. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is excretion? - ANSWER -The removal of drugs from the body. The kidneys account for the majority of drug excretion. There are many non-renal routes of drug excretion: breast milk, bile, feces, lungs, sweat, and saliva. What are ways to determine renal function? - ANSWER -Creatinine clearance - best way, however it takes a long time (24 hours; typically performed with geriatric patients) Serum creatinine - generally how we determine renal function because results can be determined immediately What are the three plasma drug levels? - ANSWER -Minimum effective concentration - defined as the plasma drug level below which therapeutic effects will not occur. Toxic concentration - when the plasma drug levels climb too high. Therapeutic range - when enough drug is present to produce therapeutic responses. The objective of drug dosing is to maintain plasma drug levels within the therapeutic range. What is the therapeutic index? - ANSWER -This is the measure of a drug's safety. The larger/higher the therapeutic index, the safer the drug. It is also defined as the LD50:ED50 ratio. What is a single-dose time course? - ANSWER -This describes drug levels that rise as the medicine undergoes absorption and declines with metabolism and excretion. The duration of effects is determined largely by the combination of metabolism and excretion. What is the half life of a drug? - ANSWER -This is the most common description of a drug's duration. This describes the time it takes for the blood level of a drug to fall to one-half (50%) of the level measured at some prior time. This tells how fast it disappears from the bloodstream due to metabolism and excretion. This determines the dosing interval. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is the plateau principle? - ANSWER -The plateau principle describes when you give the same dose of the same drug by the same route, at the same time interval, and nothing else changes, it takes 4 to 5 half lives from the start of drug administration for blood levels to reach a plateau. A steady state describes the point at which the amount of the drug being administered and the amount being eliminated balance off, and a plateau will have been reached. What is pharmacodynamics? - ANSWER -It is the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced. It is also the study of what drugs do to the body and how they do it. What is a dose-response relationship? - ANSWER -It is the relationship between the size of an administered dose and the intensity of the response produced. This will determine the minimum amount of drug we can use, the maximum response a drug can elicit, and how much we need to increase the dosage to produce the desired increase in response. As the dosage increases, the response becomes progressively larger. Tailor treatment by increased/decreased dosage until desired intensity of response is achieved. What is maximal efficacy? - ANSWER -The biggest effect a drug can produce, also the level of effectiveness. Drugs with a high intrisnic activity have high maximal efficacy. What is a potent drug? - ANSWER -One that produces its effects at low doses. It is based on concentration. What is the plasma level prolife of a drug? - ANSWER -1. Trough: amount of drug in bloodstream just before the next dose. 2. Peak: amount of drug in bloodstream after 1 hour intravenously. What are different types of drug toxicities? - ANSWER -Specific patterns or groups of symptoms related to drug therapy that carry risk for permanent damage to an organ or system. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is an idiosyncratic effect? - ANSWER -An uncommon drug response resulting from a genetic predisposition. Some drugs don't work due to genetic makeup. What is an iatrogenic disease? - ANSWER -Used to refer to a disease produced by drugs. Sometimes also called drug-induced disease. Essentially identical to naturally occurring pathology. What is physical dependence? - ANSWER -This develops during long-term use of certain drugs which is a state when the body has adapted to drug exposure. What is a carcinogenic effect? - ANSWER -Any substance that has the potential for the formation of cancer. What is a teratogenic effect? - ANSWER -A drug-induced birth defect. It is the effect of any compound capable of interfering with embryonic and/or fetal development. What is organ specific toxicity? - ANSWER -Drugs that are toxic to specific organs. What is individual variation? - ANSWER -Used to describe how one patient responds to drugs differently than another patient. What are factors that affect individual variation? - ANSWER -1. Body weight and composition 2. Age 3. Pathophysiology (liver/renal dysfunction, acid-base imbalance, altered electrolyte status) 4. Tolerance - decreased responsiveness to a drug as a result of repeated drug administration What is pharmacodynamic tolerance? - ANSWER -Associated with long-term administration of drugs. What is metabolic tolerance? - ANSWER -Resulting from accelerated drug metabolism. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is tachyphylaxis? - ANSWER -The reduction in drug responsiveness brought on by repeated dosing over a short time. How is the placebo effect important when evaluating drug administration? - ANSWER -Any response a patient has to a placebo is based solely on his or her psychological reaction to the idea of taking a medication and not to any direct physiologic or biochemical action of the placebo itself. What is pharmacogenomics? - ANSWER -The study of how genes affect individual drug responses, such as altered drug metabolism or altered drug targets. What are changes in pregnancy that influences pharmacokinetics? - ANSWER -Total body water, increased aldosterone levels, increased body fat and weight, dilutional decrease in serum albumin levels, increased cardiac output and renal blood flow, and the stimulation of progesterone and the hepatic enzyme system. Because hepatic metabolism and glomerular filtration increase during pregnancy, dosages of some drugs may need to be increased. What is important to consider about fetal-placental pharmacokinetics? - ANSWER -All drugs can cross the placenta and the nurse should assume that any drug taken during pregnancy will reach the fetus. What is important to consider about teratogens and pharmacodynamics? - ANSWER - Teratogens can cause a characteristic set of malformations. Incidence of malformations should increase with increasing dosage and duration of exposure. Greatest risk of physical abnormalities is with use of teratogens during the first trimester. However, drug transfer to the fetus is most likely to occur during the last trimester of pregnancy and result in intellectual abnormalities. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What is important to consider about drugs and breast feeding? - ANSWER -A majority of drugs are secreted into breast milk, but very few instances are present in which the drug needs to be discontinued. Mothers should minimize the use of drugs and take them immediately after breast-feeding. Choose drugs that tend to be excluded from milk and are least likely to affect the infant. Avoid drugs that are known to be hazardous (Category X drugs). What are Category A drugs? - ANSWER -Drugs that show no harm to human fetal development. What are Category B drugs? - ANSWER -Drugs that show no harm to animal fetal development. What are Category C drugs? - ANSWER -Drugs that show adverse effects to animal fetal development OR No tests done on human or animal fetus. What are Category D drugs? - ANSWER -There has been adverse effects reported on human fetus; in selected case benefit of the potential for benefit versus risk may warrant use of these drugs in pregnant women. What are Category X drugs? - ANSWER -These drugs are NOT to be used on pregnant women. Human fetal abnormalities have been reported. What are the three most common types of fatal medication errors? - ANSWER -Giving an overdose, giving the wrong drug, and using the wrong route. What are the three most common causes of fatal medication errors? - ANSWER -Human factors (performance, knowledge errors), miscommunication, and confusion caused by similarities in drug names. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS What are pharmacodynamic changes in the elderly? - ANSWER -There are alterations in receptor properties that may underlie altered sensitivity to some drugs. Therefore, there are drugs with more intense effects in the elderly. How does polypharmacy tend to increase the risk of ADRs in elderly patients? - ANSWER - Longevity generally leads to increased illnesses and greatly increases the risk of drug interactions and ADRs. It results from simultaneously increased use of prescriptive and OTC drugs. What are reasons for unintentional nonadherence? - ANSWER -Complex regimens, awkward drug packaging, forgetfulness, side effects, low income, and failure to comprehend instructions. What are reasons for intentional nonadherence? - ANSWER -Expense, side effects, and the patient's conviction that the drug is unnecessary or the dosage is too high. As a nurse, how can one promote adherence? - ANSWER -Simplified drug regimens should be implemented with clear, concise verbal and written instructions. An appropriate dosage form should be provided with clearly labeled and easy-to-open containers. Daily reminders could help, with use of mobile devices. A support system from nurses should can improve self- confidence along with frequent monitoring. How should you assess elderly patients who are at risk for ADRs? - ANSWER -Ask for a complete drug history and list of all medications taken by client. A list of all prescribers should also be provided. Review prescription bottles for possible use of multiple pharmacies. Review all medication expiration dates and assess self-medication practices. As a nurse, how can one educate patients to take their prescriptions appropriately? - ANSWER - Review all medications with the patient. Have the patient repeat information that you are providing them. The time needed for learning often increases for geriatric patients. The nurse should perform a functional assessment. Provide a written medication schedule. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS The nurse should also modify teaching methods to sensory-perceptual deficits or cognitive decline. What is ED50? - ANSWER -This is defined as the dose required to produce a therapeutic response in 50% of a population. NURS 3330- Pharmacotherapeutics for Nursing Care - Exam 1 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS