NUR 120 MIDTERM STUDY GUIDE
Questions with Correct Answers
1. What is meant by indications for a drug? What is the difference between therapeutic
class and pharmacologic class? Correct Answer Indications- the conditions for which a
drug is approved
Therapeutic class- what is being TREATED
Pharmacological class-how the drug acts
2. Know the phases of clinical trials: What takes place in each? NURSING ROLES
Correct Answer Clinical trials-3
1- 20-80 volunteers, focuses on safety
2- 12-350 participants w/disease, focuses on effectiveness, placebo is given
3- Large # of patients w/disease, determines variability in response to drug, drug-drug
interactions are seen.
3. What is post-marketing surveillance? Correct Answer Stage 4- assesses for harmful
drug effects in larger population, adverse effects are reported through the FDA Adverse
Event Reporting System every nurse everyday assessments and observing for adverse
effects.
4. What is absorption, distribution, metabolism and excretion? What factors can affect
each of these? Where does each take place? Correct Answer Pharmacokinetics:
Absorption - Process by which drug molecules move from their site of admin, to the
blood .
Factors= route of admin, enteral, parenteral, and topical
Location= Blood
Distribution - describes how drugs are transported throughout the body
Factors= blood flow to tissues, drug solubility, tissue storage, and protein binding
(explain the terminology)
Location=drugs interact with blood components
Metabolism (FIRST PASS AFFECT)- involves complex biochemical pathways, and
reactions that alter the structure and function of drugs, nutrients, minerals, and vitamins
Factors= age groups, metabolic conditions, and alcohol/tobacco use (liver enzymes/
and liver functions) CYPO450
Location= hepatic-portal system
Excretion - removal of drugs from body
Factors= liver or kidney disease
Location= renal, pulmonary, glandular, fecal and biliary
5. How can medication errors be prevented? Correct Answer Always check the MAR,
double check any similar spelled drugs, use only official abbreviations, and don't take
unclear orders. THE FIVE RIGHTS!
,6. How is each phase of the nursing process used in medication administration? Correct
Answer Assesment- obtaining through medication history
Diagnostic-
Planning- avoid unclear orders, abbreviations, and follow policies
Implementation- focus entirely on the task
Evaluation- asses for expected therapeutic outcomes
7. What is non-adherence in terms of medications? How can we improve adherence to
the medication regimen? Correct Answer Non-adherence- not taking medication as
prescribed
Improved adherence- inform patient thoroughly about the medication and all of its
effects, interactions w/ herbs and drugs, and side effects.
We also need to keep in mind things like if they can afford medications, and how the
meds are supposed to be taken. (ASSESSMENT OF WHY) A SYSTEM TO REMIND
THE PT WHY THEY CAN/CANT TAKE IT. Can they afford it
8. What is the nursing action if a patient experiences an allergic reaction to a drug.
Correct Answer STOP THE MEDICATION, ASSESS THE PT CALL FOR HELP
SUPPORT THE AIRWAY IS THERE A PRN MED?. ANAPHALAXIS? Health care
provider must be notified, it must be documented, and reported to next shift
9. What are the five rights of medication administration? Correct Answer Right
medication
Right patient
Right route
Right time
Right dose
documentation
10. What are some advantages and disadvantages to using CAM? Correct Answer
Advantages- treat mind and body, and may eliminate the need of using specific meds
Disadvantages- herbs vary in formulation and I the amount of active ingredient in the
herb, dietary supplements aren't regulated by the FDA. CHEAPER BUT NOT AND NOT
COVERED BY INSURANCE
11. Which acute and chronic conditions must be managed in pregnancy? How are
decisions made regarding medication usage during pregnancy? Correct Answer Acute-
Thromboembolic disorders, gestational diabetes, and gestational hypertension,
antibiotics, UTIs, and STIs
Chronic- epilepsy, asthma, hypertension, or psychiatric disorder
MED IS THERAPEUTIC TO RISK TO BABY. LIFE THREATENING/SERIOUS IF I
DON'T TREAT THE MOM HOW WILL THE FETUS BE AFFECTED?
12. Why do medications need to be adjusted in the older adult? Correct Answer Older
adults undergo many physical changes that are a part of the aging process. They are
more likely to be taking multiple drugs for various conditions. Their bodies may respond
, very differently in all aspects of pharmacokinetics-less effective absorption less efficient
distribution because of fewer plasma proteins and less efficient perfusion, altered
biotransformation or metabolism or drugs because of age-related liver changes, and
less effective excretion owing to less efficient kidneys.
13. Why do medications have to be adjusted in the pediatric population? Correct
Answer Age is a factor primarily in children and older adults. Children are not just little
adults. Children metabolize many drugs differently than adults do, and they have
immature systems for handling drugs. Many drugs come with recommended pediatric
doses, and others without recommended doses can be converted to pediatric doses
using one of several conversion formulas.
14. What are the implications of drug abuse by the mother, in the first trimester of
pregnancy? Correct Answer Teratogenicity- many drugs that reach the developing fetus
or embryo can cause death or congenital defects, which can include skeletal and IMDb
abnormalities, CNS alterations, heart defects, and the like. The exact effects of a drug
on the fetus may not be known
15. Which physiologic change during pregnancy can alter absorption of medications?
Correct Answer Nausea and vomiting can decrease drug absorption. Gastric PH is
higher and gastric emptying is delayed which are some factors that decrease intestinal
absorption. Increased gastrointestinal blood flow can increase drug absorption.
ROUTE TO THE BLOOD HIGHER CIRCULATION OF BLOOD AND BLOOD
INCREASES.
16. Which medications should never be crushed? Why do some medications have an
enteric coating? Correct Answer Enteric coating (SLOWED RELEASED AND
CAPSULES) tables should never be crushed. Enteric coating is used to protect
underlying dosage form and drug substance, allowing it to remain intact in the gastric
environment and instead dissolve and undergo drug release in the small intestine.
17. What strong acid in the stomach helps to break food down, activates pepsinogen,
and kills ingested microbes? Which structure in the GI system does not secrete
digestive enzymes? Correct Answer Hydrochloric acid- acid released by the parietal
Cells of the stomach in response to gastric release or parasympathetic stimulation;
makes the stomach contents more acidic to aid digestion and breakdown of food
products
Histamine-2 (H2) receptors: sites near the parietal cells of the stomach that, when
stimulated, cause the release of hydrochloric acid into the lumen of the stomach; also
found near cardiac cells.
THE LIVER DOES NOT SECRETE DIGESTIVE ENZYMES
18. Know the risk factors and characteristics of peptic ulcer disease. Correct Answer
Erosions in the lining of the stomach and adjacent areas of the GI tract are called peptic
ulcers. Ulcer patients present with a predicate lie description of gnawing, burning pain
often occurring a few hours after meals. Ulcers were caused by a defect in the mucous
