N3 Richard's Practice Qs for E1

1. Which of the following is the most common method by which drugs can cross the cell membrane to exert an effect?

a. Passage through channels or pores
b. Passage with the aid of a transport system
c. Direct penetration of the membrane
d. Transmission along a sodium channel

2. Which of the following is a true statement in regards to pH-dependent ionization?

a. An acid is a proton donor while a base is a proton acceptor.
b. Acids will ionize best in an acidic media.
c. For bases to ionize, the media must be alkaline.
d. When acids give up positively charged ions, the acid will become more basic.

3. A patient is receiving warfarin, a drug with a strong attraction to albumin. While taking the warfarin, the patient begins to take a second drug that also has a strong attraction to albumin. The nurse would need to watch the patient for signs of:

a. decreased effects of the warfarin since the second drug may cause the warfarin to bind more strongly to the albumin.
b. increased effects of the warfarin since the second drug may cause the warfarin to bind more strongly to the albumin.
c. subtherapeutic levels of warfarin since the second drug may displace the warfarin from the albumin.
d. toxic levels of warfarin since the second drug may displace the warfarin from the albumin.

4. The first-pass effect primarily alters a drug’s:

a. absorption.
b. distribution.
c. metabolism.
d. excretion.

5. Which of the following statements regarding antagonists is true?

a. They produce pharmacologic effects by causing receptor activation.
b. They cause receptor activation using exogenous substances.
c. Competitive antagonists bind reversibly to receptors while binding of non-competitive agonists is irreversible.
d. They are stronger in the absence of agonist substances.

6. When compared with a drug having a therapeutic index of 20, the margin of safety for a drug with a therapeutic index of 2 would be considered:

a. no different.
b. less safe.
c. safer.
d. less potent.

7. Two hours after taking a dose of penicillin, a patient arrives in the emergency department complaining of feeling ill. The nurse notes that the patient is scratching and that there is a widespread distribution of hives. While completing the assessment, this patient develops difficulty breathing and his blood pressure drops. The assessment of the situation is that:

a. the patient is experiencing a moderate allergic reaction that should improve shortly.
b. the patient is having a mild reaction that can be treated easily with an antihistamine.
c. these symptoms are probably due to something else because less than 10% of patients really have allergic responses.
d. The patient is experiencing an anaphylactic response.

8. The primary determinant of the intensity of an allergic drug reaction is:

a. the dose of drug ingested.
b. The body surface area of the patient.
c. the patients performance status.
d. the degree of sensitization.

9. Which of the following patients is most at risk for QT prolongation when a new drug is initiated?

a. a 60 year old man
b. a patient with hypertension
c. a patient with hypermagnesemia
d. a 50 year old woman

10. Which route of drug administration is most likely to affect drug bioavailability?

a. P.O.
b. Subcutaneous
c. Intramuscular
d. Intravenous