Sterile Compounding Final Exam Questions

kcal in 1 gram of carbohydrates/dextrose

3.4 kcal

kcal in 1 gram of protein

4 kcal

kcal in 1 gram of fat

10 kcal

maximum oxidation rate in mg/kg/min for IV dextrose

5

how many kcal/kg/day should be provided to patients with severe head injuries or severe burn wounds

40

T/F: when preparing injections for HDs Luer-locking syringes must be used

true

T/F: positive pressure should be maintained in multi-dose vials when reconsituting or withdrawing HDs

false

T/F: PhaSeal is an open and needle-safe system for preparation, administration, and waste handling

false

it is a closed system

T/F: health care workers or patients can be exposed to HDs drugs by inhalation, absorption, ingestion, or injection

true

T/F: in addition to USP 800, sterile compounding of HD drugs must follow standards in USP 797

true

T/F: a LAFW can be used for compounding an antineoplastic HD

false

T/F: the residue that is generated when tablets of HD drugs are cut to prepare a smaller dose is not considered hazardous waste

false

T/F: the following designated areas must be available for HDs: receipt and unpacking; storage; non-sterile compounding; sterile compounding

true

T/F: USP 800 describes practice and quality standards for handling HD drugs in healthcare settings and help promote patient safety, worker safety, and environmental protection

true

T/F: all personnel who handle HDs must be trained based on their job functions

true

T/F: the 5 rights of medication administration are: pharmacist, drug, dose, route, and time

false

should be patient instead of pharmacist

T/F: infused medications must overcome natural resistance to flow from vascular backpressure

true

T/F: enteral feeding is reserved for patients with a gut that works

true

T/F: to administer an IM medication you need two syringes, one containing the saline flush and one containing the drug solution

false

need 3: flush, med, then another flush

T/F: the z-track method is a type of IM injection technique used to prevent tracking (leakage) of the medication into the subcutaneous tissue

true

T/F: polydimethylsiloxane is a biodegradable polymer for injection

false

T/F: poly(lactive acid-co-glycolic acid) (PLGA) degrades faster than poly(glycolic acid)

true

T/F: secondary structure of a protein refers to its overall folded structure in water

false

secondary structure is when the protein is in beta pleated sheets or alpha helix

T/F: lispro insulin dissociated more slowly than regular insulin after SC injection

false

T/F: all marketed recombinant protein drugs have a preservative to extend their expiration date after reconstitution

false

physical instabilities of recombinant protein drugs include the following except:

-denaturation

-deamidation

-aggregation

-precipitation

-adsorption

deamidation

oxidation of recombinant protein drugs occurs at the following amino acids except:

-histidine

-methionine

-tryptophan

-tyrosine

-asparagine

asparagine

a protein drug adsorbs maximally onto a surface:

-below its isoelectric point

-above its isoelectric point

-at its isoelectric point

-in the presence of human serum albumin

-in the presence of Tween 80

at its isoelectric point

which factor influences the immunogenicity of protein drugs?

-impurities

-amino acid sequence

-route of administration

-glycosylation

-all of the above

all of the above

one of the prerequisites for ANH is _____

-the definition of a therapeutic goal to be achieved

-an NPO order from a physician

-the absence of patient risk factors

-the presence of patient hunger

the definition of a therapeutic goal to be achieved

total parenteral nutrition is also occasionally referred to as which?

-hypodermoclysis, hyperalimentation, or hyperal

-IV hyperalimentation, hyperal, or hypodermoclysis

-hyperalimentation, hypodermoclysis, or IV hyperalimentation

-hyperal, hyperalimentation, or IV hyperalimentation

hyperal, hyperalimentation, or IV hyperalimentation

what is the most common carbohydrate used for TPN?

-dextrose

-fructose

-invert sugar

-lactose

dextrose

what substances are generally added to TPN solutions?

-electrolytes, trace elements, and vitamins

-antifungal agents, electrolytes, and vitamins

-electrolytes, antihistamine antagonists, and vitamins

-citrate preservative, electrolytes, and vitamins

electrolytes, trace elements, and vitamins

which solution of three-in-one refers to the combination in one container of which of the following?

-lipids, dextrose, and amino acids

-lipids, heparin, and electrolytes

-lipids, vitamins, and trace elements

-lipids, electrolytes, and amino acids

lipids, dextrose, and amino acids

which of the following statements accurately reflect principles of central venous parenteral nutrition?

-it is useful for long-term therapy

-it is indicated for patients with low calorie and nutrient needs

-the 1800-2000 mOsm/kg concentration range frequently causes phlebitis

-lipid administration is done only IVPD

it is useful for long-term therapy

T/F: human serum albumin has an isoelectric point=4.9 and has a net negative charge and pH=7.4

true

T/F: lispro insulin is a long-acting insulin

false

it is short acting

T/F: protein adsorption does not happen at an air/water interface

false

T/F: a therapeutic protein is the most immunogenic for the IV route

false

which one is intermediate-acting and contains amorphous insulin?

-regular

-lispro

-lente

-NPH

-ultralente

lente

isomerization of proteins occurs at which amino acid?

-alanine

-thiol

-methionine

-asparagine

-tyrosine

asparagine

in the handling of biologicals, which statement is false?

-the proper diluent is critical

-proteins adsorb onto plastic and glass

-proteins are usually injected SC or IV

-usually require storage at room temperature

-excessive agitation can denature proteins

usually require storage at room temperature

-most require refrigeration

what is the molecular weight cutoff for the renal clearance of proteins (g/mol)?

-6,000

-22,000

-32,000

-50,000

-150,000

50,000

role of protamine sufate

complexing agent

role of glycerin

isotonicity agent

role of dibasic sodium phosphate

buffer

role of M-cresol

preservative

role of zinc ion

complexing agent

role of phenol

preservative

which of the following ethical principles most directly support the ANH prerequisite to have an indication for medical treatment?

-justice and autonomy

-autonomy and beneficence

-non-maleficence and justice

-beneficence and non-maleficence

beneficence and non-maleficence