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What aspect of pharmacology does a nurse study? (Select one that does not apply.)
- A. Adverse and anticipated drug effects
- B. Molecular pharmacology
- C. Impact of drugs on the body
- D. The body's response to a drug
Correct Answer: B
Rationale: Nurses study pharmacology from a pharmacotherapeutic level, which includes the effect of drugs on the body, the body's response to drugs, and both expected and unexpected drug effects. Chemical and molecular pharmacology (Options A and B) are not included in nursing pharmacology courses.
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Drugs mostly cross biological membranes by
- A. Passive diffusion
- B. Active diffusion
- C. Active transport
- D. Carrier mediated transport
Correct Answer: A
Rationale: Most drugs cross membranes via passive diffusion based on concentration gradients.
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for to be used for an episode of status epilepticus.
- A. IV phenobarbital
- B. Rectal diazepam (Diastat)
- C. IV phenytoin (Dilantin)
- D. Oral carbamazepine (Tegretol)
Correct Answer: B
Rationale: Rectal diazepam is a rescue medication for status epilepticus at home.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
Which of the following is an insulin effect in the liver:
- A. Inhibition of glycogenolisis
- B. Inhibition of glycolysis
- C. Decrease of glycogenesis
- D. Decreases of pyruvatkinase, phosphofructokinase and glucokinase activity
Correct Answer: A
Rationale: Insulin inhibits glycogenolysis in the liver, promoting glucose storage as glycogen rather than its breakdown.
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
- A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia
- B. The initial dose of glargine is 2 to 10 units per day
- C. Patients who have been on high doses of NPH will need tests for insulin antibodies
- D. Obese patients may require more than 100 units per day
Correct Answer: A
Rationale: Switching to glargine reduces the dose by 20% to prevent hypoglycemia due to its steady action vs. NPH peaks.