TEST BANK for Focus on Pharmacology: Essentials for Health Professionals 3rd Edition by Jahangir Moi

(Focus on Pharmacology, Essentials for Health Professionals 3e Jahangir Moini) (Test Bank all Chapters)

Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 1 Introduction to Pharmacology 1) The study of drugs derived from herbal sources is known as: A) pharmacotherapeutics B) pharmacognosy C) pharmacokinetics D) pharmacodynamics Answer: B Explanation: B) Pharmacognosy is the study of drugs derived from herbal sources, and other natural sources. By studying the compositions of natural substances and how the body reacts to them, one gains better knowledge for developing purified versions.

2) Which of the following organizations is a part of the United States Department of Health and Human Services?

A) DEA B) CDC C) FDA D) TJC Answer: C Explanation: C) The Food and Drug Administration (FDA) is part of the United States Department of Health and Human Services. The determination of the correct use of prescription and OTC agents is controlled by the branch of the FDA known as the Center for Drug Evaluation and Research (CDER).

3) Animal pharmacology and toxicology data are obtained during which of the following phases of drug approval?

A) Phase I B) Phase II C) Phase III D) Phase IV Answer: A Explanation: A) Phase I of drug approval is when animal pharmacology and toxicology data are obtained. This phase is known as Preclinical Investigation. It involves extensive research on human and microbial cells in a laboratory. Cultured cells and animal studies are used to determine dosages, effectiveness, and adverse effects.

4) Which of the following drug approval phases consists of three trials?

A) Phase I B) Phase II C) Phase III D) Phase IV Answer: B Explanation: B) Phase II of drug approval consists of three trials. It is also known as Clinical Investigation, and is the longest, occurring over 2 to 10 years, 5 years being the average. Clinical Phase 1 trials occur over several months. Clinical Phase 2 trials occur over several months to 2 years. Clinical Phase 3 trials occur over 1 to 4 years.

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5) Which of the following is NOT an example of a drug withdrawn from the U.S. market as a result of postmarketing surveillance?

A) aprotinin B) morphine sulfate C) gatifloxacin D) lumiracoxib Answer: B Explanation: B) Morphine sulfate is not an example of a drug withdrawn from the U.S. market as a result of postmarketing surveillance. Examples of drugs withdrawn from the U.S. market since 2005, as a result of postmarketing surveillance, include aprotinin, propoxyphene, gatifloxacin, lumiracoxib, ozogamicin, pergolide, and sibutramine.

6) Which of the following is the most famous examples of a drug that was withdrawn after postmarketing surveillance?

A) celecoxib B) furosemide C) atenolol D) penbutolol Answer: A Explanation: A) Celecoxib is the most famous example of a drug that was withdrawn after postmarketing surveillance. It was withdrawn along with valdecoxib and rofecoxib. All three were linked to safety concerns of stroke and heart attack. Celecoxib remains on the market, but carries a black box warning.

7) Which of the following is NOT an example of a biologic drug?

A) vaccine B) interferon C) antibody D) toothpaste Answer: D Explanation: D) Toothpaste is not an example of a biologic drug. A drug is any agent that produces biologic responses within the body. Drugs differ from other products such as cosmetics, foods, and household chemicals, such as toothpaste, shampoo, and others.

8) How many people are injured annually by medication errors in the United States?

A) 99,000 B) 450,000 C) 840,000 D) 1,300,000 Answer: D Explanation: D) 1,300,000 people are injured annually by medication errors in the United States, according to the Centers for Disease Control and Prevention. Medication errors cause at least one death every day.

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9) Which of the following four phases of drug approval includes review of the New Drug Application (NDA)?

A) Phase I B) Phase II C) Phase III D) Phase IV Answer: C Explanation: C) Phase III of drug approval involves review of the New Drug Application (NDA). During this phase, the trade name is finalized. Based on the preclinical testing, clinical trials and further animal testing may continue. For a new drug, it usually takes about 24 months for the full NDA review.

10) Manufacturers start developing their trade names for a new drug during which of the following drug approval phases?

A) Clinical phase 1 trials B) Clinical phase 2 trials C) Clinical phase 3 trials D) Phase IV Answer: A Explanation: A) In Clinical Phase 1 trials, manufacturers start developing their trade name for a new drug. Dosages and adverse effects are assessed on approximately 20-100 human volunteers initially, who have the disease or condition that the drug is being tested to treat. Doses are often subtherapeutic, but ascending (increasing) doses are used.

11) Complementary and alternative medicine (CAM) therapies are controlled by which of the following organizations?

A) CDC B) EPA C) NCCAM D) CFSAN Answer: C Explanation: C) The National Center for Complementary and Alternative Medicine (NCCAM) is the organization that controls complementary and alternative medicine (CAM) therapies. This agency studies the usefulness and safety of these therapies in improving health care.

12) How long does preclinical investigation usually take?

A) Between one and six months B) Between three and nine months C) Between one and three years D) Between three and nine years Answer: C Explanation: C) Preclinical investigation usually takes between one and three years. It is the first stage of new drug testing, and involves extensive research on human and microbial cells in a laboratory. The average time for preclinical investigation is 18 months. This phase is always inconclusive since results may be insufficient or excessive in comparison to how human subjects will actually react to a new product.

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13) The percentage of drugs in clinical phase 2 trials that move on to the next phase of clinical testing is: A) 25% B) 33% C) 46% D) 78% Answer: B Explanation: B) About 33% of drugs in clinical phase 2 trials move on to the next phase of clinical testing. These trials use between several dozen and 300 volunteers that have the disease or condition that the drug is being tested to treat. The drug is assumed not to have a therapeutic effect until further testing occurs.

14) Which of the following drugs carries a black box warning?

A) celecoxib B) valdecoxib C) rofecoxib D) rifampin Answer: A Explanation: A) Celecoxib carries a black box warning, but remains on the market. Its warning is about potentially fatal cardiovascular disease, serious gastrointestinal problems, and bleeding ulcerations.

15) Pharmacology deals with all the drugs used in society today, including prescription, legal, OTC, and ________ drugs.

A) generic B) legend C) illegal D) experimental Answer: C Explanation: C) Illegal drugs, as well as prescription, legal, and OTC drugs, are dealt with by today's pharmacology. To administer a drug safely, one must know its usual dose, frequency, route of administration, indications, contraindications, significant adverse reactions, and major drug interactions.

16) Any substance intended to be used to improve a physiologic or pathologic condition is known as a: A) drug B) dose C) solution D) compound Answer: A Explanation: A) A drug is any substance intended to be used to improve a physiologic or pathologic condition. It produces biologic responses within the body. When a drug response is desired, it is referred to as therapeutic. When the response is undesired, it is referred to as adverse.

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17) A "medicine" refers to a drug mixed with other ingredients that may improve its taste, physical form, or: A) effectiveness B) stability C) odor D) color Answer: B Explanation: B) A "medicine" is a drug mixed with other ingredients that may improve its stability, taste, or physical form. A medicine is also known as a "medication".

18) A sugar pill (which may be thought to be a drug by the patient) is also known as a(n): A) diet pill B) energy pill C) placebo D) antihyperglycemic agent Answer: C Explanation: C) A placebo is a sugar pill, which may be thought to be a drug by the patient.

19) Once a drug has been administered to a patient, it is called: A) biological B) therapeutic C) an alternative drug D) a medication Answer: D Explanation: D) A medication is a drug that has been administered to a patient. Both drugs and medications are thought of as components of normal physiological activities.

20) Herbal products and dietary supplements are controlled by: A) The Center for Biologics Evaluation and Research B) The Center for Food Safety and Applied Nutrition C) The Center for Drug Evaluation and Research D) The Center for Disease Control and Prevention Answer: B Explanation: B) The Center for Food Safety and Applied Nutrition (CFSAN) controls herbal products and dietary supplements. It is a branch of the FDA. Herbal products and dietary supplements are also regulated by the Dietary Supplement Health and Education Act of 1994.

Herbal and dietary supplements can still be marketed without FDA approval.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 2 Pharmacodynamics 1) The pharmacologic actions of a drug that determine its therapeutic effects are called: A) pharmacology B) pharmacokinetics C) pharmacognosy D) pharmacodynamics Answer: D Explanation: D) The pharmacologic actions of a drug that determine its therapeutic effects are called pharmacodynamics, which can also determine the drug's adverse effects. The term pharmacodynamics describes how a medication causes changes in the body. It studies the biochemical as well as the physiologic effects of drugs, along with the molecular mechanisms used to produce these effects.

2) Which of the following body fluids is the most commonly used to characterize pharmacologic drug actions?

A) Urine B) Cerebrospinal fluid C) Blood D) Sputum Answer: C Explanation: C) Blood is the body fluid most commonly used to characterize pharmacologic drug actions. Usually, there are correlations between pharmacokinetics and pharmacodynamics that demonstrate the relationship between drug dose and blood or other biological fluid concentrations.

3) Which of the following can determine the dose-effect relationship?

A) Pharmacokinetics B) Pharmacodynamics C) Both D) Neither Answer: C Explanation: C) Both pharmacokinetics and pharmacodynamics can determine the dose-effect relationship, which is also called the dose-response relationship. It is the relationship between the dose of a drug (or other agent) that produces therapeutic effects and the potency of the effects on an individual person.

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4) Which of the following represents the number of patients that respond to the actions of a drug?

A) Frequency distribution curve B) Median effective dose C) Dose-effect relationship D) Median lethal dose Answer: A Explanation: A) The frequency distribution curve represents the number of patients that respond to the actions of a drug. It represents the number of patients that respond to the actions of a drug at different doses. A few patients are shown to have responded to a medication at very low doses, whereas increasing numbers of patients responded as the dosage was increased.

5) Where are intracellular receptors located?

A) in the mitochondrion B) in the cytoplasm C) in the nucleus D) in the ribosomes Answer: B Explanation: B) The intracellular receptors are located in the cytoplasm. Some drugs act on these receptors, including corticosteroids and thyroid hormone.

6) Drugs must ________ before being absorbed.

A) be diluted B) circulate C) be compounded D) dissolve Answer: D Explanation: D) Drugs must dissolve before being absorbed. Then, they are able to pass through the small intestine and enter the blood circulation. Some of these drugs are absorbed and metabolized before reaching the site of action. The factors that may influence the onset, duration, and intensity of drug effects include absorption, metabolism, reabsorption, excretion, site of action, and observed response.

7) A drug's potency does NOT indicate anything about which of the following?

A) tolerance B) target molecules C) affinity D) maximal efficacy Answer: D Explanation: D) A drug's potency does not indicate anything about its maximal efficacy. This term describes the largest effect that a drug can produce.

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8) An example of a toxic agent in which a small dose causes drowsiness, but a large dose can be fatal is: A) carbon monoxide B) sulfuric acid C) hydrochloric acid D) carbon dioxide Answer: A Explanation: A) Carbon monoxide is a toxic agent in which a small dose causes drowsiness, but a large dose can be fatal. None of the answer choices have these effects.

9) A drug that blocks the effects of another substance is called which of the following?

A) stimulant B) depressant C) antagonist D) potentiator Answer: C Explanation: C) An antagonism is a drug that blocks the effects of another substance. It can also be another agent, and can also block functions. Antagonists are often used when treating overdoses.

10) The amount of medication needed to produce a specific response in 50% of patients is called the: A) frequency distribution curve B) median effective dose C) maximal efficacy drug D) dose-effect relationship Answer: B Explanation: B) The amount of medication needed to produce a specific response in 50% of patients is called the median effective dose. It appears at the top of the frequency distribution curve of a drug, which indicates if a measurable response occurred in the test group of patients.

The median effective dose is abbreviated as "ED50".

11) The therapeutic index of a drug is used to predict whether a certain: A) drug has any side effects B) dosage is toxic for pregnant women C) dosage is safe for a specific patient D) dosage is lethal for a specific patient Answer: C Explanation: C) The therapeutic index of a drug is used to predict whether a certain dosage is safe for a specific patient. Like the median effective dose, frequency distribution curves are also used to determine the median lethal dose (LD50) of a drug during preclinical trials. The therapeutic index is calculated by dividing the LD50 by the median effective dose (ED50).

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12) The higher the value of the therapeutic index, A) the safer the medication is to use B) the cheaper the drug may be, and still be effective C) means that the safety of the medication is uncertain D) the less effective a generic drug will be compared to a trade name drug Answer: A Explanation: A) The higher the value of the therapeutic index, the safer the medication is to use.

A larger therapeutic index means that the difference between the median lethal dose and median effective dose is larger.

13) The affinity for a target receptor is its: A) transcription factor B) enzyme activation C) target molecule D) attractive force Answer: D Explanation: D) The affinity for a target receptor is its attractive force. The cell recipient is known as a receptor — usually a specific protein — situated in cell membranes on cell surfaces.

Intracellular receptors are located within the cellular cytoplasm.

14) Which of the following are NOT triggers of second-messenger events?

A) B-complex vitamins B) Retinoids C) Steroid agents D) Hormones Answer: A Explanation: A) B-complex vitamins are not triggers of second-messenger events. Once bound to a receptor, a drug may trigger these events inside cells. Examples include release of intracellular calcium, activation of enzymes and specific G proteins, and conversion of adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cyclic AMP). The agents that bind intracellular components include hormones, steroid medications, retinoids, and vitamin D. 15) Which of the following are NOT included in the four primary drug-receptor families?

A) Ligand-gated ion channels B) G protein-coupled receptor systems C) Antagonists D) Transcription factors Answer: C Explanation: C) Antagonists are NOT included in the four primary drug-receptor families. They are drugs or other agents that block or antagonize the effects of other substances or functions.

The four primary drug-receptor families include: enzymes embedded in cell membranes, ligandgated ion channels, G protein-coupled receptor systems, and transcription factors.

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16) Which of the following are examples of agonist-antagonists?

A) dobutamine and insulin B) pentazocine and meperidine C) norethindrone and dobutamine D) antihistamine and naloxone Answer: B Explanation: B) Pentazocine and meperidine are examples of agonist-antagonists, which are agonists that produce weaker or less effective responses than endogenous chemicals. They are also known as partial agonists, and have only slight intrinsic activity. Pentazocine has much lower pain-relieving actions than a full agonist such as meperidine.

17) Transcription factors are located in the: A) cell nucleus B) cell membrane C) mitochondria D) cytoplasm Answer: A Explanation: A) Transcription factors are located in the cell nucleus, on deoxyribonucleic acid (DNA). They regulate protein synthesis with delayed responses. Activation required highly lipidsoluble cell membrane ligands. Examples include thyroid hormone and all steroid hormones.

18) Which of the following is NOT a substance that utilizes a G protein-coupled receptor system?

A) serotonin B) histamine C) testosterone D) norepinephrine Answer: C Explanation: C) Testosterone is NOT a substance that utilizes a G protein-coupled receptor system. Instead, it utilizes transcription factors for its actions. Examples of substances that do use G protein-coupled receptor systems include norepinephrine, histamine, serotonin, and many peptide hormones.

19) Which of the following in an enzyme embedded in cell membranes?

A) insulin B) acetylcholine C) gamma-aminobutyric acid D) serotonin Answer: A Explanation: A) Insulin is an enzyme embedded in cell membranes. The ligand-binding domain is where drug and endogenous regulatory molecule binding occurs. It is on the cell surface, and catalytic sites of the enzymes are inside.

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20) Which of the following is NOT true regarding a median toxicity dose?

A) It produces a given toxicity in 50% of patients.

B) It is determined from animal testing data.

C) It cannot be tested in humans.

D) It determines adverse effects occurring during patient clinical trials.

Answer: C Explanation: C) A median toxicity dose can be tested in humans, so answer choice "C" is NOT true. The median toxicity dose is the dose that produces a given toxicity in 50% of patients, and can be determined from animal testing data or because of adverse effects occurring during patient clinical trials.

21) Which of the following is a component of nonspecific cellular responses?

A) osmotic diuretic B) insulin C) acetylcholine D) progesterone Answer: A Explanation: A) An osmotic diuretic is a component of nonspecific cellular responses. Other agents that work via these responses include general anesthetics and ethyl alcohol. All of these agents act independently of cellular receptors by either changing cellular membrane permeability, by changing how cellular pumps work, or by depressing membrane excitability.

22) A drug that binds to a receptor, and produces a stimulatory response that is similar to what an endogenous substance would have done if it were bound to the receptor is known as a(n): A) receptor B) agonist C) antagonist D) agonist-antagonist Answer: B Explanation: B) An agonist is a drug that binds to a receptor, and produces a stimulatory response that is similar to what an endogenous substance would have done if it were bound to the receptor. For example, adrenaline is an agonist at beta-adrenoceptors. When adrenaline binds to beta-adrenoceptors in the heart, the heart rate increases. Agonists drugs have affinity, which allows them to bind to receptors, as well as high intrinsic activity, which allows them to activate the functions of receptors.

23) Which of the following is a true statement regarding antagonists?

A) Combining two antibiotics may increase each drug's effects.

B) All antagonists produce a stimulatory response that is similar to what an endogenous substances produces.

C) They have affinity and high intrinsic activity.

D) All antagonists are associated with receptors.

Answer: D Explanation: D) It is true that all antagonists are associated with receptors. They often compete with agonists for their receptor binding sites. However, they have almost no effects upon receptor function on their own. If no agonist is present, an administered antagonist will have no observable effect.

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24) Competitive antagonists are also referred to as: A) surmountable antagonists B) insurmountable antagonists C) agonist-antagonists D) partial agonists Answer: A Explanation: A) Competitive antagonists are also referred to as surmountable antagonists. The majority of antagonists are classified as competitive antagonists. They bind reversible to receptors, producing receptor blockade because they compete with agonists for receptor binding.

25) The amount of drug required to cause an effect is referred to as: A) maximal efficacy B) dose-effect relationship C) relative potency D) adverse effect Answer: C Explanation: C) The amount of drug required to cause an effect is referred to as relative potency.

Note that potency is rarely important overall. A drug with a higher potency requires smaller doses to produce the same effect as a drug with lower potency. The largest effect that a drug can produce is also known as its maximal efficacy, but its potency does not indicate anything about its maximal efficacy.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 3 Pharmacokinetics 1) Simple diffusion involves: A) drugs crossing membranes against their gradient from areas of low concentration to high concentration B) movement of molecules from areas of higher concentration to areas of lower concentration C) a certain carrier protein D) unevenly distributed electrical charges Answer: B Explanation: B) Simple diffusion involves movement of molecules from areas of higher concentration to areas of lower concentration. Over time, drug molecules are inactivated (metabolized) by tissues, and additional doses may be administered to create a continual concentration gradient, from blood to tissue.

2) Which of the following is false regarding plasma membranes?

A) They contain two layers of phospholipids.

B) They contain cholesterol, carbohydrates, and proteins.

C) Their phospholipids have a round head and one tail.

D) Cholesterol and phospholipids are essential.

Answer: C Explanation: C) Regarding plasma membranes, their phospholipids do NOT have a round head and one tail. While their heads are round and contain the phosphate, they have two tails, which are long-chain hydrocarbons. Other substances embedded in the membrane include cholesterol, carbohydrates, and proteins.

3) An example of a polar molecule is the: A) water molecule B) hydrogen molecule C) sugar molecule D) alcohol molecule Answer: A Explanation: A) A water molecule is an example of a polar molecule, which has unevenly distributed electrical charges. In the water molecule, the negative electrons remain closer, most of the time, near the oxygen atom in comparison to the two hydrogen atoms. Therefore, the area near the oxygen atom is usually negatively charged, whereas the area near the hydrogen atoms is usually positively charged.

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4) The primary site of gastrointestinal (GI) absorption of a drug is the: A) esophagus B) stomach C) small intestine D) large intestine Answer: C Explanation: C) The small intestine is the primary site of GI absorption of a drug, because of its very large surface area, across which drugs may diffuse. Acids are normally absorbed more extensively in the intestines that in the stomach even though the intestines have a higher pH. The higher the pH, the more alkaline; the lower the pH, the more acidic.

5) The speed of systemic availability depends on pharmaceutical factors and: A) bloodstream absorption B) gastrointestinal absorption C) rate of excretion D) cellular absorption Answer: B Explanation: B) The speed of systemic availability (or bioavailability) depends on pharmaceutical factors and gastrointestinal absorption. Pharmaceutical factors include the rate at which a tablet or capsule dissolves, or the use of binding products in formulating the medication.

Factors that affect drug absorption include food in the stomach, other drugs taken concurrently, intestinal motility, or certain disease states.

6) Which of the following is false regarding the GI tract and drug absorption?

A) pH partitioning influences absorption.

B) The presence of food in the stomach or intestine influences absorption.

C) Protein solubility influences absorption.

D) Blood flow influences absorption.

Answer: C Explanation: C) Regarding the GI tract and drug absorption, protein solubility does NOT influence absorption. However, absorption is influenced by pH partitioning, the presence of food in the stomach or intestine, and blood flow. The term pH partitioning refers to a drug's molecules being more likely to be ionized in the plasma, because of differences between plasma pH and the pH at the site of administration.

7) Many drugs are bound to circulating proteins; the most common of which is usually: A) interferon B) enzymes C) glycoproteins D) albumin Answer: D Explanation: D) The most common circulating protein to which drugs are bound is usually albumin. Many drugs are also bound to lipoproteins or glycoproteins. Only the fraction of drugs not bound to protein can bind to cellular receptors, pass across tissue membranes, and gain access to cellular enzymes, thus being distributed to body tissue.

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8) During pregnancy, the placenta may transfer drugs that are: A) ionized B) lipid-soluble C) water-soluble D) metabolized Answer: B Explanation: B) During pregnancy, the placenta may transfer drugs that are lipid-soluble from the mother to the fetus. The substances most likely to pass through the placenta are those that are lipid-soluble and nonionized. These agents are linked to birth defects, drug dependency, and respiratory depression.

9) Most drug metabolism occurs in the: A) liver B) kidneys C) bloodstream D) lungs Answer: A Explanation: A) Most drug metabolism (or biotransformation) occurs in the liver, through the same biochemical pathways and reactions that affect nutrients, vitamins, and minerals. The majority of metabolism in the liver occurs through the hepatic microsomal enzyme system (P450 system). Its key component is cytochrome P450, which is actually a group of 12 enzyme families.

10) An important mechanism that affects varying drug action and metabolism is the: A) GI tract effect B) intestinal effect C) first-pass effect D) toxic drug action Answer: C Explanation: C) An important mechanism that affects varying drug action and metabolism is the first-pass effect. When oral drugs are absorbed from the GI tract, they move to the liver through the hepatic portal vein. Metabolism accomplishes the conversion of molecules as well as biodegradation of foreign substances.

11) The initial rate of distribution of a drug is heavily dependent on the ________ to various organs.

A) blood flow B) hepatic portal circulation C) oxygen distribution D) reactions Answer: A Explanation: A) The initial rate of distribution of a drug is heavily dependent on the blood flow to various organs. Lipid-soluble drugs enter the CNS rapidly. Because of the blood-brain barrier, certain drugs are poorly distributed to the CNS because they pass through the barrier. The three major influencing factors related to drug distribution are: blood flow to the body tissues, how drugs are able to exit the vascular system, and how drugs are able to enter body cells.

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12) Which of the following carries blood directly to the liver?

A) A biochemical pathway B) Renal portal circulation C) Hepatic portal circulation D) Lymphatic portal circulation Answer: C Explanation: C) The hepatic portal circulation carries blood directly to the liver. If the liver has a high metabolic capacity, the drug is totally inactivated on its first pass, and no therapeutic effects occur. A drug may be given parenterally in order to avoid the first-pass effect. The liver is temporarily bypassed, and the drug reaches therapeutic levels in the systemic blood.

13) Orally administered drugs are usually absorbed in the: A) lower GI tract B) esophagus C) pharynx D) upper GI tract Answer: D Explanation: D) Orally administered drugs are usually absorbed in the upper GI tract (the stomach and the small intestine). From the small intestine, drugs are absorbed and immediately move to the liver for metabolism, involving various enzymes, to reach the systemic circulation.

This process is called the first-pass effect.

14) The stomach has a(n) ________ environment.

A) basic B) acidic C) alkaline D) physiochemical Answer: B Explanation: B) The stomach has an acidic environment. Lipid-soluble drugs and weak acids may be absorbed directly from the stomach. Weak bases are not normally absorbed from the site.

Aspirin and other drugs that have an acidic pH are easily absorbed in the stomach's acidic environment.

15) Most drug metabolism is also referred to as: A) glucuronidation B) oxidation C) biotransformation D) conjugation Answer: C Explanation: C) Most drug metabolism is also referred to as biotransformation. It is the process of conversion of drugs via enzymatic actions, and may be divided into four main stages: oxidation, reduction, hydrolysis, and conjugation. Oxidation is combination with oxygen.

Reduction involves the gaining of electrons. Hydrolysis is the cleaving of a compound into simpler compounds, with uptake of hydrogen and hydroxide from water molecules. Conjugation is the combination of substances with glucuronic or sulfuric acid.

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16) Which of the following medications temporarily bypasses the liver?

A) Vitamin D B) Penicillin C) Vitamin A D) Nitroglycerin Answer: D Explanation: D) Nitroglycerin temporarily bypasses the liver. It may avoid the first-pass effect via sublingual administration, since this method allows it to be absorbed directly into the systemic circulation. The drug moves to its sites of action prior to being exposed to liver enzymes.

17) For which of the following drugs may toxicity occur when blood levels of potassium are lower than normal?

A) digoxin B) cortisol C) tetracycline D) morphine Answer: A Explanation: A) For digoxin, toxicity may occur when blood levels of potassium are lower than normal. This is a highly significant example of altered drug response due to electrolyte imbalance. Lower than normal levels of potassium may result in digoxin toxicity, and potentially fatal dysrhythmias.

18) Which of the following is NOT one of the three categories of tolerance?

A) pharmacodynamic B) hydrophilic C) metabolic D) tachyphylaxis Answer: B Explanation: B) The term "hydrophilic" is NOT one of the three categories of tolerance. It refers to a substance that is water-soluble. The three categories of tolerance include: pharmacodynamic tolerance, metabolic tolerance, and tachyphylaxis.

19) Which of the following chemical substances in the blood normally cannot pass during glomerular filtration?

A) simple sugars B) electrolytes C) proteins D) uric acids Answer: C Explanation: C) Proteins in the blood normally cannot pass during glomerular filtration. This process occurs at the glomerulus of the kidney tubule. Drugs are forced through pores of capillary walls, then into the tubular urine. However, blood cells and large molecules such as proteins cannot undergo this process due to their size. Therefore, drugs bound to albumin remain in the blood.

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20) Manipulation of urinary pH results in decreased passive reabsorption and increased: A) excretion B) glomerular filtration C) recirculation of urea D) elimination of iron Answer: A Explanation: A) Manipulation of urinary pH results in decreased passive reabsorption and increased excretion. Regarding competition for active tubular transport, if two drugs are administered concurrently that both use the same transport system, excretion of each drug is delayed by the other's presence.

21) Certain drugs are poorly distributed to the CNS because they: A) must be approved by the FDA B) are fat soluble C) pass through the blood-brain barrier D) are hepatotoxic Answer: C Explanation: C) Certain drugs are poorly distributed to the CNS because they pass through the blood-brain barrier. This is the highly-selective permeable barrier separating the blood from the brain extracellular fluid in the CNS. It prevents entry of many undesirable chemicals.

22) The lowest amount of blood flow in solid tumors occurs because: A) they are infected B) they have metastasized to other organs C) they are benign D) there is a limitation of blood supply Answer: D Explanation: D) The lowest amount of blood flow in solid tumors occurs because there is a limitation of blood supply. Low regional blood flow affects drug therapy in tumors and abscesses. When a tumor is sold, the lowest amount of blood flow is in the tumor's core. High drug levels, therefore, cannot reach the deeper parts of a tumor, making solid tumors highly resistance to drug therapy.

23) Faster drug excretion via the kidneys occurs by converting: A) lipid-soluble drugs into more water-soluble forms B) water-soluble drugs into more lipid-soluble forms C) the color of urine D) urea to amino acids Answer: A Explanation: A) Faster drug excretion via the kidneys occurs by converting lipid-soluble drugs into more water-soluble forms. This speeds up excretion of many drugs. Methods of conversion include the structural addition of a hydroxyl group, or by glucuronidation, which is the addition of glucuronic acid to a substrate. This process is often involved in metabolism of drugs and other substances. It is also called glucuronosylation.

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24) Which of the following is NOT a stage of biotransformation?

A) hydrolysis B) fluoridation C) oxidation D) conjugation Answer: B Explanation: B) Fluoridation is NOT a stage of biotransformation. The stages of biotransformation include oxidation, reduction, hydrolysis, and conjugation. Fluoridation is defined as the addition of fluorides to the public water supply, to reduce the incidence of tooth decay.

25) End-products of a drug occur in the: A) small intestine B) pancreas C) kidneys D) liver Answer: D Explanation: D) End-products of a drug occur in the liver, after the drug was previously moved from the liver, through the bile duct, to the duodenum, and then moved back to the liver via the portal blood. Since the liver is the major site of drug metabolism, liver disease may result in drugs accumulating in the body.

26) Total clearance of a drug is directly affected by the: A) dosage of the drug B) amount of blood flow to the organs of elimination C) age, sex, and race of the patient D) drug plasma concentration Answer: B Explanation: B) Total clearance of a drug is directly affected by the amount of blood flow to the organs of elimination. The rate of drug clearance can also be significantly affected by cardiac disease, as well as drugs that alter blood flow. Also, for some drugs, clearance is not constant.

27) Peak concentration of a drug is the: A) plasma level at which toxic effects begin to occur B) plasma drug levels below which therapeutic effects do not occur C) highest level at which a drug is present in the body D) minimum effective concentration and the toxic concentration Answer: C Explanation: C) Peak concentration of a drug is the highest level at which it is present in the body, whereas the trough concentration is the lowest level at which a drug is present in the body.

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28) A comparatively large dose given at the beginning of treatment to quickly obtain therapeutic effects is called a: A) loading dose B) maintenance dose C) plateau D) half-life Answer: A Explanation: A) A loading dose is a comparatively large dose given at the beginning of treatment to quickly obtain therapeutic effects. A maintenance dose keeps the plasma concentration of the drug continuously in the therapeutic range. However, the more a drug is taken, the more chance that drug accumulation will occur.

29) When patients are taking monoamine oxidase inhibitors (MAOIs), they may eat: A) beef liver B) ripe cheese C) fish D) yeast products Answer: C Explanation: C) When patients are taking monoamine oxidase inhibitors (MAOIs) — used for depression - they may eat fish but not products such as beef liver, ripe cheese, or yeast products.

This is because these foods, as well as Chianti wine, may trigger serious malignant hypertension.

30) Which of the following defines the "half-life" of a drug?

A) the time taken for it to metabolize in the liver B) the time taken for its concentration to increase from one-half to full, after the last dose C) the time taken for it to be excreted by the kidneys D) the time taken for its concentration to decrease from full to one-half, after the last dose Answer: D Explanation: D) A drug's half-life is the time taken for its concentration to decrease from full to one-half, after the last dose. This is the major determinant of the duration of drug action. The half-life of each may be different.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 4 Drug Toxicity and Pharmacogenomics 1) Side effects are generally predictable, and their intensity is: A) dose dependent B) based on the patient's age C) based on preexisting conditions D) based on gender Answer: A Explanation: A) Side effects are generally predictable, and their intensity is dose dependent.

They are peripheral or secondary effects caused by drugs and other agents. Some side effects develop soon after drug use begins, whereas others may not appear until a drug has been taken for weeks or months.

2) Programmed cell death that allows cells to self-destruct is called: A) necrosis B) ascites C) toxicosis D) apoptosis Answer: D Explanation: D) Programmed cell death that allows cells to self-destruct is called apoptosis. This process involves the activation of specific proteins. It is helpful when the process kills damaged cells but does not harm surrounding tissue. In cancer cells, apoptosis is often inhibited.

3) Unknown mechanisms of action of an adverse effect of a drug are referred to as: A) overdose B) idiosyncratic C) prophylaxis D) polymorphism Answer: B Explanation: B) Unknown mechanisms of action of an adverse effect of a drug are referred to as idiosyncratic. These responses are unpredictable reactions to a drug, and occur rarely.

4) The FDA requires serious or unexpected events to be reported within how many days?

A) 3 B) 7 C) 15 D) 30 Answer: C Explanation: C) The FDA requires serious or unexpected events to be reported within 15 days of occurrence. During new drug application studies, all adverse events must be reported, regardless of their severity. Additionally, once the drug reaches the market, adverse events of all types must still be reported.

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5) Any components inside the body to which drugs bind are called: A) drug targets B) pathogens C) genomes D) autosomes Answer: A Explanation: A) Any components inside the body to which drugs bind are called drug targets.

They are also influenced by genetic variations. Also called biological targets, they are often proteins within the body that may be modified by drugs, altering their activities. In most cases, common drug targets are either proteins or nucleic acids. More than 50% of drug targets are G protein-coupled receptors.

6) The interferon lambda-3 enzyme is encoded by the IFNL3 gene, which is linked to which of the following infections?

A) meningitis B) hepatitis A C) hepatitis C D) pancreatitis Answer: C Explanation: C) The interferon lambda-3 enzyme is encoded by the INFL3 gene, which is linked to hepatitis C infection. In patients with the favorable genotype, these enzymes have resulted in about double the success rate in curing the condition with proper treatment. This involves pegylated interferon with ribavirin, with our without a protease inhibitor.

7) Which of the following is NOT a sign or symptom of anaphylactic shock?

A) paralysis of the diaphragm B) hypertension C) urticaria D) swelling of the oropharynx Answer: B Explanation: B) Hypertension is not a sign or symptom of anaphylactic shock, but hypotension is, along with urticaria, paralysis of the diaphragm, and swelling of the oropharynx. The end result may be cardiac collapse. Anaphylactic shock is a true medical emergency, occurring so swiftly and severely that controlled clinical studies of treatment have never been possible.

8) Which of the following drugs are most commonly linked to physical dependence?

A) immunosuppressants B) antibiotics C) antihistamines D) narcotics Answer: D Explanation: D) Narcotics are most commonly linked to physical dependence. Narcotics include prescribed opioids as well as illegal drugs such as heroin. Many other drugs produce physical dependence, including amphetamines, barbiturates, and ethanol. Some drugs cause specific type of physical dependence even though their effects are outside of the CNS.

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9) The generic name of "Lipitor" is: A) niacin B) atorvastatin C) valproic acid D) rifampin Answer: B Explanation: B) The generic name of Lipitor is atorvastatin. It is an example of a "statin", used to lower lipid levels. Other examples of statins and lipid-lowering drugs include fenofibrate, fluvastatin, gemfibrozil, lovastatin, niacin, pravastatin, and simvastatin.

10) Anaphylaxis is an example of type ________ allergic drug reactions.

A) I B) II C) III D) IV Answer: A Explanation: A) Anaphylaxis is an example of type I allergic drug reactions. It is also referred to as "immediate hypersensitivity". Examples of drugs or classes of drugs linked to anaphylaxis include penicillins, streptomycin, local anesthetics, neuromuscular-blocking drugs, and radiologic contrast media.

11) Type II allergic drug reactions are described as: A) immediate hypersensitivity B) immune complex-mediated hypersensitivity C) antibody-dependent cytotoxic hypersensitivity D) delayed-type hypersensitivity Answer: C Explanation: C) Type II allergic drug reactions are described as antibody-dependent, cytotoxic hypersensitivity. Examples of drugs or classes of drugs linked to these reactions include quinine, quinidine, rifampicin, and metronidazole. When such a reaction occurs, the drug binds to (usually) red blood cells, and is recognized by the antibody (primarily, IgG).

12) Epinephrine is frequently injected to combat anaphylactic shock, but must be administered: A) after 8 hours B) after 24 hours C) within the intensive care unit only D) soon after shock begins Answer: D Explanation: D) Epinephrine is frequently injected to combat anaphylactic shock, but must be administered soon after shock begins. Epinephrine is also known as adrenaline. Patients who are predisposed to allergic reactions should wear an alerting bracelet or necklace such as Medic Alert®.

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13) Before administering a drug, knowledge of a patient's ________ is essential.

A) allergies B) Rh factor C) blood type D) family history Answer: A Explanation: A) Before administering a drug, knowledge of a patient's allergies is essential. Ask all patients if they have a history of allergies, such as hay fever, rashes, or asthma; or have had unusual reactions to any drugs taken orally or by injection in the past.

14) When a drug to which a person has become physically dependent is discontinued, what will occur?

A) anaphylactic shock B) toxicity C) tolerance D) abstinence syndrome Answer: D Explanation: D) Abstinence syndrome will occur when a drug is discontinued to which the user has become physically dependent. Each drug's abstinence syndrome is unique.

15) How many adverse drug events occur annually in hospitals?

A) more than 770,000 B) more than 320,000 C) less than 120,000 D) less than 25,000 Answer: A Explanation: A) More than 770,000 adverse drug events occur annually in hospitals. This is often because of unclear or missing drug information.

16) An interaction between two drugs that causes an effect greater than that which would have been expected from the additive properties of the drugs involved is called: A) physical dependence B) polymorphism C) potentiation D) overdose Answer: C Explanation: C) Potentiation is the term that describes an interaction between two drugs causing an effect greater than that which would have been expected from the additive properties of the drugs involved. For example, alcohol potentiates the sedating effects of the tranquilizer diazepam (Valium®) when the two drugs are ingested at the same time.

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17) A drug reaction that is noxious, unintended, and occurs at doses normally used in humans for the prophylaxis, diagnosis, or treatment of disease is known as: A) an idiosyncratic drug reaction B) an adverse drug reaction C) a toxicity reaction D) a hepatotoxic effect Answer: B Explanation: B) An adverse drug reaction is one that is noxious, unintended, and occurs at doses normally used in humans for the prophylaxis, diagnosis, or treatment (therapy) of disease.

Examples include severe nausea, vomiting, and diarrhea. Adverse drug reactions may range in intensity from mildly annoying to life-threatening.

18) A drug's adverse effects are based on its: A) margin of safety B) manufacturing process C) date of expiration D) frequency of use Answer: A Explanation: A) A drug's adverse effects are based on its margin of safety, between the effective dose and the toxic dose. An overdose is usually linked to a drug with a large margin of safety, whereas adverse effects can occur from therapeutic doses when the margin of safety is small or nonexistent. Margin of safety applies to all drugs — prescription or nonprescription.

19) Pharmacogenomics is focused on genes encoding metabolic enzymes that alter ________.

A) drug distribution B) drug solubility C) drug activity D) adverse effects Answer: C Explanation: C) Pharmacogenomics is focused on genes encoding metabolic enzymes that alter drug activity. It was formerly known as pharmacogenetics. It is the study of genetic factors that influence variations in drug responses. More than one genetic variant may play a part in varied drug responses.

20) Which of the following is the fourth major drug-related cause of death, especially among elderly patients in the USA? A) polymorphism B) hypersensitivity C) autoimmunity D) adverse drug reaction Answer: D Explanation: D) Adverse drug reaction(s) are the fourth major drug-related cause of death, especially among elderly patients in the USA. They do occur in patients of all ages, however.

More than 770,000 adverse drug events occur annually in hospitals, often because of unclear or missing drug information.

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21) Stevens-Johnson syndrome may cause severe damage of which organ?

A) liver B) pancreas C) brain D) heart Answer: A Explanation: A) Stevens-Johnson syndrome may cause severe damage of the liver. It is a severe hypersensitivity reaction that can also cause toxic epidermal necrosis. This syndrome is a lifethreatening skin condition, in which cell death causes separation of the epidermis from the dermis.

22) Any drug that causes harm to an embryo is called a(n): A) carcinogen B) interferon C) teratogen D) allergen Answer: C Explanation: C) Any drug that causes harm to an embryo is called a teratogen. Teratogens can also be illnesses that harm embryos. Examples of teratogens include alcohol, cigarette smoke, medications, illegal drugs, some vaccines, certain viral infections, radiation, some occupational chemicals, and maternal autoimmune disorders.

23) Serum sickness is an example of which type of hypersensitivity?

A) I B) II C) III D) IV Answer: C Explanation: C) Serum sickness is an example of type III hypersensitivity. This type requires formation of antibodies, usually IgG or IgM, against soluble antigens. Complexes of antigens and antibodies are then deposited in tissues, primarily the joints, kidneys, and lung vascular endothelium. Serum sickness involves inflammation due to activation of complement and leukocytes inside the tissues.

24) Which of the following drugs may cause "Red man syndrome"?

A) penicillin B) vancomycin C) bupropion D) cefaclor Answer: B Explanation: B) Vancomycin may cause Red man syndrome, which is a rare condition involving degranulation of the mast cells that is independent of preformed complement or IgE. Other drugs that cause Red man syndrome include amphotericin B, ciprofloxacin, rifampicin, and teicoplanin. Usually, wheals and urticaria of the skin develop on the neck, arms, and upper trunk.

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25) Which of the following is most often linked to cumulative toxicity?

A) ethyl alcohol B) methyldopa C) aspirin D) caffeine Answer: A Explanation: A) Ethyl alcohol is most often linked to cumulative toxicity, out of the answer choices. This may occur rapidly. A cumulative effect occurs when the body is not able to metabolize and excrete one dose of a drug completely before the next dose is given. With repeated doses, the drug starts to collect in the blood and body tissues.

26) The combined action of two drugs that produce an effect greater than each of their unique effects is called: A) cumulative B) tolerance C) polypharmacy D) synergism Answer: D Explanation: D) The combined action of two drugs that produce an effect greater than each of their unique effects is called synergism. Some drug interactions exhibit synergism, which, depending on the circumstances, may be beneficial or harmful. An example of harmful synergism is the combination of aspirin with the anticoagulant warfarin (Coumadin®), which can reduce blood clotting to the extent of spontaneous hemorrhage if doses are not carefully monitored.

27) An example of an herbal supplement that interacts with NSAIDs is: A) cranberry B) ginkgo biloba C) chondroitin D) saw palmetto Answer: B Explanation: B) Ginkgo biloba is an example of an herbal supplement that interacts with NSAIDs. Since both agents inhibit platelet aggregation, concurrent use may increase risk of bleeding.

28) The bacterial peptidoglycan cell wall is a drug target for certain ________ drugs.

A) antifungal B) antiviral C) antibacterial D) antiprotozoal Answer: C Explanation: C) The bacterial peptidoglycan cell wall is a drug target for certain antibacterial drugs. These drugs interrupt peptidoglycan synthesis. Cell lysis results from abnormal cell wall synthesis. Penicillins can harm these drug targets while causing little toxicity to normal cells.

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29) A chemical inside an organism that is NOT normally produced or even expected to be present is called: A) xenobiotic B) a peptidoglycan C) aspartate aminotransferase D) alanine aminotransferase Answer: A Explanation: A) A chemical inside an organism that is not normally produced or even expected to be present is called xenobiotic. Many drug products are xenobiotics. Plasma membrane transporters mediate selective uptake as well as removal of endogenous compounds and xenobiotics. Transporters work with drug-metabolizing enzymes to a great degree.

30) Which of the following is NOT an example of an antifungal?

A) itraconazole B) ketoconazole C) terbinafine D) simvastatin Answer: D Explanation: D) Simvastatin is not an example of an antifungal. It is a statin, which helps to lower lipid levels in the body. Examples of antifungals include: itraconazole, ketoconazole, and terbinafine.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 5 Law and Ethics of Medications 1) Amphetamines are most commonly classified as which type of scheduled drug?

A) Schedule I B) Schedule II C) Schedule III D) Schedule IV Answer: B Explanation: B) Amphetamines and codeine are usually listed as Schedule II drugs, although specific products containing smaller quantities of Schedule II substances–usually combined with noncontrolled substances–are listed as Schedule III or IV. 2) Certificates of registration for pharmacist licensure are granted in most states for a period of: A) 1 to 2 years B) 2 to 3 years C) 3 to 4 years D) 4 to 5 years Answer: A Explanation: A) Most states guarantee licensure for 1 to 2 years. Continuing education must be undertaken so pharmacists and pharmacy technicians remain on the cutting edge of new advancements in their practice. This relatively short period of licensure (before having to become relicensed) helps to ensure better quality of skills, abilities, and continuing growth of knowledge.

3) Medical facilities must comply with the Bloodborne Pathogens Standard and be able to prove their compliance to: A) CDC inspectors B) DEA inspectors C) FDA inspectors D) OSHA inspectors Answer: D Explanation: D) OSHA is the regulatory agency that inspects medical facilities and requires compliance with the Bloodborne Pathogens Standard. The other agencies listed focus on different types of regulatory activities.

4) In the United States, drug legislation began in the: A) 1700s B) 1800s C) 1900s D) 1950s Answer: C Explanation: C) Drug legislation in the United States began in the 1900s. Before that, there was little regulation for the way drugs were manufactured, tested, packaged, or sold. This correct answer rules out the "1950s" as being a possible choice because the first drug legislation occurred early in the century.

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5) The Comprehensive Drug Abuse Prevention and Control Act of 1970 is concerned with certain drugs called: A) OTC drugs B) prescribed drugs C) generic drugs D) controlled substances Answer: D Explanation: D) This act is concerned with controlled substances. The other choices cannot be correct because OTC drugs are sold without a prescription, requiring no governmental controls except to regulate that they are safely manufactured with the proper amounts of approved ingredients; all prescription drugs do not fall under the heading of "controlled substances," which this act is concerned with; and "generic drugs" includes many substances outside the scope of those that are controlled by this act.

6) The first Pure Food and Drug Act was passed by Congress in: A) 1806 B) 1851 C) 1906 D) 1951 Answer: C Explanation: C) This act was passed in 1906–early in the 20th century, also known as the 1900s.

Before 1906, drugs such as opium were freely advertised and sold to consumers with no control as to how much of the drug was purchased, ingested, resold, and so on. The other dates in this question are not correct; before 1906, there were no drug acts, and by 1951, many different acts had already taken effect.

7) Diethylene glycol, the poison that caused the sulfanilamide disaster of 1937, is used today as: A) soap B) antifreeze C) gasoline D) diesel fuel Answer: B Explanation: B) Diethylene glycol is used today as antifreeze. It has a pleasant color and taste but is deadly if consumed. This substance was mixed with sulfanilamide and sold as a sore throat remedy, with no testing as to its toxicity. A total of 107 reported deaths occurred as a result.

8) Thalidomide was being sold as a sleeping pill outside the United States when it was discovered that the drug could harm: A) elderly patients B) female patients C) fetuses during the first trimester of pregnancy D) children allergic to penicillin Answer: C Explanation: C) Thalidomide caused serious malformations of fetuses during the first trimester of pregnancy, including missing or deformed limbs. The drug is currently used for special conditions, such as to treat leprosy, but it cannot be used by pregnant mothers (especially during the first trimester).

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9) The nation's only legal drug enforcement agency is called the: A) FDA B) DEA C) CDC D) FTC Answer: B Explanation: B) The DEA is the only legal drug enforcement agency in the United States. The other choices stand for Food and Drug Administration, Centers for Disease Control and Prevention, and Federal Trade Commission.

10) In the United States, drugs that treat diseases affecting 200,000 people or fewer are called: A) orphan drugs B) OTC drugs C) scheduled drugs D) controlled substances Answer: A Explanation: A) Orphan drugs treat fewer than 200,000 people in the United States. The government offers special incentives for their development and marketing, including tax breaks and a 7-year monopoly on their sale by the company that develops them. OTC drugs are simply over-the-counter drugs, and scheduled drugs are listed in the five drug schedules, which list controlled substances and how they may be used.

11) Which act prohibits the reimportation of a drug into the United States by anyone but the manufacturer?

A) Safe Medical Devices Act of 1990 B) Prescription Drug Marketing Act of 1987 C) Orphan Drug Act of 1983 D) Drug Abuse Control Amendment of 1965 Answer: B Explanation: B) The Prescription Drug Marketing Act of 1987 controls drug reimportation. The Safe Medical Devices Act concerns patient harm caused by a medical device, the Orphan Drug Act controls the development and marketing of drugs that treat fewer than 200,000 people in the United States, and the Drug Abuse Control Amendment permitted authorized registrants to manufacture stimulant drugs.

12) Anabolic steroids are derived from: A) vitamins B) minerals C) hormones D) enzymes Answer: C Explanation: C) Anabolic steroids are derived from hormonal substances related to estrogen, progestins, testosterone, and corticosteroids. They are regulated under the CSA. Vitamins and minerals are available OTC, and enzymes are naturally found in the human body; hence, none of these fit the criteria of the uses for anabolic steroids.

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13) OSHA's mission is to ensure: A) that drugs are not sold across international borders B) that orphan drugs are regularly developed in the United States C) compliance with the requirements of scheduled drugs D) workplace safety and a healthy workplace environment Answer: D Explanation: D) OSHA, which is part of the Department of Labor, is concerned with safe and healthy workplaces. The other choices are incorrect because they are outside the scope of OSHA's activities. The DEA controls all illegal drug activities, such as the import and export of drugs and the legalized use of scheduled drugs. Orphan drugs are governed by the Orphan Drug Act of 1983.

14) HIPAA stands for: A) Health Insurance Protection Amendment Act B) Hospital Intern/Physician Accountability Act C) Health Insurance Portability and Accountability Act D) Health Insurance Protection and Associated Amendments Answer: C Explanation: C) HIPAA stands for the Health Insurance Portability and Accountability Act. The other choices are not actual names of acts but use the HIPAA initials, and all appear to be realistically possible names for the act.

15) All drug administration laws are initiated, implemented, and enforced by the: A) DEA B) FDA C) CDC D) HIPAA Answer: B Explanation: B) Although it would seem that the DEA might be the correct choice, it is important to understand the distinction between the DEA and the FDA (which is the correct choice for this question). The FDA controls all drug administration laws. The DEA enforces controlled substance laws and regulations. The other choices—the CDC and the HIPAA—are incorrect because drugs are not the focus of the CDC, and HIPAA is concerned with health insurance.

16) The CDC's primary function is to issue: A) infection-fighting drugs B) regulations about drugs for specific diseases C) infection control regulations D) black box warnings Answer: C Explanation: C) The CDC primarily issues infection control regulations. It focuses on worldwide diseases, either common or rare. Current worldwide concerns include SARS and bird flu. The other choices are incorrect because they all relate to drugs and drug packaging, which are outside the scope of the CDC.

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17) Pharmacy practice is primarily governed by: A) pharmaceutical associations B) federal law C) poison control centers D) state law Answer: D Explanation: D) State law is the main controller of pharmacy practice. Federal law does not govern pharmacy practice but may become involved in pharmacy practice disputes based on appeals. Pharmaceutical associations do not have any legal governing authority. Poison control centers are concerned with treating poisonings, not governing.

18) Standards of behavior and the concept of right and wrong beyond legal considerations are known as: A) empathy B) ethics C) confidentiality D) ordinances Answer: B Explanation: B) Ethics are standards of behavior outside the scope of law; hence, this is the correct choice. The other choices are incorrect because empathy concerns the ability to understand another person's position, confidentiality involves the keeping of patient information secure and safe from others who have no right to have access to it, and ordinances are specific legal rulings.

19) Drug samples: A) may be sold to any qualified person B) traded between people for other drugs that they may require C) may not be sold unless to another physician D) may not be sold Answer: D Explanation: D) Drug samples may not be sold. They are provided by drug companies so physicians can give them out free of charge as samples; this is to promote future sales of these drugs. Trading drugs between different people is not a legal activity. The patient who is intended to take a drug–whether it is a free sample or a prescribed, purchased drug–is the only one who should take it.

20) Which type of drug cannot be sold without a prescription?

A) Legend B) OTC C) Aspirin D) Acetaminophen Answer: A Explanation: A) Legend drugs cannot be sold without a prescription. OTC means over the counter, not requiring a prescription. Aspirin and acetaminophen are examples of OTC drugs.

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21) Which types of scheduled drugs have "high abuse potential"?

A) Schedules I and II B) Schedules II and III C) Schedules I and V D) Schedules IV and V Answer: A Explanation: A) Schedules I and II contain drugs with "high abuse potential." The schedules range from Schedule I (the highest abuse potential) to Schedule V (the least abuse potential).

22) Which governing agency approves the investigational use of drugs on humans?

A) HIPAA B) CDC C) DEA D) FDA Answer: D Explanation: D) The FDA approves investigational use of drugs on humans. Again, the FDA is concerned with all drug administration laws. The DEA enforces drug laws, and the CDC is concerned with disease prevention. HIPAA focus on insurance coverages.

23) Allied health professionals must use confidentiality in all areas that concern: A) medications and their sale B) medications and their adverse effects C) medications and their administration D) medications and their relationship to allergies Answer: C Explanation: C) Confidentiality must be used concerning medications and their administration.

The other choices are incorrect because allied health-care workers may, for example, discuss with patients, questions about medications that they may sell; the adverse effects of medications; and, of course, whether a patient's allergies may affect the use of a certain medication.

24) Which type of pharmacy requires special procedures because of the possible exposure to chemotherapy?

A) Investigational pharmacy B) Compounding pharmacy C) Institutional pharmacy D) Nuclear pharmacy Answer: D Explanation: D) Nuclear pharmacy is concerned with chemotherapy and requires special procedures as well as special precautions. It is the first specialty area of pharmacy for which a special regulation at the state level has been established. The other choices are incorrect because they do not focus on chemotherapy preparations and have lower levels of danger to pharmacy staff.

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25) Prescription pads must be used only for: A) writing prescriptions for medications B) writing down incoming calls from other physicians C) writing instructions for patients on the use of free samples D) writing directions to the pharmacy for patients Answer: A Explanation: A) Prescription pads must be used only for writing prescriptions for medications.

They should be kept secure so patients cannot remove blank pads from the office, and no other sort of communication should be written on them because of the possibility of them being erased and reused with forged prescription information. Physicians are 100% liable for prescriptions that come from their offices, and prescription pads should be carefully safeguarded from misuse.

26) Which type of schedule drug is NOT approved for medical use in the United States?

A) Schedule IV B) Schedule III C) Schedule II D) Schedule I Answer: D Explanation: D) Schedule I drugs are not approved for medical use in the United States. All other scheduled drugs are approved for medical use in the United States, so all the other choices are incorrect.

27) Why is heroin considered a Schedule I drug but cocaine is considered a Schedule II drug?

A) Because heroin only comes from overseas B) Because cocaine is found in many food products C) Because cocaine has accepted medical use in the United States but heroin does not D) Because heroin comes from the poppy plant, which is illegal to grow Answer: C Explanation: C) Cocaine has accepted medical use but for only very specific conditions; heroin has no accepted medical use. It does not matter where these drugs originate from concerning their assigned drug schedule. Cocaine is not used in food products. Poppy plants are not illegal to grow; only the manufacturing of heroin from them is illegal in the United States.

28) Today, federal regulations prohibit the use of drugs that would be: A) detrimental to consumers B) too expensive for some patients C) not strong enough for the prescribed condition D) too strong for the prescribed condition Answer: A Explanation: A) Federal regulations prohibit the use of drugs that would be detrimental to consumers. The effectiveness or lack of effectiveness of a drug does help physicians to pinpoint the most correct drug to use in treating a condition but is not something that causes the drug to be prohibited from use. The cost of a drug is based on its formulation, strength, depth of research and development, fair market value, and many other concerns, but the federal government does not prohibit the use of a drug just because of its cost.

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29) Severe psychological or physical dependence may result from abuse of which of the following types of scheduled drugs?

A) Schedule II B) Schedule III C) Schedule IV D) Schedule V Answer: A Explanation: A) Schedule II drugs may result in severe psychological or physical dependence.

The other schedules contain drugs whose psychological or physical dependence potential is less than that in Schedule II. 30) Which of the following types of agents are sometimes used by athletes to increase physical performance and require a prescription?

A) Catabolic steroids B) Anabolic steroids C) Sterols D) Protein supplements Answer: B Explanation: B) Anabolic steroids are often in the news because of their use by athletes to increase physical performance and because they are often obtained illegally for this purpose.

Catabolic steroids do not have the same desired action as anabolic steroids. Sterols are not used for these purposes. Protein supplements, although they help to increase energy and muscle mass, do not require a prescription.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 6 Terminology, Abbreviations, and Dispensing Prescriptions 1) Most anatomic terms come from: A) Latin origins B) Greek origins C) French origins D) Arabic origins Answer: A Explanation: A) Most anatomic terms come from Latin origins. The Greek language influenced a majority of terms related to surgery and diagnosis. The other two choices do not have major influences on medical terminology.

2) The most common combining vowel is the letter: A) "a" B) "e" C) "i" D) "o" Answer: D Explanation: D) The letter "o" is the most common combining vowel. It is followed by the letter "i." The other two choices are not commonly used combining vowels.

3) Most tablets are intended to be swallowed whole for dissolution and absorption by the: A) larynx B) pharynx C) gastrointestinal tract D) bloodstream Answer: C Explanation: C) The gastrointestinal (GI) tract is the site of absorption of most tablets that are swallowed whole for dissolution. The larynx and pharynx do not absorb but act as conduits for breathing and swallowing. Although it does eventually circulate a dissolved tablet throughout the body, the bloodstream does not absorb the tablet's medication.

4) The medications most commonly administered by means of troches include: A) nitroglycerin B) nicotine C) glucose D) cough suppressants Answer: D Explanation: D) Troches are commonly used to administer cough suppressants. Nitroglycerin is usually administered sublingually. Nicotine is commonly administered by a transdermal patch.

Glucose is used for the treatment of diabetes, which commonly does not involve troches.

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5) Most rectal drugs offer: A) antitussive effects B) localized effects C) systemic effects D) antipyretic effects Answer: C Explanation: C) Rectal drugs usually supply systemic effects because of a high rate of absorption via the colon. A lesser amount of rectal drugs is intended to provide localized effects, such as suppositories that treat hemorrhoids. The other choices are incorrect because the use of rectal drugs for antitussive and antipyretic effects is not common.

6) An important cardiac glycoside is: A) digoxin B) insulin C) glucose D) heparin Answer: A Explanation: A) Out of these choices, digoxin is the only cardiac glycoside. Insulin is used to treat people with diabetes. Glucose also relates to diabetes. Heparin is used as a "blood thinner" for a variety of conditions.

7) Enteric coatings may be used to keep a drug from dissolving in the: A) esophagus B) bloodstream C) gallbladder D) stomach Answer: D Explanation: D) Enteric coatings are used to keep a drug from dissolving in the stomach and passing into the intestines for dissolution instead. The esophagus and gallbladder are not sites of dissolution, and the bloodstream simply circulates a drug for systemic effects.

8) "Vital signs" are commonly abbreviated as: A) Rx B) Tx C) VS D) Vit Answer: C Explanation: C) VS is commonly used to abbreviate "vital signs." Rx is the abbreviation for "prescription." Tx is the abbreviation for "treatment." Vit is not a medical abbreviation.

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9) For rapid absorption, sublingual tablets must be dissolved: A) underneath the skin B) in the cheek C) under the tongue D) in the intestines Answer: C Explanation: C) Sublingual tablets must be dissolved under the tongue for rapid absorption.

They are not implanted underneath the skin. Tablets dissolved in the cheek are known as "buccal." Tablets dissolved in the intestines are commonly known as "enteric coated."

10) Preparations that must be shaken before being administered are known as mixtures or: A) ointments B) suspensions C) powders D) capsules Answer: B Explanation: B) Mixtures (also known as suspensions) must be shaken before being administered. This is because in these types of liquid drugs, the drug agent is mixed with a liquid but not dissolved. Ointments, powders, and capsules do not have to be shaken before administration.

11) Ophthalmic drugs must be isotonic so they do NOT cause: A) burning B) itching C) swelling D) foaming Answer: A Explanation: A) Ophthalmic drugs must be isotonic so they do not cause burning and possibly injure the eyes. The other choices are not related to isotonic ophthalmic drugs.

12) A prescription cannot be carried out if it is NOT: A) phoned in B) signed by the physician C) signed by the pharmacist D) signed by the pharmacy technician Answer: B Explanation: B) A prescription cannot be carried out if it is not signed by the physician.

Although the pharmacist and pharmacy technicians play important roles, their signatures are not required because they are not the originators of the prescription, as the physician is. The first choice is incorrect because many prescriptions are physically carried by the patient to the pharmacy and not phoned in.

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13) Standing orders must be backed up later by: A) a phone call B) a faxed blank prescription form C) a written confirmation by the doctor D) the doctor personally visiting the pharmacy Answer: C Explanation: C) Standing orders must be backed up later by a written confirmation by the doctor. Phone calls do not suffice. Faxed blank prescription forms are totally against the legalities of pharmacy practice; anyone could photocopy the form and then use copies of it to create other prescriptions. Also, if a blank prescription form was faxed so someone at the pharmacy could then fill it out with the standing order's information, the doctor could be in serious trouble if the order was not filled out correctly or taken. Obviously, the last choice is incorrect because doctors do not have time to visit pharmacies to follow up standing orders, which are designed to save them critical time in the first place.

14) Alkaloids are organic nitrogen-containing compounds that are alkaline and are usually: A) acidic B) bitter tasting C) sweet tasting D) sour tasting Answer: B Explanation: B) Alkaloids are usually bitter tasting. They are derived from plant sources and combined with acids to make a salt. They are not acidic in nature and are neither sweet nor sour tasting.

15) Topical drugs are applied directly to the skin and usually offer: A) a cooling action B) a drying action C) a local effect D) a systemic effect Answer: C Explanation: C) Topical drugs usually offer a local effect, not a systemic effect. Most topical drugs do not offer cooling or drying actions, although some of them do. However, these are not in the majority and cannot be considered correct choices.

16) Prescriptions in hospitals are usually written on a drug chart or physician order sheet and then transcribed onto a: A) prescription pad B) medication administration record (MAR) C) faxed prescription form D) sticker placed on the patient's clothes Answer: B Explanation: B) In hospitals, the transcription of drug charts and physician order forms occurs on a medical administration record (MAR). All the other choices are incorrect because they are not used for this information in a hospital.

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17) All elixirs contain: A) ionized water B) a bitter flavor C) alcohol D) isotonic solutions Answer: C Explanation: C) All elixirs contain alcohol, not ionized water or isotonic solutions. The choice of "a bitter taste" is incorrect because most elixirs are sweetened.

18) In 1990, the first successful gene therapy was used to treat: A) the common cold B) pneumonia C) cancer D) an immune system defect in children Answer: D Explanation: D) The first successful gene therapy treated an immune system defect in children.

Although the common cold, pneumonia, and cancer are all under constant study for improved medications, gene therapy did not succeed with any of them initially.

19) Pharmaceutics is the science of: A) the history of medications B) curing disease C) poisonings D) formulating drugs Answer: D Explanation: D) Pharmaceutics is the study of the formulation of drugs. It focuses on different types of drug preparations and the way they influence pharmacokinetics and pharmacodynamics.

It does not take into account the history of medications, curing disease, or poisonings.

20) Failure to administer a drug in the correct form results in a: A) prescription error B) pharmacist error C) medication error D) physician error Answer: C Explanation: C) Failure to administer a drug in the correct form results in a medication error.

Prescription errors are not focused on errors in administration. Pharmacists do not administer drugs, and physicians seldom do; hence, this type of error is known as a medication error.

21) Liquid drugs are more rapidly available for GI absorption than solid drugs because they are: A) more rapidly dissolved than solid drugs B) injectable C) able to be used topically D) less rapidly dissolved than solid drugs Answer: A Explanation: A) Liquid drugs are more rapidly dissolved than solid drugs and therefore are more available for GI absorption. Topical and injectable drugs do not affect GI absorption.

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22) Sustained-release drugs should never be crushed or dissolved because: A) this would negate their sustained-release action B) this ruins their taste C) they become liquid drugs D) they will then have to be used topically Answer: A Explanation: A) Sustained-release drugs should not be crushed or dissolved because this would negate their sustained-release action. Their taste, form, and route of administration are not affected.

23) Lotions are intended for topical use and have a(n): A) oil base B) alcohol base C) water base D) powder base Answer: C Explanation: C) Lotions have a water base and are used topically. Oil bases are generally used in creams and ointments. An alcohol base would create a quick-drying effect, and the medication would not be conveyed into the skin as easily. A powder base would not be used in this type of application.

24) An example of a drug commonly administered transdermally is: A) warfarin B) nicotine C) insulin D) heparin Answer: B Explanation: B) Nicotine is commonly used transdermally. Warfarin, insulin, and heparin are commonly injected medications.

25) Enteric coating prevents an irritating drug from causing a(n): A) idiosyncratic reaction B) ulcer of the stomach C) burning of the skin D) bitter flavor Answer: B Explanation: B) Enteric coating helps to keep an irritating drug from causing a stomach ulcer.

Idiosyncratic reactions may be caused by all types of drugs. Enteric coating is intended to protect the GI tract from a drug's possibly irritating effects, so topical drugs would not need enteric coating. There is little to no flavoring of enteric-coated drugs.

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26) A popular example of a drug that is available in the form of a cream is: A) potassium chloride powder B) zinc oxide C) benzoyl peroxide D) salicylic acid Answer: C Explanation: C) Benzoyl peroxide is a commonly used cream medication used to treat acne.

Potassium chloride is a powder. Zinc oxide is an ointment. Salicylic acid is commonly in the form of a plaster.

27) Injectable (parenteral) forms of medication may be available as: A) elixirs or solutions B) powders or solutions C) creams or solutions D) ointments or solutions Answer: B Explanation: B) Injectable (parenteral) medications may be available as ready-to-use solutions or as powders that must be reconstituted before use. The other choices are incorrect because elixirs contain alcohol and are not injected, and creams and ointments are intended for topical use.

28) An example of a pharmaceutical gas that may be inhaled is: A) halothane B) nitroglycerin C) hydrogen D) estrogen Answer: A Explanation: A) Halothane is an example of a pharmaceutical gas that may be inhaled.

Nitroglycerin and estrogen are not gases, and hydrogen is not meant to be used for pharmaceutical inhalation.

29) Which of the following does NOT belong on a prescription label?

A) Address of the prescriber's office B) Signature of the prescriber C) Prescriber's DEA number D) Signature of the pharmacist Answer: D Explanation: D) The signature of the pharmacist is not required on a prescription label or prescription. However, the signature of the prescriber is essential. All the other choices are items that should be included on the prescription.

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30) Which of the following suffixes means "disease"?

A) -phobia B) -pathy C) -ectomy D) -itis Answer: B Explanation: B) "-pathy" is the suffix meaning "disease." "-phobia" means "abnormal fear." "ectomy" means "excision" or "removal." "-itis" means "inflammation."

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 7 Administration of Medications 1) In the ambulatory care setting, most medicines are ordered: A) in tablet form B) in liquid form C) stat D) asap Answer: C Explanation: C) In the ambulatory care setting, most medicines are ordered stat. This is so they are available as quickly as possible because of an emergency or because an emergency situation may be imminent. The other choices are incorrect because there is no single clear-cut form of medication (tablet or liquid) that is predominantly used. The final choice— "asap"—is not as critical as a "stat" order.

2) The most common medication error involves: A) the dosage of the drug B) the correct route of administration C) the monitoring of side effects D) not noticing drug information or warnings Answer: A Explanation: A) Dosage of the drug is the most common medication error because correct dosage amounts are so prone to calculation errors, among other types. Route of administration, side effect monitoring, and not noticing drug information or warnings all contribute to medication errors but are nowhere near as prevalent as errors involving drug dosages.

3) Drug errors most often involve: A) antitussives and analgesics B) anti-inflammatories and antibiotics C) antibiotics and analgesics D) antipyretics and anti-inflammatories Answer: C Explanation: C) Drug errors most often involve antibiotics and analgesics. Many prescriptions are issued concerning the fighting of infections (antibiotics) and the relief of pain (analgesics), and this large amount helps to contribute to increased errors. The other choices involve antiinflammatories, antipyretics, and antitussives, which are prescribed on a lesser scale.

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4) Which of the following routes is the most common route by which medications are given?

A) Intravenous B) Subcutaneous C) Topical D) Oral Answer: D Explanation: D) The oral route is the most common route of administration. Combining prescribed medications and OTC medications–by far the most popular method of administering drugs–is by oral tablets, capsules, liquids, powders, and so on. Intravenous, subcutaneous, and topical medications are all used widely but are nowhere as popular as those given orally. In the case of injectable drugs, this is partly because of the pain and discomfort that they involve compared with the ease of oral administration. Topicals are intended primarily for localized effects, not systemic, and treat more specialized conditions.

5) Most needles are made of stainless steel and are: A) reusable B) disposable C) dull until sharpened D) tuberculin Answer: B Explanation: B) Most needles are made of stainless steel and are disposable, although some needles are made to be reused several times. The reusable types are far less abundant than the disposable needles. Needles are packaged already sharpened and ready for use, not dull.

Tuberculin needles are just one type of needle available and are not the most popular type.

6) Ampules are usually marked with ink and: A) sealed with a rubber cap B) opaque C) prescored D) must be filled with medication Answer: C Explanation: C) Ampules are usually marked with ink at the point at which they are to be broken open; this point of the neck of the ampule is "prescored" for easy opening. They are not sealed with a rubber cap (as vials are); are clear, not opaque; and usually contain a single dose of medication before use.

7) The most common method of administering an intramuscular injection involves a: A) 15-degree angle B) 45-degree angle C) 90-degree angle D) 180-degree angle Answer: C Explanation: C) A 90-degree angle is the most commonly used method of administering an intramuscular injection. The needle pierces through the dermal and subcutaneous layers of skin and proceeds into the desired muscle. The Z-track method of injection is also used but is not as popular for IM injections. The other choices of angles are incorrect in that they do not offer an optimal penetration of the skin tissues required to reach the muscle.

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8) How many times must the medication label be checked during its preparation to confirm the right drug, dose, and strength?

A) One B) Two C) Three D) Four Answer: C Explanation: C) It must be checked three times. It cannot be stressed enough that careful, repetitive standards of practice, such as rechecking this type of information, is one of the best methods of ensuring accuracy. Nothing less than three checks of the information are allowed, so the first two choices are incorrect. The last choice, although not wrong, is beyond the minimum expected amount of information checks to be carried out.

9) After administering a medication, you must ensure that the patient: A) is not allergic to the medication B) does not have a reaction to the medication C) lies still for at least 15 minutes without moving D) does not drive a car for at least 15 minutes Answer: B Explanation: B) After administering a medication, you must make sure the patient does not have a reaction to it. A patient should never be allowed to leave without this occurring. Determining a potential allergy to the medication must always be checked before administering the medication.

Having the patient lie still is not a realistic scenario for most medications, and only certain medications create the scenario that requires a patient to not drive a car immediately after their administration.

10) Medication errors must be documented in the medical record with: A) the initials of the physician in charge B) a pen containing indelible ink C) the signature of the individual who made the error D) the initials of the medical office administrator Answer: C Explanation: C) Medication errors must be documented in the medical record with the signature of the individual who made the error. It is not required for the physician or medical office administrator to initial the notation; what is important is that the person responsible signs the record to indicate his or her taking responsibility for the mistake. The type of ink used is not a concern.

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11) Intradermal injections are usually given into the inner forearm or ________.

A) outer forearm B) upper back C) lower back D) thigh Answer: B Explanation: B) Intradermal injections are usually given into the inner forearm or the upper back—areas that usually have little hair growth. The outer forearm and thigh (especially of men) usually have thicker hair growth, and the lower back is sometimes more abundant with hair in men.

12) Because suppositories are designed to melt at body temperature, they are usually kept: A) warm B) at room temperature C) in the refrigerator D) in ice Answer: C Explanation: C) Suppositories are usually kept in a refrigerator because of their ability to melt at body temperature. As such, keeping them warm would not contain their solidity. Storing them in ice would make them too cold for proper use. Room temperature is not cold enough for the secure storage of suppositories.

13) The first time you should check a medication's label is when: A) the medication is removed from its container B) the medication is returned to the storage area C) you are about to administer the medication D) the medication is taken from the storage area Answer: D Explanation: D) The first time to check a medication's label is when it is removed from the storage area. The second time to check it is just before it is removed from its container. The third time to check it is when it is returned to the storage area or just before administration.

14) Which of the following significantly reduces medication errors?

A) history of allergies B) unit-dose systems C) checking the patient's chart D) wasting of expired medications Answer: B Explanation: B) Unit-dose systems significantly reduce medication errors because the medications they contain are already in the correct dose. When using other types of medications that are not packaged as unit-dose systems, it is important to perform appropriate dosage calculations to determine the accurate dose.

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15) The route that may be more dangerous than others because of the possibility of injecting a drug incorrectly into a vein is which of the following routes?

A) Intradermal route B) Intramuscular route C) Intravenous route D) Anti-tick drugs Answer: C Explanation: C) The intravenous route may be more dangerous than the others because of the possibility of injecting a drug incorrectly into a vein, causing serious harm or even death.

Intravenous medications are absorbed more quickly than oral medications and are irretrievable after being injected. The intradermal and intramuscular routes are not as dangerous because injecting between skin layers or muscles does not involve the same speed of absorption as does intravenous injection. The intrathecal route is not discussed in this capacity in this chapter.

16) Aseptic technique is used when administering parenteral drugs because these drugs require which type of procedure?

A) Invasive B) Infective C) Isotonic D) Iodized Answer: A Explanation: A) The aseptic technique is used for parenteral administration because it is an invasive procedure. The body is "invaded" when the needle punctures through the skin, and the wound becomes a pathway for infection. The other choices are incorrect because infective means "causing infection," isotonic means "purified for use with the body or its openings," and iodized means "treated with iodine."

17) The easiest way to make sure the drug is being given to the patient it was ordered for is to: A) look at the patient's chart B) ask the patient his or her name C) ask a family member the patient's name D) check the physician's order Answer: B Explanation: B) The easiest way to make sure the drug is being given to the patient ordered is to ask the patient his or her name. You may also call the patient before administering the medication. Never assume that the patient is the correct person without verifying his or her name. None of the other choices are enough to ensure the patient is the correct one.

18) Which of the following is NOT a site of administration for subcutaneous injections?

A) abdomen B) back C) arms D) chest Answer: D Explanation: D) The chest is not a site of administration for subcutaneous injections, which are usually given into the subcutaneous tissue below the dermis in the upper arms, upper back, or upper abdomen.

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19) Drugs that are absorbed through the gastrointestinal tract are known as: A) intrathecal B) enteral C) percutaneous D) parenteral Answer: B Explanation: B) Drugs that are absorbed through the gastrointestinal tract are known as "enteral." Intrathecal refers to drugs injected between tendon spaces, parenteral refers to all injected drugs, and percutaneous means "placed in direct contact with the skin or mucous membranes."

20) Which of the following is often used as a diluent in parenteral medications?

A) Cocoa butter B) Alcohol C) Powder D) Sterile normal saline Answer: D Explanation: D) Sterile normal saline is often used as a diluent in parenteral medications.

Powder or cocoa butter cannot be used as diluents because they are either solid or semisolid.

Alcohol is not used as a diluent because it has its own strong effects on the body, and a diluent essentially must be a stable, pure liquid.

21) The intramuscular route is commonly used for drugs that are irritating to: A) subcutaneous tissue B) muscles C) the esophagus D) the ears Answer: A Explanation: A) Sometimes, certain drugs irritate subcutaneous tissue, and they are injected intramuscularly to avoid irritating the subcutaneous tissue. Intramuscular injections are not used to avoid irritation to the muscles, esophagus, or ears.

22) Piggyback infusions are sometimes used as part of which type of injections?

A) Subcutaneous injections B) Intravenous injections C) Intramuscular injections D) Intradermal injections Answer: B Explanation: B) Piggyback infusions are sometimes used as part of intravenous injections. In piggyback infusions, drugs are mixed with compatible fluids and administered over 30 to 60 minutes; this is along with another intravenous drug that is already being administered.

Piggyback infusions are not used with the three other choices.

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23) The legal document recording the medication's order and its administration is known as the: A) wall chart B) want book C) PDR D) medical record Answer: D Explanation: D) The medical record is the legal document recording the medication's order and its administration. A wall chart is a reference tool for medical information, a want book is used in pharmacy stocking, and the PDR is a drug-reference publication.

24) Dull or damaged needles should: A) be repaired B) be sharpened C) never be used D) be used only once and then discarded Answer: C Explanation: C) Dull or damaged needles should never be used. They should not be repaired or sharpened. They should especially not be used once and then discarded. Dull or damaged needles can cause serious harm to the patient and/or the health-care worker.

25) Commonly used needle shafts may range from: A) 1 to 5 inches B) 1/10 to 1 inch C) 1/2 to 1 inch D) 1/2 to 2 inches Answer: D Explanation: D) Commonly used needle shafts range from 1/2 to 2 inches. All the other choices are either nonexistent or extremely uncommon available sizes of needle shafts.

26) "Wasting the medication" concerns the disposal of: A) normal saline B) OTC medications C) controlled substances D) only oral medications Answer: C Explanation: C) "Wasting the medication" refers to the disposal of controlled substances, involving someone who witnesses the event and the documentation of the disposal. This term only applies to controlled substances, not normal saline or OTC medications. Controlled substances may be in many different forms, not just oral medications.

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27) Which type of tube is placed directly into the patient's stomach and used to feed the patient?

A) Gastrostomy B) Nasopharynx C) Nasogastric D) Catheter Answer: A Explanation: A) A gastrostomy tube is placed directly into a patient's stomach and used to feed the patient. Nasogastric and nasopharynx refer to "through the nose," and a catheter may be inserted into various body orifices–often used for draining, not for feeding.

28) Two common socioeconomic problems for elderly adults are the lack of finances to purchase medications and: A) proper housing B) proper nutrition C) the lack of transportation to obtain them D) the lack of access to technology Answer: C Explanation: C) Elderly people often experience the downside of socioeconomic factors, such as the lack of finances for medications and the lack of transportation to obtain them. Proper housing and nutrition as well as access to technology are factors that may affect some of the elderly population, but these are not as common and thus are not discussed in this chapter.

29) The three most commonly used types of syringes are hypodermic, tuberculin, and: A) IV B) insulin C) saline D) butterfly Answer: B Explanation: B) Hypodermic, tuberculin, and insulin syringes are the three most common types.

IV administration uses needles inserted by using short angles to the skin, directly into a vein, and taped down to the skin. This method allows longer term, continuous infusion of IV medications.

There are no specific syringes referred to as "saline" syringes. The term butterfly refers to a clamp used in IV administration.

30) The most common nasal instillations are: A) nasal decongestants B) nasal blocks C) for infections D) cough suppressants Answer: A Explanation: A) The most common nasal instillations are nasal decongestants. This is accomplished by the shrinking of swollen mucous membranes and the loosening and drainage of secretions. Nasal instillations are used for nasal infections but not as commonly. Cough suppressants are administered orally.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 8 Principles of Math in Medicine 1) The Roman numeral system consists of letters that represent number values—most commonly of numbers between: A) 0 and 50 B) 1 and 10 C) 1 and 100 D) 100 and 500 Answer: C Explanation: C) The Roman numeral system most commonly represents the numbers between 1 and 100. These are the numbers that Roman numerals are used to represent most frequently. The number 0 is not represented by a Roman numeral. Numbers greater than 100 are seldom represented by Roman numerals, especially in medical applications.

2) The fraction bar, which separates the numerator and denominator in a fraction, also means: A) multiplied by B) added to C) divided by D) subtracted from Answer: C Explanation: C) The fraction bar also means "divided by." The numerator may be divided by the denominator, so the fraction may be rewritten as a decimal. For example, 3/4 equals 3 divided by 4, which is equivalent to the decimal 0.75.

3) To multiply fractions, you must: A) first add the numerators and then multiply the denominators B) first subtract the numerators and then multiply the denominators C) first multiply the numerators and then multiply the denominators D) invert the second fraction and then multiply Answer: C Explanation: C) To multiply fractions, first multiply the numerators and then multiply the denominators. You do not add, subtract, or invert numbers when multiplying standard fractions.

(Inverting the second fraction of two fractions is done in the process of dividing fractions).

4) To divide by a decimal fraction, first move the decimal point in the divisor enough places: A) right to make it a whole number B) left to make it a whole number C) right one place only D) left two places Answer: A Explanation: A) To divide by a decimal fraction, first move the decimal point in the divisor enough places right to make it a whole number. Moving the decimal point to the left would decrease its value and keep it a decimal fraction. Moving it one or two places right or left may or may not make it a whole number, and it must be a whole number to correctly conduct the division.

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5) If you are required to cross-multiply the fractions 3/4 and 1/2, by which number would you multiply the "4" in the first fraction?

A) 1 B) 2 C) 3 D) 4 Answer: A Explanation: A) To multiply 3/4 and 1/2, you would cross-multiply the 4 in the first fraction by the 1 in the second fraction. You would then multiply the 3 in the first fraction by the 2 in the second fraction. Cross-multiplication simply means multiplying the first fraction's numerator by the second fraction's denominator and then the first fraction's denominator by the second fraction's numerator.

6) When working with numbers that range from 1 to 30, only three Roman numerals are required, used in various combinations. Which of the following choices of Roman numerals is correct?

A) I, X, L B) I, V, X C) I, V, C D) V, X, M Answer: B Explanation: B) The Roman numerals I (1), V (5), and X (10) are the only ones required to be used to make up the numbers 1 through 30. None of the other choices can be correct because they contain Roman numerals that are larger than 30. ("L" equals 50, "C" equals 100, and "M" equals 1,000.)

7) In prescriptions, Roman numerals are commonly used to express units of the: A) Avoirdupois system B) English system C) metric system D) apothecary system Answer: D Explanation: D) Roman numerals are commonly used to express units of the apothecary system in prescriptions. They are not used to represent metric, English, or Avoirdupois units.

8) A common fraction represents: A) a number that is greater than 1 B) equal parts of a whole C) a percentage D) a Roman numeral Answer: B Explanation: B) A common fraction represents equal parts of a whole. Common fractions are less than 1 in value. Common fractions are not thought of as representing percentages in general.

They also do not represent Roman numerals because Roman numerals are concerned with whole numbers (except for the Roman numeral "ss," which is occasionally used to represent the fraction 1/2," although this is not a very common usage).

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9) When subtracting, if fractions do NOT have the same denominator, change the fractions so they have the: A) greatest common denominator B) smallest common denominator C) equivalent of 1 D) number 100 as the denominator Answer: B Explanation: B) When subtracting, if fractions do not have the same denominator, change the fractions so they have the smallest common denominator. The greatest common denominator would not simplify the fractions for subtracting. Being equivalent to 1 would mean that there would be no subtraction needed. A denominator of 100 (or a multiple of 10) is only used in calculating percentages.

10) Which of the following is the smallest (or "lowest") common denominator of 2, 5, and 7?

A) 10 B) 35 C) 56 D) 70 Answer: D Explanation: D) The smallest common denominator of 2, 5, and 7 is 70 (the smallest number that is divisible by all three of the numbers). The other choices are incorrect because all three of the numbers cannot be divided into them.

11) In Roman numerals, if a lower valued letter is placed before a higher valued letter: A) the equivalent is less than zero B) the higher-valued letter is added to the lower-valued letter C) the lower-valued letter is subtracted from the higher-valued letter D) the lower-valued letter is divided by the higher-valued letter Answer: C Explanation: C) In Roman numerals, if a lower-valued letter is placed before a higher-valued letter, the lower-valued letter is subtracted from the higher-valued letter. Examples: IX = 1 and 10. In this case, you must subtract 10 - 1 = 9 (IX = 9). XL = 10 and 50. In this case, you must subtract 50 - 10 = 40 (XL = 40). Roman numerals represent whole numbers, which are greater than zero. Roman numeral characters are not divided to arrive at their equivalent Arabic number value.

12) Fractions are used in apothecary and household measures for: A) numbers that are less than zero B) dosage calculations C) numbers greater than 1 unit D) ratios only Answer: B Explanation: B) Fractions are used in apothecary and household measures for dosage calculations. They are greater than zero but may be less than 1. They are not used for ratios only.

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13) The numerator of an improper fraction is: A) always greater than its denominator B) smaller than its denominator C) greater than or equal to its denominator D) either a whole number or another fraction Answer: C Explanation: C) The numerator of an improper fraction is greater than or equal to its denominator. Proper fractions have numerators that are smaller than their denominators. The numerators of improper fractions are not fractions themselves; these are used in complex fractions.

14) The value of a mixed fraction is always: A) less than 1 B) greater than 1 C) less than 0 D) between 0 and 1 Answer: B Explanation: B) The value of a mixed fraction is always greater than, not less than, 1. Therefore, it cannot be less than 0 or be valued at between 0 and 1.

15) You have added the fractions 2/5 and 4/10 by converting 2/5 into 4/10 so the denominators are the same. Your addition has given you the total of 8/10. Now what must you do?

A) You are finished; the answer is 8/10.

B) You must convert 8/10 into 80%.

C) You must divide 10 into 8.

D) You must reduce 8/10 to lowest terms (4/5).

Answer: D Explanation: D) After conducting this addition, you must reduce your answer of 8/10 to the lowest terms, which is 4/5. Fractions should always be expressed in their lowest terms after any mathematical procedure for ease of use. There is no need to convert 8/10 into a percentage or divide 8 by 10.

16) 10/12 minus 12/36 equals which of the following choices? Make sure your answer is in lowest terms.

A) 1/2 B) 15/18 C) 1/3 D) 2/9 Answer: A Explanation: A) 30/36 minus 12/36 is equivalent to 30/36 minus 12/36, which equals 18/36.

When reduced to lowest terms, it is equal to 1/2.

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17) 10/12 plus 12/36 equals which of the following choices? Make sure your answer is in lowest terms.

A) 42/36 B) 1 and 6/36 C) 1 and 1/6 D) 11/18 Answer: C Explanation: C) 10/12 plus 12/36 is equivalent to 30/36 plus 12/36, which equals 42/36. This improper fraction must be converted to a mixed fraction. 42/36 equals 1 and 6/36 but must be reduced to lowest terms, which is 1/6.

18) Multiply 2/7 by 7/10 and then reduce to lowest terms.

A) 14/70 B) 20/49 C) 7/35 D) 1/5 Answer: D Explanation: D) 2/7 multiplied by 7/10 equals 14/70, which when reduced to lowest terms is equal to 1/5.

19) Divide 8/12 by 3/12. Remember to invert the divisor and then to reduce to lowest terms.

A) 96/36 B) 2 and 16/48 C) 2 and 2/3 D) 24/9 Answer: C Explanation: C) To divide 8/12 by 3/12, you must invert the divisor so the equation becomes 8/12 × 12/3. You can cancel out the "12" in each resultant fraction, leaving 8/3. Reducing this to lowest terms involves making it a mixed number of 2-2/3.

20) Decimal fractions, or decimals, are used within which of the following systems?

A) Avoirdupois B) Household C) Metric D) Apothecary Answer: C Explanation: C) Decimal fractions, or decimals, are used within the metric system. Each decimal fraction has a denominator of 10 or a multiple of 10. The metric system is also based on the number 10 or multiples of 10.

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21) In writing a decimal fraction, always place a: A) one to the left of the decimal point B) zero to the left of the decimal point C) zero to the right of the decimal point D) multiple of 10 as the numerator Answer: B Explanation: B) When writing a decimal fraction, always place a zero to the left of the decimal point. This is vital in making sure the decimal point is seen because the zero alerts the reader to the fact that this is a decimal fraction and not a whole number. Simply writing ".25" instead of "0.25" can cause the reader to not see the decimal point and assume that the number written is the whole number "25." (Imagine if a desired dose was 0.25 g but a person who was ready to administer a given medication thought that 25 g was correct.)

22) The decimal fraction 0.763 is equivalent to: A) 76 and 3/10 B) 763/1,000 C) 1/763 D) 7.63/1,000 Answer: B Explanation: B) 0.763 is equal to 763/1,000. This is easy to tell because the zero to the left of the decimal point signifies that the result is less than 1. By counting the places to the right of the decimal point, you can tell that because 1 place equals "tenths," two places equal "hundredths," and three places equal "thousandths" that the denominator must be "1,000."

23) Add the following decimals: 1.763 + 0.29 + 12.4321.

A) 12.6113 B) 14.2241 C) 14.4851 D) 12.6374 Answer: C Explanation: C) 1.763 + 0.29 + 12.4321 = 14.4851. It is important to place the decimal points in each of the numbers to be added in a line so they are even with each other. Another good idea is to add zeros to fill out all the empty places in each number so (because 12.4321 has the most characters of the three numbers being added) they have the same amount of characters as each other. Therefore, you can think of the numbers being added as 01.7630 + 00.2900 + 12.4321.

24) Subtract the following decimals: 10.975 - 3.15 - 2.7.

A) 10.633 B) 5.125 C) 5.85 D) 7.125 Answer: B Explanation: B) 10.975 - 3.15 - 2.7 = 5.125. Again, it is important to line up the decimal points and helpful to add zeros to the blank spaces in each number so each of them has the same amount of characters. It may also be helpful to subtract just 3.15 from 10.975 first and then subtract 2.7 from that result.

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25) If the multiplicand has three decimal places and the multiplier has two decimal places, how many decimal places will the product have?

A) Five B) Six C) One D) Three Answer: A Explanation: A) You need only add the amount of decimal places in the multiplicand and multiplier to find out how many decimal places there will be in the product. Thus, 3 + 2 = 5.

Example: 1.123 × 2.34 = 2.62782.

26) The two quantities in a ratio are separated by a colon, which means: A) percentage B) multiplication C) equivalent D) division Answer: D Explanation: D) The two quantities in a ratio are separated by a colon, which means "division."

The expression 3:4 means "there are 3 parts to a total of 4 parts," although the 3 may be divided by the 4 to give the percentage of 0.75. Ratios are frequently used to show concentrations of a medication in a solution or to express measurement equivalents and dosage of medications per unit.

27) Proportions express the relationship of equality between two ratios. In the proportion 1:4 :: 3:12, which terms are called the extremes and which are called the means?

A) 1 and 12 are the extremes and 4 and 3 are the means B) 1 and 12 are the means and 4 and 3 are the extremes C) 1 and 3 are the means and 4 and 12 are the extremes D) 1 and 4 are the means and 3 and 12 are the extremes Answer: A Explanation: A) In the example given, the outer terms are the extremes (1 and 12) and the inner terms are the means (4 and 3). The way to determine that this proportion consists of two equal ratios is by multiplying the means and then multiplying the extremes and comparing their results.

In this case, 4 × 3 = 12 and 1 × 12 = 12.

28) The term percent (%) means: A) tenths B) hundredths C) thousandths D) hundreds Answer: B Explanation: B) The term percent (%) means "hundredths." For example, 40 percent (or 40%) means 40/100. Likewise, 67 percent means 67/100.

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29) To change a percent to a decimal, move the decimal point: A) one place to the right B) two places to the right C) two places to the left D) three places to the left Answer: C Explanation: C) To change a percent to a decimal, move the decimal point two places to the left.

For example, 67 percent is equal to the decimal 0.67.

30) To change a fraction to a percent, divide the numerator by the denominator and then multiply the result by: A) 0.01 B) 0.1 C) 10 D) 100 Answer: D Explanation: D) To change a fraction to a percent, divide the numerator by the denominator and then multiply the result by 100. (Then, add the percent symbol.) For example, to find the percentage that is equivalent to the fraction 3/12, first divide: 3 ÷ 12, which equals 0.25. Multiply the result by 100. Thus so, 0.25 ×100 = 25. Then, add the percent sign. Therefore, 25% is equivalent to 3/12.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 9 Measurement Systems and Their Equivalents 1) The most common, accurate, and safest system of measurement in all countries is the: A) Avoirdupois system B) household system C) metric system D) apothecary system Answer: C Explanation: C) The other choices are incorrect because they are either not used in all countries or are not as accurate as the metric system.

2) Which of the following is the most used parameter and is essential as a dosage unit?

A) Weight B) Length C) Volume D) Energy Answer: A Explanation: A) Weight is the most used parameter and is essential as a dosage unit. A unit is defined as a standard of measure, weight, or any other similar quality. Measurement of volume is the next most important parameter and is used for liquids. Length is the least used parameter for dosage calculations.

3) The basic unit of weight in the metric system is the: A) kilogram B) gram C) liter D) meter Answer: B Explanation: B) The basic units of weight and volume in the metric system are based on the number "10," as in the decimal system. The metric system uses the gram as the unit of weight. It is equivalent to 15.432358 grains.

4) In the metric system, the basic unit of volume is the: A) milliliter B) milliequivalent C) liter D) ounce Answer: C Explanation: C) In the metric system, the basic unit of volume is the liter. Although the milliliter is commonly used, it is not the basic unit.

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5) In the metric system, the basic unit of length is the: A) kilometer B) inch C) centigram D) meter Answer: D Explanation: D) In the metric system, the basic unit of length is the meter. The kilometer is used only to measure long distances.

6) The very old English system, which has been slowly replaced by the metric system, is known as the: A) apothecary system B) household system C) Avoirdupois system D) international system Answer: A Explanation: A) The apothecary system is a very old English system that has been slowly replaced by the metric system. It is not as accurate and shares some of its measurements with the household system.

7) In the apothecary system, the basic unit of volume is the: A) ounce B) minim C) dram D) grain Answer: B Explanation: B) The basic unit of volume in the apothecary system is the minim. However, the other choices are used in the apothecary system.

8) Drams are apothecary measures that are equivalent to: A) 1/8 of an ounce B) 1 ounce C) 1 minim D) 1 grain Answer: A Explanation: A) Drams are equivalent to 1/8 of an ounce and are also known as fluidrams.

9) The basic unit of weight in the apothecary system is the: A) fluidram B) dram C) grain D) minim Answer: C Explanation: C) The basic unit of weight in the apothecary system is the grain. Other apothecary weight measurements include drams, ounces, and pounds.

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10) In the household system, the only units of measurement used to measure drugs are units of: A) weight B) length C) mass D) volume Answer: D Explanation: D) The only household units of measurement that are used to measure drugs are units of volume. These include the drop, teaspoon, tablespoon, ounce (fluid), cup, pint, quart, and gallon.

11) Milliequivalents and international units indicate the: A) masses of certain drugs B) volumes of certain drugs C) strengths of certain drugs D) weights of certain drugs Answer: C Explanation: C) Milliequivalents and international units are used to indicate the strength of certain drugs. Milliequivalent measures are defined as an expression of the number of grams of equivalent weight of a drug contained in 1 mL of a normal solution.

12) Vitamins are measured in: A) international units B) minims C) milliequivalents D) milliliters Answer: A Explanation: A) Vitamins are measured in standardized units called international units.

International units do not measure a medication (or substance) in terms of its physical weight or volume.

13) The international system was first developed for use throughout the world in 1960 by which country?

A) United States B) England C) France D) Greece Answer: C Explanation: C) A system for international standardization of metric units was established throughout the world in 1960 with the introduction of the International System, or SI (from the French Système International).

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14) Which of the following is NOT measured in units?

A) Aspirin B) Insulin C) Heparin D) Penicillin Answer: A Explanation: A) Aspirin is not measured in units, but all three of the other choices are.

15) There are two common scales of temperature used throughout the world: Fahrenheit and: A) Cirius B) Kelvin C) Celsius D) Centigram Answer: C Explanation: C) Fahrenheit and Celsius (also known as centigrade) are the two common types of temperature measurement scales used throughout the world.

16) 32°F (freezing) is equivalent to: A) 0°C B) 23°C C) 100°C D) 212°C Answer: A Explanation: A) Water freezes at 32°F and at 0°C, making these two temperatures equivalent.

17) 100°C (boiling) is equivalent to: A) 0°F B) 32°F C) 100°F D) 212°F Answer: D Explanation: D) Water boils at 100°C and at 212°F, making these two temperatures equivalent.

18) Each Celsius degree is: A) 1.8 times greater than each Fahrenheit degree B) equal to each Fahrenheit degree C) 1.8 times less than each Fahrenheit degree D) 9.5 times greater than each Fahrenheit degree Answer: A Explanation: A) Each Celsius degree is 1.8 times greater than each Fahrenheit degree. This is the same as 9/5 times greater than each Fahrenheit degree.

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19) To convert Celsius into Fahrenheit, which equation is correct?

A) 5/9 × °C - 32 B) 1.8 × °C + 32 C) 1.8 × °C - 32 D) 5/9 × °C + 32 Answer: B Explanation: B) Because Celsius degrees are 1.8 times greater than Fahrenheit degrees, it is easy to understand that you must multiply a given Celsius temperature by 1.8 and then add 32 to the result because of the differential in calculating temperatures on these scales. For further understanding, whereas the Fahrenheit scale ranges from 32 to 212 degrees between its freezing and boiling points, the Celsius scale only ranges from 0 to 100 degrees between its equivalent points.

20) Household measurements are NOT precisely accurate, so they should never be used in the: A) home B) administration of liquid medications C) medical setting D) administration of medications to children Answer: C Explanation: C) Household measurements should never be used in the medical setting because of their inaccuracies. Although the household system is used in most American homes, its measuring equipment consists of commonly used home utensils, such as teaspoons and tablespoons, which are not calibrated and may differ in size according to their manufacturer's choosing.

21) Milliequivalents are commonly used to measure: A) temperatures B) NSAIDs C) vitamins D) electrolytes Answer: D Explanation: D) Such electrolytes as sodium and potassium are commonly measured in milliequivalents. Because these dosages are individualized, no calculations are involved. Drugs that are measured in milliequivalents include potassium chloride, sodium bicarbonate, and sodium chloride.

22) Most prescriptions and medication orders are written in the: A) Roman numeral system B) household system C) Avoirdupois system D) metric system Answer: D Explanation: D) Most prescriptions and medication orders are written in the metric system.

However, it is important to be able to convert between units of measurement–within the same system and from one system of measurement to another.

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23) The temperature measurement scale most commonly used in the United States is: A) centigrade B) mercury C) Fahrenheit D) Celsius Answer: C Explanation: C) Fahrenheit is the temperature scale most commonly used in the United States.

Celsius (which is also called centigrade) is used throughout most of the rest of the world.

Mercury is not a scale but is the substance that was previously used in thermometers that reacted to temperatures. Mercury is being phased out because of its dangerous toxicity.

24) Which of the following is the smallest unit of measurement?

A) Kilogram B) Gram C) Milligram D) Microgram Answer: D Explanation: D) The microgram is the smallest. It is 1/1,000,000 of a gram. A milligram is 1/1,000 of a gram, and a kilogram is equal to 1,000 grams.

25) Which of the following is the largest unit of measurement?

A) Liter B) Kiloliter C) Centiliter D) Milliliter Answer: B Explanation: B) The kiloliter is the largest. It is equal to 1,000 liters. A centiliter is 1/100 of a liter, and a milliliter is 1/1,000 of a liter.

26) Which of the following is NOT a unit of volume?

A) Ounce B) Pound C) Pint D) Quart Answer: B Explanation: B) A pound is a unit of weight. All the others are units of volume.

27) An amount of medication required to produce a specific effect, the size of which varies for each drug, is a: A) unit B) milliequivalent C) minim D) grain Answer: A Explanation: A) A unit is the amount of medication required to produce a specific effect. The size of a unit varies for each drug.

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28) 1 milliliter (mL) is equivalent to 1: A) pint B) dram C) cubic centimeter D) ounce Answer: C Explanation: C) 1 milliliter (mL) is equivalent to 1 cubic centimeter (cc). Therefore, 1,000 cc is also equivalent to 1 liter.

29) 16 ounces are equivalent to 1: A) tablespoon B) cup C) gallon D) pound Answer: D Explanation: D) 16 ounces is equivalent to 1 pound, which in turn is equivalent to 7,000 grains.

30) For measuring medications at home, it is important to understand that 1 tablespoon equals: A) 2 teaspoons B) 1/2 cup C) 3 teaspoons D) 1 cup Answer: C Explanation: C) 1 tablespoon is equal to 3 teaspoons. This is important to understand so overdosage or underdosage does not occur when taking medications at home. Teaspoons and tablespoons are not accurate medical measurement devices but may be used if the instructions on a medication list them as acceptable for administration.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 10 Adult and Pediatric Dosage Calculations 1) The definition of the term therapeutic is: A) causative B) prophylactic C) curative D) toxic Answer: C Explanation: C) Therapeutic is best defined as "curative." For example, the dose of a drug is the amount taken by a patient for the intended therapeutic (curative) effect.

2) The definition of the term units is: A) milliequivalents B) quantities C) milligrams D) milliliters Answer: B Explanation: B) Units are best defined as "quantities." For example, the dose for most drugs is given in units (quantities) of weight, but the dose for some drugs, such as biologics, is given based on activity.

3) A dropper that is marked with graduated measurements is: A) conical B) a teaspoon C) a syringe D) calibrated Answer: D Explanation: D) A calibrated dropper is a dropper that is marked with graduated measurements.

They are not the same as syringes or teaspoons and are not conical in shape.

4) The amount to be administered at one time is known as the: A) total amount B) desired dose C) dosage ordered D) dose on hand Answer: B Explanation: B) The desired dose is the amount to be administered at one time. It must be in the same unit of measurement as the dosage unit.

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5) Changing the strengths of the drug ordered and the drug available into a single unit is known as: A) compounding B) formulation C) conversion D) computing Answer: C Explanation: C) The first step in computing medication dosage is to make certain the strength of the drug ordered and the strength of the drug available are in the same unit of measure. If necessary, conversion (changing) to a single unit must be carried out.

6) Less concentrated mixtures are known as: A) elixirs B) dilutions C) solutions D) suspensions Answer: B Explanation: B) Less concentrated mixtures are known as dilutions. For example, heparin–an anticoagulant–is often distributed in vials in prepared dilutions (less concentrated mixtures) of 10,000 units per milliliter.

7) Tablets may be broken into parts only if they are notched or: A) scored B) ground C) unscored D) granulated Answer: A Explanation: A) Tablets may be broken into parts only if they are scored (notched), and they must be broken only along the line of scoring. Unscored tablets must not be broken into parts.

8) Injectable medications may be prescribed in units, grains, or: A) suspensions B) milligrams C) diluents D) ounces Answer: B Explanation: B) Injectable medications are prescribed in grams, milligrams, micrograms, grains, or units. They contain a drug dissolved in an appropriate liquid.

9) A pancreatic hormone that stimulates glucose metabolism is known as: A) heparin B) warfarin C) insulin D) bilirubin Answer: C Explanation: C) Insulin is a pancreatic hormone that stimulates glucose metabolism. There are different forms of insulin, and it may be administered several ways depending on the form.

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10) A numerical relationship chart that is used to determine body surface area is a: A) formula B) nomogram C) BSA D) pharmacopeia Answer: B Explanation: B) Body surface area (BSA) is determined by using a nomogram (a numerical relationship chart) and the child's height and weight.

11) The schedule of dosing for a drug is the: A) intended dose B) nomogram C) dosing regimen D) dose on hand Answer: C Explanation: C) The dosage regimen is the schedule of dosing for a drug. Many factors contribute to determining the dose and dosage regimen, including the potency of the drug and route of administration as well as such patient factors as weight, disease state, and tolerance.

12) To produce an adequate blood level to yield the desired therapeutic effect, some drugs require: A) a loading dose B) a maintenance dose C) a prophylactic dose D) a therapeutic dose Answer: A Explanation: A) A loading dose may be required for some drugs to produce an adequate blood level to yield the desired therapeutic effect. This dose would then be followed by smaller maintenance doses to maintain an adequate blood level.

13) The most common form of solid oral medication is the: A) granule B) lozenge C) tablet D) gelcap Answer: C Explanation: C) The tablet is the most common form of solid oral medication. Always check the drug label to find out how a tablet is meant to be administered (sublingually, buccally, chewed, dissolved in water, and so on).

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14) Oval-shaped gelatin shells containing medication are known as: A) pills B) capsules C) lozenges D) granules Answer: B Explanation: B) Capsules are usually oval-shaped gelatin shells that contain medication in powder or granule form.

15) You can calculate the amount to administer by using the: A) fraction proportion method B) scoring method C) ratio method D) height of the patient only Answer: A Explanation: A) Before administering medication to a patient, you need to determine how many tablets or capsules will deliver the desired dose. If necessary, convert the dosage ordered to the desired dose by using the same unit of measurement as the dose on hand. Then, you can calculate the amount to administer by using the fraction proportion method.

16) To prevent medication errors, which of the following abbreviations should be avoided?

A) tid B) U C) prn D) qid Answer: B Explanation: B) The abbreviation "U" should be avoided in practice to prevent medication errors. This is because it may easily be mistaken for a zero, causing an inaccurate amount to be administered.

17) If the safe dosage for a pediatric patient is NOT listed on the drug label, you can find it on the package insert, in the PDR, or in the: A) nomogram B) lid of the drug container C) U.S. Pharmacopeia D) drugstore Answer: C Explanation: C) If the amount of a prescribed pediatric dosage is not on the drug label, it can be found on the package insert or in the Physician's Desk Reference (PDR), hospital formulary, pharmacology texts, or the U.S. Pharmacopeia.

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18) Standard nomograms for a child's dose require the child's body surface area (in square meters) divided by the average body surface area of an adult, which is: A) 0.7 m2 B) 1 m2 C) 1.7 m2 D) 7.1 m2 Answer: C Explanation: C) The average body surface area (BSA) of a normal adult is 1.7 m2. This figure is divided into the BSA of the child who is to receive a drug. The result is then multiplied by the average adult dosage of the drug to determine the child's dose.

19) Before calculating a child's dose by body weight, you must convert his or her weight into: A) grams B) kilograms C) milligrams D) pounds Answer: B Explanation: B) Before calculating a pediatric dosage by body weight, you must first make sure the child's body weight is expressed in kilograms. If it was given to you in pounds, you must divide by 2.2 to obtain the weight in kilograms.

20) Clark's rule is based on the: A) age of the child B) height of the child C) weight of the child D) sex of the child Answer: C Explanation: C) Clark's rule is based on the weight of the child and is considered more accurate than Young's or Fried's rules.

21) Average adult weight is considered to be: A) 100 lb B) 150 lb C) 100 kg D) 150 kg Answer: B Explanation: B) Average adult weight is considered to be 150 lb (which is equivalent to 70 kg).

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22) Using Clark's rule to calculate a pediatric dose, you must first divide the child's weight in pounds by: A) 50 lb B) 50 kg C) 100 kg D) 150 lb Answer: D Explanation: D) In Clark's rule, you must first divide the child's weight in pounds by the average adult weight of 150 lb and then multiply by the average adult dose to determine the child's dose.

23) Young's rule is used for children: A) younger than 1 year old B) older than 1 year old C) born prematurely D) between 12 and 18 years old only Answer: B Explanation: B) Young's rule is used to calculate pediatric dosages for children older than 1.

24) In Young's rule, you must first divide the child's age in years by: A) the child's age in years plus 12 B) 150 lb C) 1.7 m2 D) 70 kg Answer: A Explanation: A) Young's rule requires you to first divide the child's age in years by the child's age in years plus 12 and then multiply by the average adult dose.

25) Fried's rule is used for patients who are: A) younger than 1 year old B) are more than 150 lb in weight C) have a body surface area of more than 1.7 m2 D) older than 12 years old Answer: A Explanation: A) Fried's rule is used for patients who are younger than 1 year old.

26) In Fried's rule, the child's age in months is divided by: A) the child's age in years plus 12 B) 150 lb C) 1.7 m2 D) the child's age in years Answer: B Explanation: B) In Fried's rule, the child's age in months is divided by the average adult weight, which is considered to be 150 lb.

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27) In the formula D/H × Q = X, the D stands for: A) dosage available B) dose on hand C) desired dosage D) dosage ordered Answer: C Explanation: C) In this formula, the "D" stands for "desired dosage." This is the amount of drug that is intended for administration to the patient.

28) In the formula D/H × Q = X, the H stands for: A) desired dosage B) dosage available C) hospital unit D) hours to be administered Answer: B Explanation: B) In this formula, the "H" stands for "dosage available." The D (desired dosage) and the dosage available must be in the same unit of measure.

29) In the formula D/H × Q = X, the Q stands for: A) the number of tablets (or other units) that contain the dosage available B) the quotient C) dose on hand D) dosage ordered Answer: A Explanation: A) In this formula, the "Q" stands for the number of tablets (or other units) that contain the dosage available (H).

30) In the formula D/H × Q = X, the X stands for: A) dosage unit B) dose on hand C) unit of measure D) the number of units the desired dosage will be contained in Answer: D Explanation: D) In this formula, the "X" stands for the number of capsules (or other units) that the desired dosage (D) will be contained in. This is also known as the "amount to be administered."

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 11 Medication Errors and Prevention 1) Receiving two or three medications for the same condition is referred to as: A) polypharmacy B) pharmacology C) polytoxicity D) none of the above Answer: A Explanation: A) Polypharmacy is the term used when two or three medications are received for the same condition.

2) Strategies for handling medication errors include all the following except: A) planning B) evaluation C) administration D) assessment Answer: C Explanation: C) Administration is not a strategy for handling medication errors, while planning, evaluation, and assessment are all used.

3) Unexpected occurrences involving death or serious physical or psychological injury are called: A) adverse effects B) sentinel events C) side effects D) medication errors Answer: B Explanation: B) Sentinel events are unexpected occurrences involving death or serious physical or psychological injury.

4) Which organization has established patient safety standards?

A) FDA B) DEA C) TJC D) CDC Answer: C Explanation: C) The Joint Commission (TJC) has established patient safety standards. They are officially known as "National Patient Safety Goals," or NPSGs, and were designed to help accredited organizations address specific areas of concern with regards to patient safety.

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5) Which of the following agencies coordinates the reporting of medication errors?

A) FDA B) DEA C) TJC D) CDC Answer: A Explanation: A) The Food and Drug Administration (FDA) coordinates the reporting of medication errors.

6) Toxic effects of medications may be caused by: A) decreased renal function B) altered memory C) less acute vision D) all of the above Answer: D Explanation: D) All the answer choices are correct. Toxic effects of medications may be caused by decreased renal function, altered memory, and less acute vision.

7) The most common medication error involves: A) packaging B) stat orders C) dosage D) preparation Answer: C Explanation: C) The most common medication error involves dosage. Studies have shown that as many as 41% of medication errors are related to dosages.

8) Medication errors can occur in how many stages within the medication process?

A) 2 B) 3 C) 5 D) 7 Answer: B Explanation: B) There are three stages within the medication process wherein medication errors can occur. They are during prescribing or ordering, during dispensing, and during administration and monitoring.

9) According to the Institute of Medicine, how many deaths occur from medical errors annually in the United States?

A) 7,440 B) 19,000 C) 45,000 D) 98,000 Answer: D Explanation: D) About 98,000 deaths occur from medical errors in the United States annually, according to the Institute of Medicine.

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10) Which of the following general recommendations may reduce medication errors?

A) Providing suitable work environments for safe, effective drug preparation B) Clearly defining a system for drug administration C) Using standardized measurement systems D) All of the above are correct Answer: D Explanation: D) All the answer choices are correct; they are all general recommendations that may reduce medication errors.

11) Which type of medication error describes an occurrence that required intervention necessary to sustain life?

A) Category A B) Category B C) Category G D) Category H Answer: D Explanation: D) Medication error category H describes an occurrence that required intervention necessary to sustain life.

12) Health-care professionals should double-check medications against which of the following?

A) Superbill B) Invoice C) Family history D) Medication administration record (MAR) Answer: D Explanation: D) The medication administration record (MAR) is the document against which health-care professionals should double-check medications.

13) A system designed to prevent future mistakes and ask what happened, why it happened, and what can be done to prevent its recurrence is called: A) sentinel event B) root cause analysis (RCA) C) MedWatch D) polypharmacy Answer: B Explanation: B) Root cause analysis (RCA) is a system designed to prevent future mistakes and ask what happened, why it happened, and what can be done to prevent its recurrence.

14) Keeping track of a patient's medications as he or she changes health-care providers is called: A) polypharmacy B) PHI C) automatic surveillance D) medication reconciliation Answer: D Explanation: D) Medication reconciliation is defined as keeping track of a patient's medications as he or she changes health-care providers.

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15) How many drug orders and label checks must be performed when dispensing and administering medications?

A) Two B) Three C) Five D) Ten Answer: B Explanation: B) Three drug order and label checks must be performed when dispensing and administering medications.

16) In larger facilities, what departments are utilized to minimize medication errors and examine risks that may cause them?

A) Risk management B) Automation C) Coding D) Administration Answer: A Explanation: A) Risk management is the department in large facilities that focuses on minimizing medication errors and examining risks that may cause them.

17) MedWatch is a program for reporting medication errors and was established by which government agency?

A) CDC B) DEA C) OSHA D) FDA Answer: D Explanation: D) The FDA established the MedWatch program for reporting medication errors.

18) Which organization has helped to standardize the medication error reporting system?

A) OSHA B) TJD C) NCC MERP D) CDC Answer: C Explanation: C) The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) has helped to standardize the medication error reporting system.

19) Which medication error-reporting program, established by the U.S. Pharmacopeia, is used by hospitals?

A) MEDMARX B) Safe Medicine C) NSPG D) AERP Answer: A Explanation: A) MEDMARX is the medication error reporting program established by the U.S. Pharmacopeia that is used by hospitals.

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20) A separate written report that is completed after updating the specific records about a medication error is known as which of the following?

A) Anonymous report B) Incident or occurrence report C) MAR D) Legal record Answer: B Explanation: B) An incident or occurrence report is a separate written report completed after updating the specific records about a medication error.

21) The steps that can help in avoiding medication errors and promoting safe administration of medications include assessment, planning, implementation, and: A) education B) double-checking C) evaluation D) identification Answer: C Explanation: C) Evaluation, assessment, planning, and implementation are the steps that can help in avoiding medication errors and promoting safe administration of medications.

22) A medication error classified as Category I is described as which of the following?

A) Circumstances or events that have the capacity to cause errors B) Errors that reached the patient but did not cause any harm C) Errors that occurred and may have contributed to or resulted in temporary harm to the patient (and required intervention) D) Errors that occurred that might have contributed to or resulted in the patient's death Answer: D Explanation: D) Category I is the medication error category that describes errors that occurred that might have contributed to or resulted in a patient's death.

23) Nearly half of all fatal medication errors occur in patients older than: A) 2 years old B) 12 years old C) 30 years old D) 60 years old Answer: D Explanation: D) Patients older than 60 experience nearly half of all fatal medication errors.

24) Why are children more likely to experience medication errors in relation to dosages?

A) Because of polypharmacy B) Because up-to-date information is not available C) Because dosages are based on body weight D) Because of their diurnal rhythms Answer: C Explanation: C) Children are more likely to experience medication errors because child dosages are based on body weight.

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25) After a patient is discharged, he or she should receive a complete list of which of the following?

A) Any dosing errors that occurred B) Other health-care providers C) Medications to be taken D) Herbal supplements that can be used instead of approved medications Answer: C Explanation: C) Upon discharge, the patient should receive a complete list of medications to be taken.

26) Patients must be educated so they understand the potential adverse effects that need to be reported: A) immediately B) during the next visit they make to their physician C) that are allergy related D) to family members so the effects can be monitored by them Answer: A Explanation: A) Patients must be educated so they understand the potential adverse effects that need to be reported immediately.

27) First stage errors can occur during prescribing or ordering when practitioners are: A) distracted or interrupted B) inexperienced C) distracted from counseling patients D) not monitoring patients for reactions to medications Answer: A Explanation: A) First stage errors can occur during prescribing or ordering when practitioners are distracted or interrupted.

28) Manufacturing mistakes can lead to which of the following?

A) Polypharmacy B) Root cause analysis C) Medication errors D) None of the above Answer: C Explanation: C) Medication errors can be caused by manufacturing mistakes. The FDA encourages manufacturers to report mistakes in order to reduce potential medication errors.

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29) A medication error may occur when dealing with outpatients because pharmacists do NOT do which of the following?

A) Administer medications correctly B) Report medication errors C) Adequately counsel patients D) Write prescriptions clearly Answer: C Explanation: C) When pharmacists do not adequately counsel patients in the "outpatient" setting, medication errors may occur.

30) The seven potential causes of medication errors include all the following except: A) wrong patient B) wrong age C) incorrect dose D) incorrect time Answer: B Explanation: B) The seven potential causes of medication errors do not include "wrong age."

They are: wrong patient, incorrect route, incorrect drug, incorrect dose, incorrect time, incorrect technique, and incorrect information on the patient chart.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 12 Nutritional Aspects of Pharmacology 1) The process by which the body takes in and uses food and other sources of nutrients for growth and tissue repair is: A) absorption B) catabolism C) nutrition D) hemostasis Answer: C Explanation: C) Nutrition is the process of how the body takes in and uses food and other sources of nutrients for growth and the repair of tissues.

2) The seven basic food components that provide nutrients to the human body are proteins, fats, carbohydrates, vitamins, minerals, water, and: A) acids B) fiber C) milk D) soy Answer: B Explanation: B) Fiber, proteins, fats (fatty acids), carbohydrates, vitamins, minerals, and water make up the seven basic food components that provide a human's required nutrients.

3) Nutrients that cannot be synthesized by the body, which are required for normal functioning, are known as: A) essential nutrients B) vital nutrients C) component nutrients D) nonessential nutrients Answer: A Explanation: A) Essential nutrients cannot be synthesized by the body and are required for normal functioning.

4) Dietary minerals needed by the body in high quantities are known as: A) microminerals B) electrolytes C) macrominerals D) macronutrients Answer: C Explanation: C) Macrominerals are dietary minerals needed by the body in high quantities, which (along with carbohydrates, fats, proteins, and water) are known as macronutrients.

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5) Of the 20 amino acids found in proteins, how many are essential amino acids?

A) 4 B) 5 C) 7 D) 9 Answer: D Explanation: D) Nine of the 20 amino acids in proteins are essential. Essential amino acids are components of proteins that cannot be synthesized by the body and must be provided by the diet.

6) Essential fatty acids must be provided by the diet and include linoleic and linolenic acids, which are found in: A) dairy products B) animal muscles C) prostaglandins D) vegetable oils Answer: D Explanation: D) Linoleic acid and linolenic acid are provided by vegetable oils, which are good sources of essential fatty acids.

7) There are two basic types of carbohydrates: complex carbohydrates and: A) fiber B) simple sugars C) fatty acids D) starch Answer: B Explanation: B) The two basic types of carbohydrates are simple sugars (fruits, some vegetables, milk, table sugar) and complex carbohydrates (pastas, breads, rice, potatoes, broccoli, corn, apples, pears).

8) A small amount of glucose is stored in the liver and muscles as starch, which is also known as: A) adipose B) fructose C) glycogen D) sucrose Answer: C Explanation: C) A small amount of glucose is stored in the liver and muscles as glycogen (starch).

9) Any mixture of ingredients based on plant sources and designed for the improvement of health or treatment of certain conditions is known as which of the following?

A) Macromineral B) Micromineral C) Herbal supplement D) Vitamin Answer: C Explanation: C) An herbal supplement is any mixture of ingredients based on plant sources and designed for the improvement of health or the treatment of certain conditions.

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10) Micronutrients are required in very small amounts by the human body and include vitamins and: A) essential trace minerals B) nonessential trace minerals C) electrolytes D) fiber Answer: A Explanation: A) Vitamins and essential trace minerals comprise micronutrients–a group of nutrients that are required in very small amounts by the body for normal functioning.

11) Vitamins are organic substances needed in very small amounts that are soluble either in water or in: A) saliva B) fat C) blood D) stomach acid Answer: B Explanation: B) Vitamins are organic substances required for normal body function–needed by the body in very small quantities–that are classified by their solubility. They are soluble in either water or fat.

12) Water-soluble vitamins include vitamin C and eight members of the: A) vitamin A group B) vitamin B group C) vitamin D group D) vitamin E group Answer: B Explanation: B) Water-soluble vitamins include vitamin C (ascorbic acid) and eight members of the vitamin B group.

13) Herbal supplements are considered by the FDA to be which of the following?

A) Drug products B) Traditional medical therapies C) Synthetic drugs D) Food products Answer: D Explanation: D) The FDA considers herbal supplements to be food products because they fall under the classification of "dietary supplements," which are also considered to be food products.

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14) The main dietary sources of riboflavin (vitamin B) are liver, yeast products, and: A) whole-grain cereals B) fish C) peanuts D) dairy products Answer: D Explanation: D) Riboflavin (vitamin B2) is found mainly in dairy products, yeast products, and liver. Almonds and many other plant products also contain reasonable amounts of riboflavin.

15) Nicotinamide is also known as: A) pantothenic acid B) cholesterol C) niacin D) quinidine Answer: C Explanation: C) Nicotinamide is also known as niacin (vitamin B3). Humans can actually make some of this vitamin from the amino acid known as tryptophan.

16) Deficiency of nicotinamide causes: A) arthritis B) pellagra C) constipation D) coma Answer: B Explanation: B) A deficiency of nicotinamide causes pellagra, which is marked by the "four Ds" (dementia, dermatitis, diarrhea, and death).

17) A major source of folate is from: A) milk B) carrots C) dark green leafy vegetables D) beef liver Answer: C Explanation: C) A major source of folate is from dark green leafy vegetables. The name folate comes from the Latin word falium, meaning "leaf."

18) A direct deficiency of folate causes: A) pernicious anemia B) beri-beri C) aplastic anemia D) megaloblastic anemia Answer: D Explanation: D) A direct deficiency of folate causes megaloblastic anemia, which is a particular risk during pregnancy because of increased fetal growth demands.

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19) Cobalamin (vitamin B12) is found only in: A) animal products B) plant products C) soy D) milk Answer: A Explanation: A) Vitamin B12 (cobalamin) is found only in animal products; it is originally made by bacteria in the intestine of herbivores.

20) Drug activity may be altered by interactions with which of the following?

A) Foods B) Herbs C) Foods, herbs, and other natural substances D) Other drugs only Answer: C Explanation: C) Drug activity may be altered by interactions with foods, herbs, and other natural substances. Foods can influence the absorption of a number of drugs.

21) Vitamin C (ascorbic acid) acts as a(n): A) CNS depressant B) diuretic C) antioxidant D) enzyme Answer: C Explanation: C) Vitamin C acts as a protective agent (antioxidant) and plays a role in many metabolic and immunologic activities.

22) Unlike water-soluble vitamins, fat-soluble vitamins are stored: A) in clear containers B) in the body C) in plant products only D) in the bone marrow only Answer: B Explanation: B) Unlike water-soluble vitamins, the fat-soluble vitamins are stored in the body.

These include the A, D, E, and K vitamin groups.

23) The major function of retinol (vitamin A) is in: A) the retina of the eye B) protecting from cancer C) stopping hair loss D) digestion Answer: A Explanation: A) The major function of vitamin A (retinol) is in the retina of the eye. Adequate intake of retinol prevents blindness and burning or itching of the eyes.

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24) Cholecalciferol (vitamin D3) is NOT a true vitamin because: A) it cannot be taken orally B) it is made in our own bodies with the help of ultra-violet rays C) it is not water- or fat-soluble D) excess intake may cause toxicity Answer: B Explanation: B) Cholecalciferol (vitamin D3) is not a true vitamin because it is made in our own bodies with the help of the sun's ultraviolet rays.

25) In young infants, vitamin E (tocopherol) can prevent: A) rheumatitis B) hemolytic anemia C) reproduction D) bleeding Answer: B Explanation: B) Vitamin E can protect fragile red blood cell walls (mainly in premature infants) from breaking down–a condition termed hemolytic anemia.

26) Vitamin K plays an important role in: A) combating depression B) the retina of the eye C) rheumatitis D) blood clotting Answer: D Explanation: D) Vitamin K is composed of a group of substances with similar biologic activity in blood clotting.

27) The major minerals include calcium, phosphorus, potassium, magnesium, chlorine, and: A) carotene B) amino acid C) sodium D) sulfur Answer: C Explanation: C) Elements called major minerals occur in large amounts in the human body.

These major minerals include calcium, phosphorus, sodium, potassium, magnesium, and chlorine.

28) The major electrolyte in the extracellular fluid is: A) sodium B) calcium C) magnesium D) phosphorus Answer: A Explanation: A) Sodium is the major electrolyte in the extracellular fluid. It helps body fluid balance and acid-base balance.

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29) The major condition caused by iron deficiency is: A) stroke B) anemia C) hemophilia D) thrombosis Answer: B Explanation: B) The major condition caused by iron deficiency is anemia. Iron-deficiency anemia is the most prevalent nutritional problem in the world today.

30) A lack of iodine in the diet contributes to several deficiency diseases, such as congenital hypothyroidism and: A) retarded sexual maturation B) diabetes C) goiter D) gigantism Answer: C Explanation: C) A lack of iodine in the diet contributes to several deficiency diseases such as goiter (a swelling of the thyroid gland) and congenital hypothyroidism (a condition of extreme hypothyroidism) as well as myxedema (marked by coma, hypothermia, and respiratory depression).

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 13 Dietary Supplements and Alternative Therapies 1) Complementary and alternative medicine does NOT involve which of the following?

A) special diets B) nutritional supplements C) FDA-approved medications D) herbal therapies Answer: C Explanation: C) Complementary and alternative medicine does not involve FDA-approved medications. They are outside of mainstream health care, and focus on treating each person individually, considering the health of the whole person. CAM involves different healing systems and therapies, including herbal therapies, nutritional supplements, and special diets.

2) The label of a Class 3 herbal product does NOT include: A) dosage B) prescription number C) potential adverse effects D) contraindications Answer: B Explanation: B) The label of a Class 3 herbal product does not include a prescription number.

The label must include: dosage, contraindications, potential adverse effects, potential drug interactions, and any other relevant information related to safe use.

3) The indications of alfalfa include: A) cleansing the body B) decreasing pain from burns C) treating diarrhea D) treating varicose veins Answer: A Explanation: A) The indications of alfalfa include cleansing the body. This herbal supplement is also a nutritional supplement. Potential interactions include warfarin, contraceptives, estrogens, immunosuppressants, and photosensitizing agents.

4) The herb cayenne may be used for: A) boosting energy B) treating diarrhea C) relieving headache D) reducing anxiety Answer: A Explanation: A) The herb cayenne may be used for boosting energy. It also improves digestion, increases circulation, and stimulates the heart. Potential interactions include cocaine, anticoagulants, antiplatelet agents, theophylline, and ACE inhibitors.

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5) Astragalus is indicated for: A) urinary tract infections B) diarrhea C) skin irritation D) upper respiratory infections Answer: D Explanation: D) Astragalus is indicated for upper respiratory infections. It also increases energy, promotes tissue regeneration, increases metabolism, and strengthens the body. Potential interactions include cyclophosphamide, lithium, and immunosuppressants.

6) Cranberry is used for: A) relieving menopausal symptoms B) inflammatory conditions C) urinary tract infections D) upper respiratory infections Answer: C Explanation: C) Cranberry is used for urinary tract infections. Potential interactions include warfarin, and cytochrome P450 2C9 (CYP2C9) substrates.

7) Green tea is used for: A) thyroid disorders B) hemorrhoids C) lowering LDL cholesterol D) enhancing sexual function Answer: C Explanation: C) Green tea is used for lowering LDL cholesterol. It is also an antioxidant, prevents cancer, and relieves various GI problems. Potential interactions include antacids, bronchodilators, MAOIs, xanthines, dairy products, and ephedra.

8) The herbal supplement melatonin has ________ effects.

A) diuretic B) sedative C) antioxidant D) antitoxin Answer: B Explanation: B) The herbal supplement melatonin has sedative (and tranquilizer) effects.

Potential interactions include CNS depressants, contraceptives, caffeine, fluvoxamine, antidiabetes agents, immunosuppressants, anticoagulants, antiplatelet agents, nifedipine GITS, benzodiazepines, and verapamil.

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9) Which herbal supplement is used to treat circulatory problems, varicose veins, edema, itching, cramping, and hemorrhoids?

A) horse chestnut seed extract B) green tea C) ginger D) garlic Answer: A Explanation: A) Horse chestnut seed extract is used to treat circulatory problems, varicose veins, edema, itching, cramping, and hemorrhoids. Potential interactions include anticoagulants, antidiabetic agents, aspirin and other salicylates, and iron salts.

10) Milk thistle is known as a(n): A) sedative B) antitoxin C) tranquilizer D) anticoagulant Answer: B Explanation: B) Milk thistle is known as an antitoxin. It protects against liver disease. Potential interactions include drugs that are metabolized by the P-450 enzyme, such as beta-blockers and certain analgesics.

11) The herbal supplement used for chest and nasal congestion is called: A) red clover B) parsley C) rose hips D) saw palmetto Answer: C Explanation: C) Rose hips is the herbal supplement used for chest and nasal congestion.

Potential interactions include aluminum-containing medications, estrogens, fluphenazine, lithium, warfarin, aspirin, choline magnesium trisalicylate, and salsalate.

12) The herbal supplement that reduces depression and anxiety is: A) valerian B) soy C) yohimbe D) St. John's wort Answer: D Explanation: D) St. John's wort is the herbal supplement that reduces depression and anxiety. It also has anti-inflammatory properties. However, it must be used cautiously due to a variety of adverse effects. Potential interactions include CNS depressants, opioid analgesics, cyclosporine, efavirenz, indinavir, protease inhibitors, SSRIs, TCAs, antidepressants, and warfarin.

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13) The herbal supplement used for weight loss is called: A) yohimbe B) tee tree oil C) rose hips D) red clover Answer: A Explanation: A) Yohimbe is the herbal supplement used for weight loss. It also increases male sexual potency and has aphrodisiac properties. Potential interactions include ACE inhibitors, antihypertensives, beta-blockers, calcium channel blockers, alpha-adrenergic blockers, CNS stimulants, MAOIs, phenothiazines, SSRIs, sympathomimetics, TCAs, caffeine-containing products, and high-tyramine foods (such as wine, beer, aged cheese, and liver).

14) Saw palmetto is indicated for: A) liver disease B) treatment of benign prostatic hypertrophy C) anxiety D) nasal congestion Answer: B Explanation: B) Saw palmetto is indicated for treatment of benign prostatic hypertrophy.

Potential interactions include anticoagulants, antiplatelet agents, hormones such as estrogens, oral contraceptives, androgens, immunostimulants, and NSAIDs. 15) Glucosamine must be used with caution in patients with: A) diabetes B) osteoarthritis C) skin rashes D) liver disease Answer: A Explanation: A) Glucosamine must be used with caution in patients with diabetes. It is indicated for osteoarthritis and other arthritic conditions. Potential interactions include warfarin, antimitotic chemotherapeutics, acetaminophen, and diabetes medications.

16) Baking soda in water is used for: A) bronchitis B) stress relief C) urinary tract infections D) cold sores Answer: C Explanation: C) Baking soda in water is used for urinary tract infections. It is a popular home remedy used for alternative therapies.

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17) Lemon is useful to treat: A) diarrhea B) nausea C) bronchitis D) eczema Answer: B Explanation: B) Lemon is useful to treat nausea. Also lemon balm tea is used topically for cold sores, and lemon in water is taken orally for colds and congestion. It is a very popular home remedy used for alternative therapies.

18) Olive oil may be used for: A) nausea B) headache C) eczema D) earache Answer: C Explanation: C) Olive oil may be used for eczema. It is applied topically.

19) Salt water is indicated for: A) hiccups B) arthritis C) nausea D) sore throat Answer: D Explanation: D) Salt water is indicated for sore throat. It should only be used to gargle with, and never swallowed. Salt water also reduces mucus.

20) Foot odor may be treated with topical use of: A) vodka B) sugar C) potato juice D) spinach juice Answer: A Explanation: A) Foot odor may be treated with topical use of vodka.

21) Which home and folk remedy may be used for bad breath?

A) yogurt B) vodka C) turmeric D) vinegar Answer: A Explanation: A) Yogurt may be used for bad breath (halitosis).

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22) Potato juice, taken orally, is used for: A) bronchitis B) chest pain C) arthritis D) sore throat Answer: C Explanation: C) Potato juice, taken orally, is used for arthritis.

23) An example of a remedy that relieves deep coughing and reduces uneasy breathing is: A) onions B) oregano oil C) orange juice D) olive oil Answer: B Explanation: B) Oregano oil relieves deep coughing and reduces uneasy breathing. It also reduces soreness from bronchitis.

24) Chondroitin is used for: A) osteoarthritis B) depression C) bronchitis D) sore throat Answer: A Explanation: A) Chondroitin is used for osteoarthritis, as well as other arthritis conditions.

Potential interactions include warfarin.

25) Bilberry is used only for a short period of time to treat: A) mild sedation B) itching C) diarrhea D) headaches Answer: C Explanation: C) Bilberry is used, only for a short period of time, to treat diarrhea. It also treats menstrual cramps, vision problems, varicose veins, and circulatory problems. Potential interactions include anticoagulants, antiplatelet agents, aspirin, insulin, ion, NSAIDs, and oral antidiabetic agents.

26) Bronchitis may be treated by: A) cloves B) garlic C) baking soda D) bay leaf Answer: D Explanation: D) Bronchitis may be treated by bay leaf. It may be taken orally or applied topically to the chest.

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27) Ginger is an example of a remedy that is known as an: A) antiviral agent B) anti-inflammatory agent C) antibiotic D) antiseptic Answer: B Explanation: B) Ginger is an example of a remedy that is known as an anti-inflammatory agent.

It also strengthens immunity.

28) A paste of licorice with petroleum jelly is indicated for: A) calluses B) colds C) fever D) stress Answer: A Explanation: A) A paste of licorice with petroleum jelly is indicated for calluses and corns. It is applied topically.

29) Orange juice and gelatin is used for treatment of: A) eczema B) arthritis C) nausea D) cold sores Answer: B Explanation: B) Orange juice and gelatin is used for treatment of arthritis. Gelatin can also be taken orally to relieve diarrhea.

30) Urinary tract infections may be treated by: A) garlic B) lemon in water C) dandelion tea D) eucalyptus oil Answer: C Explanation: C) Urinary tract infections may be treated by dandelion tea. It is taken orally.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 14 Toxicology 1) In 2014, the total number of reported exposures to poisons in the United States was more than: A) 200,000 B) 800,000 C) 1.4 million D) 2.2 million Answer: D Explanation: D) In 2014, the total number of reported exposures to poisons in the United States was more than 2.2 million.

2) Safety caps are examples of which type of medication packaging?

A) Chemotherapy B) Long-term care facility C) Child-resistant D) Unit dose Answer: C Explanation: C) Child-resistant packaging was introduced in 1972. Safety caps, which require the user to press downward and turn simultaneously, are commonly used in this type of packaging.

3) To diagnose and evaluate chronic intoxications, it is very important to analyze: A) noxious agents B) preventive agents C) aversive agents D) palatable agents Answer: C Explanation: C) To diagnose and evaluate chronic intoxications, it is very important to analyze body fluids or tissues. While some common poisons can be identified by relatively simple laboratory procedures, others require more complex toxicologic tests.

4) The term toxic may be defined as: A) noxious or painful B) poisonous or harmful C) causative or palatable D) intoxicating or sedating Answer: B Explanation: B) Toxic substances are defined as those that are poisonous or harmful. The identification of toxic agents should always be attempted because specific antidotal therapy is obviously impossible without first identifying the toxic agent in question.

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5) Vomiting is referred to as: A) effusion B) perfusion C) emesis D) lavage Answer: C Explanation: C) Emesis is the term used to describe vomiting. It is one of the methods used for eliminating poisons from the gastrointestinal tract.

6) Washing out the stomach with sterile water or a salt-water solution is known as gastric: A) intubation B) hemoperfusion C) dialysis D) lavage Answer: D Explanation: D) Gastric lavage is the process of washing out the stomach with sterile water or a saltwater solution; it is used to remove poisons from the gastrointestinal tract.

7) Which type of poisoning causes severe damage to the brain, nerves, red blood cells, and digestive system?

A) alkalies B) digitalis C) lead D) acetaminophen Answer: C Explanation: C) Lead poisoning causes severe damage to the brain, nerves, red blood cells, and digestive system. Symptoms of acute poisoning include a metallic taste in the mouth, abdominal pain, vomiting, diarrhea, collapse, and coma.

8) What is performed or administered to remove ingested mercuric salts?

A) intubation and sorbitol B) emesis and water or milk C) lavage and activated charcoal D) chelation and ipecac syrup Answer: C Explanation: C) Ingested mercuric salts can be removed by lavage, with activated charcoal also administered. For acute ingestion of mercuric salts, dimercaprol can be given unless the patient has severe gastroenteritis.

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9) The most important manifestation of acetaminophen toxicity is: A) metallic taste B) hepatic damage C) abdominal pain D) bloody diarrhea Answer: B Explanation: B) Hepatic damage is the most important manifestation of acetaminophen toxicity and becomes evident 1-2 days after ingestion. Treatment should begin with the induction of emesis or gastric lavage, followed by the administration of activated charcoal. Treatment with acetylcysteine is most effective if started within 10 hours after ingestion.

10) Death from formaldehyde poisoning is usually caused by: A) circulatory failure B) severe diarrhea C) severe vomiting D) internal bleeding Answer: A Explanation: A) Death from formaldehyde poisoning is usually caused by circulatory failure.

This type of poisoning is diagnosed by the characteristic odor of formaldehyde. This agent reacts chemically with cellular components and depresses cellular functions.

11) When a person is seriously poisoned by aspirin or another salicylate, what highly effective procedures may be used to remove the salicylate?

A) gastric lavage and formalin administration B) esophagoscopy and steroid administration C) chelation and blood transfusions D) peritoneal dialysis and hemodialysis Answer: D Explanation: D) Peritoneal dialysis and hemodialysis are highly effective in removing salicylates from patients with serious poisoning. Other treatments include inducing emesis, gastric lavage, activated charcoal, osmotic cathartics, artificial ventilation with oxygen, and if convulsions are occurring, administration of diazepam or phenobarbital.

12) In the United States, there are: A) 24 poison control centers B) two poison control centers–located in Illinois and North Carolina C) more than 600 poison control centers D) more than 1.900 poison control centers Answer: C Explanation: C) There are more than 600 poison control centers in the United States. See the website www.aapcc.org for poison treatment information.

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13) People who study poisons, toxic agents, and the treatments for them are known as: A) toxinologists B) poison controllers C) poisonologists D) toxicologists Answer: D Explanation: D) Toxicologists are people who study poisons, toxic agents, and their treatments.

They specialize in the study of poisons.

14) Ingestion of just 15 mL of which of the following has caused permanent blindness?

A) atropine B) methyl alcohol C) cyanide D) magnesium sulfate Answer: B Explanation: B) Ingestion of only 15 mL of methyl alcohol (methanol) has caused permanent blindness by producing severe optic nerve and central nervous system (CNS) toxicity.

15) Which potential poison is a natural element present in water and soil that is easily absorbed by the roots of rice plants?

A) toluene B) digitalis C) arsenic D) phosphorus Answer: C Explanation: C) Arsenic is a natural element that is present in water and soil and is easily absorbed by the roots of rice plants. Arsenic is a cellular toxin that is readily absorbed through the GI tract and lungs. Poison may cause neurotoxic effects and multisystem organ failure.

16) Sodium fluoroacetate is a powerful rodent poison that is a form of which of the following?

A) sodium iodide B) fluoride C) edetate calcium disodium D) cationic detergent Answer: B Explanation: B) Sodium fluoroacetate is a powerful rodent poison that is a form of fluoride.

Fluorides are used in insecticides. The gas called "fluorine" is used in industry. Fluorine and fluorides are cellular poisons.

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17) Ethylene glycol is a common poison that is found in: A) photocopier solutions B) car oil C) antifreeze D) ethanol Answer: C Explanation: C) Ethylene glycol is commonly found in antifreeze and windshield deicing solutions and is often colorless with a sweet taste. It can severely damage the liver and even cause inflammation of the lungs (pneumonitis). Gastric lavage should be performed within 30 minutes of the ingestion of ethylene glycol.

18) Methanol is very toxic to the human body because it is metabolized into: A) chloroform B) ethylene glycol C) ethanol D) formaldehyde Answer: D Explanation: D) Methanol is far more toxic to the human body than ethanol because it is metabolized into formaldehyde. It is also known as wood alcohol and is found in gas-line antifreeze, windshield washer fluid, and as a solvent in photocopier solutions.

19) An abnormal state induced by a chemical agent such as a drug, serum, or toxin is known as: A) potentiation B) euphoria C) intoxication D) depression Answer: C Explanation: C) Intoxication is an abnormal state induced by a chemical agent, such as a drug, serum, or toxin. Essentially, intoxication is a form of poisoning. It can lead to permanent disability and sometimes death.

20) Isopropyl alcohol and acetone are both classified as: A) detergents B) insecticides C) CNS depressants D) petroleum distillates Answer: C Explanation: C) Isopropyl alcohol and acetone are both classified as CNS depressants. Isopropyl alcohol is a clear, colorless, bitter aromatic liquid that is miscible with water, ether, chloroform, and ethyl alcohol. Acetone is used in cleaners, nail polish removers, and solvents.

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21) Severe intoxication with opioids is signified by: A) damage to the brain, nerves, red blood cells, and digestive system B) hypotension, bradycardia, hypothermia, coma, and respiratory arrest C) gastroenteritis, neurologic toxicity, bloody diarrhea, and shock D) abdominal pain, nausea, vomiting, and diarrhea Answer: B Explanation: B) Severe intoxication with opioids is signified by hypotension, bradycardia, hypothermia, coma, and respiratory arrest. Death is usually caused by apnea or pulmonary aspiration of gastric contents.

22) Which of the following occurs in a red, nonpoisonous form, and a yellow, highly toxic form?

A) phosphorus B) cocaine C) opium D) alkalies Answer: A Explanation: A) Phosphorus occurs in a red, nonpoisonous form and a yellow, fat-soluble, highly toxic form. The yellow form of phosphorus is used in rodent and insect poisons and in fireworks.

23) The treatment of poisonings with bleach consists of ingesting water or: A) milk B) ethyl alcohol C) benzodiazepines D) antihistamines Answer: A Explanation: A) Bleaches cause corrosive action in the mouth, pharynx, and esophagus.

Treatment consists of diluting ingested bleach with water or milk.

24) Carbon monoxide, which is produced by the exhaust of internal combustion engines, causes the skin and mucous membranes to become: A) bluish B) black C) colorless D) cherry red Answer: D Explanation: D) Severe carbon monoxide poisoning causes a characteristic cherry (red) color in the skin and mucous membranes. Treatment requires ventilation with pure oxygen.

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25) Which of the following is the antidote for cyanide?

A) ethanol B) atropine C) oxygen D) amyl nitrate Answer: D Explanation: D) Amyl nitrate is the antidote for cyanide. Antidotes are drugs or other substances that oppose the action of a poison. Most cyanide antidote kits consist of amyl nitrate, sodium nitrate, sodium thiosulfate, disposable syringes, and a stomach tube.

26) Where do accidental poisonings occur most often?

A) in medical offices B) at home C) in industrial environments D) outside in the environment Answer: B Explanation: B) Accidental poisonings occur far more often at home than through industrial exposure, and the effects are usually acute. Accidental poisoning usually results from the ingestion of toxic substances, with the majority of occurrences involving children.

27) The preferred treatment for digoxin poisoning is: A) gastric lavage B) activated charcoal C) ipecac syrup D) water or milk Answer: B Explanation: B) Digoxin poisoning should be treated with activated charcoal as well as atropine or phenytoin. As the initial treatment, activated charcoal is preferred over gastric lavage or ipecac syrup.

28) Which of the following is an ingredient present in some types of glue that is sniffed or huffed as a recreational drug?

A) lithium B) toluene C) atropine D) phenol Answer: B Explanation: B) Toluene is an ingredient present in some types of glue that is "sniffed" or "huffed" as a recreational drug. Acute poisoning causes CNS manifestations.

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29) Which of the following are the complications of lithium poisoning?

A) corrosive effects on the GI tract B) permanent encephalopathy, nystagmus, ataxia, and choreoathetosis C) permanent brain and kidney damage D) hyperpnea, pulmonary edema, stupor, and coma Answer: B Explanation: B) Complications of lithium poisoning may include permanent encephalopathy, nystagmus, ataxia, and choreoathetosis (the occurrence of involuntary movements).

30) The antidote for methanol poisoning is: A) ethanol B) flumazenil C) N-Acetylcysteine D) atropine Answer: A Explanation: A) The antidote for methanol poisoning is ethanol. Methanol is a wood alcohol that is very dangerous and often causes blindness. It is primarily used as a wood polish ingredient.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 15 Substance Abuse and Misuse 1) Sedatives and hypnotics promote: A) insomnia B) the induction of sleep C) agitation D) constipation Answer: B Explanation: B) Sedatives and hypnotics promote the induction of sleep. They promote relaxation in small doses but can induce sleep and confusion when used in higher doses. Very high doses can induce coma and even death.

2) Dextroamphetamine is used for short-term: A) narcolepsy B) insomnia C) diarrhea D) constipation Answer: A Explanation: A) Dextroamphetamine is used for short-term narcolepsy, and for short-term weight loss after other methods have failed.

3) LSD may cause: A) hypertension B) hyperthermia C) increased heart rate D) all of the above Answer: D Explanation: D) All the answer choices are correct. LSD may cause hypertension, hyperthermia, and increased heart rate.

4) Cannabinoids include: A) lysergic acid B) diethylamide C) hashish D) ketamine Answer: C Explanation: C) Cannabinoids include hashish, as well as marijuana and hash oil. They are obtained from the hemp plant and are usually smoked to obtain their effects.

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5) The long-term use of amphetamines results in feelings of: A) restlessness B) hypotension C) urinary retention D) hypothermia Answer: A Explanation: A) The long-term use of amphetamines results in feelings of restlessness, as well as anxiety and rage.

6) Which of the following hallucinogens is known as "special coke"?

A) Ketamine B) Mescaline C) LSD D) PCP Answer: A Explanation: A) Ketamine is the hallucinogen known as special coke. Other street names for this drug include "special K" and "kit kat."

7) Daily use of marijuana increases the risk of: A) constipation B) lung cancer C) hypermotivation D) narcolepsy Answer: B Explanation: B) Daily use of marijuana increases the risk of lung cancer. Studies have shown that a single "joint" may be as carcinogenic as 20 cigarettes.

8) The prototype hallucinogen is: A) LSD B) cocaine C) nicotine D) alcohol Answer: A Explanation: A) The prototype hallucinogen is LSD. It was first synthesized as LSD-25 from lysergic acid in 1938 by the Swiss biochemist Albert Hofmann, but its hallucinogenic properties were not discovered until 1943.

9) Methamphetamine is commonly known as: A) dope B) grass C) ice D) pot Answer: C Explanation: C) Methamphetamine is commonly known as "ice." Over the past 25 years, methamphetamine use has increased rapidly throughout the world.

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10) LSD is classified as a: A) sedative B) hallucinogen C) narcotic D) CNS stimulant Answer: B Explanation: B) LSD is classified as a hallucinogen. When biochemist Albert Hofmann unintentionally ingested the substance in 1943, he experienced what he described an "extremely stimulated experience."

11) Withdrawal from cocaine and amphetamines is usually less intense than from: A) barbiturates B) marijuana C) hashish D) hash oil Answer: A Explanation: A) Withdrawal from cocaine and amphetamines is usually less intense than from barbiturates.

12) Which of the following hallucinogens is also known as "angel dust"?

A) PCP B) LSD C) MDA D) DOM Answer: A Explanation: A) PCP is a hallucinogen that is also known as "angel dust." It is also known as phencyclidine and was originally discovered in 1926 but was not introduced as a dissociative general anesthetic until the 1950s.

13) Methadone is often used to treat an addiction to: A) marijuana B) morphine C) hashish D) none of the above Answer: B Explanation: B) Methadone is often used to treat addiction to morphine. In 1974, the Narcotic Addict Treatment Act allowed regulated methadone treatment for opioid addiction.

14) The generic name of Ritalin is: A) dextroamphetamine B) methadone C) methylphenidate D) caffeine Answer: C Explanation: C) The generic name of Ritalin is methylphenidate. It is used to treat attention disorders as part of a total treatment plan, including psychological, educational, and social measures.

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15) CNS stimulants are used for all the following except: A) narcolepsy B) stopping smoking C) attention deficit disorder D) obesity Answer: B Explanation: B) CNS stimulants are not used for stopping smoking but are used for narcolepsy, attention deficit disorder, and obesity.

16) LSD was originally derived from a fungus growing on: A) yogurt B) soil C) mushrooms D) grain (rye) Answer: D Explanation: D) LSD was originally derived from a fungus growing on rye, which is a grain.

The fungus is called ergot, and the chemical derived from it is called ergotamine.

17) Acute overdoses of alcohol cause all of the following except: A) respiratory failure B) coma C) severe hypertension D) vomiting Answer: C Explanation: C) Acute overdoses of alcohol do not cause severe hypertension but do cause respiratory failure, coma, and vomiting.

18) Which of the following is NOT an effect of marijuana?

A) increased appetite B) euphoria C) confusion D) hypertension Answer: D Explanation: D) Hypertension is not an effect of marijuana. Its effects include: decreased coordination and motor activity, confusion, paranoia, euphoria, increased thirst and hunger, and bloodshot eyes.

19) Which of the following is NOT a hallucinogen?

A) Ketamine B) Mescaline C) PCP D) Secobarbital Answer: D Explanation: D) Secobarbital is not a hallucinogen, but ketamine, mescaline, and PCP are all considered to be hallucinogens.

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20) Which of the following abuse substances are obtained from the hemp plant?

A) Cannabinoids B) Opioids C) Barbiturates D) Hallucinogens Answer: A Explanation: A) Cannabinoids are substances of abuse that are obtained from the hemp plant.

There are 40 cannabinoids that have been identified, including THC, cannabidiol (CBD), and cannabinol (CBN).

21) The use of more than one abused drug is known as: A) withdrawal B) polysubstance abuse C) addiction D) tolerance Answer: B Explanation: B) The use of more than one abused drug is known as polysubstance abuse. This diagnosis is given when the abused substances have been consumed within a 12-month period without the use of one outweighing the other.

22) What type of problem exists in a patient who fails to fulfill parenting obligations, exhibits hazardous behaviors, experiences related legal problems, and continues using substances despite continuing social or interpersonal problems?

A) Polypharmacy B) Substance abuse C) Significant distress D) Increasing consumption Answer: B Explanation: B) Substance abuse exists in a patient who fails to fulfill parenting obligations, exhibits hazardous behaviors, experiences related legal problems, and continues using substances despite continuing social or interpersonal problems.

23) There are seven signs of substance dependence. Which of the following is NOT one of them?

A) Increasing consumption B) Desire to quit C) Less time spent on abuse D) Fewer occupational, recreational, or social activities Answer: C Explanation: C) Less time spent on abuse is not one of the seven signs of substance dependence.

The seven signs do include increasing consumption; a desire to quit; fewer occupational, recreational, or social activities; tolerance; withdrawal; excessive time spent on abuse; and continued use while understanding the physiologic and psychological effects.

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24) Progressive, chronic abuse of a substance that causes a person to use the substance repeatedly, despite serious health and social consequences, is known as: A) risk taking B) addiction C) tolerance D) additive effect Answer: B Explanation: B) Addiction is defined as progressive, chronic abuse of a substance that causes a person to use the substance repeatedly despite serious health and social consequences.

25) Any combination of sedatives and hypnotics can be lethal; this is known as which of the following?

A) Tolerance B) Progression C) Additive effect D) Toxicity Answer: C Explanation: C) Any combination of sedatives and hypnotics can be lethal. This is known as an additive effect.

26) Which is the most commonly abused illegal drug in the United States?

A) Alcohol B) Sedatives C) Marijuana D) Methamphetamine Answer: C Explanation: C) Marijuana is the most commonly abused illegal drug in the United States. It is derived from the Cannabis sativa plant.

27) The two major types of sedatives (tranquilizers) are barbiturates and: A) alcohol B) nonbarbiturate sedative-hypnotics C) marijuana D) LSD Answer: B Explanation: B) The two major types of sedatives (tranquilizers) are barbiturates and nonbarbiturate sedative-hypnotics.

28) Which of the following CNS depressants have largely replaced barbiturates?

A) Opioids B) Cannabinoids C) Hallucinogens D) Benzodiazepines Answer: D Explanation: D) Benzodiazepines are the CNS depressants that have largely replaced barbiturates and are generally much safer to use.

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29) What is the abbreviation for the amphetamine commonly known as Ecstasy?

A) LSD B) PCP C) THC D) MDMA Answer: D Explanation: D) MDMA is the abbreviation for the amphetamine commonly known as Ecstasy.

30) Which of the following Schedule II drugs is the second-most commonly abused illegal drug in the United States and has rapid and intense actions?

A) Methamphetamine B) Cocaine C) Methadone D) Methylphenidate Answer: B Explanation: B) Cocaine is the schedule Ii drug that is the second-most commonly abused illegal drug in the United States. It has rapid, intense actions.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 16 Antibacterial Agents 1) The term pathogenic means: A) biological B) chemical C) nuclear D) disease-causing Answer: D Explanation: D) Pathogenic means "disease causing." Pathogenic microorganisms have been used as a tool of war and terrorism. Weapons of mass destruction may be nuclear, chemical, or biological in nature.

2) Antibiotics are substances produced by microorganisms that can: A) inhibit other microorganisms only B) inhibit or kill other microorganisms C) produce other microorganisms D) block the portal of exit Answer: B Explanation: B) Antibiotics can inhibit or kill other microorganisms. Repeated exposure to certain antibiotics can cause antibiotic resistance to develop.

3) Subtherapeutic doses are those that are: A) resistant B) pathogenic C) below the level used to treat diseases D) above the level used to treat diseases Answer: C Explanation: C) Subtherapeutic doses are those that are below the level used to treat diseases.

They may play a part in antibiotic resistance. Some bacteria have developed resistance to antibiotics through repeated exposure to subtherapeutic doses and use of antibiotics for nonbacterial infections.

4) The mechanisms of action for the sulfonamides include: A) blocking the biosynthetic pathway of tocopherol B) blocking the biosynthetic pathway of folic acid C) inhibiting the biosynthetic pathway of ascorbic acid D) inhibiting the biosynthetic pathway of amino acid Answer: B Explanation: B) The mechanism of action for sulfonamides is the inhibition of folic acid synthesis. They block a specific step in the biosynthetic pathway of folic acid.

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5) The first antimicrobial agents that were discovered were the: A) penicillins B) sulfonamides C) macrolides D) cephalosporins Answer: B Explanation: B) The first antimicrobial agents discovered were the sulfonamides. They were first synthesized in 1908, but it was many years before their therapeutic value was discovered. In 1937, researchers in England synthesized sulfapyridine, which was the first sulfonamide used with great success in combatting pneumonia.

6) Cephalosporins are classified in how many generations?

A) 4 B) 5 C) 2 D) 3 Answer: A Explanation: A) There are four generations of cephalosporins—numbered 1 through 4. They are a group of antibiotics closely related to the penicillins. Their classifications are based on their Gram-negative spectrum and stability in the presence of beta-lactamases (agents that retard the actions of enzymes).

7) The generic name of Zithromax® is: A) ciprofloxacin B) norfloxacin C) azithromycin D) clarithromycin Answer: C Explanation: C) The generic name of Zithromax® is azithromycin. This drug is a macrolide, which is the term used for drugs having the large chemical ring structure characteristic of the antibiotics.

8) An example of a ureidopenicillin is: A) mezlocillin (Mezlin®) B) ticarcillin (Ticar®) C) ampicillin (Omnipen®) D) penicillin G (Pfizerpen®) Answer: A Explanation: A) The drug mezlocillin (Mezlin®) is an example of a ureidopenicillin. These drugs also include piperacillin and tazobactam. They act similarly to the extended-spectrum penicillins.

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9) The term bactericidal means: A) derived from molds B) antibiotic C) systemic D) killing microbes Answer: D Explanation: D) Bactericidal means "killing microbes." Systemic agents can be bactericidal or bacteriostatic. Facts to consider when selecting antibiotics for therapy in patients should include identification of their bactericidal versus bacteriostatic properties.

10) The term bacteriostatic means: A) localized B) invading C) inhibiting microbial growth D) relying on host defenses Answer: C Explanation: C) Bacteriostatic means "inhibiting microbial growth." Sulfonamides are examples of drugs that are primarily bacteriostatic, and not bactericidal.

11) Bacteria that have the ability to resist decolorization with alcohol after being treated with Gram's crystal violet stain are known as: A) gram negative B) penicillin G C) staphylococci D) gram positive Answer: D Explanation: D) The term gram positive means the ability to resist decolorization with alcohol after being treated with Gram's crystal violet stain. Gram's stain is used to impart a violet color to the bacterium when viewed by microscope.

12) A reaction to a foreign serum is known as: A) angioedema B) toxicity C) penicillinase D) serum sickness Answer: D Explanation: D) A reaction to a foreign serum is known as serum sickness. It is a common manifestation of the allergic response to penicillin. Other manifestations of the allergic response include a raised, itchy skin rash, angioedema, difficulty breathing, and nephropathy.

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13) Examples of agents with gram-negative spectrum are: A) safranins B) beta-lactamases C) cephalosporins D) penicillins Answer: C Explanation: C) Cephalosporins are classified into four generations based on their gramnegative spectrum and stability in the presence of beta-lactamases. Gram-negative bacteria cannot resist decolorization with alcohol after being treated with Gram's crystal violet.

14) The range of bacteria against which an agent is effective is known as its: A) generation B) antibacterial spectrum C) antibiotic spectrum D) gram-negative spectrum Answer: B Explanation: B) An antibacterial spectrum is the range of bacteria against which an agent is effective. Whereas those with a broad spectrum are effective against many different kinds of bacteria, those with a narrow spectrum may be effective against only a single type or a few.

15) Antibiotics effective against a wide range of organisms are known as: A) positive spectrum B) wide spectrum C) broad spectrum D) antibacterial spectrum Answer: C Explanation: C) Broad-spectrum antibiotics are effective against a wide range of organisms.

These include the aminoglycosides, which are very important for the treatment of infections caused by Gram-negative bacilli.

16) The most common superinfection is: A) thrush B) hepatotoxicity C) candidiasis D) diarrhea Answer: C Explanation: C) The most common superinfection is candidiasis, which is caused by Candida spp., especially Candida albicans, usually resulting from debilitation, physiologic change, prolonged administration of antibiotics, and barrier breakage.

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17) The generic name of Ceclor® is: A) cefadroxil B) cefaclor C) cefprozil D) cefoperazone Answer: B Explanation: B) The generic name of Ceclor® is cefaclor. It is a second-generation cephalosporin, along with the generic drugs cefonicid, cefoxitin, and cefuroxime.

18) Aminoglycosides are used for the treatment of: A) sore throat B) herpes zoster C) sepsis D) arthritis Answer: C Explanation: C) Aminoglycosides are used in the treatment of sepsis. They are also used for the treatment of life-threatening infections and in immunocompromised patients.

19) The most common cause of death for people with a chronic or critical illness is: A) diabetes B) heart attack C) infection D) stroke Answer: C Explanation: C) Infection is the most common cause of death for many people affected with a chronic or critical illness, with the very young and the very old being particularly susceptible.

20) Control of infectious disease occurrence depends on breaking the: A) antibiotic resistance B) portal of exit C) reservoir D) chain of transmission Answer: D Explanation: D) Control of infectious disease occurrence depends on breaking the chain of transmission in one or more places. A pathogen can be vulnerable in one or more links of the transmission chain.

21) Antibiotics were discovered in 1928 by: A) Sir Alexander Fleming B) Sir Arthur Fleming C) Louis Pasteur D) Ewins and Phillips Answer: A Explanation: A) Antibiotics were discovered in 1928 when Sir Alexander Fleming was performing research on influenza. One year later, he found penicillin by culturing the mold Penicillium notatum.

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22) The first sulfonamide used with great success in combating pneumonia was: A) PABA B) trimethoprim C) sulfapyridine D) sulfamethoxazole Answer: C Explanation: C) In 1937, Ewins and Phillips of England synthesized sulfapyridine, which was the first sulfonamide used with great success in combating pneumonia.

23) The original penicillin was: A) penicillin A B) penicillin B C) penicillin I D) penicillin G Answer: D Explanation: D) Penicillin G is the original penicillin and remains the drug of choice for the treatment of almost all infections caused by non-penicillinase-producing and non-methicillinresistant gram-positive bacteria.

24) First-generation cephalosporins have their highest activity against: A) cefazolin B) gram-positive bacteria C) gram-negative bacteria D) broad-spectrum bacteria Answer: B Explanation: B) First-generation cephalosporins have their highest activity against gram-positive bacteria and their lowest activity against gram-negative bacteria.

25) Aminoglycosides are very important for the treatment caused by: A) gram-negative bacilli B) gram-positive bacilli C) mycoplasma D) chlamydia Answer: A Explanation: A) Aminoglycosides have been very important antibiotics for the treatment of infections caused by gram-negative bacilli. They are broad-spectrum antibiotics, effective against a wide range of organisms.

26) For patients who are allergic to penicillins, which of the following types of drugs are commonly used instead for infections?

A) Tetracyclines B) Sulfa drugs C) Macrolides D) Cephalosporins Answer: C Explanation: C) Macrolides are commonly used as alternative drugs in patients who are allergic to penicillin because they are effective against many of the same organisms.

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27) Agents that have become a dominant class of antimicrobials since 1990 are known as: A) fluoroquinolones B) sulfa drugs C) tetracyclines D) aminoglycosides Answer: A Explanation: A) Since 1990, the fluoroquinolones have become a dominant class of bactericidal antimicrobial agents. Quinolones have been in use since 1964.

28) Agents that may cause discoloration in the developing teeth of children younger than 8 years old are known as: A) streptogramins B) fluoroquinolones C) aminoglycosides D) tetracyclines Answer: D Explanation: D) Tetracyclines cause many adverse effects, including the graying of the developing teeth of children younger than 8 years of age. GI toxicity is common with oral use. It is probably caused by the combined effect of local irritation and alteration of the intestinal flora.

29) Chloramphenicol should only be used for: A) patients with severe liver or kidney disease B) very serious infections that cannot be managed by other drugs C) severe sore throat D) elderly patients Answer: B Explanation: B) Chloramphenicol should be used only for very serious infections that cannot be managed by other drugs. This is because of the serious toxic reactions it causes.

30) The best drug for the topical treatment of acne vulgaris appears to be: A) linezolid B) vancomycin C) spectinomycin D) clindomycin Answer: D Explanation: D) Clindamycin is perhaps the best drug for the topical treatment of acne vulgaris out of the choices given. It is the drug of choice for the treatment of GI infections caused by Bacteroides fragilis.

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31) The trade name for rifapentine is: A) Floxin® B) Rifater® C) Priftin® D) Seromycin® Answer: C Explanation: C) The trade name for rifapentine is Priftin®. It is one of the most commonly used antituberculotics.

32) An example of tetracyclines is: A) clindamycin B) spectinomycin C) minocycline D) vancomycin Answer: C Explanation: C) Minocycline is an example of tetracyclines. Its trade name is Minocin®.

33) The generic name of Zyvox® is: A) laniazid B) linezolid C) ofloxacin D) cycloserine Answer: B Explanation: B) The generic name of Zyvox® is linezolid. It is characterized as a "miscellaneous antibacterial agent."

34) Ethambutol is an anti-tuberculotic agent that occasionally causes: A) optic neuritis B) loss of memory C) seizures D) heart failure Answer: A Explanation: A) Ethambutol is an anti-tuberculotic agent that occasionally causes optic neuritis, with blurred vision and diminished visual acuity to green light.

35) You should inform patients that ________ may cause tears and urine to become a red-orange color.

A) pyrazinamide B) ethambutol C) isoniazid D) rifampin Answer: D Explanation: D) You should inform patients that rifampin may cause tears and urine to become a red-orange color. This discoloration may also affect the sweat and saliva.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 17 Antiviral Agents 1) Tiny genetic parasites that require the host cell to replicate and spread are known as: A) fungi B) viruses C) bacteria D) parasites Answer: B Explanation: B) Tiny genetic parasites that require the host cell to replicate and spread are known as viruses. The number of drugs available to treat many types of viruses is still quite low.

2) Nucleoside analogs are derived from: A) protease inhibitors B) nicotinic acid C) hydrochloric acid D) nucleic acid Answer: D Explanation: D) Nucleoside analogs (or analogues) are derived from nucleic acid. They are combined with protease inhibitors and used in HAART therapy. This type of therapy involves the combination of three to four drugs effective against HIV. 3) Patients with weakened immune systems are termed to be: A) encephalitic B) immunocompromised C) HAART D) drug-resistant Answer: B Explanation: B) Patients with weakened immune systems are termed to be immunocompromised. These include patients with HIV and AIDS. Patients who are immunocompromised are more prone to infections than other people.

4) Certain viruses protect themselves from attack by the human immune system by creating which of the following?

A) an envelope B) an interferon C) an antitoxin D) a virion Answer: A Explanation: A) Certain viruses protect themselves from attack by the human immune system by creating an envelope. Viruses contain cores of deoxyribonucleic acid or ribonucleic acid, surrounded by protein coatings.

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5) VirScan® is a new test that may identify approximately 1,000 viruses that have previously reached a person's bloodstream. Which of the following body fluids is tested?

A) urine B) semen C) saliva D) blood Answer: D Explanation: D) Blood is tested as part of VirScan® testing, to identify approximately 1,000 viruses that have previously reached a person's bloodstream. The test uses just one drop of blood.

6) The trade name of acyclovir is: A) Videx® B) Zovirax® C) Symmetrel® D) Cytovene® Answer: B Explanation: B) The trade name of acyclovir is Zovirax®. This drug is used for initial and recurrent mucosal and cutaneous herpes simplex virus types 1 and 2, and also for herpes zoster infections in immunocompromised patients.

7) Which of the following antiviral agents is administered by inhalation?

A) ganciclovir (Cytovene®) B) didanosine (Videx®) C) ribavirin (Virazole®) D) amantadine (Symmetrel®) Answer: C Explanation: C) The antiviral called ribavirin (Virazole®) is administered by inhalation. It is a synthetic nucleoside analogue with broad-spectrum antiviral activity against both DNA and RNA viruses.

8) The human immunodeficiency virus infects which type of leukocytes?

A) CD4 cells B) CD8 cells C) B cells D) plasma cells Answer: A Explanation: A) Human immunodeficiency virus infects the leukocytes known as CD4 cells.

These cells are also called helper T-lymphocytes. Once HIV attaches to CD4 proteins on their surfaces, the cells die within about 30 hours.

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9) How many people has AIDS killed since 1981?

A) 3 million B) 7 million C) 22 million D) 58 million Answer: C Explanation: C) AIDS has killed 22 million people, worldwide, since 1981. More than 58 million people worldwide have contracted the HIV virus since 1981.

10) Which of the following is false regarding the structure of HIV? A) It is made up of DNA. B) It is surrounded by core proteins.

C) It is surrounded by a capsid.

D) Its envelope contains glycoproteins.

Answer: A Explanation: A) The HIV virus is not made up of DNA. Its structure is simplistic, being made up of RNA (ribonucleic acid), surrounded by core proteins, which are then surrounded by a protein shell known as a capsid.

11) During all stages of HIV infection, the virus replicates very quickly, particularly during stage: A) 1 B) 2 C) 3 D) 4 Answer: A Explanation: A) The HIV virus replicates most quickly during stage 1. This is because the amount of CD4 cells is still very large, and the host has not developed an immune response against the virus.

12) After exposure to HIV, prophylactic antiretroviral drugs should be administered within: A) 1-2 hours B) 72-96 hours C) 1-2 weeks D) 3-4 weeks Answer: A Explanation: A) After exposure to HIV, prophylactic antiretroviral drugs should be administered within 1 to 2 hours, and no longer than 72 hours after exposure. These drugs must be continued for 28 days. The patient must be tested for antibodies against HIV at the time of exposure if possible, then again at 6 weeks, 12 weeks, and 6 months after exposure.

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13) In which phase of HIV infection are patients asymptomatic?

A) replication phase B) clinical latency phase C) post clinical phase D) final phase Answer: B Explanation: B) Patients with HIV infection are usually asymptomatic in the clinical latency phase. In this phase, HIV levels are lower. Even so, HIV does continue to replicate as CD4 Tlymphocytes progressively decline. This period averages about 10 years in duration.

14) Which of the following is false regarding highly active antiretroviral therapy (HAART)?

A) It reduces viral load.

B) It increases viral load.

C) It increases CD4 cell lymphocyte counts.

D) It delays the onset of AIDS. Answer: B Explanation: B) Highly active antiretroviral therapy (HAART) does not increase viral load, it reduces it. This therapy also increases CD4 lymphocyte counts, delays the onset of AIDS, and prolongs survival of patients with AIDS. In HAART therapy, three to four drugs effective against AIDS are combined.

15) Nucleoside reverse transcriptase inhibitors (NRTIs) inhibit synthesis of viral DNA by reverse: A) protease inhibition B) viral load response C) strand transfer D) transcriptase Answer: D Explanation: D) Nucleoside reverse transcriptase inhibitors (NRTIs) inhibit synthesis of viral DNA by reverse transcriptase. These are structural analogs of nucleosides or nucleotides, the basics of DNA. The NRTIs are the mainstays of therapy.

16) The trade name of zidovudine (AZT or ZDV) is: A) Epzicom® B) Truvada® C) Retrovir® D) Zerit® Answer: C Explanation: C) The trade name of zidovudine (AZT or ZDV) is Retrovir®. The abbreviation "AZT" stands for azidothymidine, the simplified chemical name of the drug. The abbreviation "ZDV" is newer. Zidovudine was the first NRTI available.

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17) Abacavir (Ziagen®) is also referred to as: A) TRZ B) ABC C) AZT D) ZDV Answer: B Explanation: B) Abacavir (Ziagen®) is also referred to as ABC. It is an analog of the naturally occurring pyrimidine known as guanine. It is approved only for HIV-1 infection, and should always be combined with other antiretroviral drugs.

18) The major adverse effects of didanosine (Videx®) are: A) peripheral neuropathies and pancreatitis B) heart failure and vasculitis C) kidney failure and acidosis D) encephalitis and hypertrophy of prostate Answer: A Explanation: A) The major adverse effects didanosine (Videx®) are peripheral neuropathies and pancreatitis, which may be fatal. These effects are more likely in high doses of the drug. It is minimally toxic to bone marrow.

19) Which of the following drugs is NOT classified as a non-nucleoside reverse transcriptase inhibitor (NNRTI)?

A) delavirdine (Rescriptor®) B) efavirenz (Sustiva®) C) zidovudine (Retrovir®) D) rilpivirine (Edurant®) Answer: C Explanation: C) The drug called zidovudine (Retrovir®) is not classified as a non-nucleoside reverse transcriptase inhibitor (NNRTI). It is classified as a nucleoside reverse transcriptase inhibitor (NRTI). This type of drug inhibits synthesis of viral DNA by reverse transcriptase.

20) Which of the following NNRTIs is the only first-line therapy against HIV, and is highly effective?

A) etravirine (Intelence®) B) nevirapine (Viramune®) C) efavirenz (Sustiva®) D) rilpivirine (Edurant®) Answer: C Explanation: C) The drug called efavirenz (Sustiva®) is the NNRTI that is the only first-line therapy against HIV, and is highly effective. It is considered a preferred agent against HIV, and can be given once per day due to its long half-life. It binds directly to HIV reverse transcriptase, disrupting its active center and suppressing its activity, and is only effective against HIV-1.

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21) Atazanavir (Reyataz®) is a protease inhibitor that is NOT used in infants younger than 3 months because it may cause: A) kernicterus B) hepatitis C) brain damage D) aplastic anemia Answer: A Explanation: A) Atazanavir (Reyataz®) is a protease inhibitor that is not used in infants younger than 3 months because it may cause kernicterus. It is used in combination with other antiretrovirals for HIV-1 infection.

22) The trade name of saquinavir is: A) Viracept® B) Norvir® C) Aptivus® D) Invirase® Answer: D Explanation: D) The trade name of saquinavir is Invirase®. It was the first protease inhibitor approved by the FDA, and appears to be more potent than the other PIs. Its effectiveness is boosted by administration along with ritonavir.

23) Which agent is used for prophylaxis and treatment of systemic cytomegalovirus?

A) entecavir B) ganciclovir C) acyclovir D) amantadine Answer: B Explanation: B) For prophylaxis and treatment of systemic cytomegalovirus, ganciclovir is used. It is a synthetic purine nucleoside analogue used in immunocompromised patients. It is also prescribed for CMV retinitis.

24) The most common complication of influenza is bacterial: A) meningitis B) laryngitis C) pneumonia D) pancreatitis Answer: C Explanation: C) The most common complication of influenza is bacterial pneumonia. Primary influenza viral pneumonia is rare, yet has a high fatality rate. Risks for complications and hospitalizations are higher in people age 65 or older, in very young children, or in any age if there are certain underlying medical conditions. Other complications may include Reye syndrome, myocarditis, and death.

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25) Amantadine is used for the treatment of influenza and: A) parkinsonism B) hepatitis C C) cytomegalovirus D) cirrhosis of the liver Answer: A Explanation: A) Amantadine is used for the treatment of influenza and parkinsonism. It is also used to prevent or treat respiratory tract illnesses, in patients of all ages. Amantadine inhibits replication of the influenza A virus by interfering with viral attachment and by the uncoating of the virus.

26) Ribavirin is administered as an aerosol into an infant oxygen hood for the treatment of: A) bacterial pneumonia B) respiratory failure C) respiratory syncytial virus pneumonia D) pneumoconiosis Answer: C Explanation: C) Ribavirin is administered as an aerosol into an infant oxygen hood for the treatment of respiratory syncytial virus pneumonia. It is believed to selectively interfere with viral ribonucleic protein synthesis.

27) Which type of viral hepatitis is more severe when contracted by pregnant women?

A) hepatitis B B) hepatitis E C) hepatitis C D) hepatitis A Answer: B Explanation: B) Hepatitis E is more severe when contracted by pregnant women. It is more common in young adults and those visiting endemic areas such as Africa, Asia, Central America, or India. Hepatitis E is mostly transmitted through the fecal-oral route, via contaminated drinking water. Less commonly, it is transmitted through contaminated food, blood transfusions, and during pregnancy.

28) Which type of viral hepatitis is usually spread via the fecal-oral route by ingestion of fecal contaminants?

A) hepatitis G B) hepatitis D C) hepatitis A D) hepatitis E Answer: C Explanation: C) Hepatitis A is usually spread via the fecal-oral route by ingestion of fecal contaminants. It is most common among male homosexuals and individuals with HIV infection.

Symptoms develop slowly.

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29) The route of administration of immunoglobulin to treat viral hepatitis is: A) IM B) IV C) SC D) ID Answer: A Explanation: A) The intramuscular (IM) route of administration is used for immunoglobulin in the treatment of viral hepatitis. Human immunoglobulin is marketed under trade names such as BayGam®, Biogam®, and GamaSTAN S/D®.

30) Which type of viral hepatitis may be prevented by vaccine?

A) hepatitis E B) hepatitis G C) hepatitis C D) hepatitis A Answer: D Explanation: D) Hepatitis A may be prevented by vaccine, as well as hepatitis B. The other forms of hepatitis currently have no vaccines. Hepatitis A may also be treated with IM immunoglobulin, and hepatitis B may also be treated with NRTIs and antiviral interferons.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 18 Antifungal Agents 1) A fungal infection is termed a: A) local infection B) phagocytosis C) mycosis D) filamentous Answer: C Explanation: C) A fungal infection is termed a mycosis. The causative fungus may be either yeast or a filamentous fungus. Normal healthy individuals are resistant to most fungal infections.

2) A common candidiasis infection of the mouth is known as: A) thrush B) aspergillosis C) thrombophlebitis D) gossypol Answer: A Explanation: A) Also known as moniliasis, thrush is a common opportunistic candidiasis infection of the mouth caused by Candida albicans, which is a normal resident of the gastrointestinal tract and vagina.

3) The term fungicidal is defined as: A) having a killing action on protozoans B) increasing fungal growth C) slowing fungal growth without destroying the fungi D) having a killing action on fungi Answer: D Explanation: D) Fungicidal is defined as "having a killing action on fungi." The term "fungistatic" means "slowing fungal multiplication". Many antifungal agents affect the cell membranes of fungi and act in relation to their concentration in body tissues.

4) The drug with the widest spectrum of antifungal activity is: A) griseofulvin B) amphotericin B C) flucytosine D) ketoconazole Answer: B Explanation: B) Amphotericin B is the antifungal with the widest spectrum of antifungal activity of any systemic antifungal drug. Administration of this drug by the IV route is extremely useful for therapy of systemic fungal diseases such as Candida albicans.

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5) Most antifungal drugs act by interfering with the synthesis of: A) fluorouracil B) gossypol C) moniliasis D) ergosterol Answer: D Explanation: D) Most antifungal drugs act by interfering with the synthesis of ergosterol–a chemical found in fungal cell membranes. This results in a change in the permeability of the fungal cell membrane, and either slowed growth or destruction of the fungal organism.

6) The most serious adverse effect of amphotericin B is: A) fever B) renal damage C) thrombophlebitis D) loss of hearing Answer: B Explanation: B) The most serious adverse effect of amphotericin B is renal damage. This drug is also able to cause blood dyscrasias and loss of hearing.

7) The drug of choice to treat chromomycosis is: A) ketoconazole B) amphotericin B C) fluorouracil D) flucytosine Answer: D Explanation: D) Flucytosine is the drug of choice to treat chromomycosis and of second choice to treat systemic candidiasis. It is converted in the fungus to 5-fluorouracil, which is incorporated into RNA and interferes with normal protein synthesis.

8) Severe cutaneous dermatophyte infections that resist griseofulvin therapy should be treated with: A) flucytosine B) chloroquine C) ketoconazole D) amphotericin B Answer: C Explanation: C) Ketoconazole is used to treat many varieties of candidiasis infections and for severe cutaneous dermatophyte infections that resist griseofulvin therapy.

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9) Griseofulvin is fungistatic and NOT fungicidal, and must be used systemically: A) for a long period of time B) to kill all remaining fungi C) in patients with porphyria D) to increase contraceptive efficacy Answer: A Explanation: A) Because it does not kill but only arrests the reproduction of organisms, griseofulvin must be continually used for a long period of time so the entire epidermis can be replaced to remove reinfecting organisms.

10) Fungal superinfections usually occur in the anal, genital, and: A) skin areas B) eye areas C) oral areas D) ear areas Answer: C Explanation: C) Fungal superinfections usually occur in the anal and genital areas or in the vagina or mouth. They cause itching, vaginal discharge, and lesions on the tongue or mouth. A common type of fungal superinfection is known as candidiasis or moniliasis.

11) A fungus is a one-celled plant that lacks: A) virulence B) spores C) color and chlorophyll D) pathogenicity Answer: C Explanation: C) A fungus is a one-celled plant that lacks both color and chlorophyll. The various fungi that can cause human diseases are either mold-like or yeast-like.

12) The trade name for nystatin is: A) Flucytosine® B) Pentamidine® C) Lovastatin® D) Mycostatin® Answer: D Explanation: D) Mycostatin® is the trade name for nystatin. Topical forms of this drug are used for local Candida albicans infections of the skin. Nystatin and other antifungal agents affect the cell membranes of fungi, and act in relation to the amount of drug concentrated in body tissues.

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13) Candidiasis may occur because of an overgrowth of: A) yeast-like fungi B) mold-like fungi C) tissue D) a certain type of worm Answer: A Explanation: A) Candidiasis may occur because of an overgrowth of yeast-like fungi, such as in the vagina. Normally, multiplication of these microorganisms is controlled because of a strain of vaginal bacteria known as Doderlein bacillus. Penicillin therapy may destroy these bacteria, causing the fungi to multiply at a rapid rate.

14) Which of the following is derived from fungi?

A) vaccines B) immunoglobulins C) antitoxins D) antiviral agents Answer: C Explanation: C) Antitoxins may be derived from fungi. Also, fungi may be used to develop certain antibiotics. Other types of fungi are used as food for various organisms, and also in the fermentation process of medical substances, industrial substances, and alcohol.

15) Which of the following is NOT a risk factor for candidal infections?

A) diabetes B) hypertension C) pregnancy D) administration of corticosteroids Answer: B Explanation: B) Hypertension is not a risk factor for candidal infections. Those at highest risk for these infections include diabetics, pregnant women, females taking oral contraceptives, and patients taking antibiotics or corticosteroids, including postsurgical or post-transplant patients.

16) The trade name of fluconazole is: A) Diflucan® B) Grifulvin® V C) Amphocin® D) Mycamine® Answer: A Explanation: A) The trade name of fluconazole is Diflucan®. This drug has fungistatic actions that are believed to deplete sterols, which are substances in fungal cells that are similar to fats.

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17) The most serious toxic effect of amphotericin B is: A) liver damage B) deafness C) retinopathy D) kidney damage Answer: D Explanation: D) The most serious toxic effect of amphotericin B is kidney damage. This drug is very toxic, and is usually administered intravenously. Elderly patients must be very careful concerning this drug and potential kidney damage. Older adults who have renal impairment must be tested for creatinine clearance.

18) Griseofulvin is contraindicated in patients with: A) cataracts B) porphyria C) gastritis D) pancreatitis Answer: B Explanation: B) Griseofulvin is contraindicated in patients with porphyria. Safe use of this drug during pregnancy, lactation, or in children younger than 2 years has not been established.

19) Onychomycosis is also known as: A) tinea unguium B) tinea corporis C) tinea barbae D) tinea pedis Answer: A Explanation: A) Onychomycosis is also known as tinea unguium. It is a chronic fungal disease of the nails, which thicken, discolor, disfigure, and split. About 50% of all nail disorders are caused by onychomycosis, which is the most common nail disease in adults.

20) Micafungin should NOT be given to patients who have which of the following?

A) fever or chills B) liver or kidney disease C) fungal infections D) heart failure Answer: B Explanation: B) Micafungin should not be given to patients who have liver or kidney disease, or who may be allergic to this drug. It may interact with drugs such as sirolimus, itraconazole, and nifedipine.

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21) Terbinafine (Lamisil®) is used for the treatment of: A) histoplasmosis B) candidiasis C) blastomycosis D) onychomycosis Answer: D Explanation: D) Terbinafine (Lamisil®) is used for the treatment of onychomycosis. It is fungicidal against certain types of fungi, and works by inhibiting biosynthesis of ergosterol, causing cell death.

22) The trade name of sulconazole is: A) Oxistat® B) Monistat® C) Exelderm® D) Tinactin® Answer: C Explanation: C) The trade name of sulconazole is Exelderm®. It is a broad-spectrum antifungal agent that inhibits growth of many types of fungi. Sulconazole is used to treat jock itch and tinea corporis, as well as tinea versicolor. It is not effective against athlete's foot.

23) The trade name of tioconazole is: A) Monistat® B) Tinactin® C) Oxistat® D) Naftin® Answer: A Explanation: A) The trade name of tioconazole is Monistat®. This drug inhibits the growth of pathogenic yeasts. It has fungicidal activity in vitro against Candida albicans, other Candida species, and against Torulopsis glabrata.

24) Cryptococcal meningitis can be treated by intravenous injection of the antifungal agent known as: A) griseofulvin B) fluconazole C) voriconazole D) itraconazole Answer: B Explanation: B) Cryptococcal meningitis can be treated by intravenous injection of the antifungal agent known as fluconazole. This drug has good central nervous system (CNS) penetration. Fluconazole is also indicated for the treatment of vaginal candidiasis, oropharyngeal candidiasis, and esophageal candidiasis.

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25) Which of the following systemic antifungal agents can be administered intravenously?

A) fluconazole (Diflucan®) B) ketoconazole (Nizoral®) C) griseofulvin (Grifulvin V®) D) caspofungin (Cancidas®) Answer: D Explanation: D) The systemic antifungal agent called caspofungin (Cancidas®) can be administered intravenously. It is used for a variety of serious internal fungal infections, and often in patients who cannot use or do not respond to other antifungals. It is administered IV via slow infusion, which can take at least 1 hour to complete.

26) The trade name of posaconazole is: A) Noxafil® B) Lamisil® C) Vfend® D) Nystex® Answer: A Explanation: A) The trade name of posaconazole is Noxafil®. It is an azole antifungal agent, available as a concentrated solution to be diluted before IV administration, as a delayed-release tablet, or as an oral suspension.

27) Which of the antifungal agents may cause angioedema, taste sensation changes, and hepatitis?

A) caspofungin B) fluconazole C) amphotericin B D) flucytosine Answer: B Explanation: B) Fluconazole may cause angioedema, taste sensation changes, and hepatitis. Its other adverse effects include headache, nausea, vomiting, abdominal pain, diarrhea, dyspepsia, dizziness, anaphylaxis, and skin rash. Hepatobiliary effects such as hepatitis are rare, but have included mild transient elevations in transaminases, cholestasis, and fulminant hepatic failure— which have caused death.

28) The trade name of voriconazole is: A) Nizoral® B) Grifulvin V® C) Vfend® D) Lamisil® Answer: C Explanation: C) The trade name of voriconazole is Vfend®. It is an azole antifungal that may be administered in a variety of ways. It usually works equally well in patients who do not have other conditions, and in patients who are at risk of aspergillosis, such as those with malignant neoplasms of the lymphatic or hematopoietic tissues.

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29) Onychomycosis is a chronic fungal disease of the: A) skin B) nails C) hair D) sweat glands Answer: B Explanation: B) Onychomycosis is a chronic fungal disease of the nails. Also known as tinea unguium, if untreated, the nails can become so thick that they press against the insides of gloves or shoes. This may cause pressure, irritation, and pain. Toenails are much more likely to be infected than fingernails, and incidence of onychomycosis has been increasing.

30) The trade name of butenafine is: A) Naftin® B) Mycostatin® C) Lotrimin® D) Mentax® Answer: D Explanation: D) The trade name of butenafine is Mentax®. It is a synthetic antifungal agent, and is classified as a benzylamine. It is used for skin infections, including tinea versicolor (pityriasis), tinea pedia (athlete's foot), tinea corporis (ringworm), and tinea cruris (jock itch).

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 19 Antiprotozoal Agents 1) Malaria is a serious disease that is caused by a: A) bacterium B) catabolism C) fungi D) protozoan Answer: D Explanation: D) Malaria is caused by a protozoan transmitted to humans by mosquitoes.

Protozoans are microorganisms that include all the acellular or loosely held together, nontissued unicellular forms.

2) The ideal antimalarial should eradiate the microzoan from the blood and the tissue to ensure: A) a cycle B) resistance C) prevention D) a radical cure Answer: D Explanation: D) The ideal antimalarial should eradicate the microzoan not only from the blood but also from the tissue to affect a radical cure. For treatment of malaria, several antimalarial agents differ in their points of interruption of the cycle of the parasite, and in the type of malaria affected.

3) Malaria is caused by several species of the protozoan: A) P. ovale B) Plasmodium C) Anopheles D) microzoan Answer: B Explanation: B) Malaria is caused by several species of the protozoan Plasmodium, of which Plasmodium vivax and Plasmodium falciparum are the most common. The most serious infections involve P. falciparum, which causes a higher incidence of complications and deaths.

4) The drug of choice for the treatment of most types of malaria is: A) nucleic acid B) quinine C) chloroquine D) quinidine Answer: C Explanation: C) The drug of choice for the (oral) treatment of most types of malaria is chloroquine. It is used for all types of malaria except that caused by resistant P. falciparum.

Chloroquine is a protozoacidal drug, and destroys Plasmodia organisms by interfering with their metabolism, or inhibiting normal replication of the protozoan.

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5) An antimalarial agent that is very important for the radical cure of relapsing P. vivax or P. ovale malaria is: A) quinine B) primaquine C) quinidine D) hydroxychloroquine Answer: B Explanation: B) An antimalarial agent that is very important for the radical cure of relapsing P. vivax or P. ovale malaria is primaquine. It is not used for suppressive therapy, or for the control of the acute clinical attacks of the disease.

6) The treatment of choice for severe P. falciparum infection is: A) quinidine B) quinine C) primaquine D) hydroxychloroquine Answer: B Explanation: B) The treatment of choice for severe P. falciparum infection is quinine. A chemically related drug—quinidine gluconate—is an antidysrhythmic drug that is used off-label to treat severe malaria via IV administration.

7) A drug used adjunctively with primaquine to eradicate P. vivax and P. malariae is: A) quinidine B) hydroxychloroquine C) quinine D) chloroquine Answer: B Explanation: B) Hydroxychloroquine is used adjunctively with primaquine to eradicate P. vivax and P. malariae. It is also commonly prescribed for the treatment of rheumatoid arthritis and lupus erythematosus.

8) Two protozoal organisms—Entamoeba histolytica and Giardia lamblia—frequently cause: A) thrush B) dermatophyte infections C) malaria D) dysentery Answer: D Explanation: D) Dysentery is frequently caused by the organisms Entamoeba histolytica and Giardia lamblia. It is an infection that is also known as amebiasis. Dysentery is most common in areas of the world with poor sanitation and economic conditions, including Central America, South America, Africa, and India.

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9) The most commonly reported intestinal protozoal infection in the United States is: A) giardiasis B) dysentery C) amebiasis D) colitis Answer: A Explanation: A) Giardiasis is the most commonly reported intestinal protozoal infection in the United States. It is an infection in which trophozoites attach to the mucosa of the duodenum and jejunum, then multiply using binary fission. Most cases of giardiasis are transmitted through contaminated water or food, sexual contact, and other direct contact.

10) Which of the following is indicated for trichomoniasis, acute intestinal amebiasis, and amebic liver abscess?

A) hydroxychloroquine B) quinidine C) metronidazole D) iodoquinol Answer: C Explanation: C) Metronidazole is indicated for trichomoniasis, acute intestinal amebiasis, and amebic liver abscess. It is direct-acting, and usually indicated for preoperative prophylaxis in colorectal surgery, elective hysterectomy or vaginal repair, and emergency appendectomy.

11) Iodoquinol is an anti-infective, antiprotozoal, and: A) antiamebicide agent B) antiemetic agent C) analgesic agent D) antiseptic agent Answer: A Explanation: A) Iodoquinol is an anti-infective, antiamebicide, and antiprotozoal agent. It is a direct-acting amebicide that works in the intestinal lumen. It is used only as a luminal amebicide, and has no effect against extraintestinal amebic infections.

12) Gametes are: A) germ cells B) sperm cells C) egg cells D) liver cells Answer: A Explanation: A) Gametes are germ cells. An example of a drug that is destructive to gametes is quinine. This drug remains the first-line therapy for severe P. falciparum malaria. It is not generally used in chemoprophylaxis owing to its toxicity.

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13) Trichomonas vaginalis causes trichomoniasis, which is common in the United States and is transmitted: A) by insects B) by contact with the infected skin of another person C) sexually D) by spores Answer: C Explanation: C) Trichomonas vaginalis causes trichomoniasis, common in the United States. It is transmitted sexually, and is an important protozoal infection.

14) The trade name of chloroquine is: A) Vibramycin® B) Lariam® C) Aralen® D) Primaquine® Answer: C Explanation: C) The trade name of chloroquine is Aralen®. Though an extremely effective drug, it is contraindicated in patients with liver disease, hypersensitivity to 4-aminoquinolines, psoriasis, porphyria, and renal disease. It should also not be used by children, or by pregnant or lactating women.

15) The most common drug used for the prophylaxis and treatment of acute malarial attacks is: A) doxycycline B) chloroquine C) primaquine D) quinine Answer: B Explanation: B) The most common drug, of the given answer choices, used for the prophylaxis and treatment of acute malarial attacks is chloroquine. It is effective against causative agents such as P. vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum.

16) The trade name of iodoquinol is: A) Yodoxin® B) Tindamax® C) Flagyl® D) Paromomycin sulfate® Answer: A Explanation: A) The trade name of iodoquinol is Yodoxin®. This drug is commonly prescribed either concurrently or in alternating courses with another intestinal amebicide.

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17) Yodoxin® is classified as: A) antiprotozoal, anti-malarial B) anti-infective, antiamebicide, antidepressant C) anti-malarial, antiviral, antacid D) antiamebicide, antiprotozoal, anti-infective Answer: D Explanation: D) Yodoxin® is classified as antiamebicide, antiprotozoal, and anti-infective. It works in the intestinal lumen, entering protozoal cells to affect DNA, inhibit synthesis, and cause cell death.

18) Paromomycin is a broad-spectrum antibiotic that works very similarly to: A) neomycin B) tetracycline C) tinidazole D) nitazoxanide Answer: A Explanation: A) Paromomycin is a broad-spectrum antibiotic that works very similarly to neomycin, which is actively transported across cell membranes to bind with receptor proteins.

This interferes with DNA and RNA of the target microorganisms. Paromomycin is produced by Streptomyces riomosus, specifically the variant known as paromomycinus.

19) The trade name of nitazoxanide is: A) Tinidazole® B) Alinia® C) Flagyl® D) Tindamax® Answer: B Explanation: B) The trade name of nitazoxanide is Alinia®. It is a synthetic antiprotozoal agent for oral administration, recommended to be administered with food. The drug is able to interfere with the enzymes needed by protozoa for energy metabolism.

20) The treatment of choice for severe Plasmodium falciparum is: A) doxycycline B) primaquine C) quinine D) chloroquine Answer: C Explanation: C) The treatment of choice (first-line therapy) for severe Plasmodium falciparum is quinine. Its actual mechanism of action is unknown.

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21) Aplastic anemia and alopecia are the adverse effects of which of the following drugs?

A) chloroquine B) hydroxychloroquine C) doxycycline D) mefloquine Answer: B Explanation: B) Aplastic anemia and alopecia are the adverse effects of hydroxychloroquine.

Though rare, these effects are serious, and also include agranulocytosis and thrombocytopenia.

22) Primaquine is contraindicated in patients with: A) lupus erythematosus B) asthma C) urinary tract infections D) sinusitis Answer: A Explanation: A) Primaquine is contraindicated in patients with lupus erythematosus. It is also contraindicated with rheumatoid arthritis, and should be avoided in pregnancy.

23) Pyrimethamine is used to treat acute malaria and: A) Chagas disease B) amebiasis C) toxoplasmosis D) giardia Answer: C Explanation: C) Pyrimethamine is used to treat acute malaria and toxoplasmosis. It is also used for the prophylaxis of malaria, along with sulfonamides, chloroquine, or quinine.

24) The trade name of metronidazole is: A) Tindamax® B) Yodoxin® C) Alinia® D) Flagyl® Answer: D Explanation: D) The trade name of metronidazole is Flagyl®. This drug is indicated for liver abscess, intestinal amebiasis, trichomoniasis, anaerobic infections, vaginosis, diarrhea, colitis, pelvic inflammatory disease, and to prevent post-operative infection after colorectal surgery.

25) Which of the following drugs is used to treat giardiasis in patients 1 year of age and older?

A) nitazoxanide B) pyrimethamine C) benznidazole D) nifurtimox Answer: A Explanation: A) Nitazoxanide is used to treat giardiasis in patients over 1 year of age and older.

It is also used for diarrhea that is caused by Cryptosporidium parvum in patients between 1 and 11 years of age.

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26) Chagas disease is caused by: A) Giardia lamblia B) Entamoeba histolytica C) Toxoplasma gondii D) Trypanosoma cruzi Answer: D Explanation: D) Chagas disease is caused by Trypanosoma cruzi. It is transmitted by Triatominae insect bites. These insects are commonly known as conenose bugs, kissing bugs, assassin bugs, or triatomines. Their bites transmit infected feces, entering either through the bite wound or penetrating the mucous membranes of conjunctivae.

27) Abdominal cramps with eructation and foul-smelling diarrhea are symptoms of: A) malaria B) giardiasis C) amebiasis D) toxoplasmosis Answer: B Explanation: B) Abdominal cramps with eructation and foul-smelling diarrhea are symptoms of giardiasis. Symptoms appear between 1 and 2 weeks following infection. Additional symptoms include abdominal cramps with distention, flatulence, epigastric discomfort, intermittent nausea, and occasionally, slight malaise and anorexia.

28) All patients taking pyrimethamine should also receive: A) folinic acid B) vitamin B6 C) vitamin B12 D) vitamin E Answer: A Explanation: A) All patients taking pyrimethamine should also receive folinic acid. If bone marrow suppression occurs from pyrimethamine, this can be minimized with folinic acid.

29) The trade name of nifurtimox is: A) Flagyl B) Alinia C) Fasigyn D) none; it is generic only Answer: D Explanation: D) There is no trade name of nifurtimox. It is generic only, and not commercially available in the United States. However, it may be obtained from the Centers for Disease Control and Prevention (CDC), and is a systemic antiprotozoal.

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30) A severe complication of congenital toxoplasmosis is: A) encephalitis B) pancreatitis C) blindness D) retrograde amnesia Answer: C Explanation: C) Blindness (in infants) is a severe complication of congenital toxoplasmosis.

Treatment of toxoplasmosis, when indicated, is usually with pyrimethamine/sulfadiazine, though other medications may also be used.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 20 Vaccines and Immunoglobulins 1) The Food and Drug Administration (FDA) classifies immunizing agents and allergenic extracts as: A) antibodies B) lymphocytics C) pathogenics D) biologics Answer: D Explanation: D) Immunizing agents and allergenic extracts are the two main groups of drugs that are classified by the FDA as biologics. These are chemical agents that produce biological responses in the body.

2) The most common adverse effect associated with vaccinations is: A) high fever B) severe headache C) localized inflammation D) asthma Answer: C Explanation: C) The most common adverse effect associated with vaccinations is localized inflammation at the site of injection. Other common adverse effects include a mild fever, headache, malaise, nausea, and dizziness.

3) Which of the following is a live attenuated vaccine?

A) pertussis B) pneumococcal conjugate C) hepatitis B D) BCG Answer: D Explanation: D) The Bacillus Calmette Guérin (BCG) vaccine is a live attenuated vaccine. It is administered intradermally. However, it is not generally recommended for use in the United States because of a low risk of infection with Mycobacterium tuberculosis, and other reasons. It should only be considered for people who meet specific criteria determined by a tuberculosis expert.

4) Special proteins that are made by lymphocytes that fight invaders are known as: A) glycoproteins B) amino acids C) antigens D) antibodies Answer: D Explanation: D) The body continues to fight invaders by forming special proteins manufactured by the lymphocytes, called antibodies. The dominant cells of the lymphatic system, lymphocytes are vital to our ability to resist or overcome infection and disease.

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5) Lymphocytes respond to the presence of cancer cells, foreign proteins, and invading: A) lymphocytes B) antibodies C) pathogens D) antigens Answer: C Explanation: C) Lymphocytes respond to the presence of invading pathogens (such as bacteria or viruses), abnormal body cells (such as cancer), and foreign proteins (such as toxins released by some bacteria). Lymphocytes attempt to eliminate these threads or render them harmless by a combination of physical and chemical attack.

6) Which of the following vaccines can be administered at birth?

A) hepatitis B B) diphtheria C) influenza D) varicella Answer: A Explanation: A) The hepatitis B vaccine can be administered at birth. Neonates born to mothers who are positive for hepatitis B should be immunized immediately with the vaccine (EnergixB®) and hepatitis B Ig. 7) The ability to resist infection and disease through the activation of specific defenses is known as: A) immune response B) immunity C) hypersensitivity D) tolerance Answer: B Explanation: B) Immunity is the ability to resist infection and disease through the activation of specific defenses. The lymphatic system includes three components: a network of lymphatic vessels, a fluid called lymph, and lymphoid organs, which are connected to the lymphatic vessels and contain large numbers of lymphocytes.

8) Varivax® is very effective against: A) polio B) chickenpox C) measles D) mumps Answer: B Explanation: B) Varivax® is very effective against chickenpox. It is also called the varicella vaccine, and was licensed in 1995. It is still much too early to completely evaluate the impact of the immunization program on the epidemiology of varicella-zoster.

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9) T cells, which compromise about 80% of circulating lymphocytes, are the primary cells that provide: A) antigens B) plasma cells C) cell-mediated immunity D) antibodies Answer: C Explanation: C) T cells comprise approximately 80% of circulating lymphocytes. Cytotoxic T cells directly attack foreign cells or body cells infected by viruses. These lymphocytes are the primary cells that provide cell-mediated immunity.

10) How many doses of H1N1 vaccine must be administered to children younger than the age of 10 years?

A) two B) three C) five D) none; it is contraindicated Answer: A Explanation: A) Two doses of H1N1 vaccine must be administered to children younger than the age of 10 years. The vaccine became available in October 2009. It is available in killed and inactivated forms — either by injection or as a nasal spray. For children under 10, the two doses are given 21 to 28 days apart.

11) The only routine immunizations recommended for all normal adults between the age of ________ are booster doses of adult diphtheria and tetanus every 10 years.

A) 18 and 30 years B) 20 and 45 years C) 18 and 65 years D) 20 and 85 years Answer: C Explanation: C) The only routine immunizations recommended for all normal adults between the ages of 18 and 65 are booster doses of adult diphtheria and tetanus every 10 years. If this has not been done, it is important to updated these vaccinations at age 65.

12) Humoral immunity, which is based on the antigen—antibody response, is brought about by which type of cell?

A) Macrophages B) B cells C) T cells D) Natural killer cells Answer: B Explanation: B) Humoral immunity is based on the antigen antibody response. B cells, which are responsible for humoral immunity, produce circulating antibodies to act against an antigen.

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13) A form of acquired immunity that develops in an individual in response to an immunogen (antigen) is known as: A) fetal immunity B) vaccine immunity C) passive immunity D) active immunity Answer: D Explanation: D) Active immunity is a form of acquired immunity that develops in an individual in response to an immunogen (antigen). This may occur either naturally, by exposure to an infectious disease, or artificially, by receiving active immunizing agents (vaccines).

14) Active immunization is also known as: A) passive immunity B) vaccination C) active immunity D) immunoglobulin activity Answer: B Explanation: B) The term vaccination is used as a synonym for active immunization. Active immunity is a form of acquired immunity that develops in an individual, in response to an immunogen (antigen).

15) The transfer of immunoglobulins or antibodies from an immune individual to another is involved in which type of immunity?

A) Active B) Passive C) Natural D) All of the above Answer: B Explanation: B) Passive immunity involves the transfer of the effectors of immunity, which are called immunoglobulins or antibodies, from an immune individual to another.

16) A preparation of microorganisms that is administered to produce or artificially increase immunity to a particular disease is known as a(n): A) vaccination B) immunogen C) prophylactic D) vaccine Answer: D Explanation: D) A vaccine is a preparation of killed microorganisms, live attenuated microorganisms, or living virulent organisms that are administered to produce or artificially increase immunity to a particular disease.

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17) Besides tuberculosis, the BCG vaccine is also used to treat: A) bladder cancer B) pancreatic cancer C) pleurisy D) polyarthritis Answer: A Explanation: A) Besides tuberculosis, the BCG vaccine is also used to treat bladder cancer, by direct instillation into the bladder. This is sometimes called nonspecific immunotherapy, but the precise mechanism is unknown.

18) The Zostavax® vaccine is indicated for: A) chickenpox B) smallpox C) shingles D) pneumonia Answer: C Explanation: C) The Zostavax® vaccine is indicated for shingles. It is given subcutaneously, and was licensed in 2006. The vaccine is effective in approximately 50% of patients over age 60.

19) A dose given to increase the effectiveness of the original medication is known as a(n): A) booster B) toxoid C) annual D) nosocomial Answer: A Explanation: A) The only routine immunization that is recommended for all normal adults between the ages of 18 and 65 years is a booster dose (a dose given to increase the effectiveness of the original medication) of adult diphtheria and tetanus toxoid every 10 years.

20) Proteins present in the blood that contain antibodies are known as: A) aqueous solutions B) isotypes C) globulins D) antigens Answer: C Explanation: C) Globulins are proteins present in blood that contain antibodies.

Immunoglobulins are derived from human plasma containing antibodies that have been formed by the body to specific antigens.

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21) Immune globulin (Ig) is given by injection into a(n): A) mucous membrane B) muscle C) vein D) artery Answer: B Explanation: B) Immune globulin (Ig) is given by injection into a muscle (usually the buttocks for adults and the leg or arm for children). The Ig intramuscular (IGIM) products are aqueous solutions containing 15% protein, of which more than 90% is IgG. 22) The term attenuated means: A) killed B) vaccinated C) processed D) live Answer: D Explanation: D) Attenuated means "live." Attenuated vaccines cause an infection within a patient to induce a protective immune response; they contain less immunogen than killed vaccines do.

23) Inactivated vaccines have been: A) killed B) slowed C) processed D) modified Answer: A Explanation: A) Inactivated vaccines contain microorganisms that have been killed. Most bacterial vaccines are inactivated. It is important to understand that the live vaccines contain less immunogen than the killed vaccines, and must actually cause an infection within the patient to induce a protective immune response.

24) The Advisory Committee on Immunization Practices recommends that children be immunized against how many infectious diseases (as well as for hepatitis A in areas of high incidence)?

A) Five B) Six C) Eight D) Ten Answer: C Explanation: C) The Advisory Committee on Immunization Practices (ACIP) currently recommends that children be immunized against eight infectious diseases as well as for hepatitis A in areas of high incidence.

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25) One of the most important public health measures in the United States remains: A) the eradication of varicella B) childhood immunization C) geriatric immunization D) public education about vaccines Answer: B Explanation: B) Childhood immunization remains one of the most important public health measures in the United States. The Advisory Committee on Immunization Practices (ACIP) currently recommends that children be immunized against eight infectious diseases, as well as against hepatitis A in areas of high incidence.

26) Three important viral diseases that can potentially be eradicated by mass active immunization are measles, mumps, and: A) rubella (German measles) B) varicella C) hepatitis A D) hepatitis B Answer: A Explanation: A) Measles, mumps, and rubella (German measles) are three important viral diseases that can be potentially eradicated by mass active immunization.

27) There are three classes of lymphocytes: T cells, B cells, and: A) foreign cells B) antibodies C) NK cells D) plasma cells Answer: C Explanation: C) T cells, B cells, and NK (natural killer) cells make up the three types of lymphocytes contained in the blood. These cells attack viruses, fungi, bacteria, and other foreign cells that invade the body.

28) The main action of active immunizing agents is to: A) treat disease B) prevent disease C) kill microorganisms D) lessen the effects of microorganisms Answer: B Explanation: B) The main action of active immunizing agents is to prevent rather than to treat disease. They prompt the immune system to become resistant to a specific disease or several diseases. They also sensitize immune cells for a possible subsequent re-exposure to the organism, thus triggering an immune response.

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29) Why must intramuscular immunoglobulin (IGIM) NOT be injected intravenously?

A) Because of increased potential for drug interactions B) Because of risk of asplenia C) Because of the risk of infection D) Because it can cause serious anaphylactic reactions Answer: D Explanation: D) Intramuscular immunoglobulin (IGIM) must not be injected intravenously because it can cause serious anaphylactic reactions. Otherwise, there are few adverse reactions except for local pain and tenderness at the injection site.

30) Biologics have prevented more morbidity and mortality than: A) antibiotics B) antioxidants C) all other drugs combined D) anti-infectives Answer: C Explanation: C) As a group, particularly the active immunizing agents, biologics may have prevented more morbidity and mortality than all other drugs combined.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 21 Analgesic, Antipyretic, and Anti-Inflammatory Agents 1) Drugs that reduce elevated body temperature (fever) to normal levels are known as: A) anti-inflammatories B) antipyretics C) analgesics D) anesthetics Answer: B Explanation: B) Antipyretics are drugs used to reduce elevated body temperature (fever) to normal levels.

2) The term analgesic means: A) swelling reduction B) sensation enhancing C) fever reducing D) pain relieving Answer: D Explanation: D) Analgesic is the term used for "pain relieving." Analgesics are drugs that relieve pain and sometimes also have antipyretic or anti-inflammatory action.

3) Pain that lasts a long time or is marked by frequent recurrence is known as: A) diagnosing pain B) physical discomfort C) chronic pain D) acute pain Answer: C Explanation: C) Chronic pain lasts a long time or is marked by frequent recurrence. This type of pain has very little positive effect on the body.

4) Part of the process of causing pain, hormone-like substances that control blood pressure, contract smooth muscle, and modulate inflammation are known as: A) bradykinin B) prostaglandins C) histamines D) serotonin Answer: B Explanation: B) Prostaglandins are hormone-like substances that are released because of pain stimuli. They control blood pressure, contract smooth muscle, and modulate inflammation.

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5) A polypeptide that mediates inflammation, increases vasodilation, and contracts smooth muscle is known as: A) bradykinin B) prostaglandin C) histamine D) serotonin Answer: A Explanation: A) Bradykinin is the polypeptide discussed in this chapter that mediates inflammation, increases vasodilation, and contracts smooth muscle.

6) Endorphins and enkephalins are examples of: A) anesthetics B) antipyretics C) neurotransmitters D) analgesics Answer: C Explanation: C) Endorphins and enkephalins are neurotransmitters, capable of binding with opioid receptors in the CNS and inhibiting the transmission of pain impulses.

7) Analgesics that are consumed in excess of 10,000 tons annually are the: A) acetaminophens B) COX-2 inhibitors C) nonsalicylates D) salicylates Answer: D Explanation: D) The salicylate group of analgesics and antipyretics are consumed in excess of 10,000 tons annually. Of all the salicylate drugs, aspirin is the most commonly used.

8) Agents that promote the excretion of uric acid in the urine are known as: A) anticoagulants B) salicylates C) uricosurics D) nonsalicylates Answer: C Explanation: C) Uricosurics promote the excretion of uric acid in the urine. They should not be taken with salicylates.

9) Premature neonates with patent ductus arteriosus may be treated with: A) uric acid B) indomethacin C) aspirin D) ibuprofen Answer: B Explanation: B) In premature neonates, indomethacin is indicated for the treatment of patent ductus arteriosus, which is an abnormal fetal connection of the left pulmonary artery and the descending aorta.

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10) The name of the group of enzymes required to produce prostaglandins from arachidonic acid is: A) meloxicam B) cyclooxygenase (COX) C) NSAID D) celecoxib Answer: B Explanation: B) Cyclooxygenase (COX) is the name for a group of enzymes required to produce prostaglandins from arachidonic acid.

11) Pain that is severe and has a rapid onset is described as: A) analgesic B) long term C) chronic D) acute Answer: D Explanation: D) Acute pain is described as having a rapid onset and being severe.

12) Drugs derived from opium poppies are known as: A) exudates B) opioids C) opiates D) opiums Answer: C Explanation: C) Opiates are drugs derived from opium poppies and include morphine and codeine.

13) Natural, synthetic, or endogenous morphine-related substances are known as: A) opioids B) narcoleptics C) exudates D) alkaloids Answer: A Explanation: A) Opioids are natural, synthetic, or endogenous morphine-related substances of certain legal status that are used for moderate to severe pain.

14) A medication that induces sleep or stupor and alters mood and behavior is referred to as: A) an opioid receptor B) an analgesic C) a narcotic D) an alkaloid Answer: C Explanation: C) A narcotic is a medication that induces sleep or stupor and alters mood and behavior.

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15) Which of the following is NOT one of the three major types of opioid receptors?

A) Delta B) Mu C) Alpha D) Kappa Answer: C Explanation: C) Alpha is not a term used for one of the three types of opioid receptors. Mu, kappa, and delta are all opioid receptors.

16) Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve inflammation, swelling, stiffness, and joint pain–all of which are commonly caused by: A) migraines B) arthritis C) ankylosis D) fever Answer: B Explanation: B) NSAIDs are used to relieve some symptoms caused by arthritis, such as inflammation, swelling, stiffness, and joint pain. They do not cure arthritis and help patients only as long as they continue to take them.

17) Aspirin may worsen any condition involving: A) pain B) headache C) fever D) bleeding Answer: D Explanation: D) Any condition involving bleeding may be worsened by taking aspirin. It should always be discontinued one week before any surgery and not be used again until one week after the surgery.

18) The isoenzyme COX-2 is primarily associated with: A) nausea B) fever C) blood flow D) inflammation Answer: D Explanation: D) COX-2 is primarily associated with inflammation. Cytokines increase the expression of COX-2, mainly at inflammatory sites, producing prostaglandins that mediate inflammation, pain, and fever.

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19) Acetaminophen is NOT: A) antipyretic B) analgesic C) anti-inflammatory D) available over the counter Answer: C Explanation: C) The analgesic efficacy of acetaminophen is essentially equivalent to that of NSAIDs, but it is not anti-inflammatory. Similar to aspirin, acetaminophen has analgesic and antipyretic actions.

20) Acute liver damage or failure in patients who drink three or more alcoholic drinks per day may be caused if they take: A) aspirin B) ibuprofen C) cholestyramine D) acetaminophen Answer: D Explanation: D) Acetaminophen may cause acute liver damage or failure in patients who consume three or more alcoholic drinks per day, but a person does not have to be a chronic drinker to experience damage. Taking acetaminophen after a weekend of drinking can prove fatal.

21) Opiates or opioids can interact with alcohol and cause CNS depression with subsequent: A) respiratory depression B) intracranial pressure C) urinary retention D) heightened sensitivity to pain Answer: A Explanation: A) Opioids or opiates can interact with alcohol, causing CNS depression with subsequent respiratory depression, which can be life threatening.

22) Indiscriminate use of codeine may lead to: A) hypertension B) excessive coughing C) dependence D) insomnia Answer: C Explanation: C) Patients should be instructed to comply with the physician-ordered drug regimen because indiscriminate use of codeine may lead to dependence.

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23) Which of the following is a semisynthetic opioid analgesic?

A) Opium B) Codeine C) Morphine D) Oxycodone Answer: D Explanation: D) Oxycodone, along with hydrocodone and oxymorphone, are examples of semisynthetic opioid analgesics.

24) Which of the following is prescribed for narcotic overdose?

A) Hydrocodone B) Naloxone C) Morphine D) Oxycodone Answer: B Explanation: B) Naloxone is prescribed for narcotic overdose and complete or partial reversal of narcotic depression, including respiratory depression induced by natural and synthetic narcotics.

25) After taking meperidine, patients should NOT smoke or: A) have any obstetric procedures B) have any surgical procedures C) walk without assistance D) stop taking their MAO inhibitors Answer: C Explanation: C) Patients should not walk without assistance or smoke after taking meperidine.

They should also avoid driving or engaging in hazardous activities until drowsiness and dizziness have passed.

26) Acetylsalicylic acid is commonly referred to as: A) aspirin B) acetaminophen C) ibuprofen D) indomethacin Answer: A Explanation: A) Acetylsalicylic acid is commonly referred to as aspirin, which of all the salicylate drugs is the most commonly used.

27) A popular trade name for ibuprofen is: A) Celebrex B) Indocin C) Advil D) Tylenol Answer: C Explanation: C) Advil is a popular trade name for ibuprofen. Another popular trade name is Motrin.

28) A popular trade name for acetaminophen is: 6 Copyright © 2018 Pearson Education, Inc.

A) Tylenol B) Bayer C) Motrin D) Nembutal Answer: A Explanation: A) Tylenol is a popular trade name for acetaminophen. Another popular trade name is Tempra.

29) Meperidine undergoes a potentially fatal reaction with: A) MAO inhibitors B) NSAIDs C) opioid analgesics D) methadone Answer: A Explanation: A) Meperidine undergoes a potentially fatal reaction with MAOIs (antidepressants). It should also not be mixed with morphine.

30) Oxycodone is commonly known by the trade name: A) Dolophine B) Narcan C) OxyContin D) Hycodan Answer: C Explanation: C) Oxycodone is commonly known by the trade name OxyContin. It is a Schedule II drug, with addiction potential comparable to morphine.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 22 Antineoplastic Agents 1) Which of the following are essential regulators of normal cellular functions?

A) carcinogenic agents B) protooncogenes C) tumor suppressor genes D) oncogenes Answer: B Explanation: B) Protooncogenes are essential regulators of normal cellular functions, including the cell cycle. They are present in all cells.

2) The resting stage of the cell cycle is: A) G0 B) G1 C) G2 D) S Answer: A Explanation: A) G0 is the resting stage of the cell cycle. It is also called the dormant stage, when cells have not started to divide.

3) The trade name of melphalan is: A) Mustargen B) Thiotepa C) Ifex D) Alkeran Answer: D Explanation: D) The trade name of melphalan is Alkeran. It is an orally administered alkylating agent.

4) Which of the following is NOT an alkylating agent?

A) Mustargen B) Hexalen C) Xeloda D) Cytoxan Answer: C Explanation: C) Xeloda is not an alkylating agent. It is an antimetabolite, administered orally.

5) The trade name for busulfan is: A) Leukeran B) Mustargen C) Busulfex D) Blenoxane Answer: C Explanation: C) The trade name for busulfan is Busulfex. It is an alkyl sulfonate administered orally or intravenously.

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6) Which of the following is NOT an antitumor antibiotic?

A) Blenoxane B) Vinblastine C) Adriamycin D) Cerubidine Answer: B Explanation: B) Vinblastine is not an antitumor antibiotic. It is a mitotic inhibitor (plant alkaloid) that is administered intravenously. Its actual generic name is vinblastine sulfate (injection) and its trade name is Vinblastine Sulfate.

7) Which of the following is classified as a plant alkaloid?

A) vincristine (Vincasar PFS) B) methotrexate (Trexall) C) mercaptopurine (Purinethol) D) bleomycin (Blenoxane) Answer: A Explanation: A) The drug called vincristine (Vincasar PFS) is classified as a plant alkaloid. It is administered intravenously.

8) Mitotic inhibitors are referred to as which of the following?

A) alkyl sulfonates B) antitumor antibiotics C) antimetabolites D) plant alkaloids Answer: D Explanation: D) Mitotic inhibitors are referred to as plant alkaloids. They are typically physiologically active organic bases containing nitrogen (and usually oxygen) that occur in seed plants. They prevent meiosis (cell division).

9) The trade name of teniposide is: A) Vinblastine B) Vumon C) Navelbine D) Matulane Answer: B Explanation: B) The trade name of teniposide is Vumon. It is a mitotic inhibitor that is administered intravenously.

10) A palliative treatment is one that: A) develops from normal genes B) arises from glandular origin C) eases a disease's effects D) aids or contributes Answer: C Explanation: C) Palliative treatment (which eases a disease's effects) may be used if a cure is not possible, to minimize the discomfort caused by cancer, or to slow the progression of the disease and prolong the patient's life.

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11) Which of the following antimetabolites is administered intravenously?

A) fluorouracil (Adrucil) B) procarbazine (Matulane) C) mercaptopurine (Purinethol) D) capecitabine (Xeloda) Answer: A Explanation: A) The antimetabolite called fluorouracil (Adrucil) is administered intravenously.

Its subclassification is as a "pyrimidine antagonist". The antimetabolites known as mercaptopurine (Purinethol) and capecitabine (Xeloda) are only administered orally. The drug procarbazine (Matulane) is not an antimetabolite, but is classified as a miscellaneous agent.

12) The trade name of estramustine is: A) Zoladex B) Eligard C) Emcyt D) Megace Answer: C Explanation: C) The trade name of estramustine is Emcyt. It is an orally administered estrogen.

13) Mercaptopurine is useful in the maintenance therapy of children with: A) myelocytic leukemia B) ovarian cancer C) brain cancer D) lung cancer Answer: A Explanation: A) Mercaptopurine is useful in the maintenance therapy of children with myelocytic leukemia. Its trade name is Purinethol.

14) Doxorubicin is used to treat which of the following cancers?

A) breast and ovarian B) Kaposi's sarcoma and Wilms' tumor C) testicular and urinary bladder D) skin and brain cancer Answer: A Explanation: A) Doxorubicin is used in the treatment of breast, ovarian, and also bone cancers.

It is also used in the therapy for acute lymphoblastic and myeloblastic leukemias.

15) The normal function of tumor suppressor genes is to: A) regulate and inhibit inappropriate cellular growth and proliferation B) cause gene mutation C) shed neoplastic cells D) split cells into new cells Answer: A Explanation: A) Tumor suppressor genes are another category of genes involved in carcinogenesis. The normal function of these genes is to regulate and inhibit inappropriate cellular growth and proliferation.

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16) Chemotherapy kills cancer cells because of its ability to: A) synthesize RNA B) synthesize DNA C) stop cell division D) increase cell division Answer: C Explanation: C) The ability of chemotherapy to kill cancer cells depends on its ability to stop cell division–usually by damaging the RNA or DNA that tells the cell how to copy itself for division.

17) The final step of the cell cycle, when the cell splits into two new cells, is known as: A) DNA synthesis B) mitosis C) resting stage D) gap phase Answer: B Explanation: B) The final step of the cell cycle is mitosis, when the cell splits into two new cells. This lasts only 30 to 60 minutes.

18) Basic structural subunits of DNA whose precise sequencing encodes the DNA are known as: A) nitrosoureas B) cell-cycle phase specific agents C) tumor cells D) nucleotides Answer: D Explanation: D) Many antineoplastic agents interfere with the cellular synthesis of DNA, RNA, and proteins. The genetic information is encoded in DNA by the precise sequencing of basic structural subunits of DNA, known as nucleotides.

19) The treatment of choice for many solid tumors is: A) surgery B) radiation C) chemotherapy D) immunotherapy Answer: A Explanation: A) Surgery remains the treatment of choice for many solid tumors, although surgery, radiation, chemotherapy, and immunotherapy are all methods used in cancer treatment.

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20) Alkylating agents cause hydrogen replacement by an alkyl group, specifically one that inhibits cell division and growth. The five major types of alkylating agents include nitrogen mustards and all the following except: A) ethyleneimines B) nitrosoureas C) triazenes D) antimetabolites Answer: D Explanation: D) The five major types of alkylating agents are nitrogen mustards, ethyleneimines, alkyl sulfonates, nitrosoureas, and triazenes. Antimetabolites are not part of these agents.

21) Most alkylating agents cause: A) paralysis B) alopecia (hair loss) C) constipation D) generalized seizures Answer: B Explanation: B) Most alkylating agents cause alopecia (hair loss), and all have toxic effects on the reproductive system.

22) Alkylating agents are able to cause birth defects in fetuses, which is described by the term: A) keratosis B) veno-occlusive C) teratogenic D) carcinogenic Answer: C Explanation: C) Alkylating agents are contraindicated during pregnancy, especially during the first trimester, because they are teratogenic (able to cause birth defects in fetuses).

23) Antimetabolites prevent cancer cell growth by affecting: A) DNA production B) RNA production C) WBC production D) RBC production Answer: A Explanation: A) Antimetabolites prevent cancer cell growth by affecting DNA production. They are only effective against cells that are actively participating in cell metabolism and include purine, adenosine, pyrimidine, and folic acid antagonists.

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24) Which of the following hormones is used to treat prostate cancer?

A) estrogen B) androgen C) progestin D) testosterone Answer: A Explanation: A) Estrogen is the hormone used to treat prostate cancer. Antiandrogens are also used.

25) The trade name of flutamide is: A) Casodex B) Zoladex C) Eulexin D) Nilandron Answer: C Explanation: C) The trade name of flutamide is Eulexin. It is an orally administered antiandrogen.

26) Make sure patients understand that mitotic inhibitors may produce serious toxicity with GI damage and: A) increased bone formation B) the migration of WBCs C) bone-marrow depression D) blocked hormone action Answer: C Explanation: C) Be sure patients are aware that mitotic inhibitors may produce serious toxicity with bone marrow depression and GI damage.

27) To treat carcinomas of the reproductive tract, which of the following is/are used?

A) Arachidonic acid B) Sex hormones C) White blood cells D) Antitumor antibiotics Answer: B Explanation: B) Sex hormones are used in carcinomas of the reproductive tract; for example, estrogen may be given to patients with testicular cancer or to patients with certain carcinomas of the breast.

28) Cancer treatments made from natural products produced by Streptomyces are known as: A) interferons B) biologic-response modifiers C) antitumor antibiotics D) hormonal agents Answer: C Explanation: C) Antitumor antibiotics are made from natural products produced by species of the soil fungus Streptomyces. They are only used to treat cancer and are not used to treat infections.

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29) The trade name of leuprolide is: A) Casodex B) Eligard C) Emcyt D) Nolvadex Answer: B Explanation: B) The trade name of leuprolide, out of the given answer choices, is Eligard. It is the intramuscular formulation of this drug. Leuprolide is also available as a subcutaneous formulation with the trade name Lupron.

30) Busulfex (busulfan) is known as: A) a mitotic inhibitor B) a plant alkaloid C) an alkyl sulfonate D) an antitumor antibiotic Answer: C Explanation: C) Busulfex (busulfan) is known as an alkyl sulfonate, and is administered orally or intravenously.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 23 Drugs Used to Treat Central Nervous System Conditions 1) The trade name of alprazolam is: A) Librium® B) Ativan® C) Xanax® D) Serax® Answer: C Explanation: C) The trade name of alprazolam is Xanax®. It is a common drug that is administered orally for various anxiety disorders.

2) Which of the following is NOT classified as a benzodiazepine?

A) clorazepate (Tranxene®) B) carbamazepine (Tegretol®) C) oxazepam (Serax®) D) triazolam (Halcion®) Answer: B Explanation: B) The drug called carbamazepine (Tegretol®) is not classified as a benzodiazepine. It is classified as a miscellaneous antiseizure drug, and is administered orally.

3) A hydantoin derivative that is chemically related to phenytoin is: A) benztropine (Cogentin®) B) procyclidine (Kemadrin®) C) phenobarbital (Luminal®) D) biperiden (Akineton®) Answer: C Explanation: C) A hydantoin derivative that is chemically related to phenytoin is phenobarbital (Luminal®). Phenobarbital is a barbiturate, with both sedative and hypnotic effects.

4) The drug of choice for control of uncomplicated absence seizures is: A) valproic acid B) phenytoin C) benztropine D) ethosuximide Answer: D Explanation: D) Ethosuximide is the drug of choice for control of uncomplicated absence seizures. Its trade name is Zarontin®, and it is administered orally.

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5) The trade name of pregabalin is: A) Lyrica® B) Topamax® C) Depakote® D) Keppra® Answer: A Explanation: A) The trade name of pregabalin is Lyrica®. It is a miscellaneous antiseizure drug that is administered orally.

6) Which of the following is one of the hydantoin drugs?

A) ethosuximide B) diazepam C) fosphenytoin D) pregabalin Answer: C Explanation: C) Fosphenytoin is one of the hydantoin drugs. Its trade name is Cerebyx®, and it is administered intramuscularly or intravenously.

7) Ativan® is the trade name of: A) mephobarbital B) lorazepam C) diazepam D) methsuximide Answer: B Explanation: B) Ativan® is the trade name of lorazepam. It is a benzodiazepine, and is administered intravenously. Its effects are mediated by GABA, and it acts on the thalamic, hypothalamic, and limbic levels of the central nervous system.

8) Which of the following is an anticholinergic drug?

A) carbamazepine (Tegretol®) B) pregabalin (Lyrica®) C) topiramate (Mysoline®) D) benztropine (Cogentin®) Answer: D Explanation: D) The drug called benztropine (Cogentin®) is an anticholinergic drug, also known as a muscarinic antagonist.

9) Abnormal electrical activity in the brain constitutes: A) drowsiness B) seizures C) ataxia D) panic disorders Answer: B Explanation: B) Abnormal electrical activity in the brain constitutes seizures. Diazepam and lorazepam are commonly used to stop repetitive seizure activity.

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10) An inability to coordinate muscle activity is known as: A) ataxia B) muscular depression C) absence seizure D) a tonic-clonic seizure Answer: A Explanation: A) Ataxia is the term used for an inability to coordinate muscle activity. It is one of the adverse effects of the use of benzodiazepines.

11) Brain dysfunction that is caused by an excessive discharge of neurons is known as: A) porphyria B) epilepsy C) ataxia D) insomnia Answer: B Explanation: B) Epilepsy is defined as brain dysfunction that is caused by an excessive discharge of neurons. The three different types of epilepsy include: generalized tonic-clonic seizures, generalized absence seizures, and partial seizures.

12) Which of the following drugs are primarily used for insomnia, and also used for partial epilepsy?

A) dopaminergic drugs B) antidepressants C) barbiturates D) anticholinergics Answer: C Explanation: C) Barbiturates are primarily used for insomnia, and also used for partial epilepsy.

These drugs are classified as CNS agents, anticonvulsants, and sedative-hypnotic drugs.

13) The generic name of Mellaril® is: A) thioridazine B) aripiprazole C) olanzapine D) risperidone Answer: A Explanation: A) The generic name of Mellaril® is thioridazine. It is a typical antipsychotic drug that is administered orally. It is contraindicated for use with the selective serotonin reuptake inhibitors (SSRIs).

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14) Seizures that were previously termed grand-mal seizures are now referred to as: A) partial seizures B) generalized myoclonic seizures C) generalized tonic-clonic seizures D) absence seizures Answer: C Explanation: C) Generalized tonic-clonic (contraction-relaxation) seizures were previously termed grand mal seizures. Generalized absence seizures (previously called petit mal seizures), generalized absence seizures, generalized myoclonic seizures, and partial seizures are other types.

15) Neuroleptic drugs that can improve thought disorders are known as: A) anxiolytics B) antihypertensives C) antineuroleptics D) antipsychotics Answer: D Explanation: D) Antipsychotics are neuroleptic drugs that can improve thought disorders. They must not be used if the patient is taking phenytoin.

16) Which of the following is NOT an example of atypical antipsychotic drugs?

A) clozapine (Clozaril®) B) lithium (Eskalith®) C) quetiapine (Zyprexa®) D) ziprasidone (Geodon®) Answer: B Explanation: B) The drug called lithium (Eskalith®) is not one of the atypical antipsychotic drugs. It is a typical antipsychotic drug, and administered orally. It can control symptoms in the manic and depressive phases of psychotic disorders, and is also used to treat bipolar disorder.

17) Which of the following is an example of a monoamine oxidase inhibitor?

A) protriptyline (Vivactil®) B) clomipramine (Anafranil®) C) amoxapine (Asendin®) D) phenelzine (Nardil®) Answer: D Explanation: D) The drug called phenelzine (Nardil®) is a monoamine oxidase inhibitor. It is administered orally.

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18) Celexa® is the trade name of: A) escitalopram B) citalopram C) fluvoxamine D) sertraline Answer: B Explanation: B) Celexa® is the trade name of citalopram. It is a selective serotonin reuptake inhibitor (SSRI) that is administered orally.

19) Which of the following is NOT an example of a selective serotonin reuptake inhibitor?

A) paroxetine (Paxil®) B) sertraline (Zoloft®) C) imipramine (Tofranil®) D) fluvoxamine (Luvox®) Answer: C Explanation: C) The drug called imipramine (Tofranil ) is not one of the selective serotonin reuptake inhibitors. It is a tricyclic antidepressant (TCA) that is administered orally.

20) The first-line drugs in the treatment of patients with major depression are the: A) MAOIs B) SSRIs C) SNRIs D) TCAs Answer: B Explanation: B) Today, the first-line drugs in the treatment of patients with major depression are the SSRIs. They are relatively newer antidepressants that have had a tremendous impact on prescribing patterns.

21) Patients taking MAOIs must not consume foods containing ________ to avoid severe hypertension, heart attack, and death.

A) tyramine B) triglycerides C) triptophan D) thrombin Answer: A Explanation: A) Patients taking MAOIs must not consume foods containing tyramine, to avoid severe hypertension, heart attack, and death. This is known as a serious hypertensive crisis.

Tyramine is one of the amino acids.

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22) Elderly men with enlarged prostate glands are at higher risk for urine retention when taking: A) SNRIs B) MAOIs C) TCAs D) SSRIs Answer: C Explanation: C) Elderly men with enlarged prostate glands are at higher risk for urine retention when taking tricyclic antidepressants (TCAs). Also, patients taking TCAs should not take any medications, including OTC medications, without notifying their physicians.

23) Sinequan® is the trade name of: A) desipramine B) doxepin C) amoxapine D) amitriptyline Answer: B Explanation: B) Sinequan® is the trade name of doxepin. It is a TCA that is administered orally.

24) Which of the following describes the effect of sedative drugs?

A) They diminish the activity of the kidneys.

B) They diminish the activity of the CNS. C) They increase insomnia.

D) They increase blood pressure.

Answer: B Explanation: B) Sedative drugs diminish the activity of the central nervous system. This effect on the CNS can, in many circumstances, relieve anxiety, which is why sedatives are often referred to as anxiolytics.

25) Benzodiazepines may be used as sedatives or: A) treatments for kidney diseases B) anesthetics during pregnancy C) hypnotics D) antipsychotics Answer: C Explanation: C) Benzodiazepines may be used as sedatives or hypnotics, but other drugs with less addiction potential should be tried before these drugs.

26) Previously, barbiturates were routinely used to treat: A) headache B) bradycardia C) nausea D) insomnia Answer: D Explanation: D) Barbiturates were primarily used (more frequently in previous years) to treat insomnia, although they were also used for partial epilepsy and tonic-clonic seizures.

27) The most commonly used and recognizable drug in the hydantoin group is: 6 Copyright © 2018 Pearson Education, Inc.

A) lithium B) Thorazine C) phenytoin D) phenobarbital Answer: C Explanation: C) Phenytoin is the most commonly used and recognizable drug in the hydantoin group. It is the sole clinical representative of the hydantoins in use as an antiseizure drug.

28) The drug of choice for childhood absence seizures is: A) GABA B) hydantoin C) valproic acid D) phenytoin Answer: C Explanation: C) Valproic acid is the drug of choice to treat childhood absence seizures, symptomatic and idiopathic generalized seizures, and juvenile myoclonic epilepsy.

29) The safest of the succinimide drugs and the only one still used in clinical practice is: A) ethosuximide B) haloperidol C) phenothiazine D) maprotiline Answer: A Explanation: A) Ethosuximide is generally considered to be the safest of the succinimide drugs and is the only succinimide still used in clinical practice. It is the drug of choice for the control of uncomplicated absence seizures.

30) The generic name of Zyprexa® is: A) ziprasidone B) risperidone C) quetiapine D) olanzapine Answer: D Explanation: D) The generic name of Zyprexa® is olanzapine. It is an atypical antipsychotic that is administered orally.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 24 Drugs Used to Treat Autonomic Nervous System Conditions 1) Levophed® is the trade name of: A) dopamine B) norepinephrine C) epinephrine D) isoproterenol Answer: B Explanation: B) Levophed® is the trade name of norepinephrine (bitartrate). It is one of the sympathomimetic drugs known as a catecholamine. Levophed is primarily used to treat shock.

2) Which of the following drugs is NOT an alpha1 agonist?

A) midodrine (ProAmatine®) B) phenylephrine (Neo-Synephrine®) C) isoproterenol (Isuprel®) D) oxymetazoline (Afrin®) Answer: C Explanation: C) The drug called isoproterenol (Isuprel®) is not an alpha1 agonist. It is a nonselective beta1-receptor agonist. Patients should be alerted that their sputum and saliva may turn pink after inhalation of isoproterenol.

3) An example of alpha2 agonists is: A) clonidine (Catapres®) B) dobutamine (Dobutrex®) C) albuterol (Ventolin®) D) terbutaline (Brethine®) Answer: A Explanation: A) The drug called clonidine (Catapres®) is an alpha2 agonist. It is used to treat hypertension.

4) Ritalin® is the trade name of: A) dobutamine B) guanabenz C) pemoline D) methylphenidate Answer: D Explanation: D) Ritalin® is the trade name of methylphenidate. It is used to treat attentiondeficit/hyperactivity disorder (ADHD) and obesity. This drug is classified as a miscellaneous adrenergic agonist.

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5) Alpha2-receptor agonists are indicated to treat: A) hypotension B) hypertension C) hypoglycemia D) hyperglycemia Answer: B Explanation: B) Alpha2-receptor agonists are indicated to treat hypertension. They stimulate alpha2 adrenergic receptors in the CNS to inhibit sympathetic vasomotor centers.

6) Which of the following is an example of beta-receptor antagonists?

A) phentolamine (Regitine®) B) prazosin (Minipress®) C) labetalol (Normodyne®) D) metoprolol (Lopressor®) Answer: C Explanation: C) The drug called labetalol (Normodyne®) is a beta-receptor antagonist that is nonselective. It is administered orally to treat hypertension.

7) The chemicals that bridge the synaptic clefts are called: A) sympathomimetics B) receptors C) neurotransmitters D) ganglions Answer: C Explanation: C) The space between each synapse (called the synaptic cleft) is bridged by chemicals called neurotransmitters. The two primary neurotransmitters in the autonomic nervous system are acetylcholine (ACh) and norepinephrine (NE).

8) Which of the following is NOT an adverse effect of the beta-receptor antagonists?

A) dizziness B) insomnia C) hypertension D) lethargy Answer: C Explanation: C) Hypertension is not an adverse effect of the beta-receptor antagonists. Betablocking drugs reduce receptor occupancy by beta agonists.

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9) Cholinergic neurons release: A) epinephrine B) norepinephrine C) acetylcholine D) dopamine Answer: C Explanation: C) Neurons that release acetylcholine are termed cholinergic. These neurons include preganglionic neurons (in the sympathetic and parasympathetic nervous systems), parasympathetic postganglionic neurons, somatic transmission at the neuromuscular junction, and sympathetic postganglionic fibers that innervate sweat glands.

10) Neurons that release norepinephrine, epinephrine, or dopamine are termed: A) catecholamine B) autonomic C) synthesizing D) adrenergic Answer: D Explanation: D) Adrenergic neurons release norepinephrine, epinephrine, or dopamine.

However, it is important to remember that norepinephrine and epinephrine are catecholamines.

11) Cylert® is the trade name of: A) pemoline B) ephedrine C) dobutamine D) clonidine Answer: A Explanation: A) Cylert® is the trade name of pemoline. It is a miscellaneous adrenergic agonist used to treat ADHD. 12) Alpha1-receptor agonists is contraindicated to treat: A) hypotension B) nasal congestion C) pheochromocytoma D) subconjunctival hemorrhage Answer: C Explanation: C) Alpha1-receptor agonists are contraindicated to treat pheochromocytoma (adrenal tumor). They are also contraindicated for severe coronary or cardiovascular disease, glaucoma, hypovolemia (within 2 takes of taking MAOIs), acute kidney disease, urine retention, thyrotoxicosis, sensitivity to adrenergic substances, supine hypertension, ventricular tachycardia, and for pregnant, lactating, and very young patients.

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13) Chemical compounds containing nitrogen that are derived from the amino acid tyrosine are known as: A) adrenalines B) alpha-adrenergic receptors C) catecholamines D) thymosines Answer: C Explanation: C) Norepinephrine and epinephrine are catecholamines (chemical compounds containing nitrogen that are derived from the amino acid tyrosine), which bind to adrenergic receptors and produce sympathetic effects.

14) The two main adrenergic receptors are alpha and beta. Whereas alpha-adrenergic receptors respond to adrenaline, beta-adrenergic receptors respond to: A) nicotine B) sympathomimetics C) acetylcholine D) norepinephrine or epinephrine Answer: D Explanation: D) Beta-adrenergic receptors respond to norepinephrine or epinephrine and are found on smooth and cardiac muscle membranes. Beta-receptor antagonists work primarily on cardiac muscle, competitively blocking beta-adrenergic receptors within the heart.

15) The parasympathetic nervous system releases acetylcholine and is also known as the: A) catecholaminic nervous system B) cholinergic nervous system C) cholinergic blocking system D) sympathomimetic system Answer: B Explanation: B) The parasympathetic nervous system, also known as the cholinergic nervous system, releases the neurotransmitter acetylcholine.

16) Sympathomimetics (or adrenergic agonists) produce symptoms of: A) somatic transmission B) dopamine C) the fight-or-flight response D) the rest-and-relaxation response Answer: C Explanation: C) Sympathomimetics (or adrenergic agonists) produce symptoms of the fight-orflight response and stimulate the sympathetic nervous system.

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17) Catecholamines and noncatecholamines are: A) adrenergic agonists B) adrenergic antagonists C) sympatholytics D) muscarinics Answer: A Explanation: A) The adrenergic agonists are categorized as catecholamines and noncatecholamines and include norepinephrine, epinephrine, and dopamine.

18) Alpha2-receptors are often used in: A) increasing renin release from the kidneys B) reducing blood pressure C) raising blood pressure D) increasing plasma concentrations of norepinephrine Answer: B Explanation: B) Alpha2-receptors are often used in reducing blood pressure. They are believed to be located on the presynaptic neurons and seem to function as controllers of neurotransmitter release by the presynaptic neurons.

19) Beta1-receptor agonists are used to treat circulatory shock, cardiac arrest, and: A) hypertension B) constipation C) tachycardia D) hypotension Answer: D Explanation: D) Beta1-receptor agonists are used to treat circulatory shock, hypotension, and cardiac arrest. They increase the rate and force of contraction of the heart, increase lipolysis in adipose tissue, decrease digestion and GI motility, and increase glomerular filtration.

20) Which of the following is NOT an adverse effect of the beta1-receptor agonists?

A) hypertension B) cardiac arrest C) tachycardia D) constipation Answer: B Explanation: B) Cardiac arrest is not an adverse effect of the beta1-receptor agonists. These agents may cause hypertension, tachycardia, and constipation.

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21) Visken® is the trade name of: A) pindolol B) propranolol C) terazosin D) phentolamine Answer: A Explanation: A) Visken® is the trade name of pindolol. It is an orally-administered drug used to treat hypertension.

22) The primary indication of atenolol (Tenormin®) is: A) hyperthyroidism B) preeclampsia C) thyrotoxicosis D) hypertension Answer: D Explanation: D) The primary indication of atenolol (Tenormin®) is hypertension. It is administered orally for this purpose, as well as to treat angina pectoris. It is administered intravenously to treat myocardial infarction (MI).

23) Cholinergic agonists are also called cholinomimetics or: A) nicotinics B) parasympathomimetics C) parasympatholytics D) muscarinics Answer: B Explanation: B) Cholinergic agonists are also called cholinomimetics or parasympathomimetics, and stimulate the parasympathetic nervous system because they mimic the parasympathetic neurotransmitter acetylcholine.

24) The types of cholinergic receptors that innervate smooth muscle and slow the heart rate are: A) muscarinic receptors B) nicotinic receptors C) lacrimal receptors D) salivary receptors Answer: A Explanation: A) Muscarinic receptors are the types of cholinergic receptors that innervate smooth muscle and slow the heart rate. Selective cholinergic drugs for the muscarinic receptors do not affect the nicotinic receptors.

25) Cardura® is classified as: A) a beta-receptor antagonist (non-selective) B) an alpha-receptor antagonist C) a beta-receptor antagonist (selective) D) an alpha-receptor agonist Answer: B Explanation: B) Cardura® is classified as an alpha-receptor antagonist. Its generic name is doxazosin, and it is administered orally to treat hypertension.

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26) Cholinergic blockers are also called anticholinergics or: A) parasympatholytics B) muscarinics C) parasympathomimetics D) tricyclics Answer: A Explanation: A) Drugs that inhibit the actions of acetylcholine by occupying the acetylcholine receptors are called cholinergic antagonists or cholinergic blockers (also called anticholinergics or parasympatholytics).

27) Pilocarpine is used most commonly in patients with: A) glaucoma B) hyperthyroidism C) asthma D) peptic ulcer Answer: A Explanation: A) Pilocarpine is used most commonly in patients with glaucoma. Its trade name is Isopto-Carpine®, and it is a direct-acting cholinergic drug.

28) Which of the following drugs is classified as an indirect-acting cholinergic agonist?

A) bethanechol B) carbachol C) neostigmine D) pilocarpine Answer: C Explanation: C) Neostigmine is classified as an indirect-acting cholinergic agonist. Its trade name is Prostigmin®, and it is an orally-administered drugs used to treat myasthenia gravis and urinary retention.

29) Which of the following is NOT an adverse effect of atropine?

A) dry mouth B) convulsion(s) C) urine retention D) blurred vision Answer: B Explanation: B) Convulsions are not one of the adverse effects of atropine. Its common adverse effects include dry mouth, decreased perspiration, blurred vision, tachycardia, constipation, and urine retention.

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30) Cognex® is the trade name of: A) tacrine B) pyridostigmine C) neostigmine D) ambenonium Answer: A Explanation: A) Cognex® is the trade name of tacrine. It is an orally-administered drug used to treat Alzheimer's disease.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 25 Anesthetic Agents 1) In which of the following stages of anesthesia is pain abolished?

A) stage II B) stage IV C) stage III D) stage I Answer: D Explanation: D) Pain is abolished in stage I of anesthesia, which is known as "analgesia".

Consciousness is still retained.

2) In which of the following stages of anesthesia does medullary paralysis occur?

A) stage III B) stage IV C) stage I D) stage II Answer: B Explanation: B) Medullary paralysis occurs in stage IV of anesthesia. This stage begins with respiratory failure and can lead to circulatory collapse. Through careful monitoring, this stage is avoided.

3) During the recovery period, the patient must be observed for underventilation by monitoring for: A) respiratory apnea B) congestive heart failure C) high fever D) respiratory edema Answer: A Explanation: A) During the recovery period, the patient must be observed for underventilation by monitoring for respiratory apnea. It is very important to watch elderly patients and those with pre-existing respiratory insufficiency.

4) The trade name of meperidine is: A) DepoDur B) Demerol C) Ativan D) Inapsine Answer: B Explanation: B) The trade name of meperidine is Demerol. It is an opioid analgesic administered intramuscularly or subcutaneously.

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5) Loss of sensation or consciousness is defined as: A) anesthetic accident B) surgical anesthesia C) analgesia D) anesthesia Answer: D Explanation: D) Anesthesia is a loss of sensation, consciousness, or both. The ideal anesthetic agent should be able to rapidly and pleasantly induce and withdraw from anesthesia.

6) Pain relief while still conscious is known as: A) analgesia B) anesthesia C) therapeutic index D) inertness Answer: A Explanation: A) Analgesia is pain relief while still conscious. Analgesics are often used in childbirth and in trauma.

7) Which of the following is NOT one of the four stages of anesthesia?

A) analgesia B) fear C) surgical anesthesia D) medullary paralysis Answer: B Explanation: B) Fear is not one of the four stages of anesthesia. The four stages are: analgesia, excitement, surgical anesthesia, and medullary paralysis.

8) Which of the following stages of anesthesia produces excitement?

A) Stage 4 B) Stage 3 C) Stage 2 D) Stage 1 Answer: C Explanation: C) Stage 2 anesthesia produces excitement and is the most unpleasant stage for the patient; the anesthesiologist must make sure the patient goes very quickly from stage 1 to stage 3.

9) The generic name of Ativan is: A) lorazepam B) midazolam C) diazepam D) omeprazole Answer: A Explanation: A) The generic name of Ativan is lorazepam. It is a benzodiazepine that is administered intramuscularly or intravenously.

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10) Inhalation anesthetics are either gases or: A) esters B) semisolids C) volatile liquids D) ambient air Answer: C Explanation: C) Inhalation anesthetic agents are either volatile liquids (easily vaporized) or gases and are usually delivered by using an anesthesia machine.

11) Which of the following is used as an antiemetic?

A) omeprazole B) atropine C) lansoprazole D) droperidol Answer: D Explanation: D) Droperidol is used as an antiemetic. Its trade name is Inapsine. It is administered intramuscularly or intravenously.

12) General anesthetics are contraindicated if a patient has taken which of the following within 14 days?

A) Anticonvulsants B) MAO inhibitors C) Alcohol D) Cimetidine Answer: B Explanation: B) General anesthetics are contraindicated in patients who have received monoamine oxidase (MAO) inhibitors within 14 days.

13) Esters cause allergic reactions due to one of their metabolites, known as: A) an amide B) para-amino benzoic acid (PABA) C) methylparaben D) benzocaine Answer: B Explanation: B) Esters are associated with a higher incidence of allergic reactions because of one of their metabolites: para-amino benzoic acid (PABA).

14) The most commonly recognized amide drug is: A) tetracaine B) benzocaine C) lidocaine D) bupivacaine Answer: C Explanation: C) The most commonly recognized drug in the class of amides is lidocaine (Xylocaine), which was synthesized in 1943. The amides are preferred to the esters because of their lower incidence of causing hypersensitive reactions.

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15) Local anesthetics should be used with caution in children younger than: A) 4 years B) 8 years C) 12 years D) 14 years Answer: D Explanation: D) Local anesthetics are contraindicated in older adults and debilitated patients and should be used cautiously in children younger than 14 years.

16) Topical anesthesia is used on the skin or: A) inner ears B) hair C) mucous membranes D) subarachnoid space Answer: C Explanation: C) Topical anesthesia involves the placement of a nerve conduction—blocking agent onto a tissue layer (skin or mucous membrane).

17) Cryoanesthesia involves the reduction of nerve conduction by: A) subcutaneous injection B) localized healing C) localized cooling D) cold water Answer: C Explanation: C) Cryoanesthesia involves the reduction of nerve conduction by localized cooling.

This may be accomplished with ice or by the use of a cryoanesthesia machine.

18) Local infiltration anesthesia works by blocking nerves and is injected directly into an area that is: A) cooling B) infected C) swollen D) painful Answer: D Explanation: D) Local infiltration anesthesia, which works by blocking nerves, is produced by the injection of local anesthetic solution directly into an area that is painful or about to be operated on.

19) Anesthesia that affects a single nerve, a deep plexus, or a network of nerves is known as: A) local infiltration anesthesia B) field block anesthesia C) spinal anesthesia D) subarachnoid anesthesia Answer: B Explanation: B) Field block anesthesia affects a single nerve, a deep plexus, or a network of nerves. Field block anesthesia and nerve block are forms of regional anesthesia.

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20) The trade name of sevoflurane is: A) Ultane B) Fluothane C) Suprane D) Ethrane Answer: A Explanation: A) The trade name of sevoflurane is Ultane. It is a widely used volatile anesthetic, and is often combined with nitrous oxide.

21) Injection of local anesthetic into the lumbar or caudal space via a catheter is referred to as: A) systemic anesthesia B) medullary anesthesia C) epidural anesthesia D) surgical anesthesia Answer: C Explanation: C) Epidural anesthesia involves the injection of the local anesthetic into the epidural (lumbar or caudal) space via a catheter that allows repeated infusions.

22) The generic name of Diprivan is: A) midazolam B) propofol C) ketamine D) fentanyl Answer: B Explanation: B) The generic name of Diprivan is propofol. It is a general anesthetic commonly given by injection, administered intravenously.

23) The most widely used volatile anesthetic is which of the following?

A) sevoflurane B) nitrous oxide C) isoflurane D) halothane Answer: A Explanation: A) The most widely used volatile anesthetic, of the answer choices given, is sevoflurane. The drug called desflurane (Suprane) is another widely used volatile anesthetic.

24) How long before surgery must the patient stop taking herbal medications?

A) 2 to 3 hours B) 2 to 3 days C) 2 to 3 weeks D) 4 to 6 weeks Answer: C Explanation: C) The patient must stop taking herbal medications 2 to 3 weeks before surgery.

This is to decrease the risk of adverse effects resulting from an enhancement or prolongation of anesthetic effects.

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25) The trade name of procaine is: A) Novocain B) Americaine C) Pontocaine D) Cocaine Answer: A Explanation: A) The trade name of procaine is Novocain. It is an ester-type local anesthetic.

26) The action of local anesthetics is: A) systemic B) different based on the patient's weight C) based on diurnal rhythms D) dose-dependent Answer: D Explanation: D) The action of the local anesthetics is dose- dependent. The more drug present, the more the inhibition until a complete block is produced.

27) Which of the following local anesthetics may be administered subcutaneously?

A) Cocaine B) Pontocaine C) Novocain D) Marcaine Answer: C Explanation: C) Novocain is a local anesthetic that may be administered subcutaneously. It is much less toxic than anesthetics such as tetracaine.

28) Adverse effects of local anesthetics include all the following except: A) light-headedness B) dizziness C) slurred speech D) temporary loss of hearing Answer: D Explanation: D) Patients should be instructed to watch for symptoms such as lightheadedness, dizziness, disorientation, or slurred speech, which are all adverse effects of local anesthetics.

Loss of hearing is not one of these adverse effects.

29) When a local anesthetic is to be administered by infiltration, which of the following may be added to decrease its dosage and prolong its duration of action?

A) Lidocaine B) Norepinephrine C) Epinephrine D) Bupivacaine Answer: C Explanation: C) When a local anesthetic is to be administered by infiltration, epinephrine may be added to it to decrease its dosage and prolong its duration of action. However, epinephrine should not be used to anesthetize fingers, toes, and other tissues with end arteries.

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30) The type of anesthesia that is popular for labor and delivery and is very slowly absorbed into the cerebrospinal fluid is known as: A) topical anesthesia B) epidural anesthesia C) local infiltration anesthesia D) field block anesthesia Answer: B Explanation: B) Epidural anesthesia involves the injection of the local anesthetic into the epidural (lumbar or caudal) space via a catheter that allows repeated infusions. After injection, the anesthetic agent is very slowly absorbed into the cerebrospinal fluid. This is popular for labor and delivery.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 26 Drugs Used to Treat Skin Conditions 1) The trade name of hydrocortisone is: A) Vanos B) Cinolar C) Topicort D) Cortaid Answer: D Explanation: D) The trade name of hydrocortisone is Cortaid. It should be applied in a small amount to the affected area one to four times per day.

2) Which of the following is a major adverse effect associated with acitretin?

A) edema B) alopecia C) burning D) nausea Answer: B Explanation: B) A major adverse effect associated with acitretin is alopecia (hair loss). Other major adverse effects of this medication include skin peeling, dry skin, pruritus (itching), rash, skin atrophy, and abnormal skin color.

3) The trade name of tretinoin is: A) Solaraze B) Actinex C) Retin-A D) Fostex Answer: C Explanation: C) The trade name of tretinoin is Retin-A. It is a topical acne medication that is applied once daily, at bedtime.

4) Which of the following is NOT a selected keratolytic agent?

A) Mediplast B) Garamycin C) Podofin D) Solaraze Answer: B Explanation: B) Garamycin is not a selected keratolytic agent. It is a topical antibiotic with the trade name being gentamicin. It is applied either as an eye solution or as an ointment.

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5) Which of the following is NOT a topical corticosteroid?

A) betamethasone B) hydrocortisone C) fluocinonide D) warfarin Answer: D Explanation: D) Warfarin should be used only orally as an anticoagulant; it is not a topical corticosteroid.

6) The trade name of ciclopirox (topical) is: A) Fungizone B) Loprox C) Monistat-Derm D) Mycostatin Answer: B Explanation: B) The trade name of ciclopirox (topical) is Loprox. It is available as a cream, gel, or lotion.

7) Which of the following is a keratolytic agent?

A) masoprocol (Actinex) B) nystatin (Mycostatin) C) phenytoin (Dilantin) D) amphotericin B (Fungizone) Answer: A Explanation: A) Masoprocol (Actinex) is a keratolytic agent. It is applied to lesions twice per day for 14 to 28 days.

8) Skin-softening agents are referred to as: A) emollients B) keratolytics C) tar treatments D) ointments Answer: A Explanation: A) Skin-softening agents are referred to as emollients. They are used in the treatment of mild skin lesions, along with keratolytic agents and topical corticosteroids.

9) Agents that separate or loosen the horny layer of the epidermis are referred to as: A) astringents B) tar treatments C) keratolytics D) emollients Answer: C Explanation: C) Keratolytic agents are those that separate or loosen the horny layer of the epidermis. They are used to treat mild skin lesions.

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10) Which of the following is NOT classified as a topical antifungal medication?

A) Penlac Nail B) Spectazole C) Fungizone D) Acticin Answer: D Explanation: D) Acticin is not classified as a topical antifungal medication. It is used to treat lice, and is available as a cream or lotion. Its trade name is permethrin.

11) Which of the following medications is used to treat lice?

A) Eurax (crotamiton) B) Aftate (tolnaftate) C) Naftin (naftifine) D) Lamisil (terbinafine) Answer: A Explanation: A) Eurax (crotamiton) is used to treat lice. It is applied directly from the neck to the toes once, then again 24 hours later. The patient must bathe 48 hours after the last application to remove the drug.

12) Which of the following drugs is used to treat acne?

A) Dovonex (calcipotriene) B) Azelex (azelaic acid) C) Uvadex (methoxsalen) D) Soriatane (acitretin) Answer: B Explanation: B) Azelex (azelaic acid) is used to treat acne. It is applied topically as a thin film to the affected area, after it has been cleaned and dried, twice per day.

13) A fungal infection caused by a related group of yeasts, mostly Candida albicans, is known as: A) tinea cruris B) tinea unguium C) candidiasis D) tinea pedis Answer: C Explanation: C) Candidiasis is a fungal infection caused by a related group of yeasts–mostly Candida albicans. This organism is normal flora of the GI tract but may overgrow and cause disease at a number of skin sites.

14) Which of the following is NOT a selected topical corticosteroid?

A) Florone B) Eryc C) Topicort D) Aclovate Answer: B Explanation: B) Eryc is not a selected topical corticosteroid. It is used to treat acne. Its generic name is erythromycin, and it is taken orally.

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15) Topical corticosteroids are contraindicated in which of the following?

A) Eczema B) Psoriasis C) Bacterial skin infections D) Insect bite reactions Answer: C Explanation: C) Topical corticosteroids should not be used with bacterial skin infections because they may exacerbate the infection and may most likely cause bacteremia.

16) Pediculicides are designed to kill: A) lice B) fleas C) mites D) Candida albicans Answer: A Explanation: A) Pediculicides kill lice. They may also be effective in treating mites. The choice of drugs—between pediculicides and scabicides–depends on where the infestation has occurred.

17) The trade name of clindamycin is: A) Differin B) Azelex C) Cleocin D) Vibramycin Answer: C Explanation: C) The trade name of clindamycin is Cleocin. Another version, called Cleocin T, is also available. It is applied topically to affected areas, twice per day.

18) Which of the following conditions is NOT an indication of keratolytic agents?

A) Pediculus humanus B) calluses C) plantar warts D) corns Answer: A Explanation: A) Pediculus humanus is not an indication of keratolytic agents. This condition is treated with anti-lice drugs known as pediculicides.

19) The trade name of crotamiton is: A) Nix B) Acticin C) Lamisil D) Eurax Answer: D Explanation: D) Eurax is the trade name of crotamiton. It is an anti-lice drug that is applied topically.

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20) Treating acne with zinc can be toxic at high doses, because it causes a deficiency of: A) iron B) copper C) vitamin A D) vitamin B12 Answer: B Explanation: B) Treating acne with zinc can be toxic at high dosages, because it causes a deficiency of copper. The most common natural products used to treat acne include zinc, niacinamide gel, and tea tree oil.

21) The trade name of adapalene is: A) Benzamycin B) Cleocin C) Differin D) Azelex Answer: C Explanation: C) The trade name of adapalene is Differin. It is used to treat acne, and is applied topically in the evening.

22) The generic name of Garamycin is: A) bacitracin B) gentamicin C) metronidazole D) azelaic acid Answer: B Explanation: B) The generic name of Garamycin is gentamicin. It is applied topically, and is an antibiotic.

23) The main OTC drug used to treat acne is: A) erythromycin B) tetracycline C) benzoyl peroxide D) hydrogen peroxide Answer: C Explanation: C) Benzoyl peroxide is the main OTC drug used to treat acne and is a powerful oxidizing agent.

24) Topical anti-acne drugs are contraindicated during: A) pregnancy B) lactation C) neither pregnancy nor lactation D) both pregnancy and lactation Answer: D Explanation: D) Topical anti-acne drugs are contraindicated during pregnancy and lactation.

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25) The generic name of Acticin and Nix is: A) lindane B) permethrin C) pyrethrum D) crotamiton Answer: B Explanation: B) The generic name of Acticin and Nix is permethrin. These drugs are used to treat lice.

26) The most commonly used keratolytic agents include resorcinol, sulfur, and: A) salicylic acid B) benzoyl peroxide C) potassium lactate D) magnesium lactate Answer: A Explanation: A) The most commonly used keratolytic agents are salicylic acid, resorcinol, and sulfur. These agents promote shedding of the horny layer of the epidermis and the softening of scales.

27) Topical anti-acne drugs are contraindicated in: A) patients with congestive heart failure B) patients with liver disease C) patients who are pregnant D) patients who are fasting Answer: C Explanation: C) Topical applications of clindamycin are used to treat acne vulgaris. Vaginal applications of this drug are used in the treatment of bacterial vaginosis in nonpregnant women.

28) The trade name of anthralin is: A) Psoriatec B) Uvadex C) Dovonex D) Soriatane Answer: A Explanation: A) The trade name of anthralin is Psoriatec. It is topical medication used to treat psoriasis.

29) Which of the following is a selected keratolytic agent?

A) Baciguent B) Azelex C) MetroGel D) Solaraze Answer: D Explanation: D) Solaraze is a selected keratolytic agent. It is applied topically to the affected are, twice per day, for 60 to 90 days.

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30) Which of the following is NOT an example of a topical antibiotic?

A) Bactroban B) Fostex C) Myciguent D) Sebizon Answer: B Explanation: B) Fostex is not an example of a topical antibiotic. It is a selected topically-applied keratolytic agent. Its generic name is salicylic acid.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 27 Drugs Used to Treat Cardiovascular Conditions 1) Which of the following is classified as an anginal medication?

A) Rectiv B) Cordarone C) Quinidine D) Inderal Answer: A Explanation: A) Rectiv is classified as an anginal medication. It is a nitrate that is applied rectally for up to 3 weeks.

2) Which of the following drugs is NOT a calcium channel blocker?

A) verapamil B) nadolol C) nifedipine D) nicardipine Answer: B Explanation: B) The drug called nadolol is not a calcium channel blocker. It is a beta-adrenergic blocker.

3) Which of the following is an example of beta-adrenergic blockers?

A) Rectiv B) Inderal C) Imdur D) Isordil Answer: B Explanation: B) Inderal is an example of the beta-adrenergic blockers. Its generic name is propranolol, and it is administered orally.

4) Which of the following is NOT true regarding the mechanism of action of nitroglycerin?

A) It decreases cardiac oxygen demand.

B) It increases oxygen supply.

C) It increases cardiac oxygen demand.

D) It relaxes spasms.

Answer: C Explanation: C) Nitroglycerin does not increase cardiac oxygen demand, but does do all of the other answer choices.

5) Which group of drugs causes vasodilation?

A) calcium channel blockers B) antidysrhythmic medications C) inotropic drugs D) diuretics Answer: A Explanation: A) Calcium channel blockers cause vasodilation. They are "Class IV" drugs that decrease the entry of calcium into the cells of the heart and blood vessels.

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6) Which of the following organic nitrates can be administered intravenously?

A) Rectiv B) Nitrostat C) Nitro-Bid D) Nitrolingual Answer: C Explanation: C) Nitro-Bid is an organic nitrate that can be administered intravenously, beginning as a 5 microgram per minute continuous infusion, then increasing by 5 micrograms per minute every 3 to 5 minutes as needed. Its generic name is nitroglycerin.

7) The grade name of atenolol is: A) Lopressor B) Tenormin C) Inderal D) Corgard Answer: B Explanation: B) The trade name of atenolol is Tenormin. It is a beta-adrenergic blocker that is administered orally.

8) Which of the following calcium channel blockers may be administered intravenously?

A) nicardipine B) diltiazem C) verapamil D) nifedipine Answer: A Explanation: A) Nicardipine is a calcium channel blocker that may be administered intravenously, under the trade name Cardene IV. It is also available as Cardene SR, which is administered orally.

9) How is Isordil administered?

A) intravenously B) transdermally C) translingually D) sublingually Answer: D Explanation: D) The route of administration of Isordil is sublingual. It is the trade name of isosorbide dinitrate.

10) Which of the following is the most common adverse effect of nitroglycerin?

A) hypotension B) constipation C) bradycardia D) hypertension Answer: A Explanation: A) Hypotension is the most common adverse effect (of the answer choices listed) of nitroglycerin. Other common adverse effects include headache and tachycardia.

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11) The trade name of disopyramide is: A) Dilantin B) Tambocor C) Norpace D) Rythmol Answer: C Explanation: C) The trade name of disopyramide is Norpace. It is a Class Ia antidysrhythmic medication that is administered orally.

12) Gingival hyperplasia is a common adverse effect of: A) lidocaine B) phenytoin C) disopyramide D) propranolol Answer: B Explanation: B) Gingival hyperplasia is a common adverse effect of phenytoin. Its other common adverse effects include blurred vision, vertigo, and nystagmus.

13) Which of the following is still the mainstay of treatment for dysrhythmia?

A) propranolol (Inderal) B) acebutolol (Sectral) C) lidocaine (Xylocaine) D) propafenone (Rythmol) Answer: A Explanation: A) The mainstay of treatment for dysrhythmia(s) is still propranolol (Inderal). It is the most common beta-blocker.

14) Which of the following groups used to treat dysrhythmia is the least toxic?

A) inotropic agents B) phosphodiesterase inhibitors C) diuretics D) beta-adrenergic blockers Answer: D Explanation: D) The group of drugs known as beta-adrenergic blockers, used to treat dysrhythmias, is the least toxic, and also the most powerful drugs available out of the four classes of antidysrhythmics.

15) Which of the following drugs is available under its generic name only?

A) propranolol B) digoxin C) verapamil D) inamrinone lactate Answer: D Explanation: D) Inamrinone lactate is available under its generic name only. It is administered intravenously.

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16) Cordarone is the trade name of: A) metoprolol B) amiodarone C) propranolol D) lidocaine Answer: B Explanation: B) Cordarone is the trade name of amiodarone. It is a Class III orally administered antidysrhythmic.

17) The trade name of nifedipine is: A) Verelan B) Isoptin SR C) Procardia D) Calan Answer: C Explanation: C) The trade name of nifedipine is Procardia. It is an orally administered calcium channel blocker.

18) Which of the following is NOT a calcium channel blocker?

A) Procardia B) Calan C) Verelan D) Corgard Answer: D Explanation: D) Corgard is not a calcium channel blocker. It is an orally administered betaadrenergic blocker.

19) Imdur is an example of the drugs known as: A) beta-adrenergic blockers B) nitrates C) antidysrhythmics D) calcium channel blockers Answer: B Explanation: B) Imdur is an example of a nitrate, and is orally administered. It is the trade name for isosorbide mononitrate. Another trade name for this generic drug is ISMO. 20) Norpace is a(n): A) antidysrhythmic drug B) calcium channel blocker C) beta-adrenergic blocker D) nitrate Answer: A Explanation: A) Norpace is an antidysrhythmic drug, in Class Ia. Its generic name is disopyramide, and it is administered orally.

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21) The trade name of flecainide is: A) Dilantin B) Rythmol C) Tambocor D) Xylocaine Answer: C Explanation: C) The trade name of flecainide is Tambocor. It is an orally administered Class Ic antidysrhythmic.

22) The trade name of ibutilide is: A) Calan B) Corvert C) Betapace D) Bretylium Answer: B Explanation: B) The trade name of ibutilide is Corvert. It is an intravenously administered Class III antidysrhythmic.

23) The oldest and most frequently prescribed drugs for anginas are: A) nitrates B) beta-adrenergic blockers C) calcium channel blockers D) antiarrhythmic agents Answer: A Explanation: A) Nitrates are the oldest and most frequently prescribed drugs that are used for anginas. Organonitrates are utilized for stopping an acute anginal attack.

24) The group of drugs that reduce the heart's oxygen demand by decreasing the heart rate is known as the: A) organonitrates B) beta-adrenergic blockers C) calcium channel blockers D) antiarrhythmic agents Answer: B Explanation: B) The beta-adrenergic blockers (also known as beta-blockers or b-blockers) reduce the heart's oxygen demand by decreasing the heart rate.

25) The group of drugs that inhibit movement of calcium ions into cardiac and smooth muscle cells and cause vasodilation is known as the: A) calcium channel blockers B) antiarrhythmic agents C) nitrates D) alpha-adrenergic blockers Answer: A Explanation: A) The calcium channel blockers inhibit the movement of calcium ions into cardiac and smooth muscle cells of the coronary and systemic arterial beds. All calcium channel blockers are vasodilators that cause a decrease in smooth muscle tone and vascular resistance.

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26) In addition to intravenous fluids, the first line of treatment for acute myocardial infarction (AMI) consists of: A) pharmacotherapeutics B) dysrhythmics C) antiarrhythmics D) sodium channel blockers Answer: A Explanation: A) In addition to intravenous fluids, pharmacotherapeutics are used as the first line of treatment for acute MI. These include nitroglycerin, aspirin, and morphine sulfate.

27) Class I antiarrhythmics (that bind to sodium channels) include all the following except: A) propranolol B) lidocaine C) moricizine D) procainamide Answer: A Explanation: A) Propranolol is the only one of these agents that is not a Class I antiarrhythmic but is classified as a Class II agent (also known as a beta-adrenergic blocker).

28) Class III antiarrhythmics interfere with: A) magnesium outflow B) potassium outflow C) calcium outflow D) sodium outflow Answer: B Explanation: B) Class III antiarrhythmics interfere with potassium outflow. This alters the repolarization phase and prolongs the potential contraction duration of the Purkinje fibers as well as the muscle fibers of the ventricles.

29) Class IV antiarrhythmics (calcium channel blockers) relax smooth muscle and cause vasodilation and are useful for treating hypertension and: A) hypotension B) stroke C) angina D) MI Answer: C Explanation: C) Class IV antiarrhythmics (calcium channel blockers) relax smooth muscle and cause vasodilation. Therefore, they are useful for angina and hypertension.

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30) The top four prescribed cardiovascular drugs include all the following except: A) lisinopril (Zestril) B) quinidine sulfate (Quinidex) C) atorvastatin (Lipitor) D) amlodipine (Norvasc) Answer: B Explanation: B) Quinidine sulfate is not one of the top four most prescribed cardiovascular drugs. The top four of these drugs are: (1) atorvastatin (Lipitor), (2) amlodipine (Norvasc), (3) lisinopril (Zestril), and (4) digoxin (Lanoxin).

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 28 Drugs Used to Treat Vascular Conditions 1) Which of the following is an example of the centrally acting blockers?

A) doxazosin (Cardura®) B) prazosin (Minipress®) C) clonidine (Catapres®) D) nifedipine (Procardia®) Answer: C Explanation: C) The drug called clonidine (Catapres®) is a centrally acting blocker. It is administered orally, though there is a transdermal formulation called Catapres-TTS®. It is usually used when a patient has not responded to other therapies for hypertension.

2) The trade name of timolol is: A) Blocadren® B) Catapres® C) Hytrin® D) Plendil® Answer: A Explanation: A) The trade name of timolol is Blocadren®. It is an orally-administered agent.

3) Calcium channel blockers are NOT used for: A) pulmonary hypertension B) hypertension C) ventricular tachycardia D) atrial fibrillation Answer: C Explanation: C) Calcium channel blockers are not used for ventricular tachycardia. They are used to treat hypertension, angina, atrial fibrillation, paroxysmal supraventricular tachycardia, subarachnoid hemorrhage, pulmonary hypertension, Raynaud's phenomenon, cardiomyopathy, and to prevent migraine headaches.

4) Which of the following drugs is classified as a vasodilator?

A) ramipril (Altace®) B) minoxidil (Loniten®) C) perindopril (Aceon®) D) valsartan (Diovan®) Answer: B Explanation: B) The drug called minoxidil (Loniten®) is classified as a vasodilator, and is administered orally. It is also used as a topical solution to help re-grow hair on the scalp.

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5) Which of the following is the treatment of choice for curing primary hypertension?

A) Beta-blockers B) Centrally acting blockers C) Alpha- and beta-blockers D) None of the above Answer: D Explanation: D) There is no cure for primary (essential) hypertension. However, many different drugs can lower blood pressure, including the other answer choices.

6) The most commonly prescribed antihypertensive agents include all the following except: A) calcium channel blockers B) ACE inhibitors C) vasoconstrictors D) angiotensin II receptor blockers Answer: C Explanation: C) Vasoconstrictors would increase blood pressure, not decrease it, which is what is required for treating hypertension. Many of the drugs used for hypertension target either cardiac output, peripheral resistance, or blood volume.

7) Severely elevated blood pressure may be fatal and is also known as: A) hypotensive crisis B) hypertensive crisis C) cerebrovascular accident D) cardiac disease Answer: B Explanation: B) Hypertensive crisis describes severely elevated blood pressure, which may be fatal. Hypertension is a major cause of cerebrovascular accident, cardiac disease, and renal failure.

8) The trade name of irbesartan is: A) Cozaar® B) Atacand® C) Teveten® D) Avapro® Answer: D Explanation: D) The trade name of irbesartan is Avapro®. It is an angiotensin II receptor blocker that is administered orally.

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9) Which of the following is both an alpha-adrenergic and a beta-adrenergic blocker?

A) Trandate® B) Visken® C) Inderal® D) Kerlone® Answer: A Explanation: A) The drug called Trandate® is both an alpha-adrenergic and a beta-adrenergic blocker. It is administered either orally. There is also a generic-only form that is administered intravenously.

10) In the treatment of hypertension, angiotensin-converting enzyme (ACE) inhibitors are used to produce vasodilation and increase: A) the heart rate B) the pulse rate C) renal blood flow D) hepatic blood flow Answer: C Explanation: C) Angiotensin-converting enzyme (ACE) inhibitors are used in hypertension to produce vasodilation and to increase renal blood flow. They prevent the angiotensin-converting enzyme from producing angiotensin II. 11) Agents that reduce circulating blood volume by blocking the reabsorption of sodium and chloride are known as: A) diuretics B) beta-adrenergic blockers C) vasodilators D) calcium channel blockers Answer: A Explanation: A) Diuretics reduce circulating blood volume by blocking the reabsorption of sodium and chloride, which results in more water being retained in the kidney and the excretion of excess fluid.

12) Patients taking alpha- and/or beta-blockers should be instructed to make position changes slowly to avoid: A) postural hypotension B) vertigo C) severe headache D) postural hypertension Answer: A Explanation: A) Patients must be made aware that when taking an alpha- or beta-blocker (such as labetalol), postural hypotension may occur and that they should make all position changes slowly and in stages, particularly from a lying to an upright position.

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13) Centrally acting adrenergic blockers are indicated in hypertensive patients when: A) they are not taking diuretics B) they are between 21 and 65 years old C) they are older than 65 years old D) they have not responded to other hypertensive therapies Answer: D Explanation: D) Centrally acting adrenergic blockers are not regarded as first-line therapies in hypertension. These drugs tend to be used in cases in which the affected person has not responded to other therapies.

14) Peripherally acting adrenergic blockers reduce blood pressure by reducing arterial and venous: A) blood flow B) vascular tone C) fibrillation D) viscosity Answer: B Explanation: B) Peripherally acting adrenergic blockers reduce blood pressure by reducing vascular tone, primarily in the veins and the arteries. They are antihypertensive in that their effects depend on the inhibition of norepinephrine release and the depletion of norepinephrine from nerve terminals.

15) ACE inhibitors decrease the formation of angiotensin II, which lowers: A) blood volume and blood pressure B) vascular tone C) viscosity D) heart rate Answer: A Explanation: A) ACE inhibitors decrease the formation of angiotensin II, which lowers blood volume and blood pressure. The renin-angiotensin system controls blood pressure and fluid balance, and is one of the body's primary homeostatic mechanisms.

16) The drugs that are becoming the drugs of choice in the first-line treatment of primary hypertension are the: A) beta-adrenergic blockers B) calcium channel blockers C) ACE inhibitors D) diuretics Answer: C Explanation: C) ACE inhibitors are becoming the drugs of choice in the first-line treatment of primary hypertension. They are relatively free of side effects for the majority of patients compared with other types of antihypertensive drugs.

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17) In diabetic patients, ACE inhibitors may produce: A) hyperglycemia B) eye problems C) hypoglycemia D) hypertensive crisis Answer: C Explanation: C) It is important to monitor the blood glucose of patients with diabetes who are taking ACE inhibitors during the first few weeks of therapy because these agents can produce hypoglycemia in diabetic patients.

18) Angiotensin II receptor blockers prevent the vasoconstriction and aldosterone secretion stimulated by: A) angiotensin I B) angiotensin II C) the vascular smooth muscle D) blood glucose Answer: B Explanation: B) Angiotensin II receptor blockers inhibit the binding of angiotensin II to the angiotensin I receptor in vascular smooth muscle, preventing the raising of blood pressure. This action blocks the vasoconstriction and aldosterone secretion stimulated by angiotensin II. 19) Agents that cause blood vessels to expand are known as: A) diuretics B) vasodilators C) vasoconstrictors D) receptor blockers Answer: B Explanation: B) Vasodilators are agents that cause blood vessels to expand, increasing blood flow and lowering blood pressure in the affected area. They decrease total peripheral resistance and thus correct primary hypertension.

20) Unlike other antihypertensive agents, which of the following agents do NOT inhibit the activity of the sympathetic nervous system?

A) Alpha-adrenergic blockers B) Calcium channel blockers C) Vasodilators D) Beta-adrenergic blockers Answer: C Explanation: C) Unlike many other antihypertensive agents, the vasodilators do not inhibit the activity of the sympathetic nervous system; therefore, orthostatic hypotension and impotence are not problems.

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21) Chronic hypertension causes the heart to work harder, and can result in: A) acute peptic ulcer B) COPD C) orthostatic hypotension D) congestive heart failure Answer: D Explanation: D) Chronic hypertension causes the heart to work harder pumping blood to organs and tissue, and can result in congestive heart failure. Uncontrolled hypertension can damage small blood vessels, causing narrowing of the arteries, which can result in kidney failure stroke, and cardiac arrest.

22) The condition described by the heart pumping at an insufficient rate, blood accumulating in heart chambers, and the stretching of the heart walls is: A) peripheral edema B) congestive heart failure C) myocardial infarction D) angina pectoris Answer: B Explanation: B) Congestive heart failure (CHF) occurs when the heart pumps less blood than it receives, resulting in blood accumulating in the heart chambers and the stretching of the heart walls.

23) Which of the following types of blockers may cause congestive heart failure (CHF)?

A) calcium channel blockers B) angiotensin II receptor blockers C) centrally acting adrenergic blockers D) peripherally acting adrenergic blockers Answer: C Explanation: C) Congestive heart failure may be an adverse effect of the centrally acting adrenergic blockers. Other adverse effects include drowsiness, sedation, headache, nightmares, anxiety, orthostatic hypotension, peripheral edema, tachycardia, bradycardia, cutaneous flush, and hepatitis.

24) Which of the following have their most profound effect on the diastolic blood pressure?

A) calcium channel blockers B) angiotensin II receptor blockers C) centrally acting adrenergic blockers D) peripherally acting adrenergic blockers Answer: D Explanation: D) The peripherally acting adrenergic blockers have their most profound effect on the diastolic blood pressure. Examples of these agents include doxazosin and phenoxybenzamine.

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25) Which of the following reduces electrical conduction in the heart, decreases force of contraction, and dilates arteries?

A) diuretics B) calcium channel blockers C) potassium channel blockers D) sodium channel blockers Answer: B Explanation: B) Calcium channel blockers reduce electrical conduction in the heart by blocking the entry of calcium. This decreases the force of contraction and dilates arteries.

26) Which of the following results in blockage of vasoconstriction and aldosterone secretion?

A) diuretics B) calcium channel blockers C) angiotensin II receptor blockers D) ACE inhibitors Answer: C Explanation: C) Angiotensin II receptor blockers result in blockage of vasoconstriction and aldosterone secretion stimulated by angiotensin II. They inhibit the binding of angiotensin II to the angiotensin I receptor in vascular smooth muscle.

27) Which of the following are examples of ACE inhibitors?

A) acebutolol and propranolol B) enalapril maleate and ramipril C) guanabenz and methyldopa D) candesartan and bisoprolol Answer: B Explanation: B) Enalapril maleate and ramipril are examples of ACE inhibitors, which prevent angiotensin-converting enzyme from producing angiotensin II. ACE inhibitors are used to treat hypertension and CHF. 28) The trade name of metoprolol is: A) Levatol® B) Visken® C) Lopressor® D) Tenormin® Answer: C Explanation: C) The trade name of metoprolol is Lopressor®. It is a beta-blocker that is administered orally.

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29) Which of the following agents is classified as a calcium channel blocker?

A) Calan® B) Hytrin® C) Zebeta® D) Avapro® Answer: A Explanation: A) Calan® is classified as a calcium channel blocker. Its generic name is verapamil, and it is administered orally.

30) Angiotensin II receptor blockers include: A) Lotrel® B) Sular® C) Plendil® D) Atacand® Answer: D Explanation: D) Angiotensin II receptor blockers include Atacand®. Its generic name is candesartan, and it is administered orally.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 29 Drugs Used to Treat Hyperlipidemia and Related Conditions 1) A patient with high serum cholesterol and increased low-density lipoprotein (LDL) is at risk for: A) diabetes B) atherosclerotic coronary disease C) cancer D) lowered triglycerides Answer: B Explanation: B) A patient with high serum cholesterol and increased low-density lipoprotein (LDL) is at risk of atherosclerotic coronary disease, myocardial infarction, and hypertension.

2) Higher than normal levels of cholesterol in the blood signifies a condition known as: A) hypervolemia B) ischemic heart disease C) hypercholesterolemia D) hypertension Answer: C Explanation: C) Hypercholesterolemia means higher than normal levels of cholesterol in the blood, and there are several different types with different outcomes if not treated properly. They can lead to ischemic heart disease and peripheral vascular disease, among others.

3) The most effective drugs for lowering cholesterol levels are the: A) fibric acid derivatives B) statins C) bile acid sequestrants D) nicotinic acids Answer: B Explanation: B) The statins (also known as the HMG-CoA reductase inhibitors) include the most effective drugs for reducing LDL and cholesterol levels. They are the most widely used drugs for lowering hyperlipidemia.

4) The type of major plasma lipid that is a major component of cell membranes is the: A) cholesterol ester B) glycerol C) triglyceride D) phospholipid Answer: D Explanation: D) The type of major plasma lipid (actually a group of lipids) that is the major component of cell membranes is the phospholipid. Examples of phospholipids include lecithin, which is a component of the yolk of chicken eggs.

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5) Which of the following substances bypass the liver circulation and empty into the bloodstream?

A) phospholipids B) chylomicrons C) triglycerides D) cholesterol Answer: B Explanation: B) Chylomicrons bypass the liver circulation and empty into the bloodstream, through the thoracic duct. Once in the bloodstream, high-density lipoprotein particles add more lipoproteins, and the chylomicrons are referred to as mature.

6) Type III hypercholesterolemia involves elevations of: A) VLDL and chylomicron particles B) lipoprotein lipase C) LDL D) LDL and HDL Answer: A Explanation: A) Type III hypercholesterolemia involves elevated VLDL and chylomicron particles. It is a rare genetic condition, and results in increased levels of triglycerides and cholesterol. It is caused by an abnormality in apolipoprotein E. 7) Type IIa hypercholesterolemia is associated with high levels of which of the following, in the blood?

A) cholesterol and HDL B) cholesterol and LDL C) VLDL and LDL D) VLDL and HDL Answer: B Explanation: B) Type IIa hypercholesterolemia is associated with high blood levels of cholesterol and LDL. Ischemic heart disease is common in this type. The condition may be hereditary, and is then termed familial hypercholesterolemia.

8) Type IIb hypercholesterolemia is associated with high: A) LDL B) HDL C) VLDL D) VLDL and LDL Answer: D Explanation: D) Type IIb hypercholesterolemia is associated with high VLDL and LDL, and therefore, high triglycerides and cholesterol blood levels. Ischemic heart disease may result. This type may be related to high alcohol intake, obesity, diabetes mellitus, and overeating.

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9) The trade name of colestipol is: A) Lipitor® B) Colestid® C) Lescol® D) Zocor® Answer: B Explanation: B) The trade name of colestipol is Colestid®. It is a bile acid sequestrant, and chemically combines with bile acids in the intestine, causing these bile acids to be excreted from the body.

10) Which of the following is NOT an HMG-CoA reductase inhibitor (statin)?

A) Pravachol® B) Zocor® C) Lopid® D) Lipitor® Answer: C Explanation: C) Lopid® is not an HMG-CoA reductase inhibitor (statin). It is a fibric acid derivative, and lowers triglycerides and VLDL while increasing HDL. 11) The trade name of rosuvastatin is: A) Crestor® B) Zocor® C) Mevacor® D) Lescol® Answer: A Explanation: A) The trade name of rosuvastatin is Crestor®. It is one of the HMG-CoA Reductase Inhibitors (statins).

12) The first drug that has been approved in the United States to lower proprotein convertase subtilisin Kexin 9 (PCSK-9) is: A) gemfibrozil (Lopid®) B) simvastatin/ezetimibe (Vytorin®) C) nicotinic acid (Niacor®) D) alirocumab (Praluent®) Answer: D Explanation: D) The first drug approved in the United States to lower proprotein convertase subtilisin Kexin 9 (PCSK-9) is alirocumab (Praluent®). The gene, PCSK-9, is important for plasma cholesterol metabolism. Alirocumab is administered by injection, and is indicated for familial hypercholesterolemia, or for patients with a history of heart disease in whom statins are not sufficiently effective.

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13) Moderate alcohol intake: A) decreases HDL B) increases HDL C) increases VLDL D) increases chylomicrons Answer: B Explanation: B) Moderate alcohol intake increases HDL, the "good" cholesterol. However, it does not reduce LDL, the "bad" cholesterol.

14) Which of the following is NOT an adverse effect of bile acid sequestrants?

A) constipation B) flatulence C) hypotension D) fat-soluble vitamin impairment Answer: C Explanation: C) Hypotension is not an adverse effect of bile acid sequestrants. Their adverse effects include constipation, nausea, flatulence, and the impaired absorption of fat-soluble vitamins.

15) Which of the following is a severe but rare adverse effect of statin drugs?

A) encephalitis B) rhabdomyolysis C) aplastic anemia D) blindness Answer: B Explanation: B) Rhabdomyolysis is a severe but rare adverse effect of statin drugs. It involves degeneration of skeletal muscle tissue, with possible renal failure. If the patient has muscle pain, creatine kinase levels should be monitored to rule out rhabdomyolysis.

16) The trade name of gemfibrozil is: A) Pravachol® B) Altoprev® C) Lescol® D) Lopid® Answer: D Explanation: D) The trade name of gemfibrozil is Lopid®. It is classified as a miscellaneous antihyperlipidemic drug, and is a derivative of fibric acid that lowers triglycerides and VLDL while increasing HDL.

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17) The most effective drugs for reducing LDL and cholesterol levels are: A) HMG-CoA reductase inhibitors B) fibric acid derivatives C) bile acid sequestrants D) nicotinic acids Answer: A Explanation: A) The most effective drugs for reducing LDL and cholesterol levels are the HMG-CoA reductase inhibitors (statins). These agents are inhibitors of reductase (HMG-CoA), which is essential to hepatic production of cholesterol.

18) Which of the following are non-absorbable drugs prescribed for decreasing serum cholesterol?

A) HMG-CoA reductase inhibitors B) fibric acid derivatives C) bile acid sequestrants D) nicotinic acids Answer: C Explanation: C) Bile acid sequestrants are non-absorbable drugs prescribed to decrease serum cholesterol. They include cholestyramine resin and colestipol, which chemically combine with bile acids in the intestine. This causes the bile acids to be excreted from the body.

19) Statin drugs may increase levels of: A) insulin B) digoxin C) acetaminophen D) rifampin Answer: B Explanation: B) Statin drugs may increase levels of digoxin. They may also increase levels of norethindrone and the oral contraceptive ethinyl estradiol. Statins are contraindicated in hypersensitivity, myopathy, active liver disease, unexplained persistent transaminase elevations, pregnancy, and lactation.

20) The trade name of fluvastatin is: A) Colestid® B) Mevacor® C) Zocor® D) Lescol® Answer: D Explanation: D) The trade name of fluvastatin is Lescol®. Along with lovastatin, simvastatin, and pravastatin, it is completely effective in inhibiting HMG-CoA reductase, the enzyme needed in cholesterol production.

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21) Which of the following should be avoided by patients who are taking the statin drug simvastatin?

A) coffee B) orange juice C) grapefruit juice D) lemon juice Answer: C Explanation: C) Grapefruit juice (as well as grapefruit itself) should be avoided by patients who are taking the statin drug called simvastatin. Regular consumption of the fruit or juice can lead to high levels of the drug in the blood. This is not true of other statin drugs.

22) The most common adverse effects of niacin therapy are: A) weight loss and nausea B) flushing and pruritus C) severe hypertension and kidney damage D) hypouricemia and sedation Answer: B Explanation: B) The most common adverse effects of niacin therapy are flushing and pruritus.

The administration of aspirin before taking niacin decreases the flushing. Some patients also experience nausea, abdominal pain, syncope, nervousness, and blurred vision. Hyperuricemia, gout, impaired glucose tolerance, and hepatotoxicity have also been reported.

23) Fibric acid derivatives are contraindicated in patients with: A) biliary cirrhosis B) diabetes mellitus C) pancreatitis D) peptic ulcer Answer: A Explanation: A) Fibric acid derivatives are contraindicated in patients with biliary cirrhosis, as well as gallbladder disease, hepatic dysfunction, severe renal dysfunction, and during pregnancy and lactation.

24) Which of the following drugs is a bile acid sequestrant?

A) gemfibrozil B) colestipol C) atorvastatin D) cholestyramine Answer: D Explanation: D) Cholestyramine (resin) is a bile acid sequestrant. It binds with bile salts in the intestinal tract to form an insoluble complex that is excreted in the feces. This reduces circulating cholesterol and increases serum LDL removal rates.

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25) Which of the following drugs are indicated for severe familial hypercholesterolemia type IIa or type IIb? A) nicotinic acid and vitamin E B) fibric acid derivatives C) statins D) bile acid sequestrants Answer: B Explanation: B) Fibric acid derivatives are indicated for severe familial hypercholesterolemia type IIa or type IIb that develops early in childhood and has failed to respond to dietary control or to other cholesterol-lowering drugs.

26) The generic name of Lipitor® is: A) lovastatin B) pravastatin C) atorvastatin D) fluvastatin Answer: C Explanation: C) The generic name of Lipitor® is atorvastatin. It is one of the HMG-CoA reductase inhibitors (statins).

27) A reduction in VLDL concentration may result in a decreased plasma: A) LDL B) HDL C) LDL and HDL D) chylomicron level only Answer: A Explanation: A) A reduction in VLDL concentration also results in a decreased plasma LDL. For example, niacin causes a decrease in liver triglyceride synthesis, which is required for VLDL production, and LDL is derived from VLDL in the plasma.

28) Lovastatin increases the risk of myopathy and: A) hyperglycemia B) hyperlipidemia C) rhabdomyolysis D) hypertension Answer: C Explanation: C) Lovastatin increases the risk of myopathy and rhabdomyolysis. It may also increase repaglinide levels and duration of action. Lovastatin is sold under the trade names Altoprev® and Mevacor®.

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29) The term "epistaxis" means: A) hematuria B) nosebleed C) hemosiderin D) hemostat Answer: B Explanation: B) The term "epistaxis" means nosebleed. This is one of the adverse effects of the fibric acid derivatives. If it occurs, the patient must notify his or her physician promptly.

30) The trade name of cholestyramine resin is: A) Colestid® B) Crestor® C) Vytorin® D) Questran® Answer: D Explanation: D) The trade name of cholestyramine resin is Questran®. It is one of the bile acid sequestrants. It interferes with the intestinal absorption of many drugs, including tetracycline, phenobarbital, digoxin, warfarin, aspirin, and thiazide diuretics.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 30 Anticoagulants 1) The trade name of pentoxifylline is: A) Coumadin B) Fragmin C) Trental D) Lovenox Answer: C Explanation: C) The trade name of pentoxifylline is Trental. It is an orally administered anticoagulant.

2) Which of the following agents is classified as an anticoagulant?

A) Heparin B) Premarin C) Haloperidol D) Hydroquinone Answer: A Explanation: A) Heparin is classified as an anticoagulant. Anticoagulants decrease the blood's ability to clot.

3) Overdosage of heparin can be treated by the administration of: A) vitamin C B) vitamin K C) dalteparin D) protamine sulfate Answer: D Explanation: D) Overdosage of heparin can be treated by the administration of protamine sulfate, given via slow infusion, as a 1% solution. A dose of 0.5 to 1 mg of protamine is required to antagonize the action of each 100 units of heparin.

4) Which of the following is the trade name of warfarin sodium?

A) Doxil B) Prevacid C) Vistide D) Coumadin Answer: D Explanation: D) The trade name of warfarin sodium is Coumadin. It is an orally administered anticoagulant.

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5) The trade name of enoxaparin is: A) Fragmin B) Innohep C) Lovenox D) ReoPro Answer: C Explanation: C) The trade name of enoxaparin is Lovenox. It is a subcutaneously administered low-molecular-weight heparin.

6) Which of the following drugs is NOT an antiplatelet medication?

A) eptifibatide (Integrilin) B) clopidogrel (Plavix) C) dalteparin (Fragmin) D) aspirin (Ecotrin) Answer: C Explanation: C) Dalteparin (Fragmin) is not an antiplatelet medication. It is a low-molecularweight heparin.

7) ReoPro (abciximab) is an example of an antiplatelet medication that is administered by which of the following routes?

A) IM B) SC C) IV D) PO Answer: C Explanation: C) ReoPro (abciximab) is an antiplatelet medication that is administered intravenously. It is given as 0.25 mg/kg initially over 5 minutes, then 10 mcg / minute for 12 hours.

8) The trade name of tirofiban is: A) Aggrastat B) Ticlid C) Ecotrin D) Plavix Answer: A Explanation: A) The trade name of tirofiban is Aggrastat. It is an intravenously administered antiplatelet agent.

9) Which of the following is NOT a thrombolytic drug?

A) Retavase B) Kinlytic C) Activase D) Aggrastat Answer: D Explanation: D) Aggrastat (tirofiban) is not a thrombolytic drug. It is an intravenously administered antiplatelet agent.

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10) Medications that prolong bleeding time and help to prevent harmful clots are known as: A) thrombolytics B) anticoagulants C) coagulants D) antiplatelets Answer: B Explanation: B) Anticoagulants are medications used to prolong bleeding time and help to prevent harmful clots from forming in blood vessels.

11) Garlic is a natural alternative agent that is used as which of the following?

A) an anticoagulant agent B) a low-molecular-weight heparin C) a thrombolytic agent D) an antiplatelet agent Answer: A Explanation: A) Garlic is a natural alternative used as an anticoagulant agent. It decreases platelet aggregation. It is wise to alert patients that using garlic along with anticoagulants may cause bleeding complications.

12) Drugs that dissolve preformed clots are NOT called anticoagulants but instead are referred to as: A) vasodilators B) vasoconstrictors C) coagulants D) thrombolytic agents Answer: D Explanation: D) Drugs that dissolve preformed clots (thrombolytic agents or tissue plasminogen activators) are not referred to as anticoagulants. They include streptokinase and urokinase.

13) The newer type of heparin, derived from unfractionated heparin, is abbreviated as: A) SH B) HMWH C) LMWH D) HS Answer: C Explanation: C) LMWH (low-molecular-weight heparin) is the newer type and is derived from unfractionated heparin. The older of the two types is unfractionated heparin, also known as standard heparin, which is derived from animal extracts.

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14) The administration of an antiplatelet drug increases the risk of: A) heartburn B) kidney failure C) bleeding D) angina pectoris Answer: C Explanation: C) The administration of an antiplatelet drug increases the risk of bleeding. These drugs inhibit platelet, and are administered for the relatively specific prophylaxis of arterial thrombosis and for the prophylaxis or therapeutic management of MI and stroke.

15) Which of the following drugs facilitate the conversion of plasminogen to plasmin?

A) low-molecular-weight heparins B) thrombolytics C) antiplatelets D) anticoagulants Answer: B Explanation: B) Thrombolytics facilitate the conversion of plasminogen to plasmin. They are indicated for the management of severe pulmonary embolism, deep vein thrombosis, and arterial thromboembolism.

16) While the major adverse effect of heparin therapy is hemorrhage, another adverse effect involves blood pooling in the skin, which is called: A) hematopoiesis B) hemarthrosis C) subdural hematoma D) ecchymosis Answer: D Explanation: D) Ecchymosis is blood that has pooled in the skin, which is one of the adverse effects of heparin therapy. Subdural hematoma (bleeding into areas below the dura mater) and hemarthrosis (blood in a joint) are also adverse effects of heparin therapy.

17) Drugs that inhibit platelet function should NOT be used with heparin. One of the most commonly used drugs that exhibits this effect is: A) calcium carbonate B) aspirin C) tetracycline D) codeine Answer: B Explanation: B) Aspirin inhibits platelet function and should not be used with heparin because it can increase the risk of hemorrhage.

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18) If the urine, vomitus, or stool exhibit color changes while taking heparin, the patient must notify his or her health-care provider because there may be: A) an embolus B) an allergic reaction C) internal bleeding D) an infection Answer: C Explanation: C) Patients taking heparin must notify their health-care providers if their urine is pink, red, dark brown, or cloudy; if their vomitus is red or dark brown; or if their stool is red or black. All these color changes may be signs of internal bleeding.

19) The trade name of dalteparin is: A) Plavix B) Ticlid C) Fragmin D) Lovenox Answer: C Explanation: C) The trade name of dalteparin is Fragmin. It is a low-molecular-weight heparin that is administered subcutaneously.

20) The oral anticoagulant of choice is: A) ticlopidine B) low-molecular-weight heparin C) warfarin D) standard heparin Answer: C Explanation: C) Warfarin is the oral anticoagulant of choice. It is the most widely used anticoagulant drug, the fourth-most prescribed cardiovascular agent, and the 11th-most prescribed drug in the United States.

21) Warfarin carries a strong warning against its use during: A) old age B) middle age C) pregnancy D) young adulthood Answer: C Explanation: C) Warfarin carries a strong warning against its use during pregnancy. It can cross the placenta and may cause teratogenicity and hemorrhage in fetuses.

22) Warfarin is an antagonist of vitamin: A) B B) C C) K D) A Answer: C Explanation: C) Warfarin is an antagonist of vitamin K, a necessary element in the synthesis of clotting factors II, VII, IX, and X. 5 Copyright © 2018 Pearson Education, Inc.

23) Antiplatelet agents help prevent the formation of blood clots by keeping platelets from binding together. This is known as: A) platelet aggregation B) thrombosis C) thrombotic stroke D) platelet activation Answer: A Explanation: A) Platelet aggregation is a process involving the formation of blood clots, which is prevented by the use of antiplatelet agents.

24) Besides aspirin, the preferred antiplatelet agent is: A) ticlopidine B) abciximab C) acetaminophen D) clopidogrel Answer: D Explanation: D) Clopidogrel is an antiplatelet agent that is preferred to other choices, such as ticlopidine, because it is more potent, better tolerated, and can be administered as a loading dose.

25) Antiplatelet agents may prevent arterial thrombosis, myocardial infarction, or: A) stroke B) kidney failure C) hemorrhage D) perfusion Answer: A Explanation: A) Antiplatelet agents are used prophylactically to prevent stroke, arterial thrombosis, and myocardial infarction. They maintain perfusion (blood flow per unit volume of tissue).

26) Which of the following dissolve blood clots?

A) Hemolytics B) Antiperfusion agents C) Platelet aggregation inhibitors D) Thrombolytics Answer: D Explanation: D) Thrombolytics dissolve blood clots and include streptokinase or tissue plasminogen activator, which cause the breakdown of blood clots that obstruct the flow of blood through blood vessels.

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27) Fibrinolysis is the: A) building up of fibrin B) building up of fibrinogen C) breakdown of fibrin D) breakdown of fibrinogen Answer: C Explanation: C) Fibrinolysis is the breakdown of fibrin. Newer thrombolytic agents bind to fibrin and activate fibrinolysis (breakdown of fibrin) more than fibrinogenolysis (breakdown of fibrinogen).

28) Clots become more difficult to lyse as they: A) dissolve B) age C) thin D) multiply Answer: B Explanation: B) Clots become more difficult to lyse (dissolve) as they age. As a result, thrombolysis must be accomplished quickly after MI or cerebral infarction.

29) Warfarin is popularly marketed as: A) Ticlid B) Plavix C) Coumadin D) Streptase Answer: C Explanation: C) Coumadin is the trade name for warfarin. It is the most widely used anticoagulant drug because of its potency and reliable bioavailability.

30) The trade name for clopidogrel is: A) Integrilin B) Plavix C) Ticlid D) ReoPro Answer: B Explanation: B) Plavix is the trade name for clopidogrel. Along with ticlopidine (Ticlid), it irreversibly inhibits platelet activation, leading to the inhibition of platelet aggregation.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 31 Drugs Used to Treat Fluid and Electrolyte Imbalances 1) Osmotic diuretics are highly effective treatments for which of the following?

A) pulmonary edema B) cerebral edema C) metabolic edema D) severe congestive heart failure Answer: B Explanation: B) Osmotic diuretics are highly effective treatments for cerebral edema, and are used primarily for this purpose. These diuretics include osmotic electrolytes and nonelectrolytes, as well as acid-forming salts.

2) The trade name of mannitol is: A) Isordil B) Sequels C) Osmitrol D) Osmoglyn Answer: C Explanation: C) The trade name of mannitol is Osmitrol. It is an osmotic diuretic that is intravenously administered, for edema or ascites.

3) Which of the following is NOT a carbonic anhydrase inhibitor?

A) Diamox B) Keveyis C) Isordil D) Sequels Answer: C Explanation: C) Isordil is not a carbonic anhydrase inhibitor. It is an osmotic diuretic that is administered orally.

4) The trade name of acetazolamide is: A) Keveyis B) Isordil C) Diamox Sequels D) Methazolamide Answer: C Explanation: C) The trade name of acetazolamide is Diamox Sequels, which is an orally administered formulation. This drug is a carbonic anhydrase inhibitor. It is also available in a generic form only for intravenous use.

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5) The most abundant organic waste is: A) nitrogen B) uric acid C) urea D) creatinine Answer: C Explanation: C) Urea is the most abundant organic waste. Each person generates about 21 g of it each day.

6) Thiazide diuretics are NOT contraindicated in patients with: A) diabetes B) hypertension C) severe renal disease D) a history of gout Answer: B Explanation: B) The thiazide diuretics are not contraindicated in patients with hypertension.

They are commonly used for this condition, and can add to the effectiveness of other antihypertensive drugs.

7) The trade name of chlorothiazide is: A) Esidrix B) Diuril C) Lozol D) Thalitone Answer: B Explanation: B) The trade name of chlorothiazide is Diuril. It is an orally administered thiazide diuretic.

8) Which of the following is an example of thiazide-like diuretics?

A) Thalitone B) Diamox C) Osmitrol D) Isordil Answer: A Explanation: A) Thalitone is an example of thiazide-like diuretics. Its generic name is chlorthalidone, and it is administered orally.

9) Which of the following drugs are the most commonly used type of diuretics?

A) loop B) potassium-sparing C) thiazide D) osmotic Answer: C Explanation: C) The thiazide diuretics are the most commonly used type of diuretics. They are used for hypertension, and for edema associated with CHF, hepatic cirrhosis, and corticosteroids or estrogen therapy. They are also used for edema caused by acute glomerulonephritis, and chronic renal failure.

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10) Which of the following are the drugs of choice in patients with acute pulmonary edema?

A) osmotic diuretics B) loop diuretics C) thiazide diuretics D) carbonic anhydrase inhibitors Answer: B Explanation: B) Loop diuretics are the drugs of choice in patients with acute pulmonary edema.

They have a rapid onset of action, and are therefore useful in emergencies.

11) Keveyis (dichlorphenamide) is known as which of the following types of diuretics?

A) thiazide-like B) carbonic anhydrase inhibitor C) loop D) potassium-sparing Answer: B Explanation: B) Keveyis (dichlorphenamide) is a carbonic anhydrase inhibitor. It is orally administered.

12) Positively charged ions, such as sodium ions in extracellular fluid, are referred to as: A) protons B) neutrons C) cations D) anions Answer: C Explanation: C) Cations are positively charged ions (such as sodium ions). Anions are negatively charged ions (such as chloride ions).

13) Which of the following is an example of potassium-sparing diuretics?

A) Dyrenium B) Demadex C) Aldactone D) Lasix Answer: C Explanation: C) Aldactone (spironolactone) is an example of potassium-sparing diuretics. It is administered orally.

14) The trade name of furosemide is: A) Lasix B) Edecrin C) Bumex D) Demadex Answer: A Explanation: A) The trade name of furosemide is Lasix. It is a loop diuretic that is administered orally. There is also an injectable form (Lasix Injection) that is administered intramuscularly or intravenously.

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15) Renin is secreted by which of the following?

A) Liver B) Kidneys C) Pancreas D) Intestines Answer: B Explanation: B) Renin is secreted by the kidneys. It helps to maintain the correct salt and fluid balance in the body.

16) Which of the following are referred to as high-ceiling diuretics?

A) thiazide diuretics B) carbonic anhydrase inhibitors C) osmotic diuretics D) loop diuretics Answer: D Explanation: D) The loop diuretics are sometimes referred to as high-ceiling diuretics. In high doses, they can increase urine output greatly, leading to severe hypovolemia and death.

17) The aim of urine production is to maintain: A) metabolism B) excretion C) homeostasis D) purity Answer: C Explanation: C) The aim of urine production is to maintain homeostasis by regulating the volume and composition of blood.

18) The trade name of indapamide is: A) Thalitone B) Diuril C) Renese D) Lozol Answer: D Explanation: D) The trade name of indapamide is Lozol. It is a thiazide-like diuretic that is administered orally.

19) Vasopressin (ADH) is released from which of the following organs?

A) Kidneys B) Liver C) Adrenal gland D) Pituitary gland Answer: D Explanation: D) ADH is a hormone (also called vasopressin) that is released from the posterior lobe of the pituitary gland.

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20) Which of the following is NOT classified as a loop diuretic?

A) Bumex B) Lozol C) Lasix D) Edecrin Answer: B Explanation: B) Lozol (indapamide) is not a loop diuretic. It is a thiazide-like diuretic that is administered orally.

21) Water balance is regulated by the perception of thirst and the secretion of: A) urea B) uric acid C) ADH D) aldosterone Answer: C Explanation: C) Water balance is regulated by the secretion of ADH and the perception of thirst.

Thirst stimulates water drinking and is experienced when water loss equals 2% of an individual's body weight or when there is an increase in osmolality.

22) Concentration of particles is referred to as: A) thickness B) perfusion C) osmolality D) water deficit Answer: C Explanation: C) Osmolality means "concentration of particles." ADH is secreted when plasma osmolality increases or circulating blood volume decreases and blood pressure drops.

23) Which of the following is a common adverse effect of thiazide diuretics?

A) hypoglycemia B) hypokalemia C) hyperkalemia D) hypertension Answer: B Explanation: B) Hypokalemia is a common adverse effect of thiazide diuretics. Other adverse effects include anorexia, gastric irritation, nausea, vomiting, cramping, diarrhea, constipation, jaundice, and pancreatitis.

24) Which of the following medications is a synthetic aldosterone antagonist?

A) triamterene B) amiloride C) spironolactone D) torsemide Answer: C Explanation: C) Spironolactone is a synthetic aldosterone antagonist. It competes with aldosterone for intracellular cytoplasmic receptor sites.

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25) Which of the following diuretics is the most ototoxic?

A) ethacrynic acid B) chlorothiazide C) methyclothiazide D) acetazolamide Answer: A Explanation: A) Ethacrynic acid is the most ototoxic diuretic. Loop diuretics, which include ethacrynic acid, are toxic to the ear, particularly when used in conjunction with the aminoglycoside antibiotics. Irreversible damage may result with continued treatment using ethacrynic acid.

26) The electrolyte that is most important for maintaining the resting potential of nerve and cardiac muscle cells is: A) calcium B) sodium C) chloride D) potassium Answer: D Explanation: D) Potassium is the electrolyte especially important in maintaining the resting potential of nerve and cardiac muscle cells. Abnormal potassium levels may cause these cells to function abnormally.

27) The chemical that regulates potassium ions, increases sodium ion reabsorption, and is excreted by the adrenal cortex is: A) hydrocortisone B) cortisone C) ADH D) aldosterone Answer: D Explanation: D) Aldosterone, which the adrenal cortex secretes, increases sodium ion reabsorption and regulates potassium ions. The kidneys and this hormone provide the primary mechanism regulating these ions.

28) Diuretics have their principal action in promoting water loss at the level of the: A) urethra B) nephrons C) kidneys D) bladder Answer: B Explanation: B) Diuretics are a group of drugs that promote water loss from the body into the urine. Because urine formation takes place in the kidneys, it is not surprising that diuretics have their principal action at the level of the nephrons.

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29) Care must be taken with potassium-sparing diuretics because they may cause: A) cirrhosis B) hyperkalemia C) edema D) hypokalemia Answer: B Explanation: B) Hyperkalemia (an abnormally high amount of potassium ions in the blood) may be caused by potassium-sparing diuretics. This is a life-threatening condition, and these diuretics may also cause acute renal failure and kidney stones.

30) Loop diuretics act directly on the loop of Henle to inhibit the reabsorption of chloride and: A) magnesium B) sodium C) potassium D) urea Answer: B Explanation: B) Loop diuretics act directly on the loop of Henle in the kidneys to inhibit sodium and chloride reabsorption.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 32 Drugs Used to Treat Endocrine Conditions 1) Which of the following hormones increases contractility of the uterus?

A) prolactin B) progesterone C) insulin D) oxytocin Answer: D Explanation: D) Oxytocin is the hormone that increases contractile 2) The islets of Langerhans are located in the: A) thyroid B) kidneys C) pancreas D) pituitary Answer: C Explanation: C) The islets of Langerhans are located in the pancreas, which is an endocrine gland responsible for the manufacturing of insulin.

3) Which of the following hormones causes hypocalcemia?

A) thymosin B) calcitonin C) thyroid hormone D) parathyroid hormone Answer: B Explanation: B) The hormone calcitonin causes hypocalcemia. It inhibits bone reabsorption and the release of calcium ions into the blood while promoting the uptake of these ions back into bone. Its effects on blood calcium levels are rapid but short-acting.

4) Which of the following organs produces somatomedin?

A) lungs B) kidneys C) pancreas D) liver Answer: D Explanation: D) The liver produces a variety of types of somatomedin, which is a stimulatory hormone.

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5) Which of the following endocrine glands secretes TSH? A) thyroid B) parathyroid C) pituitary D) thymus Answer: C Explanation: C) The pituitary gland secrets thyroid-stimulating hormone (TSH), from its anterior lobe. This hormone controls the secretion of the thyroid hormone and is important for the growth and function of the thyroid gland.

6) Antidiuretic hormone is also called: A) oxytocin B) somatomedin C) vasopressin D) calcitonin Answer: C Explanation: C) Antidiuretic hormone is also called vasopressin. It stimulates water reabsorption from the nephrons (collecting ducts) of the kidneys back into the bloodstream.

7) Hyposecretion of which hormone may cause diabetes insipidus?

A) PRL B) TSH C) ACTH D) ADH Answer: D Explanation: D) Hyposecretion of antidiuretic hormone (ADH) may cause diabetes insipidus.

This condition involves chronic increased thirst and urination caused by damage of the hypothalamus.

8) FSH is known as a(n): A) gonadotropic hormone B) adrenocorticotropic hormone C) corticosteroid D) posterior pituitary hormone Answer: A Explanation: A) FSH is known as a gonadotropic hormone. Its abbreviation stands for "folliclestimulating hormone." Its major functions are stimulation of follicular growth, secretion of estrogen, growth of testes, and promotion of development of sperm cells.

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9) The trade name of levothyroxine is: A) Cytomel B) Tapazole C) Synthroid D) Propylthiouracil Answer: C Explanation: C) The trade name of levothyroxine is Synthroid. Other trade names are Levothroid and Levoxyl. Levothyroxine is generally administered orally, though an intravenous product called Synthroid IV is also available.

10) Which of the following drugs is an antithyroid?

A) liothyronine B) levothyroxine C) lispro D) methimazole Answer: D Explanation: D) Methimazole is an antithyroid drug. Its trade name is Tapazole, and it is administered orally. Methimazole is approximately 10 times as potent as propylthiouracil, and is faster in eliciting an antithyroid response.

11) Levothyroxine is commonly prescribed as a synthetic form of: A) T3 B) T4 C) T1 D) T2 Answer: B Explanation: B) Levothyroxine is commonly prescribed as a synthetic form of T4. Its actions replicate those of natural thyroid hormone, which regulates the body's basal metabolic rate.

12) Calcitriol is a metabolite of: A) vitamin D3 B) hydrocortisone C) progesterone D) vitamin B6 Answer: A Explanation: A) Calcitriol is a metabolite of vitamin D3. The GI tract mediates calcitriol, which may be considered a hormone. PTH is a tropin for the renal synthesis of calcitriol.

13) The trade name of aspart is: A) Humalog B) NovoLog C) Apidra D) Novolin N Answer: B Explanation: B) The trade name of aspart is NovoLog. It is a rapid-acting insulin analog that is administered subcutaneously.

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14) Which of the following is an example of regular insulin?

A) NovoLog B) Humulin N C) Humulin R D) Humalog Answer: C Explanation: C) Humulin R is an example of regular insulin. It is short-acting, and is injected before a meal. Humulin R has an onset of 30 to 60 minutes, and its duration of action is 5 to 7 hours. Another trade name for regular insulin is Novolin R. 15) Which of the following insulins may be administered by inhalation?

A) lispro B) aspart C) regular insulin D) glulisine Answer: D Explanation: D) Glulisine is the type of insulin that may be administered by inhalation. Its trade name is Apidra.

16) The drugs of choice for antithyroid therapy include iodide, thioamide derivatives, and: A) insulin B) radioactive iodine C) potassium D) thiourea Answer: B Explanation: B) Iodine or potassium iodide, radioactive iodine, and thioamide derivatives are the drugs of choice for antithyroid therapy.

17) Potassium iodide is used alone to treat overactive thyroid or: A) prevalent eye problems B) hyperthyroidism C) hypothyroidism D) thyrotoxic crisis Answer: B Explanation: B) Hyperthyroidism (overactive thyroid) is treated by potassium iodide alone.

Iodide combined with antithyroid drugs and propranolol is used in the treatment of patients with thyrotoxic crisis.

18) Adrenocortical insufficiency is known as: A) pancytopenia B) hyperkalemia C) Addison's disease D) goitrogenia Answer: C Explanation: C) Addison's disease describes adrenocortical insufficiency. Iodide must be used with caution in patients with this condition.

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19) The antithyroid drug that is 10 times as potent as propylthiouracil is: A) glucagon B) parathyroid hormone C) lithium D) methimazole Answer: D Explanation: D) Methimazole is the antithyroid drug that is 10 times as potent as propylthiouracil. It is also used before surgery and radiotherapy of the thyroid.

20) Which of the following is an example of short-acting insulin?

A) isophane insulin B) regular insulin C) suspension insulin D) lispro Answer: B Explanation: B) Regular insulin is an example of short-acting insulin. Its trade names are Humulin R and Novolin R, and it is administered subcutaneously.

21) Alpha cells of the pancreas secrete which of the following hormones?

A) insulin B) oxytocin C) glucagon D) glargine Answer: C Explanation: C) Glucagon is secreted by alpha cells in the pancreas, and insulin is secreted by its beta cells.

22) The trade name of chlorpropamide is: A) Diabinese B) Tolinase C) DiaBeta D) Micronase Answer: A Explanation: A) The trade name of chlorpropamide is Diabinese. It is a first-generation sulfonylurea that is administered orally.

23) Which of the following oral antidiabetic drugs is an example of biguanides?

A) rosiglitazone (Avandia) B) metformin (Glucophage) C) glyburide (Micronase) D) glipizide (Glucotrol) Answer: B Explanation: B) The oral antidiabetic drug called metformin (Glucophage) is an example of the biguanides. These agents keep the blood sugar levels from increasing too high or too fast after meals.

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24) Aldosterone is an example of: A) glucocorticoids B) gonadalcorticoids C) mineralocorticoids D) ACTH Answer: C Explanation: C) Aldosterone is an example of mineralocorticoids, and is in fact considered the main mineralocorticoid. It causes sodium and water retention, and also increases blood pressure and blood volume.

25) The trade name of prednisone is: A) Prelone B) Cortone C) Rayos D) Celestone Answer: C Explanation: C) The trade name of prednisone is Rayos. It is a glucocorticoid, and has diverse effects. Prednisone is administered orally. One of the major pharmacological uses of the glucocorticoids is based on their anti-inflammatory and immunosuppressive actions.

26) The only representative of the parenteral type of hypoglycemic drugs is: A) glipizide B) aspart C) acetohexamide D) glyburide Answer: B Explanation: B) Aspart is the only representative of the parenteral type of hypoglycemic drugs.

All the others listed are oral medications.

27) Which of the following glucocorticoids may be administered topically?

A) cortisone (Cortone) B) hydrocortisone (Cortaid) C) betamethasone (Celestone) D) prednisone (Rayos) Answer: B Explanation: B) The glucocorticoid called hydrocortisone (Cortaid) may be administered topically. ACTH is the primary stimulus to hydrocortisone secretion within the body.

28) Insulin 70/30 contains 70% NPH and 30%: A) regular insulin B) lispro protamine insulin C) lispro insulin D) glargine insulin Answer: A Explanation: A) Insulin 70/30 contains 70% NPH insulin and 30% regular insulin. It is sold under the trade names Humulin 70/30 and Novolin 70/30.

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29) The type of oral antidiabetic drug that is considered the mainstay of this type of diabetic therapy is the group known as the: A) alpha-glucosidase inhibitors B) thiazolidinediones C) biguanides D) sulfonylureas Answer: D Explanation: D) Sulfonylurea drugs have been available in the United States since 1954 and have been the mainstay of oral antidiabetic therapy for many years.

30) The adrenocortical steroids include glucocorticoids and mineralocorticoids. The main glucocorticoid is known as: A) corticotrophin (ACTH) B) androgen C) cortisol or hydrocortisone D) aldosterone Answer: C Explanation: C) Cortisol (or hydrocortisone) is the main glucocorticoid in humans. It is secreted by the adrenal cortex.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 33 Drugs Used to Treat Reproductive Conditions 1) Which of the following male hormones may be administered transdermally?

A) Androderm B) Delatestryl C) Testred D) Oxandrin Answer: A Explanation: A) The male hormone marketed as Androderm may be administered transdermally, via a patch.

2) The trade name of nandrolone is: A) Oxandrin B) Delatestryl C) Anadrol-50 D) Durabolin Answer: D Explanation: D) The trade name of nandrolone is Durabolin. It is an anabolic steroid that is administered intramuscularly.

3) Conjugated estrogen (Premarin) should NOT be administered: A) orally B) vaginally C) intramuscularly D) intravenously Answer: B Explanation: B) Conjugated estrogen (Premarin) should NOT be administered vaginally. It is administered orally, intramuscularly, and intravenously.

4) The trade name of estropipate is: A) Vagifem B) Estrace C) Menest D) Ogen Answer: D Explanation: D) The trade name of estropipate is Ogen. It is one of the major synthetic estrogens, and is administered orally.

5) The most abundant androgen is: A) a steroid B) testosterone C) estrogen D) progesterone Answer: B Explanation: B) Testosterone is the most abundant androgen. Between the ages of 13 and 15 years, a young man's androgen production usually increases rapidly.

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6) The estrogens are contraindicated in which of the following?

A) prostate cancer B) non-pregnant women C) breast cancer D) osteoporosis Answer: C Explanation: C) The estrogens are contraindicated in breast cancer, as well as in women who are pregnant or lactating. They should be used with caution in patients with liver disease, gallbladder disease, endometriosis, pancreatitis, diabetes mellitus, heart failure, and kidney dysfunction.

7) Which of the following is an example of a progestin?

A) estropipate B) estrone C) nandrolone D) norethindrone Answer: D Explanation: D) Norethindrone is an example of a progestin. Its trade name is Ortho Micronor, and it is administered orally.

8) Large doses of testosterone may cause: A) testicular atrophy B) cryptorchidism C) infertility D) endometriosis Answer: A Explanation: A) Large doses of testosterone may cause testicular atrophy. They also suppress spermatogenesis. Androgens antagonize the effects of estrogen excess in the female breasts and endometrium.

9) Estrogen should NOT be given to women with: A) diabetes insipidus B) thyroid disease C) breast cancer D) stroke Answer: C Explanation: C) The estrogens are contraindicated in women with breast cancer and in those who are pregnant or lactating, and they should be used with caution if a patient has liver disease, gallbladder disease, endometriosis, pancreatitis, diabetes mellitus, heart failure, or kidney dysfunction.

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10) The primary progestational substance that is naturally produced by the corpus luteum is: A) prolactin B) estrogen C) testosterone D) progesterone Answer: D Explanation: D) Progesterone is the primary progestational substance that is naturally produced by the ovarian cells of the corpus luteum. It is unique and distinct from estrogen.

11) The use of estrogen-progestin combinations for postmenopausal women is: A) highly recommended B) extremely safe C) very controversial D) widely untested Answer: C Explanation: C) Estrogen-progestin combinations, when used for postmenopausal women, are very controversial. They may protect against osteoporosis and colon cancer but increase the risk for cardiovascular disease, breast cancer, and thromboembolism.

12) The most popular type of contraceptives in the United States are: A) the oral contraceptive B) intrauterine devices (IUDs) C) condoms D) coitus interruptus Answer: A Explanation: A) Oral contraceptives (hormones) are the most popular type of contraceptive used in the United States. Following, in descending order of popularity, are condoms, withdrawal (coitus interruptus), progestin injections, spermicides, diaphragms, progestin subdermal implants, and IUDs. 13) The trade name of oxymetholone is: A) Durabolin B) Oxandrin C) Anadrol-50 D) Androderm Answer: C Explanation: C) The trade name of oxymetholone is Anadrol-50. It is an anabolic steroid that is administered orally.

14) The most abundant of the estrogens is: A) progesterone B) estriol C) estrone D) estradiol Answer: D Explanation: D) Estradiol is the most abundant of the estrogens, which also include estrone and estriol. Estrogens develop and maintain the female secondary sex characteristics.

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15) Which of the following is the most widely known synthetic estrogen?

A) megestrol B) diethylstilbestrol C) norethindrone D) estrone Answer: B Explanation: B) Diethylstilbestrol is the most widely known synthetic estrogen. It possesses most of the therapeutic and untoward actions of the natural estrogenic hormones.

16) Progestins should NOT be prescribed for patients with which of the following?

A) endometriosis B) functional uterine bleeding C) breast or genital malignancies D) premenstrual syndrome Answer: C Explanation: C) Progestins should not be prescribed for patients with breast or genital malignancies. The progestins are prescribed for women with secondary amenorrhea, functional uterine bleeding, endometriosis, and premenstrual syndrome.

17) Which of the following is the route of administration of Depo-Provera?

A) intramuscular B) sublingual C) oral D) transdermal Answer: A Explanation: A) The route of administration of Depo-Provera is intramuscular. Its generic name is medroxyprogesterone, and an oral version called Provera is also available.

18) The hormone that stimulates powerful uterine contractions and aids labor in its later stages is known as: A) Pitocin B) oxytocin C) prolactin D) estrogen Answer: B Explanation: B) Oxytocin is released by the posterior pituitary gland, stimulates powerful uterine contractions, and aids labor in its later stages.

19) Which of the following drugs is a uterine relaxant?

A) Methergine B) Ergotrate C) Terbutaline Sulfate D) Pitocin Answer: C Explanation: C) Terbutaline Sulfate is a uterine relaxant. It may be administered intravenously, subcutaneously, or orally.

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20) Testosterone is marketed under the trade name(s): A) Androderm and Testopel B) Halotestin C) Anadrol-50 D) Winstrol Answer: A Explanation: A) Androderm and Testopel are two trade names under which testosterone is sold.

21) In girls, sexual development begins with the secretion of: A) prolactin (Prl) B) gonadotropin-releasing hormone (GnRH) C) follicle-stimulating hormone (FSH) D) luteinizing hormone (LH) Answer: B Explanation: B) In girls, sexual development begins when the hypothalamus secretes increasing amounts of GnRH. 22) The best known synthetic estrogen is: A) theophylline (Bronkodyl) B) cyclosporine (Restasis) C) diethylstilbestrol (Stilbestrol) D) bromocriptine (Parlodel) Answer: C Explanation: C) Diethylstilbestrol (Stilbestrol) is the best known synthetic estrogen, and it possesses most of the actions of natural estrogens.

23) The trade name of an intrauterine form of progestin is: A) Rifadin B) Dilantin C) Tegretol D) Progestasert Answer: D Explanation: D) As an intrauterine agent, progestin (Progestasert) provides fertility control.

24) Progestin-only contraceptives have a failure rate that is: A) slightly higher than with the use of coitus interruptus B) slightly higher than the combination agents C) slightly lower than the combination agents D) much higher than with the use of condoms Answer: B Explanation: B) Progestin-only contraceptives have a slightly higher failure rate (pregnancy) than do the combination agents.

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25) The milk ejection (letdown) reflex in nursing mothers is promoted by: A) contraceptive hormones B) progestins C) oxytocic drugs D) uterine relaxants Answer: C Explanation: C) Oxytocic drugs produce phasic contraction of normal delivery and promote the milk ejection (letdown) reflex in nursing mothers, thereby increasing the flow of milk.

26) Oxytocin is marketed under the trade name: A) Progestasert B) Pitocin C) Estrogen D) Progesterone Answer: B Explanation: B) Oxytocin is marketed under the trade name Pitocin. Uterine sensitivity to oxytocin increases during the gestation period and peaks sharply before parturition.

27) Oxytocin should NOT be used in patients with significant cephalopelvic disproportion, which is when: A) the fetus cannot be delivered without position conversion B) delivery has caused cerebral hemorrhage C) the fetal head is too large to pass through the mother's pelvis D) the mother has had a previous cesarean section Answer: C Explanation: C) When the head of the fetus is too large to pass through the mother's pelvis, it is termed significant cephalopelvic disproportion.

28) Uterine relaxants are which type of agonists?

A) Alpha- or beta-adrenergic B) Beta-adrenergic C) Alpha-adrenergic D) None of the above Answer: B Explanation: B) Uterine relaxants are beta-adrenergic agonists prescribed in the management of preterm (premature) labor.

29) Estrogen therapy may be used in males. However, all the following are adverse effects of this therapy in men except: A) changes in libido B) loss of facial or body hair C) feminization D) sex organ atrophy Answer: A Explanation: A) Changes in libido occur in women, not men, because of estrogen therapy. All the other choices are adverse effects of estrogen therapy in men.

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30) Oral contraceptives stop ovulation by causing the pituitary to stop secreting: A) androgens B) prolactin (Prl) C) follicle-stimulating hormone (FSH) D) luteinizing hormone (LH) Answer: C Explanation: C) Oral contraceptives provide negative feedback to the hypothalamus and inhibit gonadotropin-releasing hormone. Therefore, the pituitary does not secrete FSH to stimulate ovulation.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 34 Drugs Used to Treat Gastrointestinal Conditions 1) The trade name of magaldrate is: A) Riopan B) Tums C) Amphojel D) Mylanta Answer: A Explanation: A) The trade name of magaldrate is Riopan. It is an antacid available as an oral suspension or tablet.

2) Which of the following is NOT an H2-receptor antagonist?

A) Pepcid B) Tagamet C) Zantac D) Nexium Answer: D Explanation: D) Nexium is not an H2-receptor antagonist. It is an orally administered proton pump inhibitor.

3) Which of the following proton pump inhibitors may be administered intravenously?

A) Prilosec B) Prevacid C) Nexium D) Protonix Answer: D Explanation: D) Protonix is a proton pump inhibitor that may be administered intravenously. Its generic name is pantoprazole.

4) The trade name of misoprostol is: A) Tritec B) Cytotec C) Protonix D) AcipHex Answer: B Explanation: B) The trade name of misoprostol is Cytotec. It is an orally administered prostaglandin.

5) Which of the following is NOT one of the routes of administration for cimetidine (Tagamet)?

A) SC B) IM C) IV D) PO Answer: A Explanation: A) Cimetidine (Tagamet) is not administered subcutaneously, but may be administered intramuscularly, intravenously, or orally. It is an H2-receptor antagonist.

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6) Prostaglandins are used to prevent the effects of NSAID-induced: A) pancreatitis B) appendicitis C) diverticulitis D) gastric ulcers Answer: D Explanation: D) Prostaglandins are used to prevent the effects of NSAID-induced gastric ulcers.

7) Which of the following is NOT a proton pump inhibitor?

A) Prilosec B) Riopan C) Nexium D) Prevacid Answer: B Explanation: B) Riopan is not a proton pump inhibitor; it is an antacid, administered orally.

8) "Triple therapy"—used to treat peptic (gastric) ulcer—involves the combination of colloidal bismuth with an antibacterial or several antibacterials, such as: A) magnesium carbonate B) aluminum hydroxide C) metronidazole or amoxicillin D) omeprazole Answer: C Explanation: C) In bacteria-related peptic (gastric) ulcers, successful treatment is usually given by using a combination of such antibacterials as metronidazole, amoxicillin, or tetracyclines with such agents as colloidal bismuth or omeprazole.

9) Antacids are alkaline compounds used to neutralize hydrochloric acid that may contain aluminum, magnesium, sodium, potassium, or: A) prostaglandins B) histamine C) calcium D) antibacterial agents Answer: C Explanation: C) Antacids are alkaline compounds that may be used to neutralize hydrochloric acid in the stomach. Common bases used in antacid preparations include calcium, aluminum, magnesium, sodium, and potassium.

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10) The prototype drug of the histamine H2-receptor antagonists is: A) docusate sodium (Colace) B) chloroquine (Aralen) C) misoprostol (Cytotec) D) cimetidine (Tagamet) Answer: D Explanation: D) Cimetidine (Tagamet) is the prototype drug of the histamine H2-receptor antagonists. These agents reduce the secretion of gastric acid from stomach cells by blocking the H2 receptors.

11) Proton pump inhibitors work by stopping the production of hydrogen ions (protons) in the parietal cells, which stops the formation of: A) the intrinsic factor B) hydrochloric acid C) histamine D) serotonin Answer: B Explanation: B) The formation of hydrochloric acid depends on a supply of hydrogen ions (protons) being produced in the parietal cells, and proton pump inhibitors stop this from happening.

12) Which of the following is NOT used to treat peptic ulcer?

A) Antibiotics B) Proton pump inhibitors C) Laxatives D) Acid blockers Answer: C Explanation: C) Laxatives are not used to treat peptic ulcer, but all the other choices are common treatments for this condition.

13) The most commonly used prostaglandin analog is: A) misoprostol (Cytotec) B) camphorated opium tincture (Paregoric) C) chloroquine (Aralen) D) tetracycline (Achromycin) Answer: A Explanation: A) The prostaglandin analogue misoprostol (Cytotec) is the most commonly used and has been effective in some cases in which H2-receptor antagonists have not caused a response.

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14) Which of the following antidiarrheal drugs is classified as Schedule V? A) Pepto-Bismol B) Lomotil C) Imodium D) Maalox Answer: B Explanation: B) The antidiarrheal drug called Lomotil is classified as Schedule V. It is an opioid agent, combining two generic agents: diphenoxylate hydrochloride with atropine sulfate.

15) The most effective drugs for controlling diarrhea, which require a prescription, are the: A) opioid analgesics B) diuretics C) adsorbents D) absorbents Answer: A Explanation: A) Opioid analgesics are the most effective drugs used in treating diarrhea and require a prescription. The most commonly used of these agents is camphorated opium tincture (paregoric).

16) Antidiarrheals that coat the walls of the gastrointestinal tract and target the toxins that might be responsible for diarrhea are known as: A) laxatives B) diuretics C) adsorbents D) absorbents Answer: C Explanation: C) Adsorbents act by coating the walls of the gastrointestinal tract and by adsorbing the toxins that might be implicated in causing diarrhea.

17) Among the most misused gastrointestinal drugs are: A) emetics B) stool softeners C) laxatives D) adsorbents Answer: C Explanation: C) Laxatives are among the most misused drugs to treat constipation or, in many cases, "perceived" constipation.

18) Osmosis, as used in osmotic laxatives, means: A) to balance electrolytes B) to destroy toxins C) to attract or retain water D) to expel water Answer: C Explanation: C) The ions of sodium and magnesium attract water (osmosis), which causes a more liquid stool to be formed. The contents of osmotic laxatives are hypertonic, causing water to be retained.

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19) Stool softeners are sometimes known as surfactants or: A) spirits B) suspensions C) emulsions D) emollients Answer: D Explanation: D) Stool softeners are sometimes known as emollients or surfactants. There are not many of these compounds in common use, but one of them is docusate sodium (Colace).

20) Bulk-forming laxatives absorb free water in which of the following sections of the GI tract?

A) Stomach B) Large intestine C) Small intestine D) Esophagus Answer: B Explanation: B) In the large intestine, bulk-forming laxatives absorb free water and stimulate defecation.

21) The trade name of lactulose is: A) Surfak B) Dialose C) Cephulac D) Colace Answer: C Explanation: C) The trade name of lactulose is Cephulac. It is an osmotic laxative, administered orally.

22) A common adverse effect of antiemetics is: A) nausea B) hypertension C) drowsiness D) drooling Answer: C Explanation: C) Drowsiness is a common adverse effect of antiemetics. Additional adverse effects include confusion, dry mouth, headache, hypotension, hypersensitivity reactions, and blurred vision.

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23) A common adverse effect of laxative stimulants is abnormal dark pigmentation of the colon, referred to as: A) ulceration B) constipation rebound C) gripping D) melanosis Answer: D Explanation: D) Common adverse effects of laxative stimulants include melanosis (abnormal dark pigmentation) of the colon, anorexia, nausea, gripping, abnormally loose stools, and constipation rebound.

24) Which of the following is NOT used as an antiemetic?

A) glycerin (Osmoglyn) B) chlorpromazine (Thorazine) C) prochlorperazine (Compazine) D) haloperidol (Haldol) Answer: A Explanation: A) Glycerin (Osmoglyn) is not used as an antiemetic. It is a stool softener, also sold under the trade name Glycerol, and administered rectally.

25) The trade name for famotidine is: A) Zantac B) Pepcid C) Tagamet D) Axid Answer: B Explanation: B) Pepcid is the trade name for famotidine. It is an H2-receptor antagonist used to treat patients with peptic ulcer.

26) The generic name of Nexium is: A) pantoprazole B) lansoprazole C) esomeprazole D) misoprostol Answer: C Explanation: C) Esomeprazole is the generic name of Nexium. This drug is a proton pump inhibitor.

27) Bismuth subsalicylate is the generic name for: A) Lomotil B) Maalox C) Motofen D) Pepto-Bismol Answer: D Explanation: D) Bismuth subsalicylate is the generic name of Pepto-Bismol. It is an adsorbent used to treat diarrhea.

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28) Imodium and Kaopectate II are trade names for: A) Milk of Magnesia B) paregoric C) kaolin and pectin D) loperamide Answer: D Explanation: D) Imodium and Kaopectate are trade names for loperamide. It is used to treat diarrhea.

29) Milk of Magnesia is which type of laxative?

A) Bulk-forming laxative B) Osmotic laxative C) Stool softener D) Stimulant laxative Answer: B Explanation: B) Milk of Magnesia is an osmotic laxative. Its generic name is magnesium hydroxide.

30) A popular antihistamine that is also commonly used as an antiemetic is: A) Epsom salt B) Senokot C) Dramamine D) Thorazine Answer: C Explanation: C) Dramamine is an antihistamine that is also commonly used as an antiemetic.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 35 Drugs Used to Treat Respiratory Conditions 1) Beta2-adrenergic agonists are used for which of the following disorders or conditions?

A) Hypotension B) Diarrhea C) Asthma D) Meningitis Answer: C Explanation: C) Patients with asthma are treated with a variety of different types of agents, including the beta2-adrenergic agonists.

2) The trade name of ipratropium is: A) Proventil B) Atrovent C) Ventolin D) Foradil Answer: B Explanation: B) The trade name of ipratropium is Atrovent. It is a beta2-adrenergic agonist that is administered by inhalation, using a metered dose inhaler (MDI).

3) Which of the following is NOT an antiasthma drug?

A) Foradil B) Isuprel C) Xopenex D) Hycodan Answer: D Explanation: D) Hycodan is not an antiasthma drug. It is an opioid cough suppressant. It combines the generic drugs hydrocodone and homatropine, and is administered orally.

4) Which of the following drugs is a mast cell stabilizer?

A) Singulair B) Intal C) Accolate D) Zyflo Answer: B Explanation: B) Intal is a mast cell stabilizer. Its generic name is cromolyn, and another trade name is NasalCrom. Cromolyn may be administered by MDI or by nasal spray.

5) Which of the following drugs is a leukotriene inhibitor?

A) Deltasone B) Decadron C) Singulair D) Lufyllin Answer: C Explanation: C) Singulair is a leukotriene inhibitor. Its generic name is montelukast, and it is administered orally.

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6) The trade name of salmeterol is: A) Maxair B) Alupent C) Brethaire D) Serevent Answer: D Explanation: D) Serevent is the trade name of salmeterol. It is a beta2-adrenergic agonist used to treat asthma, and is administered via inhalation, either by aerosol or powder diskus.

7) Xopenex is the trade name of which of the following?

A) metaproterenol B) pirbuterol C) levalbuterol D) terbutaline Answer: C Explanation: C) Xopenex is the trade name of levalbuterol. It is also used for asthma, and is administered via inhalation, by nebulizer.

8) Beta2-adrenergic agonists are NOT contraindicated in which of the following?

A) narrow-angle glaucoma B) cardiogenic shock C) asthma D) hemorrhagic shock Answer: C Explanation: C) Beta2-adrenergic agonists are not contraindicated in asthma. They are the drugs of choice in the treatment of acute bronchoconstriction.

9) Which of the following is an example of xanthine derivatives?

A) montelukast B) triamcinolone C) terbutaline D) aminophylline Answer: D Explanation: D) Aminophylline is a xanthine derivative. This type of drug relaxes smooth muscle by direct action on the bronchi and pulmonary vessels.

10) The trade name of metaproterenol is: A) Maxair B) Alupent C) Serevent D) Xopenex Answer: B Explanation: B) The trade name of metaproterenol is Alupent. It is an orally administered beta2adrenergic agonist.

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11) Drugs that are chemically related to caffeine and dilate bronchioles in the lungs are known as: A) vasodilators B) xanthine derivatives C) adrenergic agonists D) mucolytics Answer: B Explanation: B) The xanthine derivatives are a group of drugs chemically related to caffeine that dilate bronchioles in the lungs. They are most often used to treat asthma.

12) Leukotriene inhibitors are used in which of the following conditions?

A) chronic asthma B) severe asthma attack C) status asthmaticus D) arrhythmia Answer: A Explanation: A) Leukotriene inhibitors are used for chronic asthma. They are also used for allergic rhinitis.

13) The trade name of benzonatate is: A) Robitussin B) Tessalon C) Benadryl D) Pulmozyme Answer: B Explanation: B) The trade name of benzonatate is Tessalon. It is an orally administered nonopioid cough suppressant.

14) Agents that are bronchodilators and leukotriene receptor antagonists are known as: A) antitussives B) leukotriene inhibitors C) corticosteroids D) mast cell stabilizers Answer: B Explanation: B) Leukotriene inhibitors and bronchodilators are leukotriene receptor antagonists.

They are metabolized from arachidonic acid, which is also responsible for forming prostaglandins. Leukotrienes cause inflammation and allergic reactions.

15) Which of the following cells release histamine?

A) dust cells B) mast cells C) parietal cells D) macrophages Answer: B Explanation: B) Mast cells are large cells found in connective tissue that contain a wide variety of biochemicals, including histamine. They are involved in inflammation. Mast cell stabilizers are drugs that stabilize mast cell membranes against rupture caused by antigenic substances.

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16) Agents that reduce coughing are known as: A) mast cell stabilizers B) antihistamines C) antiemetics D) antitussives Answer: D Explanation: D) Antitussives are agents that reduce coughing. They are also called cough suppressants.

17) Which of the following decongestants is administered nasally?

A) Sudafed B) Tavist C) Afrin D) Claritin Answer: C Explanation: C) Afrin is a decongestant that is administered nasally. Its generic name is oxymetazoline, and it is a 0.05% solution.

18) Which of the following agents is a nonopioid cough suppressant?

A) Chlorpheniramine (Tussionex) B) Dextromethorphan (Robitussin) C) Hydrocodone (Histussin) D) None of the above Answer: B Explanation: B) Dextromethorphan (Robitussin) is a nonopioid cough suppressant. The other choices are opioid cough suppressants.

19) Medications capable of dissolving or promoting the liquefying of mucus in the lungs are known as mucolytics or: A) atelectics B) cough suppressants C) expectorants D) antitussives Answer: C Explanation: C) Expectorants or mucolytics are medications that are capable of dissolving or promoting the liquefying of mucus in the lungs and facilitate the elimination of mucus through coughing.

20) The trade name of dornase alfa is: A) Pulmozyme B) Mucomyst C) Organidin NR D) Sudafed Answer: A Explanation: A) The trade name of dornase alfa is Pulmozyme. It is an expectorant/mucolytic that is inhaled through a nebulizer.

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21) Which of the following drugs is an example of mast cell stabilizers?

A) montelukast (Singulair) B) zileuton (Zyflo) C) fluticasone (Flovent) D) cromolyn (Intal) Answer: D Explanation: D) The drug called cromolyn (Intal) is a mast cell stabilizer. It is inhaled through a metered dose inhaler.

22) Which of the following drugs is used as a decongestant?

A) Phenylanoline B) Benzonatate C) Diphenhydramine D) Hydrocodone Answer: C Explanation: C) The only one of the choices that is a drug used as a decongestant is diphenhydramine.

23) Which of the following are among the most effective drugs used as antitussives?

A) Bronchodilators B) Expectorants C) Opioid analgesics D) Nonopioid analgesics Answer: C Explanation: C) Opioid analgesics are among the most effective drugs that are used as antitussives.

24) Oral decongestants should NOT be taken within 2 hours of: A) breakfast B) exercise C) dinner D) bedtime Answer: D Explanation: D) Oral decongestants should not be taken within 2 hours of bedtime because a common ingredient–pseudoephedrine–may act as a stimulant.

25) Opioid cough suppressants have limited use because of their: A) short durations of action B) unwanted side effects C) cost D) toxicity Answer: B Explanation: B) Opioid cough suppressants have limited use because of their unwanted side effects.

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26) Adrenergic medications mimic the effects of the: A) sympathetic nervous system B) parasympathetic nervous system C) both D) neither Answer: A Explanation: A) Adrenergic medications mimic the effects of the sympathetic nervous system.

Most oral agents discussed in this chapter are adrenergic medications.

27) The trade name of triamcinolone is: A) Deltasone B) Azmacort C) Prelone D) Nasonex Answer: B Explanation: B) The trade name of triamcinolone is Azmacort. It is a corticosteroid that is administered by inhalation or via a nasal spray.

28) Which of the following medications is administered by inhalation?

A) Theolair B) Lufyllin C) Pulmicort D) Terbutaline Answer: C Explanation: C) Pulmicort is administered by inhalation. Its generic name is budesonide.

29) Which of the following is the trade name of formoterol?

A) Foradil B) EpiPen C) Atrovent D) Ventolin Answer: A Explanation: A) The trade name of formoterol is Foradil. It is administered via an aerolizer inhaler.

30) If used to treat status asthmaticus, isoproterenol may cause the saliva and sputum to appear: A) pink B) yellow C) brown D) black Answer: A Explanation: A) Isoproterenol may cause the sputum and saliva to appear pink. It is not labeled for treating patients with status asthmaticus, but if used for this condition, it may cause this discoloration.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 36 Drugs Used to Treat Musculoskeletal Conditions 1) The trade name of alendronate sodium is: A) Miacalcin B) Fosamax C) Actonel D) Evista Answer: B Explanation: B) The trade name of alendronate sodium is Fosamax. It is a bisphosphonate that is administered orally.

2) Medications used to treat musculoskeletal conditions include aspirin, gold salts, NSAIDs, and: A) acetaminophen B) skeletal muscle relaxants C) iron supplements D) MAO inhibitors Answer: B Explanation: B) Skeletal muscle relaxants, along with NSAIDs, aspirin, and gold salts, are medications used to treat musculoskeletal conditions.

3) Which of the following is the generic name for Benemid?

A) Colchicine B) Sulfinpyrazone C) Probenecid D) Allopurinol Answer: C Explanation: C) Benemid is the trade name for probenecid. The other choices are also antigout medications.

4) The most abundant mineral in the human body is: A) sodium B) magnesium C) calcium D) potassium Answer: C Explanation: C) Calcium is the most abundant mineral in the human body. A typical human body contains 1 to 2 kg of calcium, with roughly 99% of it deposited in the skeleton.

5) Which of the following is NOT a hormonal agent used to treat osteoporosis?

A) Calcimar B) Miacalcin C) Evista D) Actonel Answer: D Explanation: D) Actonel is not a hormonal agent used to treat osteoporosis. It is an orallyadministered bisphosphonate.

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6) Which of the following drugs has been approved for the treatment of osteoporosis?

A) etidronate B) alendronate C) pamidronate D) tiludronate Answer: B Explanation: B) Alendronate is a drug that has been approved for the treatment of osteoporosis.

It was actually the first oral bisphosphonate approved for this condition in postmenopausal women.

7) The trade name of auranofin is: A) Myochrysine B) Ridaura C) Solganal D) Enbrel Answer: B Explanation: B) The trade name of auranofin is Ridaura. It is an orally-administered gold compound.

8) Alendronate and risedronate are used to treat osteoporosis and are drugs known as: A) gold compounds B) antirheumatics C) hydrochlorides D) bisphosphonates Answer: D Explanation: D) Bisphosphonates are musculoskeletal agents that include pamidronate, alendronate, tiludronate, and risedronate. Of these agents, only alendronate and risedronate are used to treat patients with osteoporosis.

9) The trade name of methotrexate is: A) Plaquenil B) Trexall C) Azulfidine D) Enbrel Answer: B Explanation: B) The trade name of methotrexate is Trexall. It is classified as a miscellaneous agent, administered orally, for rheumatoid arthritis.

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10) The selective estrogen-receptor modulators (SERMs) are an estrogen antagonist used primarily to treat and prevent postmenopausal osteoporosis. This agent is known as: A) hydroxychloroquine B) raloxifene hydrochloride C) calcitonin D) alendronate Answer: B Explanation: B) Raloxifene hydrochloride is one of the SERMs and is considered to be an estrogen antagonist. It is used primarily to prevent and treat osteoporosis in postmenopausal women.

11) A metallic taste in the mouth is one of the adverse effects of which of the following drugs?

A) gold compounds B) antigout medications C) muscle relaxants D) anti-osteoporosis medications Answer: A Explanation: A) A metallic taste in the mouth is one of the adverse effects of gold compounds.

Other adverse effects include hypersensitivity, syncope, bradycardia, thickening of the tongue, and hematologic abnormalities such as thrombocytopenia, leukopenia, and aplastic anemia.

12) Antirheumatic drugs that reduce or prevent joint damage and preserve joint function are referred to as: A) COX-2 inhibitors B) disease-modifying antirheumatic drugs (DMARDs) C) salicylates D) NSAIDs Answer: B Explanation: B) DMARDs (disease-modifying antirheumatic drugs) reduce or prevent joint damage and preserve joint function in patients with rheumatoid arthritis.

13) Gold compounds are effective for rheumatoid arthritis but are used infrequently today because of their: A) addiction potential B) unavailability C) cost D) toxicity Answer: D Explanation: D) Gold compounds were first proved to be effective in a large group of patients with rheumatoid arthritis in 1960 but are used infrequently today because of their toxicity.

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14) The DMARD of first choice in the treatment of rheumatoid arthritis is: A) sulfasalazine B) penicillamine C) hydroxychloroquine D) methotrexate Answer: D Explanation: D) Methotrexate is the DMARD of first choice in the treatment of rheumatoid arthritis.

15) Which of the following drugs is administered subcutaneously?

A) Ridaura B) Humira C) Plaquenil D) Trexall Answer: B Explanation: B) Humira is administered subcutaneously. Its generic name is adalimumab, and it is a miscellaneous agent used for rheumatoid arthritis.

16) The most common toxicity of methotrexate is: A) dose-related bone marrow suppression B) severe psoriasis C) psoriatic arthritis D) liver failure Answer: A Explanation: A) The most common toxicity of methotrexate is dose-related bone marrow suppression. Infertility with azoospermia and amenorrhea also occur. GI upset and mouth sores are less serious common adverse effects.

17) An anti-inflammatory agent used specifically for gout and NOT for any other condition is known as: A) probenecid B) allopurinol C) colchicine D) calcitonin Answer: C Explanation: C) Colchicine is an anti-inflammatory agent specifically used for gout and is ineffective for any other disease.

18) The trade name of allopurinol is: A) Zyloprim B) Anturane C) Benemid D) Colchicine Answer: A Explanation: A) The trade name of allopurinol is Zyloprim. Another trade name is Aloprim.

Allopurinol may be administered orally or intravenously.

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19) Uricosuric agents are used when several acute attacks of gouty arthritis have occurred or when plasma levels of uric acid will most likely cause: A) rheumatoid arthritis B) rheumatic fever C) hyperglycemia D) tissue damage Answer: D Explanation: D) Uricosuric agents should be used if several acute attacks of gouty arthritis have occurred or when plasma levels of uric acid in patients with gout are so high that tissue damage is almost inevitable.

20) Nephrotic syndrome is one of the adverse effects of: A) colchicine B) allopurinol C) centrally acting muscle relaxants D) probenecid Answer: D Explanation: D) Probenecid has a variety of adverse effects, including nephrotic syndrome, which is characterized by edema, various abnormal substances present in the urine, decreased plasma albumin, and increased blood cholesterol.

21) Which of the following agents is an example of a muscle relaxant?

A) Aspirin B) Methotrexate C) Baclofen D) Cortisol Answer: C Explanation: C) Baclofen is an example of a muscle relaxant. It relieves muscle spasms, pain, and muscular rigidity.

22) Allopurinol is known as which of the following agents?

A) an antifungal B) an antigout medication C) an anti-gouty arthritis medication D) a muscle relaxant Answer: B Explanation: B) Allopurinol is an antigout agent, sold under the names Aloprim and Zyloprim, administered orally or intravenously.

23) The trade name of methocarbamol is: A) Dantrium B) Robaxin C) Klonopin D) Flexeril Answer: B Explanation: B) The trade name of methocarbamol is Robaxin. It is an orally administered centrally acting muscle relaxant.

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24) The skeletal muscle relaxant of first choice is usually: A) carisoprodol B) tizanidine C) baclofen D) diazepam Answer: C Explanation: C) Baclofen is often the skeletal muscle relaxant of first choice because of its wide safety margin.

25) The trade name for the bisphosphonate named alendronate is: A) Calcimar B) Eskalith C) Fosamax D) Actonel Answer: C Explanation: C) Fosamax is the trade name for the bisphosphonate called alendronate. This drug was the first of the bisphosphonates to be approved for the treatment and prevention of osteoporosis in postmenopausal women.

26) The trade name of cyclobenzaprine is: A) Dantrium B) Robaxin C) Klonopin D) Flexeril Answer: D Explanation: D) The trade name of cyclobenzaprine is Flexeril. It is an orally administered centrally acting muscle relaxant.

27) Sulfinpyrazone is the generic name for: A) Lioresal B) Furadantin C) Anturane D) Benemid Answer: C Explanation: C) Sulfinpyrazone is the generic name for Anturane. It is a uricosuric drug used for gout.

28) The generic name of Valium is: A) clonazepam B) carisoprodol C) tizanidine D) diazepam Answer: D Explanation: D) Diazepam is the generic name of Valium. It reduces muscle spasticity but produces sedation.

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29) Which of the following drugs is NOT an example of centrally-acting muscle relaxants?

A) baclofen B) cyclobenzaprine C) lorazepam D) probenecid Answer: D Explanation: D) Probenecid is not an example of the centrally-acting muscle relaxants. It is an orally administered antigout medication.

30) The trade name of probenecid is: A) Zyloprim B) Aloprim C) Benemid D) Anturane Answer: C Explanation: C) The trade name of probenecid is Benemid. Along with sulfinpyrazone, it is a uricosuric drug used to decrease the amount of urate in patients with increasingly frequent gouty attacks.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 37 Drugs Used to Treat Eye Conditions 1) Which of the following is NOT a beta-adrenergic blocking agent?

A) Betagan B) Lopidine C) Timoptic D) Kerlone Answer: B Explanation: B) Lopidine is not a beta-adrenergic blocking agent. It is a topical alpha2adrenergic blocking agent.

2) The trade name of acetazolamide is: A) Diamox B) Trusopt C) Neptazane D) Lopidine Answer: A Explanation: A) The trade name of acetazolamide is Diamox. It is an orally administered carbonic anhydrase inhibitor.

3) Which of the following is an example of alpha2-adrenergic blocking agents?

A) Diamox B) Trusopt C) Neptazane D) Lopidine Answer: D Explanation: D) Lopidine is an example of the alpha2-adrenergic blocking agents. It is used in glaucoma, to decrease formation of aqueous humor.

4) Which of the following is an example of an osmotic diuretic?

A) Osmitrol B) Diamox C) Betimol D) Timoptic Answer: A Explanation: A) Osmitrol is an osmotic diuretic. Its generic name is mannitol, and it is administered intravenously.

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5) Which of the following drug therapies to treat eye disorders is available to take orally?

A) Betimol B) Diamox C) Betagan D) Alphagan P Answer: B Explanation: B) Diamox is a drug for eye disorders that is available to take orally. It is a carbonic anhydrase inhibitor, along with drugs such as dorzolamide hydrochloride and methazolamide.

6) Which of the following is NOT an example of muscarinics?

A) pilocarpine B) acetylcholine chloride C) acetazolamide D) carbachol Answer: C Explanation: C) Acetazolamide is not an example of muscarinics. It is a carbonic anhydrase inhibitor that decreases formation of aqueous humor in glaucoma patients.

7) The trade name of carbachol is: A) Humorsol B) Antilirium C) Miostat D) Propine Answer: C Explanation: C) The trade name of carbachol is Miostat. It is a direct-acting miotic (cholinergic agent), applied topically.

8) Which of the following drugs is classified as a prostaglandin?

A) Propine B) Xalatan C) Humorsol D) Miostat Answer: B Explanation: B) Xalatan is a drug classified as a prostaglandin. Its generic name is latanoprost, and it is applied topically.

9) The trade name of unoprostone is: A) Travatan B) Lumigan C) Rescula D) Xalatan Answer: C Explanation: C) The trade name of unoprostone is Rescula. It is applied topically, for glaucoma patients, and increases outflow of aqueous humor.

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10) The drugs of first choice in the treatment of intraocular hypertension and chronic open-angle glaucoma are the: A) cholinesterase inhibitors B) beta-adrenergic blockers C) carbonic anhydrase inhibitors D) osmotic diuretics Answer: B Explanation: B) Beta-adrenergic blockers are considered the drugs of first choice in the treatment of patients with intraocular hypertension and chronic open-angle glaucoma. They are relatively safe, highly efficacious, act longer than cholinergic agonists, and have no effects on pupil size or accommodation.

11) In the eyes, carbonic anhydrase inhibitors decrease the formation of: A) cataracts B) ciliary bodies C) aqueous humor D) vitreous humor Answer: C Explanation: C) The carbonic anhydrase inhibitors decrease the formation of aqueous humor in the eyes. Therefore, they are important in the treatment of glaucoma because they lower intraocular pressure.

12) Which of the following drugs is an anticholinergic?

A) bimatoprost B) atropine C) unoprostone D) pilocarpine Answer: B Explanation: B) Atropine is an anticholinergic drug. It is also an antimuscarinic agent. Along with homatropine and cyclopentolate, it acts by blocking all muscarinic responses to acetylcholine.

13) Neo-Synephrine is an example of: A) prostaglandins B) sympathomimetics C) cholinesterase inhibitors D) cholinergic drugs Answer: B Explanation: B) Neo-Synephrine is an example of sympathomimetics. Its generic name is phenylephrine hydrochloride, and it is applied topically.

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14) Indirect-acting miotics are: A) less potent than direct-acting miotic agents B) shorter acting than direct-acting miotic agents C) cholinesterase inhibitors D) used to relieve miosis Answer: C Explanation: C) Indirect-acting miotics are cholinesterase inhibitors. They produce severe miosis and muscle contractions, which cause a decreased resistance to aqueous outflow.

15) Certain sympathomimetics, such as epinephrine, should NOT be used ophthalmically while wearing soft contact lenses because they may: A) cause cataracts B) discolor the lenses C) erode (dissolve) the lenses D) cause a painful allergic reaction Answer: B Explanation: B) Epinephrine, a sympathomimetic drug, should not be used ophthalmically while wearing contact lenses because discoloration of the lenses may occur.

16) The adverse effects of prostaglandins used in the eyes include inflammation of one or both eyelids, which is known as: A) conjunctivitis B) photophobia C) ocularitis D) blepharitis Answer: D Explanation: D) Blepharitis is the inflammation of one or both eyelids and is an adverse effect of using ophthalmic prostaglandins, along with such other symptoms as ocular dryness, burning, tearing, and pain.

17) Prostaglandins may cause an irreversible change in iris color, especially in people with: A) gray or hazel eyes B) green eyes C) blue eyes D) brown eyes Answer: B Explanation: B) Patients, especially those with green eyes, should be instructed that prostaglandins may cause a possible change in iris pigmentation, which is an irreversible condition.

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18) Agents that dilate the pupil of the eye are known as: A) cycloplegics B) mydriatic agents C) prostaglandins D) sympathomimetics Answer: B Explanation: B) Mydriatic drugs are agents that dilate the pupil of the eye. They are commonly used during eye examinations to permit examination of the retina.

19) Drugs that cause paralysis of ciliary muscles, resulting in papillary dilation, are known as: A) cholinergics B) spasmodics C) muscarinics D) cycloplegics (anticholinergic agents) Answer: D Explanation: D) Cycloplegic drugs (anticholinergic agents) cause paralysis of ciliary muscles, resulting in papillary dilation. They are used for eye examinations and before eye surgery.

20) The trade name of physostigmine is: A) Humorsol B) Miostat C) Propine D) Antilirium Answer: D Explanation: D) The trade name of physostigmine (salicylate) is Antilirium. It is an indirectacting miotic (cholinesterase inhibitor), applied topically.

21) A trade name for glycerin anhydrous (as used for the eyes) is: A) Osmitrol B) Adsorbocarpine C) Ophthalgan D) Ismo Answer: C Explanation: C) Ophthalgan is the trade name for glycerin anhydrous, which is an osmotic diuretic used in patients needing eye surgery or for acute closed-angle glaucoma.

22) Which of the following is NOT classified as a carbonic anhydrase inhibitor?

A) Neptazane B) Diamox C) Trusopt D) Osmitrol Answer: D Explanation: D) Osmitrol is not classified as a carbonic anhydrase inhibitor. It is an osmotic diuretic, administered intravenously.

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23) For lowering intraocular pressure, apraclonidine should only be used for a short time because chronic use may cause: A) glaucoma B) blepharospasm C) allergic blepharoconjunctivitis D) cataract Answer: C Explanation: C) Apraclonidine (Iopidine) should be used only in the short term for lowering the intraocular pressure because with chronic use, it is associated with allergic blepharoconjunctivitis.

24) Which of the following is an example of cholinesterase inhibitors?

A) carbachol B) pilocarpine C) physostigmine D) phenylephrine Answer: C Explanation: C) Physostigmine (salicylate) is an example of cholinesterase inhibitors (indirectacting miotics), applied topically.

25) Prostaglandin agonists reduce congestion in the trabecular meshwork, lowering intraocular pressure and increasing: A) aqueous humor outflow B) tearing C) vitreous humor outflow D) iris color Answer: A Explanation: A) Prostaglandin agonist agents increase aqueous humor outflow by reducing congestion in the trabecular meshwork, resulting in lowered intraocular pressure.

26) First-line monotherapy for open-angle glaucoma may be accomplished with the use of: A) atropine (Atropisol) B) travoprost (Travatan) C) hydroxyamphetamine (Paredrine) D) phenylephrine hydrochloride (Mydfrin) Answer: B Explanation: B) Travoprost (Travatan) can be used as first-line monotherapy or in combination with timolol for open-angle glaucoma.

27) Cycloplegic drugs are also referred to as which of the following agents?

A) cholinergic B) cholinesterase inhibitor C) prostaglandin D) anticholinergic Answer: D Explanation: D) Cycloplegic drugs are also referred to as anticholinergic agents. They cause paralysis of ciliary muscles, resulting in pupillary dilation.

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28) The effects of sympathetic stimulation of the iris are: A) vasoconstriction B) relaxation (for far vision) C) contraction of the circular muscle and pupil constriction D) contraction of the radial muscle and pupil dilation Answer: D Explanation: D) Effects of sympathetic stimulation on the iris include contraction of the radial muscle and pupil dilation (mydriasis).

29) The trade name of methazolamide is: A) Lopidine B) Kerlone C) Trusopt D) Neptazane Answer: D Explanation: D) The trade name of methazolamide is Neptazane. It is a carbonic anhydrase inhibitor, administered orally.

30) An osmotic diuretic that can be administered intravenously that is also used to treat glaucoma is: A) timolol (Timoptic) B) mannitol (Osmitrol) C) acetazolamide (Diamox) D) brimonidine tartrate (Alphagan P) Answer: B Explanation: B) Mannitol (Osmitrol) is an osmotic diuretic, also used to treat glaucoma, which may be injected intravenously. Other osmotic diuretics used for glaucoma include glycerin anhydrous (Ophthalgan) and isosorbide (Ismotic).

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 38 Drugs Used to Treat Geriatric Patients 1) Which of the following medications in elderly patients may cause ototoxicity and nephrotoxicity?

A) levodopa B) thyroxin C) aminoglycosides D) carbamazepine Answer: C Explanation: C) Aminoglycosides may cause ototoxicity and nephrotoxicity in elderly patients.

For example, the half-lives of gentamicin, kanamycin, and netilmicin are more than doubled in elderly patients.

2) Which of the following agents may cause renal toxicity in elderly patients?

A) vitamin D B) digoxin C) warfarin D) cimetidine Answer: A Explanation: A) Vitamin D may cause renal toxicity in elderly patients. Its trade name is Calcijex.

3) One of the adverse effects of thyroxine administration in elderly patients is: A) ototoxicity B) nephrotoxicity C) respiratory depression D) myocardial infarction Answer: D Explanation: D) One of the adverse effects of thyroxine administration in elderly patients is myocardial infarction.

4) Which of the following does NOT influence the way drug absorption changes as we age?

A) Altered nutritional habits B) Greater use of OTC medications C) Cognitive ability D) Slower gastric emptying Answer: C Explanation: C) Cognitive ability does not affect the way the body absorbs drugs as we age. All the other factors do contribute to the rate of drug absorption.

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5) Elderly adults tend to have: A) reduced total body water B) decreased body fat C) increased lean body mass D) increased total body water Answer: A Explanation: A) Elderly adults tend to have reduced total body water, increased body fat, and reduced lean body mass.

6) In elderly patients, there may be an increase in a specific serum protein known as: A) globulin B) serotonin C) albumin D) glycoprotein Answer: D Explanation: D) Elderly adults may have an increase of a specific serum protein (glycoprotein) that binds to many basic drugs. This accompanies a decrease of serum albumin.

7) Which of the following medications in elderly patients may cause hypotension?

A) thyroxine B) cimetidine C) thioridazine D) levodopa Answer: D Explanation: D) Levodopa may cause hypotension in elderly patients. Its trade name is Dopar.

8) After age 70, blood flow to the kidneys may decrease by as much as: A) 10% B) 25% C) 35% D) 40% Answer: D Explanation: D) After age 70, blood flow to the kidneys may decrease by as much as 40%; also, by age 65, nephron function may decrease by 35%.

9) Yohimbe is a natural supplement widely taken to treat which of the following?

A) peptic ulcer B) hypertension C) erectile dysfunction D) renal disease Answer: C Explanation: C) Yohimbe is a natural supplement widely taken to treat erectile dysfunction. It is not recommended for patients with hypertension or hepatic, renal, or peptic ulcer diseases.

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10) An indicator of the glomerular filtration rate is: A) the urine protein test B) the creatinine clearance test C) the blood urea nitrogen D) the microalbuminuria test Answer: B Explanation: B) The creatinine clearance test is an indicator of the glomerular filtration rate.

Creatinine clearance is calculated in milliliters per minute by the following formula: (140 - Age) × (Weight in kg). The result is then divided by (72 × the serum creatinine in milligrams per deciliter.)

11) If hepatic and renal functions are decreased, the half-life of a drug is prolonged, which may result in: A) potentiation B) increased sedative effects C) drug toxicity D) drug ineffectiveness Answer: C Explanation: C) If the efficiency of the hepatic and renal systems is decreased, the half-life of the drug is prolonged, resulting in drug toxicity. There are special medications that must be administered in reduced dosages in elderly patients.

12) Which of the following histamine-2 receptor blockers is NOT safe to be used by elderly patients?

A) nizatidine B) famotidine C) ranitidine D) cimetidine Answer: D Explanation: D) The histamine-2 receptor blocker known as cimetidine is not safe to be used by elderly patients. It has a variety of side effects and multiple potential drug interactions.

13) Which of the following medications does NOT improve cognitive activity in some patients with Alzheimer's disease?

A) donepezil B) carbamazepine C) rivastigmine D) galantamine Answer: B Explanation: B) Carbamazepine does not improve cognitive activity in some patients with Alzheimer's disease. Its trade name is Carbatrol, and its adverse effects include ataxia and drowsiness.

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14) Thiazide drugs used to treat hypertension in the elderly do NOT cause which of the following?

A) hyperglycemia B) hyperuricemia C) hyperkalemia D) hypokalemia Answer: C Explanation: C) Thiazide drugs used to treat hypertension in the elderly do not cause hyperkalemia. The thiazides are the most commonly prescribed class of diuretics.

15) Which of the following is an adverse effect of digoxin?

A) overdose toxicity B) confusion C) respiratory depression D) renal toxicity Answer: A Explanation: A) Overdose toxicity is an adverse effect of digoxin. Its trade name is Lanoxin.

16) Drug therapy for hypertension usually begins with: A) beta-blockers B) ACE inhibitors C) diuretics D) calcium channel blockers Answer: C Explanation: C) For hypertension, drug therapy usually begins with thiazides after weight reduction and salt restriction before beginning the thiazide regimen.

17) The antihypertensive drugs that are overused by physicians, partially because of their fear of heart failure for elderly patients, are: A) diuretics B) cardiac glycosides C) anticoagulants D) antiarrhythmic drugs Answer: B Explanation: B) Cardiac glycosides are overused by physicians, partially because of their fear of heart failure for elderly patients. Because of their susceptibility of arrhythmias, older patients must be aware of the toxic effects of cardiac glycosides, especially for long-term use.

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18) An antiarrhythmic drug that should be avoided in elderly patients because of its major toxicities is: A) lidocaine B) quinidine C) disopyramide D) diltiazem Answer: C Explanation: C) Disopyramide (Norpace) should be avoided in elderly patients because of its major toxicities. Treating elderly patients who have arrhythmias is challenging because of their clearances of certain drugs, changes in hemodynamic reserve, severe coronary disease, and electrolyte disturbances.

19) The second-most common group of drugs taken by elderly patients is: A) sedatives and hypnotics B) antiarrhythmics C) diuretics D) anticoagulants Answer: A Explanation: A) Sedatives and hypnotics are the second most common group of drugs prescribed for (or taken OTC by) elderly patients. Insomnia is a common problem for elderly adults, and these drugs are usually used for this condition.

20) Geriatric patients are often more sensitive to the respiratory effects of: A) narcotic analgesics B) diuretics C) antipsychotics D) calcium channel blockers Answer: A Explanation: A) Geriatric patients are often more sensitive to the respiratory effects of narcotic analgesics because of the way their respiratory functions change with increased age.

21) For geriatric patients, which type of drugs should be started in just a fraction of the amount indicated for younger patients?

A) Antiarrhythmics B) Hypnotics C) Antidepressants and antipsychotics D) Diuretics Answer: C Explanation: C) Antidepressants and antipsychotics should be started in geriatric patients at just a fraction of the amounts used for young adults. The half-lives of some phenothiazines are increased in the geriatric population, and renal clearance affects the actions of drugs, such as lithium.

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22) In older adults, because of their reduced antimuscarinic effects, the tricyclic antidepressants of choice are: A) tacrine or ketoconazole B) donezepil or rivastigmine C) nortriptyline or desipramine D) lithium or galantamine Answer: C Explanation: C) Nortriptyline or desipramine are the tricyclic antidepressants of choice for older adults because of their reduced antimuscarinic effects.

23) A condition characterized by progressive memory and cognitive function impairment is known as: A) Parkinson's disease B) depression C) Alzheimer's disease D) hypertension Answer: C Explanation: C) Alzheimer's disease is characterized by progressive memory and cognitive function impairment. It may lead to a completely vegetative state and early death.

24) The type of drugs usually focused on as treatments for Alzheimer's disease are: A) cholinomimetic drugs B) anti-inflammatory drugs C) antimicrobial drugs D) antimuscarinic drugs Answer: A Explanation: A) Cholinomimetic drugs are usually focused on as treatments for Alzheimer's disease. These include tacrine, donepezil, rivastigmine, and galantamine.

25) In elderly patients, drugs that are used to treat osteoporosis and rheumatoid arthritis but that may still require close monitoring due to possible adverse effects include NSAIDs and: A) calcium supplements B) histamine blockers C) corticosteroids D) ACE inhibitors Answer: C Explanation: C) Corticosteroids are very useful for elderly patients who cannot tolerate full NSAID doses, but these agents cause osteoporosis that is related to the dose and duration of corticosteroid therapy.

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26) In long-term care facilities, 75% of older adults use which type of drugs on a daily basis?

A) Antidiarrheals B) Asthma medications C) Laxatives D) Antiemetics Answer: C Explanation: C) In long-term care facilities, such as nursing homes, 75% of older adult patients use laxatives on a daily basis. Fluid and electrolyte imbalances may occur with excessive use.

27) The normal creatinine clearance value for an adult is ________ mL/minute.

A) 50 - 70 B) 80 - 130 C) 110 - 145 D) 130 - 165 Answer: B Explanation: B) The normal creatinine clearance value for an adult is 80 - 130 mL/min.

Creatinine clearance is an indicator of the glomerular filtration rate. In elderly patients, serum creatinine may be within normal values because of a lack of muscle mass, but there could still be a decrease in renal function.

28) For people over age 65, drug dosages must be adjusted according to which of the following?

A) weight, diet, laboratory results, and hypersensitivities B) race, alcohol intake, gender, and allergies C) weight, body fat, laboratory results, and current health conditions D) race, amount of exercise, gender, and family history Answer: C Explanation: C) For people over age 65, drug dosages must be adjusted according to weight, body fat, laboratory results, and current health conditions.

29) Adverse effects of thioridazine (Mellaril) and cimetidine (Tagamet), in the elderly, include which of the following?

A) hypotension B) confusion C) renal toxicity D) ototoxicity Answer: B Explanation: B) Adverse effects of thioridazine (Mellaril) and cimetidine (Tagamet), in the elderly, include confusion. Elderly people may also experience confusion, along with liver dysfunction, malnutrition, and falls because of polypharmacy.

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30) A good way to reduce confusion and medication errors is to: A) prescribe a wide variety of drugs that will work together properly B) use extra-large print on prescription pads C) keep the patient's drug regimen as simple as possible D) tell the patient to have another person administer his or her drugs Answer: C Explanation: C) Health-care providers should strive to reduce patient confusion and the chance for medication errors involving drug self-administration by keeping the patient's drug regimen as simple as possible. They should try to prescribe drugs that may be taken at the same time every day by using the least number of drugs possible.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 39 Drugs Used to Treat Pediatric Patients 1) Drug absorption in infants and children is: A) much faster than in adults B) different from the way it occurs in adults C) similar to the way it occurs in adults D) much slower than in adults Answer: C Explanation: C) In infants and children, drug absorption is similar to the way it occurs in adults.

2) The circulation in the body's extremities is known as: A) dorsal blood circulation B) proximal blood circulation C) peripheral blood circulation D) distal blood circulation Answer: C Explanation: C) The circulation in the body's extremities is known as peripheral blood circulation. If this improves in an infant, a sudden increase of circulating drugs may result in potentially toxic drug concentrations.

3) The rhythmic movement of the intestines is known as: A) undulation B) excretion C) digestion D) peristalsis Answer: D Explanation: D) Peristalsis is the rhythmic movement of the intestines. In neonates, this is irregular and may be slower than anticipated.

4) During the neonatal period, the rate of gastric emptying is: A) extremely slow B) extremely rapid C) constant D) variable Answer: D Explanation: D) During the neonatal period, the rate of gastric emptying is variable. This rate is an important determinant of the overall rate and extent of drug absorption.

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5) Inadvertent poisoning may result if chemical agents are applied to the skin of a(n): A) elderly person B) adult C) premature infant D) adolescent Answer: C Explanation: C) Chemical agents applied to the skin of a premature infant may result in inadvertent poisoning. Drug toxicities are reported for the percutaneous absorption of hexachlorophene, pentachlorophenol-containing laundry detergents, hydrocortisone, and anilinecontaining disinfectant solutions.

6) In neonates, extracellular water makes up: A) 10% of body weight B) 20% of body weight C) 40% of body weight D) 60% of body weight Answer: C Explanation: C) Extracellular water makes up 40% of body water in neonates compared with 20% in adults. It is important, especially for water-soluble drugs, to determine the concentration of a drug at receptor sites.

7) Drugs that may exhibit lowered protein binding in neonates include all the following except: A) diazepam B) amoxicillin C) phenobarbital D) phenytoin Answer: B Explanation: B) Usually, the protein binding of drugs is lowered in neonates. This has been seen with local anesthetic drugs, diazepam, phenobarbital, ampicillin, and phenytoin.

8) A serious form of jaundice in newborns is known as: A) bilirubinemia B) hepatitis C) serum toxicity D) kernicterus Answer: D Explanation: D) Kernicterus is a serious form of jaundice in newborns. Drugs given to a neonate who has jaundice can replace bilirubin from albumin, and because of the greater permeability of a neonate's blood-brain barrier, large amounts of bilirubin may enter the brain and cause kernicterus.

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9) A major problem concerning drug metabolism in children of all ages is the lack of: A) willing test patients B) FDA requirements for pediatric studies C) metabolism in patients younger than 5 years old D) testing facilities Answer: B Explanation: B) The absence of FDA requirements for pediatric studies is a major problem concerning drug metabolism in children of all ages. The medical community relies on pharmacological data derived primarily from adults to determine dosage guidelines for children.

10) Full-term gestation is approximately 40 weeks, but prematurely born neonates are surviving with gestations as short as: A) 24 weeks B) 28 weeks C) 32 weeks D) 36 weeks Answer: A Explanation: A) Prematurely born neonates at gestations as short as 24 weeks are now surviving (a full-term gestation is 40 weeks).

11) Adult glomerular filtration rates are reached by the time a baby is: A) 2 to 3 months old B) 4 to 5 months old C) 6 to 12 months old D) 20 to 24 months old Answer: C Explanation: C) Adult glomerular filtration rates are reached by the time a baby is 6 to 12 months old. In newborns, this rate is much lower than in older children or adults.

12) Popular forms of drugs for pediatric administration include: A) elixirs and suspensions B) injections and patches C) inhalation and sublingual drugs D) eye drops and troches Answer: A Explanation: A) Elixirs and suspensions are popular forms of drugs for pediatric administration because of their ease of dispensing.

13) Alcoholic solutions that offer consistent dissolving and drug distribution are known as: A) troches B) patches C) elixirs D) ointments Answer: C Explanation: C) Elixirs are alcoholic solutions that offer consistent dissolving and distribution of the drugs they contain.

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14) Oral liquid medications that must be shaken to evenly distribute undissolved drug particles are known as: A) lotions B) salves C) suspensions D) ointments Answer: C Explanation: C) Suspensions contain undissolved drug particles and must be shaken to evenly distribute them. This is essential because an inadequate amount of shaking will cause some doses to have smaller amounts of drug than others or possible toxicity.

15) A good rule for avoiding "decimal point errors" is to always use a zero to: A) add to the denominator to increase to a power of 10 B) add to the numerator before dividing C) the right of a decimal point (when dealing with doses that are greater than 1) D) the left of a decimal point (when dealing with doses that are less than 1) Answer: D Explanation: D) A good rule for avoiding decimal point errors is to always use a zero to the left of a decimal point when dealing with doses that are less than 1. Also, zeros should not be used after decimal points if they are not needed.

16) Drugs that pose particular difficulties when used in neonates include digoxin, indomethacin, the methylxanthines, and: A) antiemetics B) antipyretics C) antibiotics D) antitussives Answer: C Explanation: C) Antibiotics, along with digoxin, indomethacin, and methylxanthines, pose particular difficulties when used in neonates because of the unique character of their distribution or elimination in patients in this age group or because of the unusual side effects they may cause.

17) If a drug is safe for a mother to take before breastfeeding, she should take it: A) 10 to 20 minutes before breastfeeding B) 1 to 2 hours before breastfeeding C) 30 to 60 minutes before breastfeeding D) 3 to 4 hours before breastfeeding Answer: B Explanation: B) If a drug is prescribed as safe for a mother to take while she is breastfeeding, she should take it 1 to 2 hours before breastfeeding. It may also be taken 3 to 4 hours after breastfeeding.

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18) Drugs that may stain the incoming teeth of an infant are the: A) barbiturates B) pyridoxines C) methylxanthines D) tetracyclines Answer: D Explanation: D) Tetracyclines show up as about 70% of maternal serum concentrations and can stain the incoming teeth of infants.

19) Radioactive substances taken by a breastfeeding mother can cause in their infants which of the following?

A) Hypotension B) Autonomic nervous system or depression C) Dependence D) Thyroid cancer Answer: D Explanation: D) Radioactive substances taken by breastfeeding mothers can increase the risk of thyroid cancer in their infants.

20) Pediatric doses are usually stated as: A) milligrams per kilogram B) micrograms per milligram C) grams per liter D) milligrams per milliliter Answer: A Explanation: A) Recommended pediatric doses are usually stated as milligrams per kilogram (or milligrams per pound).

21) Which of the following are NOT especially dangerous to newborns or infants?

A) Cardiac glycosides B) Antitussives C) Aminoglycoside antibiotics D) Anticonvulsants Answer: B Explanation: B) Antitussives are not especially dangerous to newborns or infants, but all the other choices are.

22) In children, physiologic conditions that can reduce the rate of blood flow to the site of drug administration include all the following except: A) vasoconstriction B) vasodilation C) heart failure D) cardiovascular shock Answer: B Explanation: B) Vasodilation does not reduce the rate of blood flow to the site of drug administration, but all the other choices do.

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23) The amount of body fat in neonates is about: A) 5% B) 15% C) 25% D) 35% Answer: B Explanation: B) Neonates have about 15% body fat, higher percentages of water than adults, and lowered protein binding of drugs.

24) Pediatric drug dosages may be based on all the following except: A) age B) body surface area C) body weight D) sex Answer: D Explanation: D) Pediatric drug dosages are not based on sex but may be based on age, body weight, or body surface area.

25) The trade name for phenytoin is: A) Laniazid B) Indameth C) Dilantin D) Lanoxin Answer: C Explanation: C) Dilantin is the trade name for phenytoin. If not shaken properly, dilantin suspensions may cause an uneven distribution of the drug and inefficacy or toxicity in children.

26) Pyridoxine supplements are sold under the trade name: A) Phisohex B) Beesix C) Dolophine D) Avinza Answer: B Explanation: B) Pyridoxine supplements are sold under the trade name Beesix. Concentrations of isoniazid in breast milk can cause signs of pyridoxine deficiency if the mother does not take pyridoxine supplements. Pyridoxine is also known as vitamin B6; hence, the trade name.

27) In the first two days of life, most neonates experience: A) fever B) diuretics C) jaundice D) diuresis Answer: D Explanation: D) Most neonates experience diuresis in the first two days of life. Diuresis is an excessive discharge of urine.

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28) Most drugs taken by lactating women: A) cause diarrhea in their infant B) show up in their breast milk C) cause toxicity in their infant D) do not show up in their breast milk Answer: B Explanation: B) Most drugs taken by lactating women do show up in their breast milk. Drug concentration in breast milk is usually low.

29) A drug that enters the breast milk in concentrations equal to those in maternal serum is: A) lobelia B) methadone C) lithium D) alcohol Answer: C Explanation: C) Lithium enters breast milk in concentrations equal to those in maternal serum, and the baby may be exposed to relatively large amounts of this drug as a result.

30) Which of the following may cause more infant deaths?

A) Baby formula B) Saline solution C) Mother's milk D) Water Answer: A Explanation: A) More babies die because of problems inherent in the feeding of baby formula than from the milk of their mothers or as a result of the other two choices.

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Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 40 Drugs Used to Treat Pregnant Patients 1) Pregnancy begins with: A) life span B) development C) conception D) homeostasis Answer: C Explanation: C) Pregnancy begins with conception. Within 24 hours after fertilization, the egg begins dividing rapidly into many cells.

2) The first stage of reproduction is: A) implantation B) germ cell formation C) coitus D) organogenesis Answer: B Explanation: B) The first stage of reproduction is germ cell formation. A germ cell is a biological cell that gives rise to the gametes of an organism.

3) During organogenesis, which of the following can develop as a result of toxicity?

A) Sterility B) Impotence C) Autism D) Withdrawal symptoms Answer: C Explanation: C) During organogenesis, autism can develop as a result of toxicity. It is a disorder of neural development characterized by impaired social interaction and communication and by restricted and repetitive behavior.

4) Blood flow through the mother's kidneys increases between 40% and 50% by which trimester?

A) First B) Second C) Third D) None of the above Answer: C Explanation: C) By the third trimester, blood flow through the mother's kidneys increases between 40% and 50%.

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5) Which of the following is a pregnancy Category X drug?

A) Folic acid B) Acetaminophen C) Clarithromycin D) Isotretinoin Answer: D Explanation: D) Isotretinoin (Accutane) is a pregnancy Category X drug. It is a medication used for the treatment of a number of cancers and severe skin conditions.

6) Which of the following is a pregnancy Category D drug?

A) Insulin B) Penicillin C) Nicotine D) Co-trimoxazole Answer: C Explanation: C) Nicotine is a pregnancy Category D drug. It has a high toxicity compared with many other alkaloids, such as cocaine.

7) Instead of being the actual administered compounds, teratogens may be: A) Malformations B) Genetic disorders C) Metabolites D) Exposures Answer: C Explanation: C) Teratogens may be metabolites instead of being the actual administered compounds. Metabolites are the intermediates and products of metabolism.

8) Because fetal tissues are more vulnerable, which of the following may be increased?

A) Growth B) Carcinogenic effects of certain agents C) Maturation D) None of the above Answer: B Explanation: B) The carcinogenic effects of certain agents may be increased because fetal tissues are more vulnerable.

9) During pregnancy, which of the following is (are) more complicated?

A) Metabolism and kinetics of drugs B) Weight gain C) Host defenses D) Sperm function Answer: A Explanation: A) Metabolism and kinetics of drugs are more complicated during pregnancy.

Metabolism increases during pregnancy so the mother's body can provide nourishment to the fetus.

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10) Compared with other times during life, during pregnancy, the gastrointestinal motility and distribution to plasma proteins is: A) increased B) unchanged C) decreased D) reversed Answer: C Explanation: C) During pregnancy, the gastrointestinal motility and distribution to plasma proteins is decreased (compared with other times during life).

11) Drugs used during pregnancy have the potential to cause which of the following?

A) Restricted growth B) Fetal malformation C) Functional defects D) All of the above Answer: D Explanation: D) All the answer choices are correct. Drugs used during pregnancy can cause restricted growth, fetal malformation, and functional defects.

12) Which of the following is widely known to damage fetuses?

A) Folic acid B) Coffee C) Alcohol D) Ascorbic acid Answer: C Explanation: C) Alcohol is widely known to damage fetuses. The effects of alcohol can include odd facial features, growth problems, learning and behavior problems, and birth defects.

13) In the postnatal stage, toxic agents may cause: A) spontaneous abortion B) cerebral palsy C) damage to sperm or egg cells D) chromosomal defects Answer: B Explanation: B) In the postnatal stage, toxic agents may cause cerebral palsy. This condition is actually a broad term describing a group of disorders that impair control of movement.

14) During a female's life span, how many oocytes undergo ovulation?

A) 30 B) 150 C) 266 D) 400 Answer: D Explanation: D) During a female's life span, 400 oocytes undergo ovulation. This is the average amount of oocytes released between menarche and menopause.

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15) Drug therapy should be continued in which of the following disorders before pregnancy or lactation?

A) Psychiatric B) Kidney stones C) Hypertension D) A and C Answer: D Explanation: D) Answer choices A and C are correct. Drug therapy should be continued with psychiatric disorders and hypertension before pregnancy or lactation.

16) Which of the following substances is NOT likely to cross a placenta?

A) An ionized or water-soluble substance B) Tetracycline C) Nicotine D) Alcohol Answer: A Explanation: A) Ionized or water-soluble substances are not likely to cross the placenta. The "placental barrier" usually allows fat-soluble chemicals to cross.

17) Which of the following substances slows the transit time for food and drugs in the GI tract in pregnant women?

A) Insulin B) Progesterone C) Glucagon D) None of the above Answer: B Explanation: B) Progesterone slows the transit time for food and drugs in the GI tract in pregnant women.

18) Inhaled drugs may be absorbed more readily in pregnant women because of increased pulmonary vasodilation and: A) expiratory reserve volume B) total lung capacity C) inspiratory reserve volume D) tidal volume Answer: D Explanation: D) Inhaled drugs may be absorbed more readily in pregnant women because of increased pulmonary vasodilation and tidal volume.

19) Which of the following may be increased during normal pregnancy?

A) Plasma volume B) Regional blood flow C) Cardiac output D) All of the above Answer: D Explanation: D) All the answer choices are correct. Plasma volume, regional blood flow, and cardiac output may be increased during normal pregnancy.

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20) Which of the following FDA pregnancy drug categories is NOT indicated for use in pregnancy?

A) Category B B) Category D C) Category X D) Category Z Answer: C Explanation: C) FDA pregnancy drug category X is not indicated for use in pregnancy. In this category, studies in animals or humans have demonstrated fetal abnormalities or there is positive evidence of human fetal risk.

21) The study of structural birth defects is called: A) teratology B) toxicology C) teratogenicity D) none of the above Answer: A Explanation: A) Teratology is the study of structural birth defects. Birth defects are known to occur in 3% to 5% of all newborns.

22) The best prevention of toxic states on the fetus is achieved through: A) immunization B) good diet C) public education D) A and B Answer: C Explanation: C) The best prevention of toxic states on fetuses is achieved through public education.

23) Which of the following birth defects was linked to the use of thalidomide by pregnant women?

A) Spina bifida B) Ventricular septal defect C) Fetal limb deformities D) All of the above Answer: C Explanation: C) Fetal limb deformities are birth defects linked to the use of thalidomide by pregnant women.

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24) Phenylketonuria may be controlled by: A) antibiotics B) diet C) folic acid D) immunoglobulin Answer: B Explanation: B) Phenylketonuria may be controlled by diet. It is an autosomal recessive metabolic genetic disorder wherein the patient cannot metabolize the amino acid phenylalanine to the amino acid tyrosine.

25) The adverse effects of sulfasalazine (Azulfidine) during breast feeding may cause: A) bloody diarrhea B) cyanosis C) bradycardia D) hypotension Answer: A Explanation: A) The adverse effects of sulfasalazine (Azulfidine) during breastfeeding may cause bloody diarrhea.

26) When an alcoholic beverage is consumed, a mother should avoid breastfeeding for how long?

A) 30 minutes B) 60 minutes C) 90 minutes D) 2 hours Answer: D Explanation: D) When an alcoholic beverage is consumed, a mother should avoid breastfeeding for 2 hours.

27) Effects of cocaine on infants through breastfeeding include: A) hypotension B) hypokalemia C) bradycardia D) hypertonia Answer: D Explanation: D) Effects of cocaine on infants through breastfeeding include hypertonia.

28) Which of the following vaccines is NOT embryotoxic during pregnancy?

A) Hepatitis B B) Tetanus C) Influenza D) Smallpox Answer: B Explanation: B) The tetanus vaccine is not embryotoxic during pregnancy. Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers.

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29) Which of the following opiates is safest when used while nursing a baby?

A) Heroin B) Morphine C) Methadone D) All of the above Answer: C Explanation: C) Methadone is the safest opiate to use while nursing a baby. However, its dosage must be controlled because it has been shown to transfer into breast milk.

30) Smoking tobacco during breastfeeding in infants may cause: A) Restlessness B) Polyuria C) Hypotension D) Bradycardia Answer: A Explanation: A) Smoking tobacco while breastfeeding may cause restlessness in infants. These infants often experience altered sleep patterns because of the passage of nicotine to them via the mother's breast milk.

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