WorksheetsNURS 321: Pharmacology 1 QUIZLET
Total questions: 99
Worksheet time: 50mins
Fill in the blank: Caritas Process 1 is to _________.
Embrace altruistic values and Practice loving kindness with self and others.
Develop a care plan for patient discharge.
Administer medication accurately and timely.
Document patient information electronically.
Fill in the blank: Caritas Process 2 is to _________.
Instill faith and hope and honor others
Demonstrate technical skills in nursing
Administer medication accurately
Maintain patient records
Fill in the blank: Caritas Process 3 is to _________.
Be sensitive to self and others by nurturing individual beliefs and practices
Maintain strict professional boundaries at all times
Focus solely on physical health outcomes
Prioritize administrative tasks over patient care
Fill in the blank: Caritas Process 4 is to _________.
Develop helping - trusting- caring relationships
Perform technical nursing skills
Administer medications accurately
Document patient care thoroughly
Fill in the blank: Caritas Process 5 is to _________.
Promote and accept positive and negative feelings as you authentically listen to another's story
Establish a healing environment at all levels
Develop helping-trusting, human caring relationships
Engage in creative problem-solving for caring decision-making
Fill in the blank: Caritas Process 6 is to _________.
Use creative scientific problem-solving methods for caring decision making
Establish a healing environment at all levels
Develop a helping-trusting, human caring relationship
Practice loving-kindness and equanimity within the context of caring consciousness
Fill in the blank: Caritas Process 7 is to _________.
Share teaching and learning that addresses the individual needs and comprehension styles
Establish a healing environment at all levels
Develop helping-trusting, caring relationships
Practice loving-kindness and equanimity within context of caring consciousness
Fill in the blank: Caritas Process 8 is to _________.
Create a healing environment for the physical and spiritual self which respects human dignity
Administer medication efficiently and quickly
Focus solely on physical health outcomes
Prioritize administrative tasks over patient care
Fill in the blank: Caritas Process 9 is to _________.
Assist with basic physical, emotional, and spiritual human needs
Develop advanced technological skills
Focus solely on administrative tasks
Ignore emotional and spiritual needs
Fill in the blank: Caritas Process 10 is to _________.
Open to mystery and Allow miracles to enter
Maintain strict boundaries at all times
Focus solely on physical healing
Avoid emotional involvement with patients
Fill in the blank: The Rights of Medication include _________
Patient, Dose, Time, Route, Drug, Storage
Doctor, Nurse, Time, Place, Drug, Storage
Patient, Doctor, Nurse, Route, Drug, Storage
Patient, Dose, Time, Place, Drug, Storage
What is teratogenicity?
Drugs that cause death or congenital defects, skeletal and limb abnormalities, CNS alterations, heart defects.
Drugs that enhance immune response in the fetus.
Drugs that improve fetal growth and development.
Drugs that prevent genetic mutations during pregnancy.
Which of the following is the safest FDA pregnancy category?
A
B
C
D
X
Which FDA pregnancy category is the most dangerous?
A
B
C
D
X
What is the risk associated with FDA Pregnancy Category A?
No risks
High risk of fetal abnormalities
Potential teratogenic effects
Increased risk of miscarriage
What are the risks associated with FDA Pregnancy Category B?
No risks in animals but lacks studies for humans
Risks in animals but no risks for humans
Risks in both animals and humans
No risks in animals or humans
What are the risks associated with FDA Pregnancy Category C?
Risks in animals, but no studies for humans OR no studies for animals and humans; Benefits may outweigh potential risks
No risk in animals or humans; Safe for use in pregnancy
Definite risk in humans; use is contraindicated in pregnancy
Only safe during the first trimester of pregnancy
What are the risks associated with FDA Pregnancy Category D?
Risks in humans; Potential benefits may outweigh potential risks
No risk in humans; safe for use during pregnancy
Risks only in animal studies; no human data available
Completely contraindicated in pregnancy; no benefits
What are the risks associated with FDA Pregnancy Category X?
Risks in both humans and animals; Risks outweigh potential benefits; Most dangerous, do not give
Safe in all trimesters; No known risks
Only minor side effects in animals; Safe for humans
May cause mild nausea but no fetal harm
What is the nursing process in drug administration?
ADPIE
SOAP
ABCDE
SBAR
The evaluation phase is important because:
It helps measure the effectiveness of a process or solution.
It initiates the planning process.
It focuses only on data collection.
It is not necessary in most projects.
What should be assessed when administering Furosemide according to the ADPIE process?
BP, lung sounds, urine output, edema
Heart rate, vision, hearing, appetite
Skin color, temperature, reflexes, speech
Blood sugar, bowel sounds, muscle strength, coordination
What is the nursing diagnosis for a patient receiving Furosemide according to the ADPIE process?
Altered fluid volume
Impaired gas exchange
Risk for infection
Chronic pain
List the planning steps for administering Furosemide according to the ADPIE process.
Give early in the day, Provide teaching, Daily weight
Administer with grapefruit juice, Monitor for hypoglycemia, Encourage high potassium foods
Give at bedtime, Restrict fluids, Avoid sunlight
Skip doses if blood pressure is normal, Double dose if missed, Avoid all dairy products
What should be evaluated or reflected upon after administering Furosemide according to the ADPIE process?
Changes to BP, lung sounds, urine output, edema; Monitor for adverse effects
Assess for increased appetite and weight gain
Monitor for signs of hypoglycemia and blurred vision
Evaluate for improved sleep patterns and reduced anxiety
What should be assessed when administering Penicillin according to the ADPIE process?
Temperature, wound drainage, WBC
Blood pressure, heart rate, respiratory rate
Blood glucose, urine output, skin turgor
Vision, hearing, speech
What is the nursing diagnosis for a patient receiving Penicillin according to the ADPIE process?
Impaired skin integrity
Ineffective airway clearance
Risk for constipation
Deficient fluid volume
List the planning steps for administering Penicillin according to the ADPIE process.
Culture & sensitivity of wound, Provide teaching
Administer medication without assessment, Skip documentation
Ignore allergies, Increase dosage arbitrarily
Delay treatment until symptoms worsen
What should be evaluated or reflected upon after administering Penicillin according to the ADPIE process?
Changes to temperature, wound drainage, WBC; Monitor for adverse effects
Assess for increased appetite and weight gain only
Monitor for signs of dehydration and increased thirst
Evaluate for improved sleep patterns and reduced anxiety
What is the first step to take to ensure patient safety in an emergency situation?
Stabilize the patient (ensure patient is safe first and foremost)
Call for help immediately without assessing the scene
Begin documentation before attending to the patient
Move the patient to another room without checking their condition
What are the priority action(s) for nurses to take in the event of a medication error?
Report the error, assess the patient, provide necessary interventions, and document the incident.
Ignore the error if the patient is not showing symptoms and continue with the next medication.
Wait for the physician to discover the error before taking any action.
Only document the error in the patient's chart and do nothing else.
Which of the following is NOT a sign or symptom of an anaphylactic reaction?
Rash, hives
Difficult breathing, wheezing, swollen airway
Hypertension
Angioedema
List two dangers of crushing extended release medications.
Risk for overdose; Disrupts the controlled release of medication.
Improves medication taste; Increases absorption rate safely.
Reduces side effects; Enhances medication stability.
Prevents drug interactions; Prolongs drug action.
Which schedule of medication has the highest abuse potential?
Schedule I (C-I)
Schedule II (C-II)
Schedule III (C-III)
Schedule IV (C-IV)
Which of the following drugs is classified as Schedule I (C-I)?
Heroin
Barbiturates
Non-narcotic analgesics
Anti-anxiety agents
Schedule II (C-II) drugs include which of the following?
Narcotics
Non-barbiturate sedatives
Anti-anxiety agents
Non-narcotic analgesics
Which schedule of medication includes some sedatives, anti-anxiety agents, and non-narcotic analgesics?
Schedule IV (C-IV)
Schedule I (C-I)
Schedule II (C-II)
Schedule III (C-III)
What are some reliable sources of drug information and administration?
Drug labels, Package Inserts, Nursing drug handbook, Physician desk reference (PDR), Karch's textbook, Internet (CDC, NIH, ADA, Mayo Clinic), Peer review journals, Nursing Central, Epocrates
Social media posts, Celebrity blogs, Unverified online forums, Personal anecdotes
Comic books, Fictional novels, Movie scripts, TV show dialogues
Advertisements, Product commercials, Unofficial YouTube reviews, Rumors
What is the definition of half-life in pharmacology?
Time it takes for the amount of the drug in the body to decrease to 1/2 of its peak level
Time it takes for the drug to reach its maximum concentration in the blood
Time it takes for the drug to be completely eliminated from the body
Time it takes for the drug to start showing its effects
If a patient is taking X dose of a drug with a half-life of Y-hours, how do you determine the amount of drug left after each Y-hour interval?
Divide X by 1/2 for every Y-hours that passes.
Multiply X by 2 for every Y-hours that passes.
Add Y to X for every Y-hours that passes.
Subtract Y from X for every Y-hours that passes.
What does ADME stand for in pharmacokinetics?
Absorption, Distribution, Metabolism (biotransformation), Excretion
Activation, Degradation, Mobilization, Elimination
Assimilation, Diffusion, Modification, Expulsion
Absorption, Digestion, Metabolism, Excretion
What happens to a drug from the time it is introduced into the body until it reaches the circulating fluids and tissues is called _________?
Absorption
Distribution
Metabolism
Excretion
The movement of a drug to the body's tissues is known as _________.
Distribution
Absorption
Metabolism
Excretion
Metabolism (biotransformation): Which organ is especially important for the metabolism (biotransformation) of drugs?
(a)
Excretion: Which organ is important for the excretion of drugs from the body?
Liver
Lungs
Kidneys
Skin
Cytochrome P450 isoenzymes are especially abundant in which organ?
(a)
Grapefruit juice is a P450 inhibitor, causing metabolism to be slower and leading to increased toxicity.
True
False
P450 Inducers: Which of the following is NOT a P450 inducer?
Penicillin
Rifampin
Phenytoin
Carbamazepine
Alcohol
List two examples of P450 inducers.
Phenobarbital, Sulfonylureas
Cimetidine, Ketoconazole
Erythromycin, Grapefruit juice
Isoniazid, Chloramphenicol
List three examples of P450 inhibitors.
Valproate, Ketoconazole, Isoniazid, Chloramphenicol, Amiodarone, Erythromycin, Quinidine, Grapefruit juice (any three)
Phenytoin, Carbamazepine, Rifampicin (any three)
Phenobarbital, St. John's Wort, Griseofulvin (any three)
Omeprazole, Rifabutin, Nevirapine (any three)
Define 'Peak' in pharmacology.
Highest concentration of a drug in the blood after being administered
Lowest concentration of a drug in the blood before the next dose
Time taken for a drug to be eliminated from the body
The amount of drug required to produce a therapeutic effect
When to draw for Peak and why?
Usually 30 mins to 1 hour; helps ensure drug reaches therapeutic levels
Immediately after administration; to check for allergic reactions
24 hours after administration; to monitor for toxicity
Before the next dose; to ensure drug is cleared from the body
Define 'Trough' in pharmacology.
Lowest concentration of a drug in the blood
Highest concentration of a drug in the blood
Average concentration of a drug in the blood
Time taken for a drug to be eliminated from the body
When to draw trough and why?
Usually just before next dose is administered; helps ensure drug doesn't fall below minimum effective concentration that could lead to suboptimal therapy or resistance
Immediately after administering the dose; to check for peak toxicity
At any random time during the dosing interval; timing does not affect interpretation
Only after therapy is completed; to confirm drug clearance
Which route provides the best and fastest absorption?
IV
Oral
Subcutaneous
Topical
What can happen when 2 highly protein drugs are given together?
They compete for binding sites on albumin, making drug duration longer; can alter effectiveness or cause/accumulate toxicity
They enhance each other's absorption, leading to reduced drug levels
They are rapidly excreted by the kidneys, shortening their duration of action
They form inactive complexes in the bloodstream, reducing their effectiveness
List three signs/symptoms or lab findings of renal insufficiency.
Elevated BUN & Cr (azotemia), Anorexia, nausea, vomit, Pruritus (any three)
Bradycardia, Hypercalcemia, Polycythemia
Hypoglycemia, Increased appetite, Jaundice
Tachypnea, Hypernatremia, Night sweats
What are some signs and symptoms of liver failure according to the Mayo Clinic?
Elevated AST & ALT, Jaundice, Ascites, Nausea, vomit, malaise, Tremors, confusion
Increased appetite, weight gain, improved energy, clear skin
Bradycardia, dry mouth, increased urination, improved vision
Frequent sneezing, itchy eyes, runny nose, sore throat
What is a substrate?
Substance that are metabolized by enzymes
A type of enzyme
A product of enzyme action
A cofactor required for enzyme activity
What is an inducer?
Substances that induces enzyme expression/activity
Substances that inhibit enzyme activity
Substances that degrade enzymes
Substances that block gene transcription
What is an inhibitor?
Substances that inhibit enzyme expression/activity
Substances that increase enzyme activity
Substances that act as enzymes
Substances that promote cell division
What is the P450 system?
The P450 system refers to the cytochrome P450 enzymes (CYP450) that are primarily found in the liver, responsible for metabolizing foreign substances that enter the body such as drug
The P450 system is a group of proteins responsible for transporting oxygen in the blood.
The P450 system is a network of nerves that controls muscle movement.
The P450 system is a type of hormone produced by the pancreas.
What is the definition of an agonist?
Any molecule that binds to a specific receptor site to activate and change a cell's activity
A molecule that blocks a receptor and prevents activation
A substance that destroys receptor sites
A protein that transports molecules across the cell membrane
Give an example of an agonist.
Opioids
Antagonists
Enzymes
Antibodies
What is the definition of an antagonist?
Drug that binds to a receptor and prevents/reverse/reduces action of another drug (agonist)
Drug that activates a receptor to produce a biological response
Drug that increases the effect of another drug
Drug that is metabolized to an active form in the body
Give an example of an antagonist.
Naloxone (opioid antagonist)
Morphine (opioid agonist)
Adrenaline (agonist)
Insulin (hormone)
What is a competitive antagonist?
An antagonist that competes for receptor site, but does not activate it.
An agonist that activates the receptor fully.
A substance that permanently destroys the receptor.
A molecule that enhances the effect of an agonist.
Which of the following is an example of a competitive antagonist? Select the correct answer.
Ketamine
Naloxone
Salicylates
CD4
Which of the following is NOT an example of a competitive antagonist?
Naloxone
Antihistamine
Propranolol
Ketamine
What is the definition of a non-competitive antagonist?
Reacts to receptor site different from receptor for the drug, but still prevents drug binding with its receptor.
Binds to the same site as the agonist and blocks its action reversibly.
Enhances the effect of the agonist by binding to a different site.
Binds irreversibly to the agonist and increases its potency.
Which of the following is an example of a non-competitive antagonist?
Atropine
Ketamine
Ibuprofen
WBC
What is an idiosyncratic reaction (IDR)?
An unusual response to a drug; a peculiar inappropriate response or adverse drug effect to an individual instead of the usual therapeutic effect occurring.
A predictable side effect that occurs in all patients taking a drug.
A delayed allergic reaction to a drug that develops after repeated exposure.
A standard therapeutic response observed in most patients.
What is the normal range for serum creatine labs?
0.6 - 1.2 mg/dL
1.5 - 2.5 mg/dL
2.0 - 3.0 mg/dL
0.2 - 0.5 mg/dL
What does a higher serum creatine lab value indicate?
Higher mean kidney damage
Improved liver function
Lower risk of dehydration
Better muscle strength
What is the normal range for WBC labs?
4 - 11 mL/dL
12 - 18 mL/dL
1 - 3 mL/dL
20 - 30 mL/dL
What does an elevated WBC lab value mean?
Elevated means infection
Elevated means dehydration
Elevated means low blood sugar
Elevated means anemia
Which of the following drugs is NOT an NSAID?
Ibuprofen
Naproxen
Ketorolac
Propranolol
What is the action of Aspirin?
Inhibits COX-1 (present in all tissues) and COX-2 (present at sites of trauma/injury)
Stimulates prostaglandin synthesis
Blocks beta-adrenergic receptors
Increases platelet aggregation
What are the indications for Aspirin?
- Treat mild-moderate pain, fever - Treat inflammatory conditions - Reduction of risk of TIA or stroke
- Treatment of diabetes mellitus - Management of hypothyroidism - Cure for viral infections
- Used as an anesthetic agent - Treatment for tuberculosis - Management of epilepsy
- Used to increase appetite - Treatment for osteoporosis - Management of glaucoma
What are the routes of administration for Aspirin?
PO, Rectal
IV, IM
Subcutaneous, Inhalation
Topical, Intrathecal
What is the typical dosing for Aspirin?
325 - 650 mg PO; Baby aspirin (81 mg) inhibits platelet aggregation; 65 - 100 mg/kg/d for pediatrics
10 - 20 mg PO; Baby aspirin (10 mg) inhibits platelet aggregation; 5 - 10 mg/kg/d for pediatrics
1000 - 2000 mg PO; Baby aspirin (500 mg) inhibits platelet aggregation; 200 - 300 mg/kg/d for pediatrics
50 - 100 mg PO; Baby aspirin (25 mg) inhibits platelet aggregation; 10 - 20 mg/kg/d for pediatrics
What are the adverse effects of Aspirin?
- Nausea, vomit, heartburn, epigastric discomfort, occult blood loss - Dizziness, tinnitus, acidosis, salicylism toxicity, asthma - Reye's syndrome in children and adolescents with viral illness
- Weight gain, increased appetite, hyperglycemia, moon face
- Bradycardia, hypotension, dry mouth, constipation
- Blurred vision, urinary retention, confusion, hallucinations
How is Aspirin metabolized and excreted?
Metabolized in liver, excreted in urine
Metabolized in kidney, excreted in bile
Metabolized in stomach, excreted in feces
Metabolized in lungs, excreted in sweat
What is the action of Ibuprofen?
Inhibits prostaglandin synthesis
Stimulates insulin secretion
Blocks beta-adrenergic receptors
Enhances dopamine release
What are the indications for Ibuprofen?
- Relief S/S of rheumatoid arthritis & osteoarthritis - Relief of mild to moderate pain, dysmenorrhea - Reduce fever
- Treatment of bacterial infections
- Management of diabetes mellitus
- Cure for viral hepatitis
What is the route of administration for Ibuprofen?
PO
IV
IM
SC
What is the typical dosing for Ibuprofen?
200-400 mg every 4-6 hours as needed
1000 mg every hour
10 mg once a week
5000 mg daily
What is the maximum daily dose of ibuprofen?
3200 mg
800 mg
1200 mg
2000 mg
List three adverse effects of ibuprofen.
Headache, dizziness, somnolence, fatigue, rash, nausea, bleeding, constipation, bone marrow, hypertension, bronchospasms, increased chance of MI, stroke
Weight gain, hair growth, improved vision
Increased appetite, muscle gain, improved memory
Enhanced hearing, rapid wound healing, increased height
Which labs should be monitored when a patient is taking ibuprofen?
AST/ALT, BUN, Cr
Hemoglobin, Hematocrit, Platelets
TSH, T3, T4
Amylase, Lipase, Glucose
Describe the pharmacokinetics of ibuprofen.
Rapidly absorbed in GI tract, metabolized in liver, excreted in urine
Slowly absorbed in the lungs, excreted unchanged in feces
Absorbed in the skin, metabolized in the kidneys, excreted in sweat
Not absorbed, directly excreted in bile
What is the action of aminoglycosides?
Decrease protein synthesis, mostly effective against gram-negative bacteria.
Inhibit cell wall synthesis, primarily targeting gram-positive bacteria.
Increase DNA replication, effective against all bacteria.
Block folic acid synthesis, mainly used for viral infections.
How are aminoglycosides administered?
Intramuscularly (IM) or intravenously (IV).
Orally only.
Topically only.
By inhalation only.
What are the adverse effects of aminoglycosides?
Ototoxicity and nephrotoxicity (which can be permanent).
Hepatotoxicity and alopecia.
Hyperglycemia and weight gain.
Photosensitivity and rash.
What should a nurse do if a patient reports hearing loss or kidney damage before administering aminoglycosides?
Do not give the medication.
Administer a higher dose of the medication.
Ignore the symptoms and proceed as usual.
Give the medication with extra fluids.
What should a nurse encourage a patient to do to help prevent kidney damage when taking aminoglycosides?
Encourage the patient to drink lots of fluids.
Limit fluid intake to a minimum.
Take the medication on an empty stomach only.
Avoid all dairy products while on the medication.
What should be encouraged to protect the kidneys when administering aminoglycosides?
Encourage adequate hydration and monitor renal function.
Restrict fluid intake and avoid monitoring renal function.
Increase protein intake and ignore urine output.
Administer aminoglycosides with NSAIDs to enhance effect.
What is the action of Carbapenems?
Inhibits cell membrane synthesis, effective against gram + and - bacteria.
Inhibits protein synthesis at the 50S ribosomal subunit.
Blocks folic acid synthesis in bacteria.
Acts as a beta-lactamase inhibitor only.
How are Carbapenems administered?
Intravenously (IV).
Orally (by mouth).
Topically (on the skin).
By inhalation.
