GCU NUR641E Week 4 Midterm Exam Latest 2021 March

NUR641E Advanced Pathophysiology & Pharamacology for Nurse Educators

Midterm Exam

1 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.

2 Which method of drug administration can have immediate effects and requires lower doses compared to oral or parenteral administration?

Intravenous

Sublingual

Transdermal

Inhalation

3 High altitudes may produce hypoxemia by:

right-to-left shunts.

atelectasis.

decreased oxygen inspiration.

emphysema.

All of the above

4 Causes of hyperkalemia include:

hyperparathyroidism and malnutrition.

vomiting and diarrhea.

renal failure and Addison's disease.

hyperaldosteronism and Cushing's disease.

5 Hypomagnesemia occurs when serum magnesium concentration is less than

1.0 mEq/L.

1.5 mEq/L.

2.0 mEq/L.

3.0 mEq/L.

6 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

7 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

40 hours

60 hours

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

Celecoxib

Indomethacin

Naproxen

Acetaminophen

9 Pulmonary hypertension:

shows an enlarged pulmonary artery.

involves deep vein thrombosis.

shows right ventricular hypertrophy.

A and C are correct

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

Incubation period

Prodromal stage

Invasion period

Convalescence

11 Which of the following agents is used to treat hypercalcemia of malignancy?

Activated vitamin D

Pamidronate (Aredia)

Hydrochlorothiazide

Kayexalate

12 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.

13 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.

14 Cell wall inhibitors include all of the following except

penicillins.

cephalosporins.

carbapenems.

tetracylclines.

15 Which of the following factors do not influence bioavailability?

First-pass hepatic metabolism

Solubility of the drug

Bioequivalence

Chemical instability

16 Which class of diuretics treats hypertension by increasing sodium and water retention?

Loop diuretics

Thiazide diuretics

Potassium sparing diuretics

Aldosterone inhibiting diuretics

17 What is the action of calcitonin?

Increases metabolism.

Decreases metabolism.

Increases serum calcium.

Decreases serum calcium.

18 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

19 The spread of microorganisms from mother to the baby across the placenta is termed

direct transmission.

vertical transmission.

horizontal transmission.

indirect transmission.

20 Which antimicrobial should be avoided in children because it is deposited in tissues undergoing calcification and can stunt growth?

Tetracycline

Ciprofloxacin

Vancomycin

Amoxicillin

21 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.

22 Death from influenza usually results from

high temperature.

dehydration.

pneumonia.

metabolic alkalosis.

23 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.

24 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

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

Beta blockers

Calcium channel blockers

ACE inhibitors

Nitrates

26 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 to 12

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

Capillary hydrostatic

Interstitial hydrostatic

Plasma oncotic

Interstitial oncotic

28 What mechanism can cause hypernatremia?

Syndrome of inappropriate antidiuretic hormone

Hypersecretion of aldosterone

Brief bouts of vomiting or diarrhea

Excessive diuretic therapy

29 What is the direct action of atrial natriuretic hormone? (Select all that apply.)

Sodium retention

Sodium excretion

Water retention

Water excretion

30 Which of the following increases the potential of cardiac toxicity if taken concurrently with digoxin?

Chloride

Potassium

Sodium

Zinc

31 Which of the following corticosteroids has the shortest half-life and thus must be dosed most frequently?

Dexamethasone

Hydrocortisone

Methylprednisolone

Prednisone

32 What causes the rapid change in the resting membrane potential to initiate an action potential?

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.

33 Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?

Increased norepinephrine

Adducin

Angiotensin II

Insulin resistance

34 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.

35 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.

36 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

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

pyrogenic bacteria.

true bacteria.

exotoxins.

spirochetes.

38 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

Tiotropium

Roflumilast

Theophylline

39 Aldosterone directly increases the reabsorption of (select all that apply):

magnesium.

calcium.

sodium.

water.

40 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.

41 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.

42 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

43 Which of the following best describes the mechanism of action of warfarin?

Directly inhibits factor Xa

Inhibits factors II, VII, IX, and X

Blocks the conversion of fibrinogen to fibrin

Upregulates antithrombin III

 

44 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

45 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.

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

emphysema.

pulmonary edema.

barbiturate overdose.

extreme fear and anxiety.

47 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.

48 The leading cause of death from a curable infectious disease throughout the world is

pneumonia.

tuberculosis.

HIV infection.

influenza.

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

Insulin-resistant diabetes mellitus

Hypertension

Polycythemia

Smoking

50 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