NURS 617 Pharm Exam 1 2025 LATEST Jean Genzale (100% CORRECT SUMMER) (Verified Answers), Exams of Nursing

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NURS 617 Pharm Exam 1 2025 LATEST Jean

Genzale (100% CORRECT SUMMER)

(Verified Answers 100%)

1. A 42 y / o woman is diagnosed with bacteremia in the ED. The NP empirically starts antibiotics and want the first dose of Vancomycin to be given prior to admission to the floor. The hospital has a vancomycin nomogram for 15 mg / kg initial dosing ( rounded to the nearest 250 mg ) , followed by pharmacy dosing / pharmacokinetic service. If the patient weighs 154 pounds , what dose of vancomycin would the patient receive in the ED? Please give your answer as a whole number without units. 1000 The study of pharmacodynamics involves all of the following EXCEPT , CHOOSE ONE ANSWER a. Biological effects of drugs 20 1919 b. Biotransformation of drugs c. Chemical alteration of the cellular environment d. Mechanism of a drug's action b. Biotransformation of drugs
2. In regard to pharmacodynamics , " affinity " can be defined as : CHOOSE ONE ANSWER a. The measure of how tightly a drug binds to plasma proteins b. The amount of time that a measurable drug effect persists

c. The degree of attraction between a drug and its receptor d. The measure of a drug's bioavailability c. The degree of attraction between a drug and its receptor

4. Antagonist drugs prevent the actions of the body's endogenous biomediators on their receptors by which mechanism? CHOOSE ONE ANSWER a. Preventing agonist drugs from binding to antagonist drug b. Binding to the receptor and activating it c. Preventing occupancy of the receptor d. Mimicking the actions of the body's endogenous biomediators c. Preventing occupancy of the receptor What are the two most important sites for drug elimination? CHOOSE ONE ANSWER a. liver and gastrointestinal tract b. kidneys and liver c. lungs and liver d. skin and kidneys b. kidneys and liver ALSY 6. Acetaminophen and codeine are given together for pain relief. The drug - drug interaction is : CHOOSE ONE ANSWER a. Beneficial inhibitory b. Beneficial potentiative c. Harmful inhibitory d. Harmful potentiative

Drugs cross the placenta membrane by : CHOOSE ONE ANSWER a. Active transport b. Exocytosis c. Filtration d. Passive diffusion d. Passive diffusion Drugs having a significant first pass effect : CHOOSE ONE ANSWER a. Are converted by the liver to more active and fat soluble forms b. Are rapidly metabolized by the liver and may have little if any action c. Bypass the hepatic circulation d. Must be given by the enteral ( Oral ) route only b. Are rapidly metabolized by the liver and may have little if any action The cytochrome P - 450 enzyme system a. Alters a parent drug by oxidation , hydrolysis , and other chemical reactions b. Is involved in excreting drugs through the kidney c. Mediates Phase II reactions in the liver d. Changes a drug to make it more fat soluble a. Alters a parent drug by oxidation , hydrolysis , and other chemical reactions The most important drug metabolizing enzyme is : CHOOSE ONE ANSWER a. CYPIA b. CYP2C

c. CYP2E d. CYP3A d. CYP3A The initial therapeutic effect on the drug concentration curve can be defined as the : CHOOSE ONE ANSWER a. Minimal adverse effect level b. Onset of action c. Peak of action d. Therapeutic range b. Onset of action An excessive dose of meperidine ( Demerol ) causing respiratory depression and sedation can be classified as what type of adverse drug reaction ( ADR )? CHOOSE ONE ANSWER a. Delayed ADR b. Idiosyncratic ADR c. Cumulative ADR d. Intrinsic ADR d. Intrinsic ADR Example ( s ) of an inhibitory pharmacodynamic drug - drug interaction would include : blocker for congestive heart failure a. Administration of protamine to a patient with a heparin overdose b. Giving a patient an ACE - inhibitor and a beta c. Concurrent use of a statin and niacin for hyperlipidemia

d. Polarized a. Fat soluble Which of the following drugs can be used to form an irreversible chemical bond between themselves and another molecular substance? CHOOSE ONE ANSWER a. Cholestyramine ( Questran ) b. Mannitol c. Sucralfate d. Talcum powder a. Cholestyramine ( Questran ) Biotransformation of a drug results in? CHOOSE ONE ANSWER a. Easier distribution b. Faster urinary excretion c. Higher protein binding d. Slower urinary excretion b. Faster urinary excretion Which statement is true concerning pharmacokinetic variations in a pediatric patient? CHOOSE ONE ANSWER a. Drugs administered topically to the skin in neonates , infants , and small children will be absorbed faster than the same drug applied to the skin of an adult b. Neonates have a larger percentage of their body weight as fat allowing a wider distribution of fat - soluble drugs c. Because drug metabolic rates are proportional to basal body temperatures , drug metabolism in neonates and infants is generally slower than an adult.

d. Glomerular filtration and renal tubular excretion does not change in the lifespan of al patient . a. Drugs administered topically to the skin in neonates , infants , and small children will be absorbed faster than the same drug applied to the skin of an adult Water soluble drugs have good absorption through all the following routes EXCEPT : CHOOSE ONE ANSWER a. Enteral b. Intravenous c. Transdermal d. Transrectal c. Transdermal Unless contraindicate or not tolerated , which drug class should be given to all patients with a recent or remote history of myocardial infarction? CHOOSE ONE ANSWER a. Beta blockers b. Diuretics c. Cardiac glycosides d. Nitrates a. Beta blockers Due to electrolyte depletion , a patient taking a thiazide diuretic may also need to receive the following supplement CHOOSE ONE ANSWER a. Calcium b. Magnesium c. Phosphates

c. Nitrates What patient education would you give when prescribing a nitrate for treatment of angina? CHOOSE ONE ANSWER a. Nitrates should not be used for acute episodes of angina b. Tolerance and physical dependence do not occur with continuous use c. Nitrates commonly cause headaches with initial doses of the drug d. Take this medication with the first meal of the day c. Nitrates commonly cause headaches with initial doses of the drug Spironolactone ( Aldactone ) is often used in combination with the thiazides because : CHOOSE ONE ANSWER a. The combination improves compliance in long term hypertensive therapy. b. The potassium sparing diuretic offsets the potential for hypokalemia often seen with the thiazides c. The antihypertensive efficacy is increased when the renin - angiotensin - aldosterone mechanism is activated d. The potential risk of reflex tachycardia is reduced. b. The potassium sparing diuretic offsets the potential for hypokalemia often seen with the thiazides Dobutamine in the treatment of acute CHF : CHOOSE ONE ANSWER a. Works as a beta agonist and an alpha agonist b. Increases the force of myocardial contraction c. Reduces systemic vascular resistance and decreases afterload d. Can be given sublingually

b. Increases the force of myocardial contraction Treatment for ACC / AHA Stage A heart failure patients includes : CHOOSE ONE ANSWER a. Digoxin ( Lanoxin ) , a cardiac glycoside b. Drugs for hypertension and lipid disorders , if they exist c. No drugs are used in this early stage d. Smoking cessation only b. Drugs for hypertension and lipid disorders , if they exist Increased life expectancy for patients with heart failure has been associated with the use of : CHOOSE ONE ANSWER a. ACE Inhibitors b. Cardiac glycosides c. Loop diuretics d. Thiazide diuretics a. ACE Inhibitors According to JNC - 8 guidelines , which of the following is the blood pressure goal for patients with diabetes? CHOOSE ONE ANSWER a. < 150/ b. < 140/ c. < 140/ d. < 130/ b. < 140/

b. Are teratogenic c. Often cause impotence in men d. Block the action of aldosterone a. Can be useful in the treatment of hypertensive crisis Drowsiness and dizziness may be adverse effects of some antihypertensive drugs. Of the following , which one is MOST LIKELY to cause this? CHOOSE ONE ANSWER a. The direct - acting vasodilator , minoxidil ( Loniten ) b. Calcium channel blocker , nifedipine ( Procardia ) c. The alpha 2 adrenergic agonist , alpha methyldopa ( Aldomet ) d. The ACE inhibitor , Lisinopril ( Prinivil ) c. The alpha 2 adrenergic agonist , alpha methyldopa ( Aldomet ) The mechanism of action of the ACE Inhibitors includes : CHOOSE ONE ANSWER a. Promoting release of aldosterone b. Reduction of arterial resistance with minimal compensatory volume increase c. Working in both the adrenal gland and the central nervous system d. Promoting the transformation of Angiotensin I into Angiotensin II b. Reduction of arterial resistance with minimal compensatory volume increase Pharmacological management of acute heart failure may include all of the following therapies , EXCEPT? CHOOSE ONE ANSWER a. Morphine Sulfate b. Dopamine ( Intropin ) c. Dobutamine ( Dobutrex )

d. Alpha - methyldopa ( Aldomet ) d. Alpha - methyldopa ( Aldomet ) HMG - CoA reductase inhibitors ( statins ) are more effective than other drugs in lowering? CHOOSE ONE ANSWER a. Triglycerides b. High - density lipoprotein ( HDL ) cholesterol c. Low - density lipoprotein ( LDL ) cholesterol d. Triglycerides and HDL cholesterol c. Low - density lipoprotein ( LDL ) cholesterol Factors that contribute to low HDL cholesterol levels include? CHOOSE ONE ANSWER a. Decreased carbohydrate intake b. Decreased triglycerides c. Taking a beta blocker d. Tight glycemic control c. Taking a beta blocker Which of the following medications slows AV conduction , improves myocardial oxygenation and lowers heart rate? CHOOSE ONE ANSWER a. ACE inhibitor b. Caclium channel blockers c. Digoxin d. Angiotensin Receptor blockers c. Digoxin

Which lab test should be monitored to detect adverse drug reactions common with statins ( HMG CoA reductase inhibitors )? CHOOSE ONE ANSWER a. glucose b. potassium c. white blood cell count d. liver function Test d. liver function Test Which of the following side effects is experienced by patients taking Verapamil? CHOOSE ONE ANSWER a. Chest pain b. Constipation c. Diarrhea d. Nocturnal cough b. Constipation Which of the following lipid lowering agents can be used during pregnancy if medication is required after lifestyle managements has been unsuccessful? CHOOSE ONE ANSWER a. Bile acid binding resins b. Nicotinic Acid c. Omega 3 fatty acids d. Statins a. Bile acid binding resins Use of pharmacogenomics can

a. Identify a patient with genetic factors responsible for variable responses to certain drugs b. Eliminate adverse effects associated with all forms of pharmacotherapy c. Alter an individual's set of CYP 450 enzymes d. Potentially make pharmacotherapy an obsolete practice a. Identify a patient with genetic factors responsible for variable responses to certain drugs Administration of an antagonist drug results in a. No direct pharmacologic action from the drug itself b. An immediate " wearing out " of the receptors that are blocked by the drug c. A binding process that causes a permanent alteration in the shape of the receptors d. Enhanced interaction of the natural endogenous biomediator with the receptor. a. No direct pharmacologic action from the drug itself Which of the following events must occur after absorption of a dose to enable a drug to reach cells in muscle tissue? a. Metabolism b. Distribution c. Clearance d. Excretion b. Distribution An adverse drug reaction characterized by a decreased response to a particular drug dosage when the drug is given repeatedly over time is called a. Dependence b. An idiosyncratic reaction

a. Renal insufficiency Which statement is true concerning pharmacokinetic variations in a pediatric patient? A. Drugs administered topically to the skin and neonate's, infants, and small children will be absorbed faster than the same drug applied to the skin of an adult b. Because drug metabolic rates are proportional to basil body temperatures, drug metabolism in neonates and infants is generally slower than an adult C. Neonates have a larger percentage of their body weight as fat allowing a wider distribution of fat soluble drugs d. Glomerular filtration and renal tubular excretion does not change in the lifespan of a patient A. Drugs administered topically to the skin and neonate's, infants, and small children will be absorbed faster than the same drug applied to the skin of an adult Which combination of drugs has the potential of producing a harmful inhibitory drug interaction? a. Concurrent use of aspirin and warfarin for anticoagulation. b. Protamine giver after heparin - induced excessive bleeding c. Injecting NPH insulin into a bottle of regular insulin d. Concurrent use of aspirin and codeine for pain relief. c. Injecting NPH insulin into a bottle of regular insulin An excessive dose of meperidine ( Demerol ) causing respiratory depression and sedation can be classified as what type of adverse drug reaction? a. Delayed ADR b. Idiosyncratic ADR c. Cumulative ADR

d. Intrinsic ADR d. Intrinsic ADR Which of the following factors has the LEAST effect on the rate or extent of drug excretion by the kidney? a. Renal blood flow b. Urinary pH c. Advanced age ( > 65 ) d. Route of administration d. Route of administration A. drug half - life can be defined as a. The time it takes , after a drug is administered , to reach an effective serum ( or tissue ) concentration that is capable of producing a minimal clinical response b. The time it takes , after a drug is administered , to reach an effective serum ( or tissue ) concentration capable of producing a maximal clinical response C. The total time a drug is present in the serum ( or tissue ) for it to produce any clinical effects ( minimal or max ) d. The time it takes , after a drug is administered , to reach an effective serum concentration equal to one half of what it was at its peak concentration d. The time it takes , after a drug is administered , to reach an effective serum concentration equal to one half of what it was at its peak concentration In the pregnant patient a. Gastric emptying is increased and speed absorption of drugs from the small intestine b. Gastric acid levels are lower than normal