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...
N617 Pharm (Exam 1) Summer 2022-Jean Genzale
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 . - answer-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 - answer-b . Biotransformation of drugs
3. 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 - answer-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 - answer-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 - answer-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 - answer-b . Beneficial potentiative
Drugs that are receptor agonists may demonstrate what property ? CHOOSE ONE ANSWER
a . Irreversible binding to the drug receptor site
,b . Desensitization or down regulation with continuous use
c . Inverse relationship between drug concentration and drug action
d . Up - regulation with chronic use - answer-b . Desensitization or down regulation with
continuous use
8. Which of the following is an example of a graded drug response ? CHOOSE ONE ANSWER
a . Blood pressure
b . Death
c . Rash
d . Sleep - answer-a . Blood pressure
In the elderly patient : CHOOSE ONE ANSWER
a . There is usually decreased plasma volume
b . Elimination of drugs in affected by their decreased glomerular filtration rate
c . There is strong tendency for increased hepatic blood flow
d . Distribution is usually affected by a decrease in body fat - answer-b . Elimination of drugs in
affected by their decreased glomerular filtration rate
Drugs cross the placenta membrane by : CHOOSE ONE ANSWER
a . Active transport
b . Exocytosis
c . Filtration
d . Passive diffusion - answer-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 - answer-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 - answer-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 - answer-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 - answer-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 - answer-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 . simultaneous administration of a thiazide diuretic and an aldosterone antagonist - answer-a .
Administration of protamine to a patient with a heparin overdose
Use of pharmacogenomics can : CHOOSE ONE ANSWER
a . Identify patients with genetic factors responsible for variable responses to certain drugs
b . Potentially make pharmacotherapy an obsolete practice
c . Alter an individual's set of CYP450 enzymes
d . Eliminate adverse effects associated with all forms of pharmacotherapy - answer-a . Identify
patients with genetic factors responsible for variable responses to certain drugs
Some medications work by interacting directly with a specific enzyme to decrease its action .
Which scenario is an example of a drug - enzyme interaction ? CHOOSE ONE ANSWER
a . Stool softeners altering the surface of hard stool allowing water from the colonic lumen to
enter the stool , making it softer .
b . Activated charcoal binding to orally ingested drugs and toxins , preventing their absorption
c . Digoxin binding to Na / K ATPase inhibiting the movement of sodium ions from within the
cardiac muscle cells and enhancing the entry of calcium ions into the cell
d . Antacids blocking the secretion of acid by gastric cells to reduce acidity in the stomach -
answer-c . Digoxin binding to Na / K ATPase inhibiting the movement of sodium ions from
within the cardiac muscle cells and enhancing the entry of calcium ions into the cell
Which drug molecules are readily able to enter and cross the lipid content of the cell
membrane ? CHOOSE ONE ANSWER
a . Fat soluble
b . Hydrophilic substances
c . Ionized
d . Polarized - answer-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 - answer-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 - answer-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 .
- 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
Water soluble drugs have good absorption through all the following routes EXCEPT : CHOOSE
ONE ANSWER
a . Enteral
b . Intravenous
c . Transdermal
d . Transrectal - answer-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 - answer-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
d . Potassium - answer-d . Potassium
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