Deck 13: Emergency Pharmacology

Question 1

All of the following statements about insulin are true, EXCEPT:

A) it must be given subcutaneously.
B) it is classified as either natural (regular) or modified.
C) it is available as short, intermediate, or long acting.
D) it can now be produced through recombinant DNA technology.

Answer 1

it must be given subcutaneously.

Question 2

In which class of the Vaughn-Williams classification system of antidysrhythmic medications does quinidine belong?

A) IA
B) IB
C) IC
D) II

Answer 2

IA

Question 3

Glucagon will affect blood glucose levels by:

A) inducing glycogenolysis and gluconeogenesis.
B) inducing the storage of glucose into the liver and skeletal muscle through glycogenesis.
C) enhancing the absorption of glucose from the gastrointestinal tract.
D) enabling the rapid absorption of glucose into the cells.

Answer 3

inducing glycogenolysis and gluconeogenesis.

Question 4

The FDA's numerical classification of a newly approved drug as "3" denotes it as a new:

A) combination not previously marketed.
B) generation of a marketed drug.
C) formulation or dosage form not previously marketed.
D) molecular drug.

Question 5

Which of the following medications would most likely be considered for emergent treatment in the prehospital management of hypertensive crisis?

A) Labetalol (Normodyne)
B) Nitroglycerin paste (Nitro-Bid)
C) Enalaprilat (Vasotec IV)
D) Nifedipine (Procardia)

Question 6

Methylphenidate (Ritalin), a drug used to treat attention deficit hyperactivity disorder (ADHD), achieves its therapeutic action by ________ the CNS, thereby causing ________ and allowing for greater concentration and focus.

A) stimulating; heightened awareness and arousal
B) depressing; sedation
C) stimulating; paradoxical sedation
D) depressing; relaxation

Question 7

All of the following statements about hormone replacement therapy (HRT) with estrogen are true EXCEPT that HRT:

A) may increase the risk of breast cancer and stroke.
B) has side effects that include nausea, fluid retention, and breast tenderness.
C) is often used to treat postmenopausal symptoms and osteoporosis.
D) ineffectively delays the onset of senile dementia in many patients.

Question 8

A diuretic that affects reabsorption early in the nephron filtration process will:

A) affect water reabsorption but not electrolytes.
B) affect electrolytes but not fluid reabsorption.
C) have a lesser impact on water and sodium removal.
D) have a greater impact on water and sodium removal.

Question 9

All of the following result from administration of insulin, EXCEPT:

A) increased synthesis of proteins, carbohydrates, lipids, and nucleic acids.
B) conversion of glucose to glycogen.
C) increased cellular transport of glucose, potassium, and amino acids
D) gluconeogenesis and glycogenolysis.

Question 10

In which class of the Vaughn-Williams classification system of antidysrhythmic medications does amiodarone belong?

A) III
B) IB
C) II
D) IV

Question 11

A larger-than-expected dose of adenosine may be necessary in patients regularly taking:

A) amphetamines.
B) benzodiazepines.
C) Class I anti-dysrhythmic.
D) aminophylline.

Question 12

The FDA's classification of a drug's treatment or therapeutic potential as "P" means that the drug:

A) offers an important therapeutic gain.
B) is an orphan drug.
C) is similar to drugs already on the market.
D) is indicated for AIDS and HIV-related disease.

Question 13

According to Starling's Law, the administration of nitroglycerin will result in ________ preload, ________ stroke volume, and ________ myocardial oxygen demand.

A) decreased; decreased; increased
B) decreased; increased; decreased
C) increased; increased; decreased
D) decreased; decreased; decreased

Question 14

The use of tobacco, because of its nicotine content, may cause subtle symptoms due to stimulation of the:

A) parasympathetic division of the autonomic nervous system.
B) nicotinic receptor sites at the neuromuscular junction in the sympathetic nervous system.
C) sympathetic division of the autonomic nervous system.
D) sympathetic and parasympathetic divisions of the autonomic nervous system.

Question 15

A lesion in the posterior pituitary gland resulting in hypersecretion of ADH may result in:

A) hypercalcemia.
B) hypokalemia.
C) hypertension.
D) hyponatremia.

Question 16

Tachyphylaxis can be managed by:

A) changing to a similar drug in the same family.
B) decreasing the frequency with which the medication is administered.
C) decreasing the dosage of the medication.
D) concurrently administering an anti-inflammatory drug to blunt the allergic response.

Question 17

Which of the following statements about hemostatic agents, such as adenosine diphosphate (ADP) and thromboxane A2 (TXA2), is TRUE?

A) They are responsible for converting plasminogen to plasmin.
B) They have their effect early in the clotting process.
C) They convert fibrinogen to fibrin.
D) They limit the clotting cascade to the immediate area of the vessel injury.

Question 18

All of the following statements about nonsteroidal anti-inflammatory drugs (NSAIDs) are true EXCEPT that NSAIDs:

A) are used as analgesics and antipyretics.
B) are prescribed to relieve pain following trauma and surgery.
C) interfere with the production of prostaglandins, thereby interrupting the inflammatory process.
D) include aspirin, acetaminophen, and ibuprofen.

Question 19

Which of the following medications has the shortest half-life?

A) Verapamil
B) Epinephrine
C) Digitalis
D) Adenosine

Question 20

Which of the following is the generic name of a drug?

A) Diazepam
B) Excedrin
C) Tylenol
D) Motrin

Question 21

Which class of hormones is NOT synthesized and secreted by the adrenal cortex?

A) Androgens
B) Catecholamines
C) Mineralocorticoids
D) Glucocorticoids

Question 22

You are caring for a 68-year-old patient with an altered level of consciousness and reported seizure activity. You obtain a blood pressure of 244/140 mmHg, a pulse of 90, and respirations of 18. Which of the following medications would be most suitable for this patient?

A) Minoxidil (Loniten)
B) Hydralizine (Apresoline)
C) Enalapril (Vasotec)
D) Nitroprusside (Nipride)

Question 23

Which of the following is NOT a potential side effect of oral contraceptives?

A) Early-onset osteoporosis
B) Hypertension
C) Thromboembolism
D) Unintended pregnancy

Question 24

A drug that blocks the muscarinic receptors in the peripheral nervous system would be classified as a:

A) sympathomimetic.
B) sympatholytic.
C) parasympathomimetic.
D) parasympatholytic.

Question 25

A gelatin container filled with powder, liquid, or tiny granules is called a:

A) tablet.
B) capsule.
C) caplet.
D) pill.

Question 26

Which class of antiarrhythmic drugs is LEAST likely to contribute to hypotension?

A) I
B) II
C) III
D) IV

Question 27

To relieve nasal congestion, which of the following medications would be most effective when administered intranasally?

A) Epinephrine
B) Propranalol
C) Physostigmine
D) Phenylepherine

Question 28

A significant characteristic of digitalis preparations is that they:

A) have a negative inotropic effect.
B) are not prodysrhythmic drugs.
C) have a positive chronotropic effect.
D) have a very narrow therapeutic index.

Question 29

Which term best describes the effects a drug has on its target organs?

A) Biotransformation
B) Pharmacodynamics
C) Pharmacokinetics
D) Bioavailability

Question 30

Digoxin is a paradoxical drug, which means :

A) its many effects on the lungs make it an effective bronchodilator.
B) its many effects on the heart make it both an ineffective antiarrhythmic and an antidysrhythmic.
C) its many effects on the heart make it both an effective antiarrhythmic and a potent prodysrhythmic.
D) its many effects on the lungs make it an ineffective bronchodilator.

Question 31

If you were to administer an antiarrhythmic drug that was a complete sodium channel blocker, which of the following would you expect?

A) It would prevent the efflux (outflow) of calcium from within the cell.
B) It would impede the sodium-potassium pump from replacing the ions to their original locations.
C) It would cause excessive muscular contraction, because sodium is the principal cation in myofibril contraction.
D) It would prevent the development of phase 0, thereby inhibiting depolarization.

Question 32

Aspirin is beneficial to patients with a history of cardiac disease because it:

A) inhibits the clotting cascade.
B) provides analgesia.
C) inhibits platelet aggregation.
D) causes thrombolysis.

Question 33

Once a drug is proven safe and tested on a limited group of people with the disease it is intended to treat, and the therapeutic dose is refined, the drug manufacturer can file a new drug application (NDA) following this phase of human studies.

A) 3
B) 4
C) 2
D) 1

Question 34

The principal mechanism of action of phenytoin (Dilantin) in treating status seizures is the:

A) blocking of GABA receptor sites to prevent further cellular activity in the CNS.
B) influx of calcium ions through calcium channels to enhance depolarization.
C) blocking of acetylcholine receptor sites at the neuromuscular junction to prevent convulsions.
D) prevention of sodium ions entering the cell by closing sodium channels.

Question 35

Which of the following diseases is characterized by hypersecretion of adrenocorticotropic hormone leading to hyperglycemia, obesity, hypertension, and electrolyte imbalances?

A) Cushing's disease
B) Gigantism
C) Hashimoto's disease
D) Addison's disease

Question 36

Which of the following medications will block the influx of calcium ions during phase 0 of the slow potential in the heart?

A) Amiodarone (Cordarone)
B) Lidocaine (Xylocaine)
C) Esmolol (Brevibloc)
D) Digoxin (Lanoxin)

Question 37

If a patient were exhibiting pupillary constriction, hypersalivation, bronchial wheezing, and bradycardia, you should suspect ________ of the ________ nervous system.

A) blockade; voluntary
B) stimulation; sympathetic
C) stimulation; parasympathetic
D) blockade; cholinergic

Question 38

Which of the following statements about antibiotics is NOT true?

A) Antibiotics typically achieve their therapeutic action by destroying the bacterial cell wall.
B) Viruses are not susceptible to antibiotics.
C) Antibiotics are generally safe and can be prescribed indiscriminately.
D) An individual who has developed a resistance to one type of antibiotic will typically respond well to other antibiotics in a similar class.

Question 39

Current treatment regimens for peptic ulcer disease may include all of the following, EXCEPT:

A) nonsteroidal anti-inflammatory drugs (NSAIDs).
B) H₂ receptor antagonists.
C) proton pump inhibitors.
D) antacids.

Question 40

Monoamine oxidase inhibitors (MAOIs) achieve their therapeutic effects by:

A) enhancing degradation of monoamine neurotransmitters at the synapses.
B) preventing the breakdown of neurotransmitters, such as norepinephrine, in the CNS.
C) enhancing the effects of monoamine oxidase at the synapse.
D) blocking the norepinephrine receptor sites in the CNS.

Question 41

Children under one year of age have a ________ plasma protein concentration than older children. Therefore, medications that bind to plasma proteins will have a ________ effect in them.

A) greater; greater
B) greater; diminished
C) lower; greater
D) lower; diminished

Question 42

Which of the following statements about vitamins is NOT true?

A) Vitamin D is unique in that it can be produced in the skin by sunlight exposure.
B) The liver stores the fat-soluble vitamins; consequently, they will become deficient only after long periods of inadequate vitamin intake.
C) The individual B vitamins are named for the order in which they are required by the body.
D) The water-soluble vitamins must be routinely ingested, because the body does not store them.

Question 43

The chief physiologic effect of nerve gas, such as VX, is to:

A) reversibly block the enzyme acetylcholinesterase.
B) competitively block the nicotinic receptor sites at the neuromuscular junction.
C) competitively block the muscarinic receptor sites at the target organs.
D) produce an adrenergic blockade throughout the body.

Question 44

One important distinction with potassium-sparing diuretics over other forms of diuretics is that potassium-sparing diuretics:

A) exert their effects early in the nephritic process.
B) are more efficient than loop diuretics in sodium and water reabsorption.
C) not only decrease sodium reabsorption, they increase potassium reabsorption.
D) are so potent that they are rarely used with other diuretics.

Question 45

The time from when a drug is administered until it reaches the minimum effective concentration is known as the:

A) peak action.
B) therapeutic interval.
C) onset of action.
D) duration of action.

Question 46

The narcotic nalbuphine (Nubain) not only binds to opiate receptor sites to provide analgesia, but it also prevents other opioids, such as morphine sulfate, from binding to these sites, lessening respiratory depression. These characteristics make the drug a(n):

A) agonist-antagonist.
B) competitive antagonist.
C) competitive agonist.
D) agonist.

Question 47

While caring for a 60-year-old man with a suspected femur fracture, your partner accidentally administers the full vial of morphine sulfate (15 mg) when only 4 mg was ordered. What adverse effects are likely to occur in this patient?

A) Widened QRS and respiratory depression
B) Hypotension and tachypnea
C) Sedation and hypertension
D) Hypotension and respiratory depression

Question 48

Sympathetic nervous system stimulation that results in vasoconstriction is most likely affecting:

A) beta₂ receptor sites.
B) alpha₁ receptor sites.
C) beta₁ receptor sites.
D) alpha₂ receptor sites.

Question 49

Teratogenic refers to the:

A) effects of a drug on the developing fetus.
B) decreased ability of the elderly to metabolize drugs.
C) potential of a drug to cause cancer.
D) likelihood of multiple births as a drug side effect.

Question 50

Medications best suited for treating bronchoconstriction generally stimulate ________ receptors.

A) beta₁
B) alpha₁
C) beta₂
D) alpha₂

Question 51

In the renin-angiotensin-aldosterone system (RAAS), which element is most responsible for widespread vasoconstriction?

A) Angiotensin I
B) Angiotensinogen
C) Angiotensin-converting enzyme (ACE)
D) Angiotensin II

Question 52

A major concern during the administration of an alpha agonist is infiltration, because it may cause:

A) enhanced systemic effects.
B) tissue necrosis.
C) excessive bleeding at the site of infiltration.
D) cardiac dysrhythmias.

Question 53

Which of the following statements about cough suppressants is TRUE?

A) Some cough suppressants contain opioid antitussives that can be habit forming.
B) They often include expectorants that reduce the amount of sputum produced.
C) They may include mucolytics that greatly diminish sputum production.
D) Non-opioid medications are available by prescription only.

Question 54

Drugs with high abuse potential and no accepted medical benefits are classified as Schedule:

A) I.
B) II.
C) III.
D) IV.

Question 55

Types of medications commonly used to relieve symptoms of bronchospasm and decrease inflammation include all of the following, EXCEPT:

A) anticholinergics.
B) beta₂ selective sympathomimetics.
C) glucocorticoids.
D) expectorants.

Question 56

Benzodiazepines are safer than barbiturates in seizure patients because:

A) the effect of benzodiazepines is limited by the amount of endogenous GABA in the CNS.
B) benzodiazepines cannot cause hypotension or respiratory depression.
C) the therapeutic dose of barbiturates is very close to the lethal dose.
D) benzodiazepines cause a counteraction by inducing high levels of dopamine in the CNS.

Question 57

Which of the following statements about warfarin (Coumadin) is NOT true?

A) It actively breaks down the fibrin network, thereby dissolving formed thrombi.
B) It helps treat chronic atrial fibrillation.
C) It prevents coagulation by antagonizing the effects of vitamin K.
D) It was originally used as rat poison.

Question 58

A concern for patients taking both insulin and beta-blockers is:

A) the two medications, when taken together, have a synergistic effect.
B) beta-blockers, due to their sympatholytic effects on the nervous system, can further reduce available ATP to the cells of the body in the presence of insulin.
C) beta₂ adrenergic blockers can both hide the effects of hypoglycemia, making it difficult to recognize, and decrease the release of glucagon.
D) beta-blockers prevent the release of insulin from the beta cells in the pancreas.

Question 59

In a patient experiencing a myocardial infarction, a medication that reduces afterload is beneficial because it:

A) reduces the workload of the heart, reducing myocardial oxygen consumption.
B) reduces the blood flow to unnecessary areas, redirecting blood to the heart.
C) improves the stroke volume of blood ejected from the heart by also reducing preload.
D) prolongs the Q-T interval, thereby allowing time for complete atrial contribution to the ventricles.

Question 60

When administering glucagon to a patient, it is important to remember that:

A) glucagon can be administered only intravenously.
B) it is effective only in patients with elevated blood glucose levels.
C) glucagon will stimulate glycogenesis in a hypoglycemic patient.
D) it increases the rate of gluconeogenesis.

Question 61

According to the classifications of the Controlled Substance Act of 1970, an example of a Schedule I drug would be:

A) atropine sulfate.
B) diazepam.
C) heroin.
D) morphine sulfate.

Question 62

A new synthetic narcotic has been developed by the pharmaceutical industry. This drug, called Drug A, has three times the efficacy of an existing synthetic narcotic, Drug B. However, Drug B has twice the affinity for opiate receptor sites in the body as Drug A. Which drug will have the greater effect when administered at the same dosage?

A) Drug A
B) Drug B
C) Identical effects when administered at the same dosage
D) Cannot be determined by the information given

Question 63

Which of the following is NOT one of the main sources of drugs?

A) Minerals
B) Synthetic materials
C) Plants
D) Animals

Question 64

A college student, in an effort to improve test scores, takes a drug, Intelliboost, which enhances cortical function by increasing dopamine release in the brain. He also is taking a cold remedy, Sneezeless, which inhibits the chemical breakdown of dopamine at all receptor sites. Which of the following best describes the drug interaction?

A) Sneezeless potentiates the effects of Intelliboost.
B) Sneezeless has a cumulative effect.
C) Sneezeless and Intelliboost have a synergistic effect.
D) Sneezeless and Intelliboost have an additive effect.

Question 65

Which of the following statements about sodium nitroprusside (Nipride) administration is NOT true?

A) Severe hypotension may occur.
B) Cyanide poisoning may occur.
C) It is given as an intravenous push.
D) It must be protected from light.

Question 66

Which statement about levodopa in the treatment of Parkinson's disease is NOT true?

A) Levodopa is an effective therapy because it converts to dopamine in the brain.
B) Levodopa crosses the blood-brain barrier.
C) Levodopa remains an effective therapy throughout the disease.
D) Levodopa is often combined with another ingredient to prevent metabolism outside the brain.

Question 67

Which of the following is a statin?

A) Lovenox
B) Activase
C) Zocor
D) Questran

Question 68

The relative therapeutic effectiveness of chemically comparable drugs is regarded as the:

A) bioassay of the drugs.
B) relative efficacy of the drugs.
C) bioequivalence.
D) therapeutic index.

Question 69

In which class of the Vaughn-Williams classification system of anti-dysrhythmic medications does propranolol belong?

A) IA
B) IB
C) IC
D) II

Question 70

Tachyphylaxis can best be described as:

A) an unexpected increase in heart rate as a side effect of a drug.
B) an allergic reaction that occurs when a drug is administered for the first time.
C) anaphylactoid episodes occurring due to cross-sensitivity.
D) rapidly decreasing effects with repeated administration of a drug.

Question 71

An important physiologic distinction between the sympathetic and parasympathetic divisions of the autonomic nervous system is:

A) the sympathetic ganglia are close to the spinal cord.
B) only the sympathetic division innervates the target organs or tissue directly.
C) the parasympathetic nervous system contains no ganglionic fibers.
D) the sympathetic division does not use acetylcholine as a neurotransmitter.

Question 72

With regard to the endocrine system, which of the following statements is NOT true?

A) The pituitary gland is often called the "master gland."
B) The posterior pituitary hormones are actually synthesized in the hypothalamus.
C) The hypothalamus and pituitary glands have no physical link.
D) The hypothalamus controls many of the functions of the pituitary gland.

Question 73

Beta-adrenergic antagonists reduce hypertension through all of the following effects, EXCEPT:

A) diminishing reflex tachycardia as a compensatory response.
B) suppressing renin release from the kidneys.
C) a negative inotropic effect.
D) reduction of peripheral vascular resistance through vasodilation.

Question 74

Which of the following is NOT typically associated with type 1 diabetes mellitus?

A) Juvenile onset
B) Inadequate insulin release from the beta cells of the pancreatic islets
C) Insulin dependence
D) Obesity

Question 75

Naloxone is an ________ to opioid receptors.

A) agonist
B) agonist-antagonist
C) antagonist
D) analgesic

Question 76

Which of the following drugs are often found in both topical and oral nasal decongestants?

A) Alpha₁ antagonists
B) Alpha₁ agonists
C) Alpha₂ agonists
D) Beta₂ agonists

Question 77

Which class of anti-dysrhythmics characteristically blocks sodium influx during fast potential depolarization?

A) I
B) II
C) III
D) IV

Question 78

Part of the reason that tricyclic antidepressants (TCAs) have fallen somewhat out of favor compared with selective serotonin reuptake inhibitors (SSRIs) is because:

A) SSRIs have the added advantage of also blocking norepinephrine and dopamine.
B) TCA overdoses have a cardiotoxic effect.
C) SSRIs have the added advantage of also blocking histamine and acetylcholine.
D) TCA overdoses often create a hypertensive crisis in patients.

Question 79

A drug that serves as a sodium channel blocker will have the greatest effect on which phase of ion exchange in the normal, fast-potential cardiac cell?

A) 0
B) 1
C) 2
D) 3

Question 80

You respond to the aid of a 19-year-old patient who is reported to have taken an overdose of a prescribed medication. She exhibits combativeness and severe tremors. Her blood pressure is 160/100 mmHg, and her pulse is 132. Sinus tachycardia appears on her ECG. Which of the following classification of drugs is most likely to cause these symptoms?

A) Benzodiazepines
B) Amphetamines
C) Opiates
D) Barbiturates