Pharmacotherapeutics for Advanced Practice 3rd Edition by Virginia Poole Arcangelo, Andrew M. Peterson – Test Bank
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Chapter 3. Impact of Drug Interactions and Adverse Events
on Therapeutics
MULTIPLE CHOICE
1. Which
of the following patients would be at higher risk of experiencing adverse drug
reactions (ADRs):
|
A. |
A 32-year-old male |
|
B. |
A 22-year-old female |
|
C. |
A 3-month-old female |
|
D. |
A 48-year-old male |
ANS: C
PTS: 1
2. Infants
and young children are at higher risk of ADRs due to:
|
A. |
Immature renal function in
school-age children |
|
B. |
Lack of safety and efficacy
studies in the pediatric population |
|
C. |
Children’s skin being
thicker than adults, requiring higher dosages of topical medication |
|
D. |
Infant boys having a higher
proportion of muscle mass, leading to a higher volume of distribution |
ANS:
B
PTS: 1
3. The
elderly are at high risk of ADRs due to:
|
A. |
Having greater muscle mass
than younger adults, leading to higher volume of distribution |
|
B. |
The extensive studies that
have been conducted on drug safety in this age group |
|
C. |
The blood-brain barrier
being less permeable, requiring higher doses to achieve therapeutic effect |
|
D. |
Age-related decrease in
renal function |
ANS:
D
PTS: 1
4. The
type of adverse drug reaction that is the result of an unwanted but otherwise
normal pharmacological action of a drug given in the usual therapeutic doses is
|
A. |
Type A |
|
B. |
Type B |
|
C. |
Type C |
|
D. |
Type D |
ANS:
A
PTS: 1
5. Digoxin
may cause a Type A adverse drug reaction due to:
|
A. |
Idiosyncratic effects |
|
B. |
Its narrow therapeutic
index |
|
C. |
Being a teratogen |
|
D. |
Being a carcinogen |
ANS:
B
PTS: 1
6. Changes
in the individual pharmacokinetic parameters of adsorption, distribution, or
elimination may result in high concentrations of the drug in the body, leading
to which type of adverse drug reaction?
|
A. |
Type A |
|
B. |
Type C |
|
C. |
Type D |
|
D. |
Type E |
ANS:
A
PTS: 1
7. According
to the World Health Organization Classification, Type B adverse reactions are:
|
A. |
When a drug is a teratogen |
|
B. |
When a drug is carcinogenic |
|
C. |
A delayed ADR, such as
renal failure |
|
D. |
An allergic or
idiosyncratic response |
ANS:
D
PTS: 1
8. Sarah
developed a rash after using a topical medication. This is a Type __ allergic
drug reaction.
|
A. |
I |
|
B. |
II |
|
C. |
III |
|
D. |
IV |
ANS:
D
PTS: 1
9. A
patient may develop neutropenia from using topical Silvadene for burns.
Neutropenia is a(n):
|
A. |
Cytotoxic hypersensitivity
reaction |
|
B. |
Immune complex
hypersensitivity |
|
C. |
Immediate hypersensitivity
reaction |
|
D. |
Delayed hypersensitivity
reaction |
ANS:
A
PTS: 1
10. Anaphylactic
shock is a:
|
A. |
Type I reaction, called
immediate hypersensitivity reaction |
|
B. |
Type II reaction, called
cytotoxic hypersensitivity reaction |
|
C. |
Type III allergic reaction,
called immune complex hypersensitivity |
|
D. |
Type IV allergic reaction,
called delayed hypersensitivity reaction |
ANS:
A
PTS: 1
11. James
has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a
corticosteroid) use. He is at risk for what type of adverse drug reaction?
|
A. |
Type B |
|
B. |
Type C |
|
C. |
Type E |
|
D. |
Type F |
ANS:
B
PTS: 1
12. The treatment
for a patient who experiences hypothalamic-pituitary-adrenal axis suppression
while taking the corticosteroid prednisone, a Type C adverse drug reaction, is
to:
|
A. |
Immediately discontinue the
prednisone |
|
B. |
Administer epinephrine |
|
C. |
Slowly taper the patient
off of the prednisone |
|
D. |
Monitor for long-term
effects, such as cancer |
ANS:
C
PTS: 1
13. The
ACE inhibitor lisinopril is a known teratogen. Teratogens cause Type ____
adverse drug reaction.
|
A. |
A |
|
B. |
B |
|
C. |
C |
|
D. |
D |
ANS:
D
PTS: 1
14. Cardiac
defects are a known Type D adverse drug reaction to lithium. Lithium causes a
Type D adverse drug reaction because it is:
|
A. |
An immunosuppressant |
|
B. |
A carcinogen |
|
C. |
A teratogen |
|
D. |
An antiseizure medication |
ANS:
C
PTS: 1
15. Immunomodulators
such as azathioprine may cause a delayed adverse drug reaction known as a Type
D reaction because they are known:
|
A. |
Teratogens |
|
B. |
Carcinogens |
|
C. |
To cause hypersensitivity
reactions |
|
D. |
Hypothalamus-pituitary-adrenal
(HPA) axis suppressants |
ANS:
B
PTS: 1
16. A
24-year-old male received multiple fractures in a motor vehicle accident that
required significant amounts of opioid medication to treat his pain. He is at
risk for Type __ adverse drug reaction when he no longer requires the opioids.
|
A. |
A |
|
B. |
C |
|
C. |
E |
|
D. |
G |
ANS:
C
PTS: 1
17. Drugs
that may cause a Type E adverse drug reaction include:
|
A. |
Beta blockers |
|
B. |
Immunomodulators |
|
C. |
Antibiotics |
|
D. |
Oral contraceptives |
ANS:
A
PTS: 1
18. Unexpected
failure of drug therapy is a Type __ adverse drug reaction, commonly caused
by____.
|
A. |
B; cytotoxic
hypersensitivity |
|
B. |
B; idiosyncratic response |
|
C. |
C; cumulative effects of
drug |
|
D. |
F; drug-drug interaction |
ANS:
D
PTS: 1
19. Clopidogrel
treatment failure may occur when it is co-administered with omeprazole, known
as a Type __ adverse drug reaction.
|
A. |
A |
|
B. |
C |
|
C. |
E |
|
D. |
F |
ANS:
D
PTS: 1
Chapter 4. Principles of Pharmacotherapy in Children
MULTIPLE CHOICE
1. The
Pediatric Research Equity Acts requires:
|
A. |
All children be provided
equal access to drug research trials |
|
B. |
Children to be included in
the planning phase of new drug development |
|
C. |
That pediatric drug trials
guarantee children of multiple ethnic groups are included |
|
D. |
All applications for new
active ingredients, new indications, new dosage forms, or new routes of
administration require pediatric studies |
ANS:
D
PTS: 1
2. The
Best Pharmaceuticals for Children Act:
|
A. |
Includes a pediatric
exclusivity rule which extends the patent on drugs studied in children |
|
B. |
Establishes a committee
that writes guidelines for pediatric prescribing |
|
C. |
Provides funding for new
drug development aimed at children |
|
D. |
Encourages manufacturers
specifically to develop pediatric formulations |
ANS: B
PTS: 1
3. The
developmental variation in Phase I enzymes has what impact on pediatric
prescribing?
|
A. |
None, Phase I enzymes are
stable throughout childhood. |
|
B. |
Children should always be
prescribed lower than adult doses per weight due to low enzyme activity until
puberty. |
|
C. |
Children should always be
prescribed higher than adult doses per weight due to high enzyme activity. |
|
D. |
Prescribing dosages will
vary based on the developmental activity of each enzyme, at times requiring
lower than adult doses and other times higher than adult doses based on the
age of the child. |
ANS:
D
PTS: 1
4. Developmental
variation in renal function has what impact on prescribing for infants and
children?
|
A. |
Lower doses of renally
excreted drugs may be prescribed to infants younger than age 6 months. |
|
B. |
Higher doses of water
soluble drugs may need to be prescribed due to increased renal excretion. |
|
C. |
Renal excretion rates have
no impact on prescribing. |
|
D. |
Parents need to be
instructed on whether drugs are renally excreted or not. |
ANS:
A
PTS: 1
5. Topical
corticosteroids are prescribed cautiously in young children due to:
|
A. |
They may cause an intense
hypersensitivity reaction |
|
B. |
Hypothalamic-pituitary-adrenal
(HPA) axis suppression |
|
C. |
Corticosteroids are less
effective in young children |
|
D. |
Young children may
accumulate corticosteroids leading to toxic levels |
ANS:
B
PTS: 1
6. Liza
is breastfeeding her 2-month-old son and has an infection that requires an
antibiotic. What drug factors influence the effect of the drug on the infant?
|
A. |
Maternal drug levels |
|
B. |
Half-life |
|
C. |
Lipid-solubility |
|
D. |
All of the above |
ANS: D
PTS: 1
7. Drugs
that are absolutely contraindicated in lactating women include:
|
A. |
Selective serotonin
reuptake inhibitors |
|
B. |
Antiepileptic drugs such as
carbamazepine |
|
C. |
Antineoplastic drugs such
as methotrexate |
|
D. |
All of the above |
ANS:
C
PTS: 1
8. Zia
is a 4 month old with otitis media. Education of his parents regarding
administering oral antibiotics to an infant includes:
|
A. |
How to administer an oral
drug using a medication syringe |
|
B. |
Mixing the medication with
a couple ounces of formula and putting it in a bottle |
|
C. |
Discontinuing the
antibiotic if diarrhea occurs |
|
D. |
Calling for an antibiotic
change if the infant chokes and sputters during administration |
ANS:
A
PTS: 1
9. To
increase adherence in pediatric patients a prescription medication should:
|
A. |
Have a short half-life |
|
B. |
Be the best tasting of the
effective drugs |
|
C. |
Be the least concentrated
form of the medication |
|
D. |
Be administered 3 or 4
times a day |
ANS:
B
PTS: 1
10. Janie
is a 5-month-old breastfed infant with a fever. Treatment for her fever may
include:
|
A. |
“Baby” aspirin |
|
B. |
Acetaminophen suppository |
|
C. |
Ibuprofen suppository |
|
D. |
Alternating acetaminophen
and ibuprofen |
ANS:
B
PTS: 1
Chapter 60. Integrative Approaches to Pharmacotherapy
– A look at Complex Cases
MULTIPLE CHOICE
1. Patients
with chronic illness may struggle with adherence to their treatment regimen.
Intelligent non-adherence occurs when the patient:
|
A. |
May not understand the
specifics of his or her medication regimen |
|
B. |
Cannot afford to pay for
all the medications in his or her regimen |
|
C. |
Occasionally misses doses
of medications due to forgetfulness |
|
D. |
Chooses to discontinue or
alter his or her medication regimen |
ANS:
D
PTS: 1
2. Steps
the provider can take to improve medication adherence in the chronically ill
patient include:
|
A. |
Tell the patient to take the
medications as prescribed for optimum health |
|
B. |
Assess adherence either
through self-report or laboratory values |
|
C. |
Encourage the patient to
take the medications regularly |
|
D. |
If noncompliant with the
medication regimen, ask if the patient values good health |
ANS:
B
PTS: 1
3. The
Beers Criteria is used to:
|
A. |
Determine appropriate
prescribing in the elderly |
|
B. |
Set guidelines for
prescribing sedatives for the elderly |
|
C. |
Assess potentially
inappropriate medications in the elderly |
|
D. |
Provide regulation in the
prescribing of potentially dangerous medications |
ANS:
C
PTS: 1
4. The
Beers Criteria recommend which muscle relaxant for use in the elderly?
|
A. |
Methocarbamol (Robaxin) |
|
B. |
Carisoprodol (Soma) |
|
C. |
Cyclobenzaprine (Flexeril) |
|
D. |
None of the above |
ANS:
D
PTS: 1
5. According
to the Beers Criteria list, the elderly should be cautiously prescribed
fluoxetine (Prozac) due to:
|
A. |
Excessive drowsiness |
|
B. |
Long half-life |
|
C. |
Dry mouth and constipation |
|
D. |
Decreased renal excretion |
ANS:
B
PTS: 1
6. The
Beers Criteria states mineral oil is not recommended to be used in the elderly
due to:
|
A. |
Lack of efficacy in this age
group |
|
B. |
Concern for oil leakage
from the anus |
|
C. |
Potential for aspiration of
oil |
|
D. |
Concern for CNS and
extrapyramidal effects |
ANS:
C
PTS: 1
7. Many
elderly patients use diphenhydramine (Benadryl) as a sleep aid. The Beers
Criteria recommends against the use of diphenhydramine in the elderly due to:
|
A. |
Lack of efficacy in the
elderly |
|
B. |
It may cause confusion |
|
C. |
It may induce depression |
|
D. |
Orthostatic hypotension |
ANS:
B
PTS: 1
8. The most
common prescribing error in long-term care facilities is:
|
A. |
The wrong drug is
prescribed |
|
B. |
The wrong dose of
medication is prescribed |
|
C. |
Medications are
administered at the wrong time |
|
D. |
Drugs with known
interaction are prescribed |
ANS: B
PTS: 1
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