NSG6020 Week 1-9 Quiz With Practice Exam with Answers (336 Solved Questions)

Name: NSG6020 Week 1-9 Quiz With Practice Exam with Answers (336 Solved Questions)
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NSG 6020 Week 1-9 Quiz With Complete Solutions
BUN - requires adequate protein ingestion
serum creatinine levels - requires adequate muscle mass
unreliable in older adults
topical medication absorption - much higher in infants and young children due to thin
stratum
leads to potential systemic toxicity
infants younger than 6 months - decreased plasma proteins for drug binding--increased
plasma levels of drug
avoid NSAIDs and monitor for drug toxicity
pediatric OTC considerations - no ASA
no alternation between APAP and ibuprofen in outpatient setting
state board of nursing - determine legal APN scope of practice and prescriptive authority
FDA, NPI, DEA - federal level agencies affecting prescribing
factors contributing to scheduled drugs - currently accepted medical use in treatment in

US relative abuse potential
likelihood of causing dependence when abused
schedule 1 drugs - no accepted medical use in the
US high potential for abuse
heroin, LSD, ecstasy
schedule 2 drugs - high potential for abuse which may lead to severe psychological or
physical dependence

Dilaudid, Demerol, oxycodone, fentanyl, morphine, codeine, hydrocodone, amphetamines
schedule 3 drugs - potential for abuse less than substances in schedule 1 or 2 and
abusemay lead to moderate or low physical dependence or high psychological
dependence
products not containing 90 mg of codeine per dosage unit, suboxone, Tylenol w/ codeine,
testosterone
schedule 4 drugs - low potential for abuse relative to substances in schedule 3
Xanax, Soma, Klonipin, Valium, Ativan, Versed, Restoril, Halcion
schedule 5 drugs - low potential for abuse related to substances in schedule 4 and
consistprimary of preparations containing limited quantities of certain narcotics
cough preparations not containing more than 200mg of codeine per 100 ml or per
100 grams
Robitussin AC or Phenergan w/ Codeine
medication error - any mistake occurring in the medication use process, regardless of
whether an injury occurred or whether the potential for injury was present

antipsychotics
chemo agents
MedWatch - FDA Safety Info and Adverse Event Reporting program
voluntarily report a serious adverse event, product quality problem, product use
error, or therapeutic inequivalence/failure that you suspect is associated with use of
FDA regulated drug, biologic, medical device, dietary supplement or cosmetic
Strategies to prevent ADE - review med list and allergies with each
encounterbe vigilant with high-risk drugs
discontinue unnecessary drugs
make sure patients are clear on new medications if intended to add or replace old
medavoid treating side effects with another drug
address non-
adherence EMR/e-
scribe
hypertriglyceridemia - Fish oil indication
depression - St. John's wort indication
dementia - Ginkgo biloba indication

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adherence - extent to which a person's behavior--taking medication, following a diet, or
making healthy lifestyle changes--corresponds with agreed-upon recommendations
from a healthcare provider
medication adherence - patient's conformance with the provider's recommendation
with respect to medication:
timing
dosage
frequenc
y
for prescribed length of time
high risk for medication non-adherence - asymptomatic diseases (HTN)
cognitive impairment
psychiatric illness
complex regimens
common non-adherent behaviors - took less often
smaller doses
stopped
sooner delayed
fill failed to fill
barriers to medication adherence - perceived/actual adverse reactions
asymptomatic conditions

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SIMPLE - Simplify the
regimen Impart knowledge
Modify patient beliefs and behavior
Provide communication and trust
Leave the bias
Evaluate adherence
pharmacokinetics - drug absorption, distribution, binding affinity, metabolism, and excretion
going in and coming out of body
what body does to drug
pharmacodynamics - interactions within body tissue
what drug does to body
pharmacogenetics - variability in drug response/toxicity due to genetic factors
how our DNA affects the way drugs work
seeks to guide the design of optimal medication regimens for individual patients

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3. pharmacodynamic
basic pharmacokinetic processes - 1. absorption--with or without
food 2. distribution--protein binding/hypoalbuminemia
3. metabolism--primarily liver
4. elimination--urine and feces
best absorbed drug form - non-ionized, lipid-soluble form
water-soluble drugs - cannot pass through lipid membranes
lipid-soluble drugs - more easily pass through cell
membranes CNS drugs
high ionization - more difficult time crossing lipid membranes
acid drug and base media or base drug and acid media
ileum - most drugs absorbed here d/t microvilli--increased surface area
albumin - most common site of plasma protein binding
Warfarin - 97% protein bound drug--only 3% free drug
urine elimination - requires drug to be water-soluble--if not must be biotransformed

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cimetidine, omeprazole, macrolides, antifungals, St. John's Wort
grapefruit juice - common CYP450 inhibitor
after 1 glass, statin level doubled
urine excretion - increased ionization=increased excretion
weak base drug+acidic urine=increased excretion of amphetamines
creatinine clearance - Cockcroft-Gault used to estimate--can overestimate in frail elders
package inserts base renal dosing on
half-life - time for plasma concentration of drug to be reduced by 50%
hepatic first-pass effect - amount of drug liver metabolizes on first pass before drug
gets toblood stream in oral administration
can be bypassed by IV, transdermal, rectal delivery
prodrug - administered drug is metabolized to another active drug with intended purpose

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set number of drug receptors available--when receptor enzymes become saturated,
moredrug is being put in than can be metabolized--increased blood levels of drug
first-order elimination - constant proportion of the drug is eliminated per unit of
time50% of drug eliminated with each half-life
linear process
5 - number of half-lives needed to reach steady state
number of half-lives needed to completely eliminate drug
steady state - each administered dose produces consistent increase and decrease
inplasma drug concentration
therapeutic range
loading dose - administering large amount of drug to immediately achieve therapeutic
steady state
drug agonist - binds to receptor and produces effect
drug antagonist - binds to receptor and produces no effect

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NSG6020 Week 1-9 Quiz With Practice Exam with Answers (336 Solved Questions)

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