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Flashcards in chapter 3 pharmacology Deck (80):
1

Naloxone is an ________ to opioid receptors.

Agonist

Agonist-antagonist

Antagonist

Analgesic

Antagonist

2

A drug with a waxlike base that melts at body temperature, allowing absorption into body tissue, is called a(n):

Capsule

Suppository

Elixir

Suspension

Suppository

3

Benzodiazepines and barbiturates achieve their sedation effects by ________ in the CNS.

Enhancing the GABA receptor sites

Depolarizing the neural membranes

Blocking the GABA receptor sites

Blocking the dopaminergic receptor sites

Enhancing the GABA receptor sites

4

Fibrinolytics achieve their therapeutic action by:

Interfering with the clotting cascade

Breaking up a thrombus that has formed

Blocking the conversion of plasminogen to plasmin

Decreasing platelet aggregation

Breaking up a thrombus that has formed

5


A large concern during the administration of an alpha agonist is infiltration because it may cause:
Enhanced systemic effects

Tissue necrosis

Excessive bleeding at the site of infiltration

Cardiac dysrhythmias


Tissue necrosis

6


Aspirin is beneficial to patients with a history of cardiac disease because it:

Inhibits the clotting cascade

Provides analgesia

Inhibits platelet aggregation

Causes thrombolysis

Inhibits platelet aggregation

7

Medications best suited for treating bronchoconstriction generally stimulate ________ receptors.

Beta1

Alpha1

Beta2

Alpha2

Beta 2

8

Which of the following statements about antibiotics is NOT true?

Antibiotics typically achieve their therapeutic action by destroying the bacterial cell wall.

Viruses are not susceptible to antibiotics.

Antibiotics are generally safe and can be prescribed indiscriminately.

An individual who has developed a resistance to one type of antibiotic will typically respond well to other antibiotics in a similar class.


unknown

9

Tachyphylaxis can be managed by:

Changing to a similar drug in the same family

Decreasing the frequency with which the medication is administered

Decreasing the dosage of the medication

Concurrently administering an anti-inflammatory drug to blunt the allergic response

Changing to a similar drug in the same family

10

Beta-adrenergic antagonists reduce hypertension through all of the following effects, EXCEPT:

Diminishing reflex tachycardia as a compensatory response

Suppressing renin release from the kidneys

A negative inotropic effect

Reduction of peripheral vascular resistance through vasodilation

Reduction of peripheral vascular resistance through vasodilation

11

While caring for a 60-year-old male with a suspected femur fracture, your partner accidentally administers the full vial of morphine sulfate (15 mg) when only 4 mg was ordered. What adverse effects are likely to occur in this patient?

Widened QRS and respiratory depression

Hypotension and tachypnea

Sedation and hypertension

Hypotension and respiratory depression


Hypotension and respiratory depression

12

Which of the following antihypertensive medications is an angiotensin-converting-enzyme (ACE) inhibitor?

Reserpine (Serpalan)

Clonidine (Catapres)

Captopril (Capoten)

Labetalol (Normodyne)

Captopril (Capoten)

13

One important reason medications are given intravenously is that they:

Bypass the liver initially

Have minimal effects on the CNS system

Can be more easily reversed if an untoward effect occurs

Have a delayed onset of action compared to the oral route

Bypass the liver initially

14

In a patient experiencing a myocardial infarction, a medication that reduces afterload is beneficial because it:
Reduces the workload of the heart, reducing myocardial oxygen consumption

Reduces the blood flow to unnecessary areas, redirecting blood to the heart

Improves the stroke volume of blood ejected from the heart by also reducing preload

Prolongs the Q-T interval, thereby allowing time for complete atrial contribution to the ventricles


Reduces the workload of the heart, reducing myocardial oxygen consumption

15

A prolonged deficiency of vitamin C may result in:
Pernicious anemia

Increased bleeding

Kwashiorkor

Scurv

Scurvy

16


Methylphenidate (Ritalin), a drug used to treat attention deficit hyperactivity disorder (ADHD), achieves its therapeutic action by ________ the CNS, thereby causing ________ and allowing for greater concentration and focus.

Stimulating, heightened awareness and arousal

Depressing, sedation

Stimulating, paradoxical sedation

Depressing, relaxation





Stimulating, heightened awareness and arousal

17

Administration of a nonselective beta-antagonist will most likely result in:

Tachycardia and diaphoresis

Increased cardiac output

Bronchoconstriction and inhibited glycogenolysis

Bradycardia and some bronchodilation



Bronchoconstriction and inhibited glycogenolysis

18

You are caring for an elderly female with suspected vertebral fracture secondary to osteoporosis. She frequently takes a hydrocodone-containing preparation (Vicoprofen) for pain. With her current injury, you find it necessary to administer a greater-than-expected dosage of morphine. Why is this higher dosage needed?
Cross-tolerance

Psychological dependency

Potentiation

Synergism

Cross-tolerance

19

In which class of the Vaughn-Williams classification system of antidysrhythmic medications does amiodarone belong?
III

IB

II

IV


III

20

All of the following changes in the geriatric patient affect the pharmacokinetics of a medication, EXCEPT:


Decreased gastrointestinal motility

Depressed liver function that may prolong drug action

Increased body fat and decreased muscle mass

Uncompromised renal function

Uncompromised renal function

21

All of the following statements about nonsteroidal anti-inflammatory drugs (NSAIDs) are TRUE EXCEPT that NSAIDs:

Are used as analgesics and antipyretics

Are prescribed to relieve pain following trauma and surgery

Interfere with the production of prostaglandins, thereby interrupting the inflammatory process

Include aspirin, acetaminophen, and ibuprofen

Include aspirin, acetaminophen, and ibuprofen

22


A beta2 specific agonist causes which of the following physiologic responses?

Bronchodilation

Bronchoconstriction

Decreased heart rate

Increased heart rate

Bronchodilation

23


You are caring for a 45-year-old male patient who was tending to his fruit orchard when he suddenly developed headache, dizziness, blurred vision, and tremors. You note that he was incontinent of urine, has pupillary constriction, and is salivating excessively. Which of the following medications would be most appropriate to manage this patient?

Atropine sulfate

Physostigmine

Diazepam

Ipratropium bromide


Atropine sulfate

24

Your patient, a known alcoholic, has developed a cardiac dysrhythmia that you intend to treat with synchronized cardioversion. Because he is awake, you decide to administer diazepam to ease this experience. However, you find that to induce the desired state you must administer more than twice the normal dose of diazepam. This condition is known as:
Cumulative effect

Cross-tolerance

Tachyphylaxis

Idiosyncrasy

Cross-tolerance

25


Glucagon will affect blood glucose levels by:

Inducing glycogenolysis and gluconeogenesis

Inducing the storage of glucose into the liver and skeletal muscle through glycogenesis

Enhancing the absorption of glucose from the gastrointestinal tract

Enabling the rapid absorption of glucose into the cells

Inducing glycogenolysis and gluconeogenesis

26

Benzodiazepines are safer than barbiturates in seizure patients because:

The effect of benzodiazepines is limited by the amount of endogenous GABA in the CNS

Benzodiazepines cannot cause hypotension or respiratory depression

The therapeutic dose of barbiturates is very close to the lethal dose

Benzodiazepines cause a counteraction by inducing high levels of dopamine in the CNS

The effect of benzodiazepines is limited by the amount of endogenous GABA in the CNS

27

At the cellular level, the treatment of seizures is generally accomplished by ________ the influx of ________ ions into the neural cells.
Enhancing, potassium

Inhibiting, potassium

Inhibiting, sodium and calcium

Enhancing, sodium and calcium

Inhibiting, sodium and calcium

28


Which of the following statements about warfarin (Coumadin) is NOT true?

It actively breaks down the fibrin network, thereby dissolving formed thrombi.

It helps treat chronic atrial fibrillation.

It prevents coagulation by antagonizing the effects of vitamin K.

It was originally used as rat poison.

It actively breaks down the fibrin network, thereby dissolving formed thrombi.

29

Sympathetic nervous system stimulation that results in vasoconstriction is most likely affecting:

Beta2 receptor sites

Alpha1 receptor sites

Beta1 receptor sites

Alpha2 receptor sites

Alpha1 receptor sites

30

A concern for patients taking both insulin and beta-blockers is:
The two medications, when taken together, have a synergistic effect

Beta-blockers, due to their sympatholytic effects on the nervous system, can further reduce available ATP to the cells of the body in the presence of insulin

Beta2 adrenergic blockers can both hide the effects of hypoglycemia, making it difficult to recognize, and decrease the release of glucagon

Beta-blockers prevent the release of insulin from the beta cells in the pancreas


Beta2 adrenergic blockers can both hide the effects of hypoglycemia, making it difficult to recognize, and decrease the release of glucagon

31

With regard to the endocrine system, which of the following statements is NOT true?

The pituitary gland is often called the "master gland."

The posterior pituitary hormones are actually synthesized in the hypothalamus.

The hypothalamus and pituitary glands have no physical link.

The hypothalamus controls many of the functions of the pituitary gland.

unknown

32

Which of the following medications is a cardioselective beta-blocker?
Propranolol

Atenolol

Metaproterenol

Albuterol

Atenolol

33

In the renin-angiotensin-aldosterone system (RAAS), which element is most responsible for widespread vasoconstriction?

Angiotensin I

Angiotensinogen

Angiotensin converting enzyme (ACE)

Angiotensin II

Angiotensin II

34

An important distinction between analgesics and anesthetics is:

Anesthetics block all sensations

Anesthetics can only be administered intravenously

Analgesics produce unconsciousness in high doses

Analgesics are reversible, whereas anesthetics are not

Anesthetics block all sensations

35


You are caring for a 68-year-old patient with an altered level of consciousness and reported seizure activity. You obtain a blood pressure of 244/140, a pulse of 90, and respirations of 18. Which of the following medications would be most suitable for this patient?
Minoxidil (Loniten)

Hydralizine (Apresoline)

Enalapril (Vasotec)

Nitroprusside (Nipride)

Nitroprusside (Nipride)

36

You are caring for a young mother who just gave birth to her first child. Despite taking all the appropriate measures, she continues to exhibit postpartum hemorrhage. In addition to crystalloid intravenous infusions, what medication might you consider to manage this patient?

Terbutaline (Brethine)

Oxytocin (Pitocin)

Epinephrine infusion

Dopamine (Intropin) infusion

Oxytocin (Pitocin)

37

What is the drug of choice when treating patients having generalized motor (grand mal) seizures?
Lithium

Romazicon

Valproic acid

Dilantin

Dilantin

38

A diuretic that affects reabsorption early in the nephron filtration process will:

Affect water reabsorption but not electrolytes

Affect electrolytes but not fluid reabsorption

Have a lesser impact on water and sodium removal

Have a greater impact on water and sodium removal

Have a greater impact on water and sodium removal

39


If a patient were exhibiting pupillary constriction, hypersalivation, bronchial wheezing, and bradycardia, you should suspect ________ of the ________ nervous system.

Blockade, voluntary

Stimulation, sympathetic

Stimulation, parasympathetic

Blockade, cholinergic

Stimulation, parasympathetic

40

One important distinction with potassium-sparing diuretics over other forms of diuretics is that potassium-sparing diuretics:
Exert their effects early in the nephritic process

Are more efficient than loop diuretics in sodium and water reabsorption

Not only decrease sodium reabsorption, they increase potassium reabsorption

Are so potent that they are rarely used with other diuretics


Not only decrease sodium reabsorption, they increase potassium reabsorption

41

Drugs with high abuse potential and no accepted medical benefits are classified as Schedule:

I

II

III

IV

unknown

42

Which of the following statements about vitamins is NOT true?

Vitamin D is unique in that it can be produced in the skin by sunlight exposure.

The liver stores the fat-soluble vitamins; consequently, they will become deficient only after long periods of inadequate vitamin intake.

The individual B vitamins are named for the order in which they are in demand by the body.

The water-soluble vitamins must be routinely ingested, because the body does not store them.

unknown




43

Oxytocin is frequently used in the prehospital setting to:
Control seizures from eclampsia of pregnancy

Stop preterm labor contractions

Help control postpartum hemorrhage

Facilitate labor and induce delivery


:
Help control postpartum hemorrhage

44

You are caring for a middle-aged male patient who has a long history of psychiatric disorders. During your assessment you note excessive tremors and uncontrollable spasms in his head, neck, and arms. This is most likely:

Manifestations of his psychotic illness

Extrapyramidal side effects of his antipsychotic medication

A purposeful action designed to draw attention away from his medical history

Drug interactions produced by antihypertensive medications and diuretics

Extrapyramidal side effects of his antipsychotic medication

45

Which of the following is NOT typically associated with Type I diabetes mellitus?

Juvenile onset

Inadequate insulin release from the beta cells of the pancreatic islets

Insulin dependence

Obesity

unknown

46

In which class of the Vaughn-Williams Classification system of antidysrhythmic medications does Propranolol belong?

IA

IB

IC

II

II

47

According to Frank-Starling's Law, the administration of nitroglycerin will result in ________ preload, ________ stroke volume, and ________ myocardial oxygen demand.


Decreased, decreased, increased

Decreased, increased, decreased

Increased, increased, decreased

Decreased, decreased, decreased

Decreased, decreased, decreased

48


Loop diuretics achieve their therapeutic effects by:

Decreasing the absorption of sodium at the glomerulus

Decreasing the reabsorption of sodium at the ascending Loop of Henle

Enhancing reabsorption throughout the Loop of Henle

Increasing the reabsorption of sodium at the ascending Loop of Henle


Decreasing the reabsorption of sodium at the ascending Loop of Henle

49


Tachyphylaxis can best be described as:

An unexpected increase in heart rate as a side effect of a drug

An allergic reaction that occurs when a drug is administered for the first time

Anaphylactoid episodes occurring due to cross-sensitivity

Rapidly decreasing effects with repeated administration of a drug

Rapidly decreasing effects with repeated administration of a drug

50

The acronym SLUDGE helps identify the effects of ________ drugs on the autonomic nervous system.

Sympathomimetic

Sympatholytic

Parasympathomimetic

Parasympatholytic

Parasympathomimetic

51


Using microdrip IV tubing, how many drops of fluid equal 1 ml?


60

10

20

15

60

52


Shortly after starting an IV on your patient, you note that the IV is not dripping. You have removed the constricting band, and all the clamps on the tubing are open. You note that there is minor swelling around the venipuncture site. There is no discoloration of the site, but it is cool and firm to the touch. Which of the following most likely accounts for your findings?
The site has become infected.

The tip of the catheter is occluded by a blood clot.

Fluids extravasated into the tissue surrounding the IV site.

The tip of the catheter is occluded by a valve in the vein.

Answer:
Fluids extravasated into the tissue surrounding the IV site.

53

Which of the following is an advantage of sublingual drug administration?

Uniform absorption through the conjunctival mucosa

Rapid absorption due to sublingual vasculature

Slow rate of drug absorption

Rapid dissolution of tablets so the medication can be swallowed

Rapid absorption due to sublingual vasculature

54

Which of the following is a parenteral route of drug administration?

Gastric tube

Oral

Intramuscular

Rectal

Intramuscular

55

A plastic or glass container with a self-sealing rubber top is known as a(n):


Vial

Blister pack

Ampule

Prefilled syringe

Vial

56


The maximum volume of medication to be delivered into the deltoid muscle is ________ ml.

3

1

2

5


2

57


Which of the following is NOT a pulmonary route of medication administration?

Inhalation of aerosolized medications

Instillation of liquid medications into an endotracheal tube

Nasal drops and sprays

Nebulization of liquid medications by pressurized air

unknown

58

By which of the following routes will medication have the quickest onset of action?

Intramuscular

Subcutaneous

Oral

Intradermal

Intramuscular

59

Which of the following is a disadvantage of pulmonary drug administration via nebulizer or metered dose inhaler?

It requires a larger dose than other routes.

It requires the patient to have adequate ventilation.

Pulmonary absorption is a slow route for drug administration.

Side effects are more likely with pulmonary drug administration.

Question 60

It requires the patient to have adequate ventilation.

60


What is the preferred access site for intraosseous infusion in both pediatric and adult patients?
Distal tibia

Proximal humerus

Distal femur

Proximal tibia

Proximal tibia

61

Administration of medication into the dorsal gluteal muscle must be injected into which quadrant of the muscle?
Upper, inner

Upper, outer

Lower, outer

Lower, inner



Upper, outer

62

Ms. Krinkle is experiencing right lower quadrant pain following a syncopal episode. She reports her last menstrual period (LMP) was about six weeks ago. While she is awaiting an abdominal CT, the surgery resident asks that you initiate an IV of lactated Ringer's solution using a blood set (10 drops/ml) and infuse 1 liter over 1 hour. What drip rate (in drops/minute) will you use to attain this rate of administration?
17

600

67

167


167

63

Your patient weighs 22 pounds and is to receive 0.02 mg/kg of atropine IV push. You have a multidose vial of atropine containing 20 ml at a concentration of 0.04 mg/ml. What volume (in ml) of medication is to be injected?

0.5

2.5

0.25

5

5

64

Which of the following is appropriate for a subcutaneous injection of medication?

Volume of 1 ml or less

18 gauge, ¾" needle

Insertion of the needle at a 90-degree angle

Up to 2 ml of medication

Volume of 1 ml or less

65


Which of the following is a contraindication to intraosseous needle placement?

Establishment of a peripheral IV line

Development of a pulmonary embolism

Too large a needle or forceful insertion

Long-term growth complications and swelling

Establishment of a peripheral IV line

66

A solid disk of compressed medicated powder, which may be scored to permit breaking, is known as a:

Suppository

Capsule

Tablet

Lozenge

Tablet

67

Which of the following is NOT a percutaneous route of medication administration?

Buccal

Sublingual

Transdermal

Inhalation


Inhalation

68

When preparing for venipuncture, a constricting band should be applied tight enough to restrict ________ flow.

Venous but not arterial

Arterial but not venous

Neither arterial nor venous

Both arterial and venous

Both arterial and venous

69

Which of the following intravenous solutions would remain in the vascular system the longest?

Plasmanate

5 percent dextrose in water

0.9 percent sodium chloride

Lactated Ringer's solution

Plasmanate

70


Into which of the following containers would it be necessary to inject a volume of air equal to the intended volume of medication before withdrawing the medication with a needle and syringe?

Ampule

Vial

Nebulizer

Prefilled syringe


Vial

71


Which of the following catheters would allow the greatest volume of fluid to be delivered in a given period?

16 gauge, 2"

14 gauge, 1 ¼"

16 gauge, 1 ¼"

14 gauge, 2"

14 gauge, 1 ¼"

72


Which of the following is a disadvantage to intravascular volume replacement with isotonic crystalloid solutions?
Two-thirds of the volume leaves the intravascular space within 1 hour.

Intracellular fluid shifts to the vascular space.

Sodium shifts into cells, and potassium shifts out of cells.

There is an immediate shift of vascular volume to the interstitial space.


Two-thirds of the volume leaves the intravascular space within 1 hour.

73

Just as you are arriving at the emergency department bay, your patient, on whom you started an IV at the scene, complains of sudden chills, back pain, and nausea. The patient appears flushed, and his skin is hot and moist to the touch. Which of the following most likely accounts for your patient's presentation?

Pulmonary thromboembolism

Pyrogenic reaction

Circulatory overload

Anaphylaxis

Pyrogenic reaction

74

A liquid preparation that contains small particles of a solid medication is known as a(n):
Suspension

Elixir

Syrup

Reconstituted medication


Suspension

75


You are to give Mr. Jenkins 50 mg of Toradol (ketorolac) IM for musculoskeletal pain. Ketorolac is supplied 60 mg/2 ml. What volume of drug (in ml) is to be drawn up for administration?

0.17

1.7

17

170

1.7

76


Which of the following solutions is appropriate for the patient needing vascular volume replacement in the prehospital setting?

0.9 percent sodium chloride solution

Dextran 40

5 percent dextrose in water

0.45 percent sodium chloride and 5 percent dextrose in water

0.9 percent sodium chloride solution

77

Mrs. Bertrand is having a cholecystectomy this evening. To prevent dehydration she is to receive 5 percent dextrose in 0.45 percent saline solution at a rate of 150 ml/hour. Using 20 drops/ml tubing, what is the drip rate in drops/minute?

150

75

60

50

50

78


Mr. Hinkley is a 46-year-old with a history of pancreatitis. He has had abdominal pain and vomiting for 24 hours. The ED physician requests that you initiate an IV for rehydration. You will be using a 15 drops/ml infusion set to administer 250 ml of 5 percent dextrose in 0.9 percent NS per hour. What drip rate (at drops/minute) is needed to deliver the fluids at this rate?

41

63

75

100

63

79

Which of the following is the appropriate method for preparing a site for venipuncture or injection?

Chemical sterilization

Use of a disinfectant

Use of an antiseptic

Use of a sanitizer


Use of an antiseptic

80

Your protocols call for a dopamine infusion beginning at 5 micrograms per kilogram per minute. You estimate that Mrs. Lincoln weighs 190 pounds. Using a standard dopamine concentration of 800 mg in 500 ml, at what drip rate (in drops/minute) will you need to administer the infusion using microdrip tubing?


27

432

4

16

16