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Test Bank For Integrated Cardiopulmonary Pharmacology, 3rd Edition, 3rd Edition

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    Colbert_icp3_TestBank_questions.doc Page 1 of 150 Test Bank Chapter 1 MULTIPLE CHOICE Choose the one alternative that best completes the statement or answers the question. 1. Which term best describes the study of drugs and their action on the body? a. Therapeutics b. Pharmacology c. Pharmacotherapy d. Disease management 2. The most common source of drugs today is: a. Plants. b. Animals. c. Chemical synthesis. d. Genetic bioengineering. 3. The agency that regulates drug testing and approves new drugs is the: a. Center for Drug Evaluation and Research (CDER). b. Centers for Disease Control and Prevention (CDC). c. National Institutes of Health (NIH). d. Food and Drug Administration (FDA). 4. The phase of drug testing that is performed to look for rare or serious adverse effects after the drug is marketed is: a. Phase I. b. Phase II. c. Phase III. d. Phase IV. 5. What organization is officially responsible for establishing public standards that approved drugs must continue to meet? a. The Physicians‟ Desk Reference (PDR) b. The American Hospital Formulary Service (AHFS) c. The United States Pharmacopeia (USP) d. The Food and Drug Administration (FDA)

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    Colbert_icp3_TestBank_questions.doc Page 2 of 150 6. The name given to a drug that is considered the nonproprietary name and is not owned by any particular pharmaceutical company is the: a. Chemical name. b. Generic name. c. Trade name. d. Brand name. . 7. A 21-year-old pregnant female has been exposed to the drug Virazole, which has been reported to cause damage to the fetus. This type of drug exposure is referred to as: a. An adverse drug reaction (ADR). b. A life-threatening reaction. c. Hypersensitivity. d. Teratogenicity. 8. Drugs that do not go directly into the systemic circulation after being absorbed and are metabolized through the liver describes a: a. Steady state. b. First-pass effect. c. Therapeutic range. d. Half-life. 9. A physician would like a patient to receive acetaminophen via the enteral route. Your choice of administration may include: I. Oral. II. Nasogastric. III. Rectal. a. I b. I and II c. I and III d. I, II, and III 10. Administration of 80 mg propranolol given orally (PO) produces the same response as 1 mg intravenously (IV). The difference in dosage is explained by: a. The first-pass effect. b. Bioavailability. c. Protein binding. d. Metabolism. 11. The most common and convenient route of drug administration is: a. Oral. b. Inhalation. c. Sublingual. d. Transdermal.

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    Colbert_icp3_TestBank_questions.doc Page 3 of 150 12. A malnourished patient is susceptible to an increase in drug response because of all except which of the following? a. A malnourished patient has less serum albumin. b. The free, unbound drug is an active drug and will lead to greater drug response. c. Less drug is absorbed systemically. d. Much of the drug will be free within the bloodstream. 13. The effect of administering a water-soluble drug to an infant, who has a higher percentage of total body water compared to an adult, would be: a. Decreased effect. b. The same effect. c. Increased effect. d. An additive effect. 14. The mechanisms responsible for metabolism of rifampin in the liver include: I. Drug oxidation. II. Enzyme inhibition. III. The cytochrome P-450 system. a. I and II b. I and III c. II and III d. I, II, and III 15. After drugs are metabolized, they can be eliminated from the body through the: a. Skin. b. Lungs. c. Feces and urine. d. All of the above. 16. The potency of a drug is best described as: a. An affinity of the drug for a particular receptor site. b. The degree in which the drug can be cleared from the body. c. The route of the drug. d. The amount of drug required to produce the response desired. 17. Excretion of drugs through the kidneys is affected by all except which of the following? a. Glomerular filtration b. Drug oxidation c. Impaired renal function d. Tubular secretion and reabsorption 18. When a drug binds to a receptor site, all except which of the following can occur? a. An ion channel can be opened or closed. b. Biochemical messengers that initiate chemical reactions can be activated. c. A normal cellular function can be turned on or off.

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    Colbert_icp3_TestBank_questions.doc Page 4 of 150 d. The therapeutic response produced is directly proportional to the number of sites occupied. 19. A drug that does not elicit a response: a. Is an agonist. b. Increases drug action. c. Is an antagonist. d. Activates the receptor. 20. A cell that becomes less responsive to a drug after exposure over time is a condition called: a. Tolerance. b. Desensitization. c. Dependence. d. Low therapeutic index. 21. You note that a physician has made a new entry on a patient‟s chart. The entry reads “500 mg acetaminophen PO QID.” What does this order mean? a. 500 mg acetaminophen by mouth, four times daily b. 500 mg acetaminophen per order, six times daily c. 500 mg acetaminophen preop, then daily d. 500 mg acetaminophen postop, then every 4 hours 22. Which of the following routes of drug administration completely bypasses the absorption step before entering the bloodstream? a. Oral b. Rectal c. Intravenous d. Intramuscular 23. To maintain a steady state of drug concentration in the plasma, a drug should be administered by which of the following methods? a. Intramuscular injection b. Continuous IV infusion c. Intravenous bolus d. Transdermally 24. Which of the following terms explains why a patient may require an increased amount of a drug after repeated use to produce the same therapeutic effect? a. Dependence b. Selectivity c. Tachyphylaxis d. Tolerance 25. Treatment for drug overdoses and poisoning includes all of the following except the:

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    Colbert_icp3_TestBank_questions.doc Page 5 of 150 a. Administration of antidotes. b. Use of an adsorbent. c. Administration of emetics. d. Use of a metabolite. TRUE/FALSE Write „T‟ if the statement is true and „F‟ if the statement is false. ______ 1. The FDA considers herbals the same as drugs because they are derived from plants that were forerunners of many current medications. ______ 2. An interaction between two drugs that causes one drug to have no direct effect but increases the response of the other drug is referred to as the drug‟s potency. ______ 3. Administration of a drug directly to the lungs is a form of topical delivery. ______ 4. Continuous infusion gives a regulated, consistent dosage over time, referred to as a steady state. On the other hand, a bolus dose causes fluctuations in the plasma drug concentration. ______ 5. As a drug increases in selectivity to a particular cell or tissue, the less useful it becomes. ______ 6. Fat-soluble drugs have a decreased effect in patients who are obese. ______ 7. For a drug to be excreted from the body, it has to be metabolized so that it is water soluble. ______ 8. Liver function tests should be conducted to determine if a patient can metabolize a prescribed drug. ______ 9. Emetics are agents that are administered to induce vomiting in the event of poisoning. ______10. A formulary is a list of drugs that a particular health care system stocks and dispenses. FILL-IN-THE-BLANK Write the word or phrase that best completes each statement. 1. A severe, life-threatening allergic reaction can result in ________________. 2. Drugs administered directly to the lungs are given via the ____________ route. 3. Drugs given parenterally go directly to the ________________ and result in rapid absorption. 4. Repeated use of the same drug may result in a decreased response, requiring an increased amount of the drug to produce the same effect. This phenomenon is known as ________________. 5. In order for digoxin to be effective, an appropriate amount of the drug must be present in the blood. This blood level is known as the ________________. 6. The _______________ name of a drug is the name assigned by the United States Adopted Name (USAN) Council.

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    Colbert_icp3_TestBank_questions.doc Page 6 of 150 7. Drugs that are released slowly once administered are referred to as _______________ formulations. 8. Patients who are ordered nothing by mouth but are prescribed a medication to be given enterally may be administered the drug _____________. 9. Biotransformation occurs when drugs are converted to a ____________ form for elimination. 10. In order for drugs to be effective without causing toxicity, they must be maintained within the ____________. SHORT ANSWER Answer the following questions or statements. 1. What is the difference between an endogenous and exogenous chemical? 2. Explain the difference in how agonist and antagonist drugs react once combined with a receptor. 3. Why are patients with liver disease likely to have greater than expected effects from prescribed drugs? 4. What is the purpose of a “do not use” list of common abbreviations? 5. What basic safeguards should be followed in order to reduce medication administration errors?

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    Colbert_icp3_TestBank_questions.doc Page 7 of 150 Chapter 2 MULTIPLE CHOICE Choose the one alternative that best completes the statement or answers the question. 1. A patient with a tidal volume of 400 milliliters has a tidal volume of how many liters? a. 40 b. 4 c. .400 d. .04 2. A patient who weighs 55 kilograms is to receive a drug dosage of 10mg/kg. How much drug should be administered? a. 550 mg b. 250 mg c 25 mg d. 5.5 mg 3. A patient‟s height is reported as 5 feet 6 inches. What is the patient‟s height i n centimeters? a. 26 cm b. 30 cm c. 145 cm d. 167 cm 4. A solution of drug contains 80 units/ml. How many milliliters would you need to deliver 320 units of the drug? a. 0.4 ml b. 4 ml c. 14 ml d. 40 ml 5. A newborn‟s length at birth is measured as 45.7 centimeters. What is the newborn‟s length in inches? a. 17 in b. 18 in c. 19 in d. 20 in 6. While preparing an aerosol bronchodilator for a patient, you place 0.5 ml of a 1% drug solution into a small-volume nebulizer. If you add 5 ml of saline instead of 2 ml of saline, the delivered dose of drug will: a. Increase b. Decrease c. Remain the same d. Weaken the drug response 7. What is the percentage strength of 20 mg of cromolyn sodium in 2 ml of normal saline?

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    Colbert_icp3_TestBank_questions.doc Page 8 of 150 a. 1% b. 2% c. 10% d. 20% 8. If a drug order is written for 0.25 mg/kg of body weight, what dosage would be administered to a patient weighing 88 lb? a. 10 mg b. 22 mg c. 40 mg d. 44 mg 9. A dosage of 4 mg of morphine sulfate is ordered for a patient. How many milliliters will be administered from a vial containing 10 mg/ml? a. 0.1 ml b. 0.4 ml c. 1 ml d. 4 ml 10. An adult female patient weighs 125 lb. In order to determine a mechanical tidal volume, you must convert her weight to kilograms. What is her weight in kilograms? a. 275 kg b. 63 kg c. 57 kg d. 28 kg 11. You have just assisted in the care of a premature infant who weighs 600 g. The baby‟s mother asks you what the weight is in pounds. You calculate the baby‟s weight as: a. 4.1 lb b. 3.5 lb c. 2.7 lb d. 1.3 lb 12. A medication bag contains 0.03 liters. This is equal to how many milliliters? a. 3 b. 30 c. 300 d. 3,000 13. A patient who is 5-feet-10 inches tall is how many centimeters tall? a. 286 cm b. 32 cm c. 154 cm d. 178 cm 14. A homogeneous mixture of two or more substances is referred to as: a. Dissolved.

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    Colbert_icp3_TestBank_questions.doc Page 9 of 150 b. A solvent. c. A solute. d. A solution. 15. Virazole is supplied in a powder form that must be mixed with normal saline or sterile water prior to nebulization. This type of solution represents a: a. Solid/solvent b. Weight/volume c. Liquid/solute d. Volume/volume 16. How much solute is in 3 ml of a 1:100 weight/volume solution? a. 10 ml b. 10 mg c. 20 ml d. 30 mg 17. Which of the following terms is a synonym for “ active ingredient ” ? a. Solution b. Solute c. Solvent d. Saline 18. What would the new concentration be, in percentage, of 1.5 ml of a 10% solution that has been increased to 3.0 ml with normal saline? a. 0.05% b. 0.5% c. 5% d. 20% 19. How much active drug is in 3 ml of a 10% solution? a. 0.3 g b. 1 g c. 0.3 mg d. 1 mg 20. A rescue dosage of surfactant calls for 3 ml/kg body weight. If a premature infant weighs 1,500 g, how many milliliters are needed? a. 5.0 ml b. 9.0 ml c. 0.45 ml d. 4.5 ml 21. If a drug contains 6% active ingredient, how many grams of the active ingredient would you need in a 30-ml dose? a. 18 g b. 36 g

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    Colbert_icp3_TestBank_questions.doc Page 10 of 150 c. 1.8 g d. 3.6 g 22. Promazine comes in a 550-mg/10-ml liquid solution. How many milliliters are needed to give a 200-mg dose? a. 3.6 ml b. 30 ml c. 0.3 ml d. 3 ml 23. Terbutaline sulfate is available as 1 mg/1 ml in an ampule. How many milliliters are needed to administer a 0.75 dose? a. 1.5 ml b. 0.75 ml c. 0.15 ml d. 0.30 ml 24. What strength of drug would be administered if 6 g of active ingredient is reconstituted with sterile water to a total volume of 300 ml? a. 2% strength b. 0.5% strength c. 20% strength d. 50% strength 25. You receive an order for 16 gtt of Mucomyst. How many milliliters of drug would you be administering to the patient? a. 0.5 ml b. 1 ml c. 1.5 ml d. 5 ml TRUE/FALSE Write „T‟ if the statement is true and „F‟ if the statement is false. ______ 1. The Joint Commission recommends that a zero always be placed after the decimal point when referring to drug dosage. ______ 2. The method used to convert between the English and metric systems is referred to as the factor-label method. ______ 3. Normal saline in solution with albuterol is known as the solvent. ______ 4. When a solute is being dissolved in a powder, the solution is termed a volume/volume solution. ______ 5. When calculating drug dosages based on a patient‟s weight in kilograms, a respiratory therapist can use the BSA nomogram to convert from pounds to kilograms. ______ 6. The International System is the system of measure used in health care.

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    Colbert_icp3_TestBank_questions.doc Page 11 of 150 ______ 7. Converting a measure from milliliters to liters is accomplished by moving the decimal point three places to the right. ______ 8. A solute can either be a liquid or a solid that is dissolved in a liquid. ______ 9. A weight/volume solution is representative of the amount of liquid solute in a volume of solution. ______10. The use of body surface area (BSA) is an appropriate method to determine a patient‟s overall size. FILL-IN-THE-BLANK Write the word or phrase that best completes each statement. 1. The metric unit of measurement for length is ________________, and the metric measurement for volume is ________________. 2. One kilogram equals ________________ pounds. 3. A liquid or solid that is dissolved in a solution is known as a ________________. 4. A 1:200 solution of a drug would contain ________________ ml of the solute dissolved in ________________ ml of solution. 5. The strength of a 5-g/100-ml solution expressed as a ratio is 1:________________. 6. The metric system of measurement is based on the __________________. 7. The United States Customary System of Measurement is based on the _______________. 8. Weight is measured as ____________ or ________________ in the metric system. 9. To convert from liters to milliliters the decimal point is moved ___________ places to the ___________. 10. The Joint Commission standards recommend the use of ________________ rather than centimeters (cc) to avoid misinterpretation of the ordered amount. SHORT ANSWER Answer the following questions or statements. 1. What do Joint Commission standards recommend for abbreviating cubic centimeter volume? 2. Give an example of converting between the English and metric systems using the factor- label method. 3. Explain the difference between a weight/volume solution and a volume/volume solution. 4. How can you express the strength of a drug in solution? 5. How can you determine how much drug to administer if the drug available is not supplied in the prescribed amount?

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    Colbert_icp3_TestBank_questions.doc Page 12 of 150 Chapter 3 MULTIPLE CHOICE Choose the one alternative that best completes the statement or answers the question. 1. All of the following explain the function of the somatic nervous system except: a. Skeletal muscle movement. b. Conduction of sensory information. c. Involuntary control. d. Voluntary movement. 2. The sympathetic system causes which of the following effects? a. Bronchoconstriction b. Increased digestion c. Decreased heart rate d. Bladder relaxation 3. The ANS regulates all the following body functions except: a. Digestion. b. Skeletal muscle movement. c. Cardiac muscle control. d. Blood vessel constriction. 4. Bronchodilation is achieved by using which of the following classifications of drugs? I. Parasympatholytic II. Sympatholytics III. Adrenergic agonists a. I and II b. II and III c. I and III d. I, II, and III 5. The peripheral nervous system is composed of all the following except: a. Afferent and efferent nerves. b. Brain and spinal nerves. c. Sympathetic and parasympathetic branches. d. The somatic and autonomic nervous systems. 6. The somatic nervous system is responsible for: a. Skeletal muscle movement. b. Cardiac muscle control. c. The digestive process. d. Involuntary muscle control. 7. Which statement best explains the control of the parasympathetic and sympathetic systems? a. The parasympathetic and sympathetic systems work independently of each other to regulate autonomic control.

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    Colbert_icp3_TestBank_questions.doc Page 13 of 150 b. The sympathetic system is in primary autonomic control. c. The parasympathetic and sympathetic systems work in a coordinated, opposite fashion to maintain balance. d. The parasympathetic system is the dominant controller. 8. The system responsible for a rise in heart rate and blood pressure when your instructor announces a surprise quiz is the: a. Central. b. Parasympathetic. c. Somatic. d. Sympathetic. 9. The systems responsible for maintaining coordination between bronchodilation and bronchoconstriction are the: a. Parasympathetic and sympathetic. b. Somatic and autonomic. c. Peripheral and autonomic. d. Autonomic and sympathetic. 10. Which of the following cannot be considered part of a two-junction system? a. The somatic nervous system b. The norepinephrine neurotransmitter c. Postganglia d. The autonomic nervous system 11. Norepinephrine is found at the terminal end of which of the following nerve fibers? a. Preganglionic junction of the sympathetic system b. Postganglionic junction of the sympathetic system c. Preganglionic junction of the parasympathetic system d. Postganglionic junction of the parasympathetic system 12. The primary action of neurotransmitters takes place at the: a. Neuroeffector site. b. Presynaptic neuron. c. Postsynaptic neuron. d. Nerve axon. 13. In a situation of stress, any of the following receptors may be stimulated except: a. Adrenergic . b. Muscarinic . c. Nicotinic . d. Beta . 14 . If you apply the alpha - adrenergic agent phenylephrine topically, which of the following occurs? a. Swollen vessels constrict. b. Blood pressure decreases. c. Heart rate decreases. d. Respiratory rate increases.

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    Colbert_icp3_TestBank_questions.doc Page 14 of 150 15. A physician has just written an order for atropine to be administered to a patient for which you are caring. This parasympatholytic drug would cause all the following except: a. Bronchodilation. b. Dry secretions. c. Bradycardia. d. Vasoconstriction. 16. Receptors that bind with acetylcholine can be referred to as: I. Cholinergic. II. Adrenergic. III. Muscarinic. IV. Nicotinic. a. I and II b. I and III c. I, II, and III d. I, III, and IV 17. Receptors that bind with norepinephrine are referred to as: I. Adrenergic . II. Alpha . III. Beta . IV. Muscarinic . a. I and II b. I, II, and III c. I and IV d. II, III, and IV 18 . Stimulation of dopamine receptors causes which of the followi ng? a. Increased heart rate b. Relaxation of renal arteries c. Constriction of peripheral blood vessel s d. Bronchodilation 19 . The primary action of sympathomimetics is to: a. Stimulate acetylcholine . b. Block acetylcholine . c. Stimulate norepinephr ine . d. Block norepinephrine . 20 . The name of the parasympathetic neurotransmitter is: a. Acetylcholine . b. Cholinesterase . c. Norepinephrine . d. Adrenalin . 21 . Drugs that antagonize the sympathetic response would be classified as all of the following except:

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    Colbert_icp3_TestBank_questions.doc Page 15 of 150 a. Antiadrenergics. b. Sympatholytics. c. Beta blockers. d. Muscarinics. 22. Beta 1 stimulation mainly affects the: a. Heart. b. Blood vessels. c. Airways. d. Skeleton and muscles. 23. Beta 2 stimulation results in: a. Bronchospasm. b. Bronchodilation. c. Vasoconstriction. d. Vasodilation. 24. A drug that is classified as a beta blocker would cause which of the following effects? a. Vasodilation b. Increased heart rate c. Increased respirations d. Bronchoconstriction 25. Drugs that antagonize or block the parasympathetic response are referred to as: a. Antiadrenergics. b. Cholinergics. c. Parasympathomimetics. d. Parasympatholytics. 26. When a drug stimulates a receptor, it can be classified as all the following except: a. Direct acting. b. An agonist. c. Sympathomimetic. d. Parasympatholytic. 27. Agents that inhibit the enzyme acetylcholinesterase cause which of the following effects on the PNS? a. Bradycardia and hypotension b. Overstimulation of the sympathetic branch of the PNS c. None d. Bronchodilation 28. Elimination of norepinephrine at the synaptic cleft is accomplished by which of the following mechanisms? I. Reuptake II. Metabolization by AChE III. Metabolization by MAO

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