gcu nur641E final exam 2021

 

1.                            Low plasma albumin causes edema as a result of a reduction in which pressure?

 

•            

Capillary hydrostatic

 

 

•            

Interstitial hydrostatic

 

 

•            

Plasma oncotic

 

 

•            

Interstitial oncotic

 

 

 

2              An increase of carbon dioxide in arterial blood causes chemoreceptors to stimulate the respiratory centers to:

 

•            

decrease respiratory rate.

 

 

•            

increase respiratory rate.

 

 

•            

develop hypocapnia.

 

 

•            

develop hypercapnia.

 

 

 

3              What is an example of compensatory hyperplasia?

 

•            

Hepatic cells increase cell division after part of the liver is excised.

 

 

•            

Skeletal muscle cells atrophy as a result of paralysis.

 

 

•            

The heart muscle enlarges as a result of hypertension.

 

 

•            

The size of the uterus increases during pregnancy.

 

 

 

4              Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called

 

•            

pyrogenic bacteria.

 

 

•            

true bacteria.

 

 

•            

exotoxins.

 

 

•            

spirochetes.

 

 

Question Points: 2.0 / 2.0             

 

5              Which NSAID is generally considered the safest for use in patients with coronary artery disease?

 

•            

Celecoxib

 

 

•            

Indomethacin

 

•            

Naproxen

 

 

•            

Acetaminophen

 

 

Question Points: 2.0 / 2.0             

 

6              Cell wall inhibitors include all of the following except

 

•            

penicillins.

 

 

•            

cephalosporins.

 

 

•            

carbapenems.

 

 

•            

tetracylclines.

 

 

7              In the immediate postnatal period, infants lose approximately 5% of

body weight due to

 

•            

loss of body water

 

 

•            

inability of the body to digest nutrients

 

 

•            

hemolysis of red blood cells

 

 

•            

poor sucking reflex

 

 

 

 

8              Heparin exerts its therapeutic action by:

 

•            

upregulating the activity of one of the body's natural anticoagulant molecules, antithrombin III.

 

 

•            

deactivating calcium-dependent clotting factors.

 

 

•            

inducing prothrombin formation.

 

 

•            

inducing the formation of fibrin.

 

 

9              Pulmonary hypertension:

 

•            

shows an enlarged pulmonary artery.

 

 

•            

involves deep vein thrombosis.

 

 

•            

shows right ventricular hypertrophy.

 

 

•            

Shows an enlarged pulmonary artery and right ventricular hypertrophy.

 

 

10           Which of the following factors do not influence bioavailability?

 

•            

 

First-pass hepatic metabolism

 

 

•            

Solubility of the drug

 

 

•                  corrected

Bioequivalence

 

 

•            

Chemical instability

 

 

11           Which of the following is true regarding prodrugs?

 

•            

They are affected considerably by renal function.

 

 

•            

They are better than amateur drugs.

 

 

•            

They are designed to overcome undesirable properties of an active drug.

 

 

•            

They may be more effective in patients with liver dysfunction.

 

 

12           When looking at arterial blood gas readings, you discover the

following: pH 7.26, pCO2 56, HCO3 24. What condition are you dealing with?

 

•            

Respiratory alkalosis

 

•            

Metabolic acidosis

 

 

•            

Metabolic alkalosis

 

 

•            

Respiratory acidosis

 

 

13           How many months does it take for the newborn to be sufficiently

protected by antibodies produced by its own B cells?

 

•            

1 to 2

 

 

•            

4 to 5

 

 

•            

6 to 8

 

 

•            

10 o 12

 

Question Points: 2.0 / 2.0

 

14 What mechanism can cause hypernatremia?

 

•            

Syndrome of inappropriate antidiuretic hormone

 

 

•                  corrected

Hypersecretion of aldosterone

 

 

•            

Brief bouts of vomiting or diarrhea

 

•            

Excessive diuretic therapy Question Points: 0.0 / 2.0 =2/2

 

15 In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by

 

•            

the site of infection and the patient's history.

 

 

•            

the sensitivity report and the colony count.

 

 

•            

the source of the infection and the color of exudate.

 

 

•            

the host defense mechanism and the immune response.

 

 

16           Which of the following increases the potential of cardiac toxicity if

taken concurrently with digoxin?

 

•            

Chloride

 

 

•            

Potassium

 

 

•            

Sodium

 

 

•            

Zinc

 

 

 

 

17           When looking at arterial blood gas readings, you discover the following: pH 7.75, pCO2 24, HCO3 40. What condition are you dealing with?

 

•            

Respiratory alkalosis

 

 

•            

Metabolic acidosis

 

 

•            

Metabolic alkalosis

 

 

•            

Respiratory acidosis

 

 

18           Which of the following statements is true regarding bioavailability?

 

•            

It has little effect on the pharmacokinetics of orally-administered drugs.

 

 

•            

It is a drug-specific property; therefore, bioavailability will be the same regardless of the dosage form used.

 

 

•            

IV-administered drugs have a bioavailability of between 50 and 75 percent.

 

 

•            

It is defined as the amount of administered drug that is available to reach the site of action.

 

 

19           Which of the following drugs are not considered for use with angina?

 

•            

Beta blockers

 

 

•            

Calcium channel blockers

 

 

•            

ACE inhibitors

 

 

•            

Nitrates

 

 

20           The primary role of cytochrome p-450, in the liver, is to:

 

•            

stimulate steroid release as a stress response.

 

 

•            

deactivate and detoxify medications and other substances.

 

 

•            

produce fibrinogen, prothrombin, and factor V.

 

 

•            

eliminate amino acids, forming urea.

 

 

21           Which antimicrobial should be avoided in children because it is

deposited in tissues undergoing calcification and can stunt growth?

 

•            

Tetracycline

 

 

•            

Ciprofloxacin

 

 

•            

Vancomycin

 

 

•            

Amoxicillin

 

 

22           Causes of hyperkalemia include:

 

•            

hyperparathyroidism and malnutrition.

 

 

•            

vomiting and diarrhea.

 

 

•            

renal failure and Addison's disease.

 

 

•            

hyperaldosteronism and Cushing's disease.

 

 

23           Which statement is true regarding the pharmacokinetics of drug

administration?

 

•            

The immature liver or kidneys of the very young may accelerate drug metabolism and excretion.

 

 

•            

Medications enter the body in solid form and change into solution for absorption and utilization.

 

 

•            

 

It includes medication absorption, distribution to tissues, metabolism, and elimination from the body.

 

 

•            

A therapeutic effect occurs as the medication reaches the target cell.

 

 

24           A patient with type 1 diabetes has been made NPO after midnight for

surgery. Knowing that the patient needs to continue the insulin pump to prevent diabetic ketoacidosis, what would be an expectation of treatment?

 

•            

Bedtime snack before midnight

 

 

•            

Dextrose containing intravenous fluids

 

 

•            

2am glucose check followed by apple juice if needed

 

 

•            

Discontinue the insulin pump

 

 

25           The major therapeutic actions of NSAIDS include all of the following

except

 

•            

reduction of inflammation.

 

 

•            

reduction of pain.

 

 

•            

reduction of fever.

 

 

•            

reduction of clotting factors.

 

 

26           A 68-year-old male has COPD with moderate airway obstruction.

Despite using salmeterol daily, as prescribed, he reports continued symptoms of shortness of breath with mild exertion. Which one of the following agents would be an appropriate addition to his current therapy?

 

•            

Systemic corticosteroids

 

 

•            

Albuterol

 

 

•                  corrected

Tiotropium

 

 

•            

Roflumilast

 

 

•            

Theophylline

 

 

27           High altitudes may produce hypoxemia by:

 

•            

right-to-left shunts

 

 

•            

atelectasis.

 

•            

decreased oxygen inspiration.

 

 

•            

emphysema.

 

 

28           Which of the following corticosteroids has the shortest half-life and

thus must be dosed most frequently?

•                  corrected

Dexamethasone

 

 

•            

Hydrocortisone

 

 

•            

Methylprednisolone

 

 

•            

Prednisone

 

 

29           Aldosterone directly increases the reabsorption of (select all that

apply):

 

•            

magnesium.

 

 

•            

calcium.

 

 

•            

sodium.

 

 

•            

 

water.

 

 

30           Which of the following agents is considered a CYP3A4 inhibitor and

should be used with caution in patients taking CYP3A4 substrates?

 

•            

Phenytoin

 

 

•            

Amiodarone

 

 

•            

Carbamazepine

 

 

•            

Rifampin

 

 

31           Which of the following agents is used to treat hypercalcemia of

malignancy?

 

•            

Activated vitamin D

 

 

•                  corrected

Pamidronate (Aredia)

 

 

•            

Hydrochlorothiazide

 

 

•            

Kayexalate

 

 

 

 

32           A drug with a half-life of 10 hours is administered by continuous

intravenous infusion. Which of the following best approximates the time for the drug to reach steady state?

 

•            

10 hours

 

 

•            

30 hours

 

 

•                  corrected

40 hours

 

 

•            

60 hours

 

 

33           What causes the rapid change in the resting membrane potential to

initiate an action potential?

•                  corrected

Potassium gates open, and potassium rushes into the cell, changing the membrane potential from negative to positive.

 

 

•            

Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive.

 

 

•            

Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.

 

 

•            

Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.

 

 

 

 

34           Which condition poses the highest risk for a cerebrovascular accident (CVA)?

 

•            

Insulin-resistant diabetes mellitus

 

 

•                  corrected

Hypertension

 

 

•            

Polycythemia

 

 

•            

Smoking

 

 

35           What is the action of calcitonin?

 

•            

Increases metabolism.

 

 

•            

Decreases metabolism.

 

 

•            

Increases serum calcium.

 

 

•            

Decreases serum calcium. Question Points: 2.0 / 2.0

 

36           Which stage of infection is occurring when the immune and inflammatory responses are triggered?

 

•                   corrected

Incubation period

 

 

•            

Prodromal stage

 

 

•            

Invasion period

 

 

•            

Convalescence

 

 

37           All of the following can be a likely cause of respiratory acidosis except:

 

•            

emphysema.

 

 

•            

pulmonary edema.

 

 

•            

barbiturate overdose.

 

 

•            

extreme fear and anxiety.

 

 

38           The leading cause of death from a curable infectious disease

throughout the world is

 

•            

pneumonia.

 

 

•                  corrected

tuberculosis.

 

•            

HIV infection.

 

 

•            

influenza.

 

 

39           Which of the following best describes the mechanism of action of

warfarin?

 

•            

Upregulates antithrombin III

 

 

•            

Directly inhibits factor Xa

 

 

•            

Blocks the conversion of fibrinogen to fibrin

 

 

•                  corrected

Inhibits factors II, VII, IX, and X

 

 

40           Hypomagnesemia occurs when serum magnesium concentration is

less than

•            

 

1.0 mEq/L.

 

 

•            

1.5          mEq/L

 

 

•            

1.            0 mEq/L.

 

 

•            

1. 0 mEq/L.

 

 

 

41           What is the direct action of atrial natriuretic hormone? (Select all that

apply.)

 

•            

Sodium retention

 

 

•                   corrected

Sodium excretion

 

 

•            

Water retention

 

 

•                   corrected

Water excretion

 

 

42           Which method of drug administration can have immediate effects and

requires lower doses compared to oral or parenteral administration?

 

•            

Intravenous

 

 

•            

Sublingual

 

 

•            

Transdermal

 

 

•            

Inhalation

 

 

 

 

43           Pulmonary emboli do not cause which of the following?

 

•            

Obstruct blood supply to lung parenchyma

 

 

•            

Have origins from thrombi in the legs

 

 

•            

Occlude pulmonary vein branches

 

 

•            

Occlude pulmonary artery branches

 

 

44           Which factor is responsible for the hypertrophy of the myocardium

associated with hypertension?

 

•            

Increased norepinephrine

 

 

•            

Adducin

 

 

•            

Angiotensin II

 

 

•            

Insulin resistance

 

 

45           The nurse has a patient who has been on multidrug therapy for

pulmonary tuberculosis. When planning patient education, the nurse

 

knows the patient needs to watch for which symptom of an adverse effect of multidrug therapy?

 

•            

Hearing loss

 

 

•            

Changes in vision

 

 

•            

Generalized pruritus

 

 

•            

Jaundice

 

 

46           The most common cause of lower respiratory tract infection is

 

•            

aspiration of oropharyngeal secretions.

 

 

•            

not receiving the vaccine.

 

 

•            

refusing to cough and take deep breaths.

 

 

•            

remaining in bed until postop day two.

 

 

47           Death from influenza usually results from

 

•            

high temperature.

 

•            

dehydration.

 

 

•            

pneumonia.

 

 

•            

metabolic alkalosis.

 

 

48           Which statement is true regarding the half-life of medications?

 

•            

Doubling the dose will double the medication half-life.

 

 

•            

Approximately 2 half-lives are required for a medication to be completely eliminated.

 

 

•            

Patients with renal or hepatic disease usually have decreased half-lives.

 

 

•            

The half-life of a drug helps determine how often the drug is to be administered.

 

 

49           The spread of microorganisms from mother to the baby across the

placenta is termed

 

•            

direct transmission.

 

 

•            

vertical transmission.

 

 

•            

 

horizontal transmission.

 

 

•            

indirect transmission.

 

 

50           Which class of diuretics treats hypertension by increasing sodium and

water retention?

 

•            

Loop diuretics

 

 

•            

Thiazide diuretics

 

 

•            

Potassium sparing diuretics

 

 

•            

Aldosterone inhibiting diuretics