The CNP orders the patient a tetracycline antibiotic and instructs him to avoid taking the medication with foods, beverages, or drugs that contain calcium, iron, or magnesium.

Question 1The CNP orders the patient a tetracycline antibiotic and instructs him to avoid taking the medication with foods, beverages, or drugs that contain calcium, iron, or magnesium. The patient takes the antibiotic along with a daily multivitamin, not realizing that the vitamin contains iron. What effect may this have on the tetracycline?

 

Select one:

 

a.Decreased metabolism

 

b.Impaired excretion

 

c.Impaired absorption

 

d.Increased distribution

 

Question 2During completion of the exam and review of the patient’s most recent medical record notes, it is noted by the CNP that the patient has a malignant brain tumor. What pharmacokinetic phase may be affected by the presence of the tumor?

 

Select one:

 

a.Absorption

 

b.Metabolism

 

c.Excretion

 

d.Distribution

 

Question 3The patient requires a drug to be prescribed by the CNP that is known to be completely metabolized by the first-pass effect. During the prescribing process the CNP knows that due to this requirement:

 

Select one:

 

a.The drug must be given in a lipid-soluble form.

 

b.The drug must be given in higher doses.

 

c.The drug must be given by a non-oral route.

 

d.The drug must be given more frequently.

 

Question 4A patient with cirrhosis of the liver exhibits decreased metabolic activity. This will require the CNP to make what possible changes in the patient’s pharmacotherapeutic regimen? (Select all that apply.)

 

Select one or more:

 

a.A change in the timing of medication administration

 

b.Giving all prescribed drugs by intramuscular injection

 

c.More frequent monitoring for adverse drug effects

 

d.An increased dose of prescribed drugs

 

e.A reduction in the dosage of the drugs

 

 

 

Question 5A patient who is in renal failure may have a diminished capacity to excrete medications. During the course of drug therapy, the CNP must assess the patient more frequently for what development?

 

Select one:

 

a.Increased risk of allergy

 

b.Increased absorption of the drug from the intestines

 

c.Increased risk for drug toxicity

 

d.Decreased therapeutic drug effects

 

 

 

Question 11The CNP is prescribing butorphanol (Stadol), a partial agonist. This term “partial agonist” reminds the CNP that Stadol:

 

Select one:

 

a.is a drug that produces a weaker, or less efficacious, response than an agonist drug.

 

b.is a drug that causes unpredictable and unexplained drug reactions.

 

c.is a drug that produces the same type of response as the endogenous substance.

 

d.is a drug that will occupy a receptor and prevent the endogenous chemical from acting.

 

Question 12Nonlinear kinetics or zero-order kinetics describes a process whereby drug elimination does not depend on its:

 

Select one:

 

a.dose

 

b.concentration

 

c.Both a and b

 

d.Neither a nor b

 

Question 13Which herbal supplement should be taken with caution by people on Plavix(clopidogrel) due to its impact on platelet activity?

 

Select one:

 

a.Garlic

 

b.Dandelion

 

c.Acacia

 

d.Meadowsweet

 

Question 14Which supplement increases bulk in stool but should be taken with a space of one to two hours from other medications?

 

Select one:

 

a.St John Wort’s

 

b.garlic

 

c.flaxseed

 

d.docusate

 

Question 15The following medication has a lower potential for abuse than schedule 1 and it is considered a schedule 3.

 

Select one:

 

a.Meperidine

 

b.Hydromorphone

 

c.Methadone

 

d.Tylenol #3

 

Question 16When prescribing drugs for an older adult, what factor affecting elimination of drugs should the practitioner consider?

 

Select one:

 

a.Increased oxidation of drugs occurs with aging.

 

b.Aging produces an increase in hepatic blood flow.

 

c.Phase II metabolism of drugs by conjugation is not affected by age.

 

d.The kidney is the major organ of drug metabolism for older adults.

 

Question 17Which statement accurately describes the structure and function of a P&T Committee?

 

Select one:

 

a.It is composed of pharmacists and insurance company CFOs.

 

b.It creates and implements medication use policies.

 

c.It helps to develop and manufacture safe, effective generic medications.

 

d.It licenses pharmacists to practice in hospital settings.

 

Question 18A health care practitioner is caring for an older patient diagnosed with dementia. Which measure is appropriate for this patient?

 

Select one:

 

a.Ordering physical restraints to prevent falls

 

b.Ordering antipsychotic medication for BPSD as first-line therapy

 

c.Treating insomnia with benzodiazepines

 

d.Periodically assessing a patient who is taking a cholinesterase inhibitor

 

Question 19When prescribing doses for pediatric patients the NP must consider

 

Select one:

 

a.Age in months

 

b.Body Surface Area (BSA)

 

c.Height in centimeters

 

d.Weight in kilograms

 

Question 20When prescribing doses for geriatric patients the NP must consider

 

Select one:

 

a.Weight in Kilograms

 

b.Renal function

 

c.Age in years

 

d.Visual acuity

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