Lehnes pharmacotherapeutics for advanced practice nurses and physician assistants pdf

COMPLETE TEST BANK FOR LEHNE'S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND

PHYSICIAN ASSISTANTS 2ND EDITION ROSENTHAL

Unit 02: Basic Principles of Pharmacology

Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician

Assistants, 2nd Edition

MULTIPLE CHOICE

1.When prescribing lovastatin, what will a provider advise to decrease the risk of developing

muscle toxicity?

a. Avoid exercise for 2 hours after administration.

b.Substitute grapefruit juice with orange juice.

c. Monitor aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

d.Take the medication with an NSAID or other anti-inflammatory drug.

ANS: B

Grapefruit juice can inhibit the metabolism of certain drugs including statins like lovastatin.

The juice raises drug levels decreasing the intestinal metabolism of the drug resulting in

increased drug levels which increases the risk for adverse effects such as muscle toxicity.

Taking the drug with an anti-inflammatory drug and avoiding exercise after administration are

not supported by science. Monitoring AST and ALT detects liver toxicity, not muscle toxicity.

2.When prescribing drugs with a narrow therapeutic index, what intervention does the provider

take to decrease risk to the patient?

a. Schedule drug administration intervals that exceed the drug’s half-life.

b. Order the medication to be administered by the intravenous route.

c. Monitor the patient’s plasma drug levels at regular intervals.

d.Teach the patient that optimal outcomes will require adherence to the medication

regimen.

ANS: C

A drug with a narrow therapeutic range or index is more difficult to administer safely, because

the difference between the minimum effective concentration and the toxic concentration is

small. Patients taking these medications must have their plasma drug levels monitored closely

to ensure that they are getting an effective dose that is not toxic. Administering medications at

longer intervals risks increased periods of subtherapeutic levels. Drugs that have a narrow

therapeutic range may be given by any route; intravenous administration is not preferable and

in most cases will not be feasible. Medication regimen adherence is necessary; however, due

to individual variation, for drugs with a narrow therapeutic range, what is an effective dose for

one patient may be a lethal dose for another. For this reason, monitoring drug levels remains

the primary method for decreasing risk.

3.A patient reports that a medication no longer effectively alleviates symptoms. What process

informs the provider’s response to the patient’s concerns?

a. Endogenous antagonists compete with the drug for receptor sites.

b.Decreased selectivity for receptors results in a variety of effects.

c. Desensitization of receptor sites results from continual exposure to the drug.

d.Additional receptor sites are synthesized in response to the medication.

ANS: C

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