Pathopharm Exam 1

A drug is a chemical agent capable of producing biologic responses within the body. When a drug is going to be administered, we call it a medication.

True or False

True

Biologics are agents naturally produced in animal cells, by microorganisms, or by the body itself. Examples of biologics include hormones, interferons, and vaccines.

True or False

True

Generic drugs are more expensive than trade-name drugs and have increased bio-availability for the patient taking the drug.

True or False

False

Nurses are most likely to be involved in the post-marketing phase of clinical trials because in this phase patients are monitored for side effects.

True or False

True

An adverse drug reaction is considered negative whereas a side effect is usually tolerable and might even be a positive effect.

True or False

True

Match

Morphine

Vicodin

Cough Syrup w/ Codeine

Lorazepam

Heroin

Class 1

Class 2

Class 3

Class 4

Class 5

Morphine - Class 2

Vicodin - Class 3

Cough Syrup - Class 5

Lorazepam - Class 4

Heroin - Class 1

A teratogen is a substance that has the potential to cause a defect in an unborn child during pregnancy. Vitamins are in category A.

True or False

True

Match

"Medication goes___"

just under skin

into a muscle

just above muscle

into the vein

intradermal

subcutaneous

intravenous

intramuscular

just under skin - intradermal

into a muscle - intramuscular

above muscle - subcutaneous

into the vein - intraveinous

Select the 5 rights of medication administration

a. right drug

b. right patient

c. right dose

d. right route

e. right room number

f. right place

g. right time

h. right attitude

a. right drug

b. right patient

c. right dose

d. right route

g. right time

When looking at pharmacokinetics, the nurse will consider absorption, distribution, metabolism, and excretion.

True or False

True

The inflammatory response can be a broad, systemic response to invasion of pathogens. It can cause 2 fatal problems. (question not fully written in quiz)

True or False

True

Signs and symptoms of inflammation include which of the following?

a. redness

b. loss of function

c. pain

d. nausea

e. shortness of breath

f. swelling

g. heat

a. redness

b. loss of function

c. pain

f. swelling

g. heat

Systemic lupus erythematosus is a condition that is caused by autoimmunity. The affected individual develops auto-antibodies that attack and damage his or her own cells including erythrocytes, coagulation proteins, lymphocytes, and platelets. It is a disease of the connective tissue and affects bones, muscles, and in particular, the kidneys.

True or False

True

Select from the list below physiological changes that occur with the inflammatory response.

a. increase in capillary permeability

b. fluid shifts to affected area

c. long lasting vasoconstriction

d. an increase in blood volume

e. vasodilation

f. increase in prostaglandin synthesis

a. increase in capillary permeability

b. fluid shifts to affected area

e. vasodilation

f. increase in prostaglandin synthesis

Memory B or T cells remember specific antigen- antibody interactions. Should the body be exposed to the same antigen in the future, the body will be able to mount a reaction sooner.

True or False

True

Attenuated (live but weakened) vaccines contain the pathogen that causes the disease, so they are able to produce disease in an otherwise healthy person.

True or False

False

The bacteria responsible for healthcare associated infections (HAIs) are often resistant to antibiotics. Examples include vanco resistant enterococci or methicillin resistant staph aureus.

True or False

True

Match

a. Reserved for severe infections from gram-positive organisms such as staphylococcus aureus and streptococcus pneumoniae

b. Reserved for serious systemic infections caused by aerobic gram negative organisms, including those caused by E. coli, Serratia, Proteus, Klebsiella, and Pseudomonas (ex - gentamicin, amikacin)

c. Broad spectrum should not be given to kids under 8 y/o ( ex - decloymycin)

d. Supress bacterial growth by inhibiting the synthesis of folic acid, or folate ( ex - septra or bactrim)

e. Works against gram-positive organisms inhibiting cell wall synthesis. Good for pts who have problems with penicilins

f. First antibiotics discovered. Effective against gram-positive organisms

cephalosporins

tetracyclines

sulfonamides

penicilins

aminoglycosides

odd abx such as vanomysin

a - odd abx such as vanomysin

b - aminoglycosides

c - tetracyclines

d - sulfonamides

e - cephalosporins

f - penicilins

Mycobacterium tuberculosis has a thick cell wall that's difficult to penetrate. Therefore, the patient must be on anitibiotics for up to a year and be on multiple drugs at the same time such as

isoniazid, rifampin (Rifadin, Rimactane), pyrazinamide (PZA), and ethambutol (Myambutol).

True or False

True

Microbes that become pathogenic when the immune system is suppressed are called suppressed organisms.

True or False

False

The parasympathetic system is voluntary. It decreases heart rate and contractility, causes bronchoconstriction, pupil constriction and increases peristalsis and relaxes sphincters.

True or False

False

The goal of Parkinson's medication is to increase dopamine at the synapses and block some of the acetylcholine.

True or False

True

Match

a. Slow to move. May have shuffling gate.

b. restless movement.

c. Fine motor movement of fingers. Rubbing thumb and fingers together.

d. Patients take on a mask-like appearance with no visible emotion

e. Shaky movements that patient can't control.

f. Muscle spasm

akathisia

bradykinesia

pill rolling

dystonia

flat affect

tremors

a - bradykinesia

b - akathisia

c - pill rolling

d - flat affect

e - tremors

f - dystonia

Acetylcholine is the main neurotransmitter of the parasympathetic nervous system. Anticholinergics block acetylcholine, thereby increasing sympathetic activity.

True or False

True

Dementia is a degenerative disorder characterized by progressive memory loss, confusion, and an inability to think or communicate effectively. After the age of 65, most people will develop dementia.

True or False

False

Select from the list below clinical manifestations of Alzheimer's disease.

a. dyspraxia

b. psychoses

c. dehydration

d. agressive behavior

e. headache

f. depression

g. memory loss

a. dyspraxia

b. psychoses

d. agressive behavior

f. depression

g. memory loss

Match the pathophysiology of Alzheimer's disease with the words.

a. Structural change caused by chronic inflammatory or oxidative cellular damage to the surrounding neurons leading to coating over neurons.

b. Structural change caused by chronic inflammatory or oxidative cellular damage to the surrounding neurons leading to tangling of neurons.

c. Treated with cholinesterase inhibitors such as donepezil (Aricept)

acetylcholine deficit in hippocampus

neurofibrillary tangles

amyloid plaques

a - amyloid plaques

b - neurofibrillary tangles

c - acetylcholine deficit in hippocampus

Multiple sclerosis (MS) is a disorder characterized by damaged myelin located in the peripheral nervous system.

True or False

False

Select clinical manifestations of multiple sclerosis from the list below.

a. diarrhea

b. constipation

c. nystagmus

d. paresthesia

e. diplopia

f. paralysis

c. nystagmus (bouncing eyeballs)

d. paresthesia (numbness)

e. diplopia (double vision)

f. paralysis

Our nervous system remains relaxed, but ready. Homeostasis is achieved through a balance of parasympathetic activity and sympathetic activity.

True or False

True

Match

a. Made at the basal ganglia, it is responsible for coordinating movements.

b. Contributes to our feelings of well-being.

c. In the family of catecholamines, the primary neurotransmitter of the sympathetic nervous system.

d. The primary neurotrasmitter of the parasympathetic division (rest and digest), released by cholinergic nerves. Also helps us to remember.

dopamine

serotonin

norepinephrine

acetylcholine

a - dopamine

b - serotonin

c - norepinephrine

d - acetylcholine

Bethanechol (Urecholine) is a direct-acting parasympathomimetic (mimics parasympathetic stimulus).It stimulates smooth-muscle contraction and is useful for patients who cannot void.

True or false

True

Donepezil (Aricept) is an acetylcholinesterase inhibitor that improves memory in Alzheimer's dementia by increasing acetylcholine at the synapse.

True or False

True

Nerves of the autonomic nervous system (ANS) exert voluntary control over the contraction of cardiac muscle and smooth muscle as well as glandular activity.

True or False

False

Select anticholinergic responses from the list below.

a. bladder relaxation

b. increase loose stools

c. mydriasis

d. suppression of oral secretions

e. bronchodilation

f. slow down breathing

g. constrict pupils

h. faster heart rate

a. bladder relaxation

c. mydriasis

d. suppression of oral secreations

e. bronchodilation

h. faster heart rate

Select from the list below the effects of adrenergics.

a. vasoconstriction

b. elevated blood pressure

c. bronchodilation

d. tachycardia

e. diarrhea

a. vasoconstriction

b. elevated blood pressure

c. bronchodilation

d. tachycardia

Adrenergic blocker drugs like tamsulosin (Flomax) relaxes the bladder, which is helpful for men with benign prostatic hypertrophy.

True or False

True

Match

a. The patient is in the middle of a divorce.

b. The patient has had feelings of dread for several months.

c. The patient recently was a victim of a violent crime and now has nightmares.

d. The patient is unable to have a CT scan due to fear of tight spaces.

e. Patient believes that germs will attack unless she washes her hands every 5 minutes.

situational anxiety

ptsd

phobias

general anxiety disorder

ocd

a - situational anxiety

b - general anxiety disorder

c - ptsd

d - phobias

e - ocd

Antidepressants are used not only to treat major depression but also anxiety conditions including general anxiety disorders, obssesive-compulsive disorders, panic, social phobia, and post-traumatic stress disorder.

True or False

True

Benzodiazepines such as lorazepam act by decreasing the neurotransmitter serotonin in the neural synapses.

True or False

False

Match (NT = neurotransmitter)

a. Feel good NT, antidepressants such as lexapro allow this to remain in synapse

b. Primary NT in parasympathetic nervous system, allows us to rest & digest. Anticholinergics are used to block this NT.

c. Primary NT in sympathetic nervous system, causes us to run from danger. Related drugs will increase heart rate, bp, and dilate bronchi

d. Principal role is reducing neuronal excitability throughout nervous system. Benzos work to increase this NT.

e. Secreted by basal ganglia cells in the subastnia nigra, responsible for coordinating movement. Parkinson's patients are given meds to replace this NT

gaba

dopamine

acetylcholine

serotonin

norepinephrine

a - serotonin

b - acetylcholine

c - norepinephrine

d - gaba (gamma-aminobutyric acid)

e - dopamine

Match

a. Sudden and severe, but temporary. Easy to treat.

b. Caused by tissue injury, this type of pain is easier to treat.

c. Tissue injury occurs in one area of the body, but the pain is felt somewhere else in the body.

d. Long lasting and recurring. Difficult to treat. Patient tend to need higher doses to achieve the same effect.

e. Caused by direct injury to the nerves, tends to be chronic and difficult to treat. Example - phantom limb pain.

f. A type of nociceptive pain, tends to be local and sharp or stabbing.

g. Produces generalized dull and internal throbbing or aching pain.

neuropathic

referred

acute

visceral

chronic

somatic

nociceptive

a - acute

b - nociceptive

c - referred

d - chronic

e - neuropathic

f - somatic

g - visceral

Match

a. treats anxiety and sids in sleeping (ex - ativan & xanax)

b. speeds up a slow heart rate, and dilates bronchi

c. used to dilate bronchi. common drug used for constricted airway is albuterol

d. relieves sympomps of depression ( ex - lexapro)

e. relieves symptoms of PD, marketed as sinemet

f. Allows more Ach to remain in synapse, and used to slow down decline in alzheimer's

g. Relieves pain, and can cause physical dependence and tolerance if taken over sever weeks or more ( ex - fent, morphine, oxy)

opiates

dopaminergic

adrenergic

benzodiazipines

anticholinergic

ssri

cholinesterase inhibitor

a - benzodiazipines

b - anticholinergics

c - adrenergic

d - ssri

e - dopamine precursor or dopaminergic

f - colinesterase inhibitor

g - opiates

Select whether each body function is sympathetic (SNS) or parasympathetic (PNS)

Dilating pupils

Tachycardia

Vasoconstriction

Normal Heart Rate (60-80)

Bigger Airways

Peristalsis

Dilating pupils - SNS

Tachycardia - SNS

Vasoconstriction - SNS

Normal Heart Rate (60-80) - PNS

Bigger Airways - SNS

Peristalsis - PNS

Match the controlled (scheduled) substances with their number.

a. high potential for addiction but with therapeutic benefit - example morphine

b. less potential for addiction - generally non-opiate example lorazepam

c. unlikely chance of addiction, usually combined with non addictive substance, example- cough syrup with opiate

d. moderate potential for addiction and has less potency - example codeine

e. high potential for addiction with no therapeutic benefit - example heroin

Schedule 1-5

a - scheule 2

b - schedule 4

c - schedule 5

d - schedule 3

e - schedule 1

Which of the following are considered classifications for pain?

a. visceral

b. ventral

c. posterior

d. nociceptive

e. neural

f. neuropathic

a. visceral

d. nociceptive

f. neuropathic

A nurse communicates with the patient and asks the patient on a scale from 1-10 how much pain are you currently in. And the patient replies and says. "I'm in severe pain right now, I would say a 10. This is an example of subjective data.

True or False

True

A patient receiving narcotic analgesics for chronic pain can minimize the gastrointestinal (GI) side effects by:

a. increasing fluid and fiber in the diet

b. taking medication on an empty stomach

c. eating foods high in lactobacilli

d. taking lomotil with each dose

a. increasing fluid and fiber in the diet

Which of the following are considered analgesics?

a. codeine sulfate

b. ibuprofen

c. oxycodone

d. lorazepam

e. morphine sulfate

a. codeine sulfate

b. ibuprofen

c. oxycodone

e. morphine sulfate

The patient is currently taking an opioid analgesic and the nurse notices that the patient is somnolent with respiratory depression. What is the nurse's priority action?

a. contact the physician and monitor the patient closely

b. leave the patient to get help

c. contact the physician and prepare to give naloxone

d. continue to monitor the patient

c. contact the physician and prepare to give naloxone

Tissue injury causes the release of:

a. histamine

b. irritating fluids

c. calcium

d. norepinephrine

e. prostaglandins

f. sodium

a. histamine

e. prostaglandins

The patient wears a fentanyl transdermal patch for cancer pain. The nurse teaches the patient to change the patch:

a. every 72 hours

b. every 24 hours

c. daily

d. when pain begins to escalate

a. every 72 hours

When assessing for the most serious adverse reaction to an opiate analgesic, the nurse is careful to monitor the patient for:

a. nausea

b. level of pain

c. respiratory rate

d. bowel motility

c. respiratory rate

A patient is admitted to the psychiatric unit for treatment of an opiate addiction. The nurse would anticipate administration of which of the following medications?

a. naloxone

b. morphine

c. methadone

d. meperidine

c. methadone

The nurse is preparing to administer an injection of morphine to a patient. Assessment notes a respiratory rate of 8 breaths/min and the patient is difficult to awaken. The nurse should:

a. administer the prescribed dose and notify the physician

b. hold the drug, record the assessment, and recheck in an hour

c. administer a smaller dose and recod the findings

d. notify the physician and delay drug administration

d. notify the physician and delay drug administration