Test Bank - Basic Pharmacology for Nurses, 17th Edition PDF

Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017), Chapter 1-49 | All Chapters written by AllStudyGuides The Marketplace to Buy and Sell your Study Materia...

Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017), Chapter 1-49 | All Chapters written by AllStudyGuides The Marketplace to Buy and Sell your Study Material At Stuvia, you will find the best notes, summaries, flashcards & other study material. Search for your school or uni and find the study material you need. www.stuvia.com Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material TEST BANK Basic Pharmacology for Nurses Michelle J. Willihnganz, and Bruce D. Clayton 17th Edition Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material Table of Contents Chapter 01: Drug Definitions, Standards, and Information Sources 1 Chapter 02: Basic Principles of Drug Action and Drug Interactions 7 Chapter 03: Drug Action Across the Life Span 15 Chapter 04: The Nursing Process and Pharmacology 24 Chapter 05: Patient Education to Promote Health 33 Chapter 06: Principles of Medication Administration and Medication Safety 40 Chapter 07: Percutaneous Administration 49 Chapter 08: Enteral Administration 57 Chapter 09: Parenteral Administration: Safe Preparation of Parenteral Medications 64 Chapter 10: Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes 71 Chapter 11: Parenteral Administration: Intravenous Route 78 Chapter 12: Drugs That Affect the Autonomic Nervous System 86 Chapter 13: Drugs Used for Sleep 95 Chapter 14: Drugs Used for Parkinson’s Disease 102 Chapter 15: Drugs Used for Anxiety Disorders 108 Chapter 16: Drugs Used for Depressive and Bipolar Disorders 115 Chapter 17: Drugs Used for Psychoses 125 Chapter 18: Drugs Used for Seizure Disorders 132 Chapter 19: Drugs Used for Pain Management 140 Chapter 20: Introduction to Cardiovascular Disease and Metabolic Syndrome 148 Chapter 21: Drugs Used to Treat Dyslipidemias 154 Chapter 22: Drugs Used to Treat Hypertension 162 Chapter 23: Drugs Used to Treat Dysrhythmias 172 Chapter 24: Drugs Used to Treat Angina Pectoris 178 Chapter 25: Drugs Used to Treat Peripheral Vascular Disease 187 Chapter 26: Drugs Used to Treat Thromboembolic Disorders 193 Chapter 27: Drugs Used to Treat Heart Failure 201 Chapter 28: Drugs Used for Diuresis 209 Chapter 29: Drugs Used to Treat Upper Respiratory Disease 217 Chapter 30: Drugs Used to Treat Lower Respiratory Disease 224 Chapter 31: Drugs Used to Treat Oral Disorders 234 Chapter 32: Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Disease 241 Chapter 33: Drugs Used to Treat Nausea and Vomiting 249 Chapter 34: Drugs Used to Treat Constipation and Diarrhea 256 Chapter 35: Drugs Used to Treat Diabetes Mellitus 264 Chapter 36: Drugs Used to Treat Thyroid Disease 273 Chapter 37: Corticosteroids 280 Chapter 38: Gonadal Hormones 288 Chapter 39: Drugs Used in Obstetrics 295 Chapter 40: Drugs Used in Men’s and Women’s Health 302 Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 41: Drugs Used to Treat Disorders of the Urinary System 309 Chapter 42: Drugs Used to Treat Glaucoma and Other Eye Disorders 316 Chapter 43: Drugs Used to Treat Cancer 323 Chapter 44: Drugs Used to Treat the Musculoskeletal System 330 Chapter 45: Antimicrobial Agents 338 Chapter 46: Nutrition 345 Chapter 47: Herbal and Dietary Supplement Therapy 351 Chapter 48: Substance Abuse 358 Chapter 49: Miscellaneous Agents 365 Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year? https://www.stuvia.com/en-us/user/AllStudyGuides  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Chapter 01: Drug Definitions, Standards, and Information Sources Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition MULTIPLE CHOICE 1. What is the name under which a drug is listed by the U.S. Food and Drug Administration (FDA)? a. Brand b. Nonproprietary c. Official d. Trademark ANS: C The official name is the name under which a drug is listed by the FDA. The brand name, or trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic, name is provided by the U.S. Adopted Names Council. DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment W W W. T B S M. W S NOT: CONCEPT(S): Patient Education 2. Which source contains information specific to nutritional supplements? a. USP Dictionary of USAN & International Drug Names b. Natural Medicines Comprehensive Database c. United States Pharmacopoeia/National Formulary (USP NF) d. Drug Interaction Facts WWW.TBSM.WS ANS: C United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA approved drugs; it does not include nutritional supplements. Natural Medicines Comprehensive Database contains evidence based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements. Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements. DIF: Cognitive Level: Knowledge REF: Page 2 | Page 3 OBJ: 4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Nutrition; Patient Education 3. What is the most comprehensive reference available to research a drug interaction? a. Drug Facts and Comparisons b. Drug Interaction Facts c. Handbook on Injectable Drugs d. Martindale—The Complete Drug Reference ANS: B ______________________________________________________________________________________________ 1|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) First published in 1983, Drug Interaction Facts is the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with clinical and scientific expertise. DIF: Cognitive Level: Comprehension REF: Page 3 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Safety; Patient Education; Clinical Judgment 4. The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug? a. Manufacturer’s section b. Brand and Generic Name section c. Product Category section d. Product Information section ANS: B A physician’s order would include the brand and/or generic name of the drug. The alphabetic index in the PDR would make this section the most user friendly. Based on a physician’s W W W. T B S M. W S order, manufacturer’s information and classification information would not be known. The Manufacturer’s section is a roster of manufacturers. The Product Category section lists products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and antibiotics. The Product Information section contains reprints of the package inserts for the major products of manufacturers. DIF: WWW.TBSM.WS Cognitive Level: Comprehension REF: Page 3 OBJ: 3 TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Safety; Patient Education; Clinical Judgment 5. Which online drug reference makes available to health care providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines? a. American Drug Index b. American Hospital Formulary c. DailyMed d. Physicians’ Desk Reference (PDR) ANS: C DailyMed makes available to health care providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines. The American Drug Index is not appropriate for patient use. The American Hospital Formulary is not appropriate for patient use. The PDR is not appropriate for patient use. DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 4 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Safety; Patient Education; Clinical Judgment 6. Which legislation authorizes the FDA to determine the safety of a drug before its marketing? a. Federal Food, Drug, and Cosmetic Act (1938) ______________________________________________________________________________________________ 2|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) b. Durham Humphrey Amendment (1952) c. Controlled Substances Act (1970) d. Kefauver Harris Drug Amendment (1962) ANS: A The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner. The Controlled Substances Act addresses only controlled substances and their categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products before marketing them. DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 6 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Safety; Patient Education; Evidence; Health Care Law 7. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall? W W W. T B S M. W S a. I b. II c. III d. IV ANS: B Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to WWW.TBSM.WS severe psychological and physical dependence. Schedule I drugs have high potential for abuse and no recognized medical use. Schedule III drugs have some potential for abuse. Use may lead to low to moderate physical dependence or high psychological dependence. Schedule IV drugs have low potential for abuse. Use may lead to limited physical or psychological dependence. DIF: Cognitive Level: Comprehension REF: Page 5 OBJ: 1 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT: CONCEPT(S): Patient Education; Addiction; Pain 8. What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment? a. List smallpox as a health orphan disease. b. Omit the preclinical research phase. c. Extend the clinical research phase. d. Fast track the investigational drug. ANS: D ______________________________________________________________________________________________ 3|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Once the Investigational New Drug Application has been approved, the drug can receive highest priority within the agency, which is called fast tracking. A smallpox outbreak would become a priority concern in the world. Orphan diseases are not researched in a priority manner. Preclinical research is not omitted. Extending any phase of the research would mean a longer time to develop a vaccine. The FDA must ensure that all phases of the preclinical and clinical research phase have been completed in a safe manner. DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 8 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT: CONCEPT(S): Health Care Law; Health Policy; Infection; Care Coordination 9. Which statement is true about over-the-counter (OTC) drugs? a. They are not listed in the USP NF. b. A prescription from a health care provider is needed. c. They are sold without a prescription. d. They are known only by their brand names. ANS: C OTC medications do not require a prescription. A variety of names, both generic and trade, can be used for individual drugs sold OTC. OTC drugs are listed in the USP NF. Prescription W W W. T B S M. W S drugs require an order by a health professional who is licensed to prescribe, such as a physician, nurse practitioner, physician assistant, or dentist. DIF: Cognitive Level: Comprehension REF: Page 2 OBJ: 5 TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education WWW.TBSM.WS 10. Which is the most authoritative reference for medications that are injected? a. Physicians’ Desk Reference b. Handbook on Injectable Drugs c. DailyMed d. Handbook of Nonprescription Drugs ANS: B The Handbook on Injectable Drugs is the most comprehensive reference available on the topic of compatibility of injectable drugs. It is a collection of monographs for more than 300 injectable drugs that are listed alphabetically by generic name. DIF: Cognitive Level: Comprehension REF: Page 3 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 11. The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug’s classification? a. Abuse potential for this drug is low. b. Psychological dependency is likely. c. There is a high potential for abuse. d. This drug is not a controlled substance. ______________________________________________________________________________________________ 4|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) ANS: A Lomotil, a Schedule V drug, has an abuse potential of limited physical or psychological dependence liability compared with drugs in Schedule IV. Because abuse potential is low with a Schedule V drug, a prescription may not be required. Psychological dependency is not likely with a Schedule V drug. Schedule V drugs are classified as controlled substances. DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education 12. The nurse is transcribing new orders written for a patient with a substance abuse history. Choose the medication ordered that has the greatest risk for abuse. a. Lomotil b. Diazepam c. Phenobarbital d. Lortab ANS: D Lortab is a Schedule III drug with a high potential for abuse but less so than drugs in Schedules I and II. Lomotil is a Schedule V drug with a low potential for abuse compared W W W. T B S M. W S with those in Schedule V. Diazepam is a Schedule IV drug with a low potential for abuse compared with those in schedule III. Phenobarbital is a Schedule IV drug with a low potential for abuse compared with those in Schedule III. DIF: Cognitive Level: Application REF: Page 5 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity WWW.TBSM.WS NOT: CONCEPT(S): Addiction; Patient Education; Safety MULTIPLE RESPONSE 1. An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient’s current medications or prescriptions. All the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource(s) would be appropriate to use in determining the medication names and doses? (Select all that apply.) a. Martindale—The Complete Drug Reference b. Physicians’ Desk Reference, Section 4 c. Senior citizens’ center d. Patient’s home pharmacy ANS: B, D The Physicians’ Desk Reference, Section 4, has full color images of commonly dispensed tablets and capsules. The patient’s pharmacy would have an accurate account of all the medications the client is currently taking. Martindale—The Complete Drug Reference has written information on medications and would not be an appropriate resource. The senior citizens’ center is not likely to have specific patient medication information. DIF: Cognitive Level: Application REF: Page 3 OBJ: 3 ______________________________________________________________________________________________ 5|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Care Coordination; Safety; Patient Education; Clinical Judgment 2. The nurse planning patient teaching regarding drug names would include which statement(s)? (Select all that apply.) a. Most drug companies place their products on the market under generic names. b. The official name is the name under which the drug is listed by the U.S. Food and Drug Administration (FDA). c. Brand names are easier to pronounce, spell, and remember. d. The first letter of the generic name is not capitalized. e. The chemical name is most meaningful to the patient. ANS: B, C, D The official name is the name under which the drug is listed by the FDA. Brand names are easier to pronounce, spell, and remember. The first letter of the generic name is not capitalized. Most drug companies place their products on the market under brand names instead of generic names. The chemical name is most meaningful to the chemist. DIF: Cognitive Level: Application REF: Page 1 | Page 2 OBJ: 1 TOP: Nursing Process Step: Planning W W W. T B S M. W S MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 3. When categorizing, the nurse is aware that which drug(s) would be considered Schedule II? (Select all that apply.) a. Marijuana b. Percodan WWW.TBSM.WS c. Amphetamines d. Fiorinal e. Flurazepam ANS: B, C Schedule II drugs have a high potential for abuse, they are currently accepted in the United States, and use may lead to severe psychological or physical dependence. Percodan and amphetamines are considered Schedule II drugs. Marijuana is a Schedule I drug. Fiorinal is a Schedule III drug. Flurazepam is a Schedule IV drug. DIF: Cognitive Level: Analysis REF: Page 5 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Addiction; Clinical Judgment; Patient Education ______________________________________________________________________________________________ 6|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Chapter 02: Basic Principles of Drug Action and Drug Interactions Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition MULTIPLE CHOICE 1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority action? a. Notify physician of allergic reaction. b. Notify physician of idiosyncratic reaction. c. Notify physician of potential teratogenicity. d. Notify physician of potential tolerance. ANS: A An allergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria, which are easily identified. An idiosyncratic reaction occurs when something unusual or abnormal happens when a drug is first administered. A teratogenic reaction refers to the occurrence of birth defects related to administration of the drug. Tolerance refers to the body’s requirement for increasing dosages to achieve the same effects that a lower dose once did. DIF: Cognitive Level: Application REF: Page 17 OBJ: 4 W W W. T B S M. W S TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after administration, the nurse finds the patient agitated and stating that “everyone is out to get me.” What is the term for this unusualWWW.TBSM.WS reaction? a. Desired action b. Adverse effect c. Idiosyncratic reaction d. Allergic reaction ANS: C Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first administered. Patients typically exhibit an overresponsiveness to a medication related to diminished metabolism. These reactions are believed to be related to genetic enzyme deficiencies. Desired actions are expected responses to a medication. Adverse effects are reactions that occur in another system of the body; they are usually predictable. Allergic reactions appear after repeated medication dosages. DIF: Cognitive Level: Knowledge REF: Page 18 OBJ: 4 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Caregiving; Safety; Sensory Perception 3. Which is the best description of when drug interactions occur? a. On administration of toxic dosages of a drug b. On an increase in the pharmacodynamics of bound drugs c. On the alteration of the effect of one drug by another drug d. On increase of drug excretion ______________________________________________________________________________________________ 7|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) ANS: C Drug interactions may be characterized by an increase or decrease in the effectiveness of one or both of the drugs. Toxicity of one drug may or may not affect the metabolism of another one. Drug interactions may result from either increased or decreased pharmacodynamics. Drug interactions may result from either increased or decreased excretion. DIF: Cognitive Level: Comprehension REF: Page 18 OBJ: 5 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Safety; Patient Education; Clinical Judgment 4. What occurs when two drugs compete for the same receptor site, resulting in increased activity of the first drug? a. Desired action b. Synergistic effect c. Carcinogenicity d. Displacement ANS: D The displacement of the first drug from receptor sites by a second drug increases the amount of the first drug because more unbound drug is available. An expected response of a drug is W W W. T B S M. W S the desired action. A synergistic effect is the effect of two drugs being greater than the effect of each chemical individually or the sum of the individual effects. Carcinogenicity is the ability of a drug to cause cells to mutate and become cancerous. DIF: Cognitive Level: Comprehension REF: Page 19 OBJ: 6 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity WWW.TBSM.WS NOT: CONCEPT(S): Safety; Patient Education 5. What do drug blood levels indicate? a. They confirm if the patient is taking a generic form of a drug. b. They determine if the patient has sufficient body fat to metabolize the drug. c. They verify if the patient is taking someone else’s medications. d. They determine if the amount of drug in the body is in a therapeutic range. ANS: D The amount of drug present may vary over time and the blood level must remain in a therapeutic range in order to obtain the desired result. Generic drugs do not necessarily produce a different drug blood level than proprietary medications. Body fat is not measured by drug blood levels. Drug blood levels only measure the amount of drug in the body; they do not determine the source of the medication. DIF: Cognitive Level: Comprehension REF: Page 17 OBJ: 4 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 6. What is the process by which a drug is transported by circulating body fluids to receptor sites? a. Osmosis b. Distribution c. Absorption ______________________________________________________________________________________________ 8|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) d. Biotransformation ANS: B Distribution refers to the ways in which drugs are transported by the circulating body fluids to the sites of action (receptors), metabolism, and excretion. Osmosis is the process of moving solution across a semipermeable membrane to equalize the dilution on each side. Absorption is the process by which a drug is transferred from its site of entry into the body to the circulating fluids for distribution. Biotransformation, also called metabolism, is the process by which the body inactivates drugs. DIF: Cognitive Level: Comprehension REF: Page 15 OBJ: 3 TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 7. The nurse assesses which blood level to determine the amount of circulating medication in a patient? a. Peak b. Trough c. Drug d. Therapeutic W W W. T B S M. W S ANS: C When a drug is circulating in the blood, a blood sample may be drawn and assayed to determine the amount of drug present; this is known as the drug blood level. Peak levels are only those drug blood levels that are at their maximum before metabolism starts to decrease the amount of circulating drug. Trough levels are only those drug blood levels that are at their minimum when metabolism has WWW.TBSM.WS decreased the amount of circulating drug and before an increase caused by a subsequent dose of the medication. Therapeutic levels are only those within a prescribed range of blood levels determined to bring about effective action of the medication. DIF: Cognitive Level: Comprehension REF: Page 17 OBJ: 3 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 8. The nurse administers 50 mg of a drug at 6:00 AM that has a half-life of 8 hours. What time will it be when 25 mg of the drug has been eliminated from the body? a. 8:00 AM b. 11:00 AM c. 2:00 PM d. 6:00 PM ANS: C Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM. 8:00 AM is 2 hours after administration; the half-life is 8 hours. 11:00 AM is 4 hours after administration; the half-life is 8 hours. 6:00 PM is 12 hours after administration; the half-life is 8 hours. DIF: Cognitive Level: Analysis REF: Page 15 OBJ: 2 TOP: Nursing Process Step: Evaluation ______________________________________________________________________________________________ 9|Page https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Elimination; Health Promotion 9. What will the nurse need to determine first in order to mix two drugs in the same syringe? a. Absorption rate of the drugs b. Compatibility of the drugs c. Drug blood level of each drug d. Medication adverse effects ANS: B Knowledge of absorption is important but not in order to mix drugs. In order to mix two drugs, compatibility is determined so there is no deterioration when the drugs are mixed in the same syringe. Drug level does not indicate if it is acceptable to mix medications in the same syringe. Adverse effects are important for the nurse to know, but not in order to mix drugs. DIF: Cognitive Level: Application REF: Page 19 OBJ: 6 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 10. A patient developed hives and itching after receiving a drug for the first time. Which W W W. T B S M. W S instruction by the nurse is accurate? a. Stop the medication and encourage the patient to wear a medical alert bracelet that explains the allergy. b. Explain to the patient that these are signs and symptoms of an anaphylactic reaction. c. Emphasize to the patient the importance to inform medical personnel that in the future a lower dosage of this WWW.TBSM.WS drug is necessary. d. Instruct the patient that it would be safe to take the drug again because this instance was a mild reaction. ANS: A This initial allergic reaction is mild, and the patient is more likely to have an anaphylactic reaction at the next exposure; a medical alert bracelet is necessary to explain the reaction. Signs and symptoms of an anaphylactic reaction are respiratory distress and cardiovascular collapse. A more severe reaction will occur at the next exposure, and the patient should not receive the drug again. DIF: Cognitive Level: Application REF: Page 18 OBJ: 4 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 11. When obtaining a patient’s health history, which assessment data would the nurse identify as having the most effect on drug metabolism? a. History of liver disease b. Intake of a vegetarian diet c. Sedentary lifestyle d. Teacher as an occupation ANS: A ______________________________________________________________________________________________ 10 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Liver enzyme systems are the primary site for metabolism of drugs. Intake of a vegetarian diet may affect absorption but not metabolism. Sedentary lifestyle and occupations could affect metabolism (exposure to environmental pollutants), but these do not have the most significant effect on metabolism. DIF: Cognitive Level: Application REF: Page 16 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 12. A physician’s order indicates to administer a medication to the patient via the percutaneous route. The nurse can anticipate that the patient will receive this medication a. intramuscularly. b. subcutaneously. c. topically. d. rectally. ANS: C The percutaneous route refers to drugs that are absorbed through the skin and mucous membranes. Methods of the percutaneous route include inhalation, sublingual (under the tongue), or topical (on the skin) administration. The parenteral route bypasses the W W W. T B S M. W S gastrointestinal (GI) tract by using subcutaneous (subcut), intramuscular (IM), or intravenous (IV) injection. The parenteral route bypasses the GI tract by using subcut, IM, or IV injection. In the enteral route, the drug is administered directly into the GI tract by the oral, rectal, or nasogastric route. DIF: Cognitive Level: Application REF: Page 14 OBJ: 1 TOP: WWW.TBSM.WS Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 13. A nurse is preparing to administer tetracycline to a patient diagnosed with an infection. Which medication should not be administered with tetracycline? a. Ativan b. Tylenol c. Colace d. Mylanta ANS: D Administering tetracycline with Mylanta can provide an antagonistic effect that will result in decreased absorption of the tetracycline. Ativan, Tylenol, and Colace are not contraindicated to administer with tetracycline. DIF: Cognitive Level: Application REF: Page 18 OBJ: 5 | 6 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety MULTIPLE RESPONSE 1. Which statement(s) about liberation of drugs is/are true? (Select all that apply.) ______________________________________________________________________________________________ 11 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) a. A drug must be dissolved in body fluids before it can be absorbed into body tissues. b. A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption into the bloodstream for transport to the site of action. c. The process of converting the drug into a soluble form can be controlled to a certain degree by the dosage form. d. Converting the drug to a soluble form can be influenced by administering the drug with or without food in the patient’s stomach. e. Elixirs take longer to be liberated from the dosage form. ANS: A, B, C, D Regardless of the route of administration, a drug must be dissolved in body fluids before it can be absorbed into body tissues. Before a solid drug taken orally can be absorbed into the bloodstream for transport to the site of action, it must disintegrate and dissolve in the GI fluids and be transported across the stomach or intestinal lining into the blood. The process of converting a drug into a soluble form can be partially controlled by the pharmaceutical dosage form used (e.g., solution, suspension, capsules, and tablets with various coatings). The conversion process can also be influenced by administering the drug with or without food in the patient’s stomach. Elixirs are already drugs dissolved in a liquid and do not need to be liberated from the dosage form. W W W. T B S M. W S DIF: Cognitive Level: Comprehension REF: Page 14 OBJ: 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 2. Which are routes of drug excretion? (Select all that apply.) a. GI tract; feces WWW.TBSM.WS b. Genitourinary (GU) tract; urine c. Lymphatic system d. Circulatory system; blood/plasma e. Respiratory system; exhalation ANS: A, B, E The GI system is a primary route for drug excretion. The GU and the respiratory systems do function in the excretion of drugs. The lymphatic and circulatory systems are involved with drug distribution, not drug excretion. DIF: Cognitive Level: Knowledge REF: Page 15 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety; Elimination 3. Which route(s) enable(s) drug absorption more rapidly than the subcut route? (Select all that apply.) a. IV route b. IM route c. Inhalation/sublingual d. Intradermal route e. Enteral route ANS: A, B, C ______________________________________________________________________________________________ 12 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) IV route of administration enables drug absorption more rapidly than the subcut route. IM route of administration enables drug absorption more rapidly because of greater blood flow per unit weight of muscle. Inhalation/sublingual route of administration enables drug absorption more rapidly than the subcut route. Intradermally administered drugs are absorbed more slowly because of the limited available blood supply in the dermis. Enterally administered drugs are absorbed more slowly because of the biotransformation process. DIF: Cognitive Level: Comprehension REF: Page 14 OBJ: 1 | 3 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 4. The nurse recognizes that which factor(s) would contribute to digoxin toxicity in a 92-year- old patient? (Select all that apply.) a. Taking the medication with meals b. Prolonged half-life of the drug digoxin c. Impaired renal function d. Diminished mental capacity ANS: B, C Impaired renal and hepatic function in older adults impairs metabolism and excretion of W W W. T B S M. W S drugs, thus prolonging the half-life of a medication. Food would decrease the absorption of the drug. Diminished mental capacity does not contribute to drug toxicity unless it is due to administration errors. DIF: Cognitive Level: Application REF: Page 15 OBJ: 2 | 3 | 7 TOP: Nursing Process Step: Assessment MSC: WWW.TBSM.WS NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 5. Which statement(s) about variables that influence drug action is/are true? (Select all that apply.) a. An older adult will require increased dosage of a drug to achieve the same therapeutic effect as that seen in a younger person. b. Body weight can affect the therapeutic response of a medication. c. Chronic smokers may metabolize drugs more rapidly than nonsmokers. d. A patient’s attitude and expectations affect the response to medication. e. Reduced circulation causes drugs to absorb more rapidly. ANS: B, C, D Body weight can affect response to medications; typically, obese patients require an increase in dosage and underweight patients a decrease in dosage. Chronic smoking enhances metabolism of drugs. Attitudes and expectations play a major role in an individual’s response to drugs. Older adults require decreased dosages of drugs to achieve a therapeutic effect. Decreased circulation causes drugs to absorb more slowly. DIF: Cognitive Level: Comprehension REF: Page 16 | Page 17 OBJ: 5|6|7 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety 6. Which factor(s) affect(s) drug actions? (Select all that apply.) ______________________________________________________________________________________________ 13 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) a. Teratogenicity b. Age c. Body weight d. Metabolic rate e. Illness ANS: B, C, D, E Age, body weight, metabolic rate, and illness may contribute to a variable response to a medication. Teratogenicity does not contribute to a variable response to a medication. DIF: Cognitive Level: Comprehension REF: Page 16 | Page 17 OBJ: 7 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety COMPLETION 1. A patient receives 200 mg of a medication that has a half-life of 12 hours. How many mg of the drug would remain in the patient’s body after 24 hours? ANS: W W W. T B S M. W S 50 The half-life is defined as the amount of time required for 50% of the drug to be eliminated from the body. If a patient is given 200 mg of a drug that has a half-life of 12 hours, then 50 mg of the drug would remain in the body after 24 hours. WWW.TBSM.WS DIF: Cognitive Level: Analysis REF: Page 15 OBJ: 2 | 3 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety ______________________________________________________________________________________________ 14 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Chapter 03: Drug Action Across the Life Span Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition MULTIPLE CHOICE 1. What time will the trough blood level need to be drawn if the nurse administers the intravenous medication dose at 9:00 AM? a. 6:30 AM b. 8:30 AM c. 9:30 AM d. 11:30 AM ANS: B Trough blood levels measure the lowest blood level of medicine and are obtained just before the dose is administered. In this case, 6:30 AM is too early to obtain the blood level. The other two times occur after the medication is administered. DIF: Cognitive Level: Application REF: Page 27 OBJ: 2 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity W W W. T B S M. W S NOT: CONCEPT(S): Clinical Judgment; Safety 2. What will the nurse expect the health care provider’s order to be when starting an older adult patient on thyroid hormone replacement therapy? a. Administering a loading dose of the drug b. Directions on how to taper the drug WWW.TBSM.WS c. A dosage that is one third to one half of the regular dosage d. A dosage that is double the regular dosage ANS: C To prevent toxicity, dosages for new medications in older adults should be one third to one half the amount of a standard adult dosage. Loading doses of drugs could cause severe toxicity. Tapering off is characteristic of discontinuation of medications and is not appropriate for this situation. Older adults generally need a lower medication dosage than younger patients. DIF: Cognitive Level: Application REF: Page 29 OBJ: 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education; Development 3. Which drugs cause birth defects? a. Teratogens b. Carcinogens c. Metabolites d. Placebos ANS: A Teratogens are drugs that cause birth defects. Carcinogens cause cancer. Metabolites are the end product of metabolism. Placebos are drugs that have no pharmacologic activity. ______________________________________________________________________________________________ 15 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) DIF: Cognitive Level: Knowledge REF: Page 30 OBJ: 6 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education; Development 4. Which life-threatening illness may occur as a result of aspirin (salicylate) administration during viral illness to patients younger than 20 years of age? a. Anaphylactic shock b. Reye’s syndrome c. Chickenpox d. Influenza A ANS: B Children are susceptible to Reye’s syndrome if they ingest aspirin at the time of or shortly after a viral infection of chickenpox or influenza. Anaphylactic shock is caused by a hypersensitivity reaction. Chickenpox is the result of being infected with a virus. Influenza A is caused by a pathogen. DIF: Cognitive Level: Knowledge REF: Page 29 OBJ: 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity W W W. T B S M. W S NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education; Development 5. Which classification of medications commonly causes allergic reactions in children? a. Antacids b. Analgesics c. Antibiotics d. Anticonvulsants WWW.TBSM.WS ANS: C Antibiotics, especially penicillins, commonly cause allergic reactions in children. Intravenous antibiotics can cause rapid reactions; therefore, the pediatric patient’s response to a medication should be assessed and monitored closely. Antacids rarely cause allergic reactions. Children are not particularly allergic to analgesics or anticonvulsants. DIF: Cognitive Level: Knowledge REF: Page 29 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety: Patient Education; Development 6. After giving instructions to an expectant mother about taking medications during pregnancy, which patient statement indicates the need for further teaching? a. “I will not take herbal medicines during pregnancy.” b. “For morning sickness, I will try crackers instead of taking a drug.” c. “If I get a cold, I will avoid taking nonprescription medications until I check with my physician.” d. “I will limit my alcohol intake to only one glass of wine weekly.” ANS: D ______________________________________________________________________________________________ 16 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) Alcohol needs to be eliminated during pregnancy and for 2 to 3 months prior to conception. Limited studies are available regarding the use of herbal medications in general, and thus they should be avoided during pregnancy. Alternative nonpharmacologic treatments are appropriate to use during morning sickness. The pregnant woman should also avoid using nonprescription drugs because few data are available about safe use in pregnancy. Because few medicines can be considered completely safe for use in pregnancy, the physician needs to approve and recommend the use of nonprescription drugs. DIF: Cognitive Level: Application REF: Page 31 | Page 32 OBJ: 6 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education 7. When is the ideal time for a nursing mother to take her own medications? a. Before the infant latches on to begin to breastfeed b. As soon as the mother wakes up in the morning c. Right before the mother goes to sleep at night d. As soon as the infant finishes breastfeeding ANS: D Taking medications after breastfeeding reduces the amount of the medication that will reach W W W. T B S M. W S the baby. Medications taken directly before breastfeeding may have a high concentration in the milk and possibly pass on to the baby. The mother must take into consideration when her medications are ordered to be taken and schedule them around breastfeeding. DIF: Cognitive Level: Comprehension REF: Page 32 OBJ: 6 TOP: Nursing Process Step: Implementation MSC: WWW.TBSM.WS NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education 8. Which age-related change would affect transdermal drug absorption in geriatric patients the most? a. Difficulty swallowing b. Diminished kidney function c. Changes in pigmentation d. Altered circulatory status ANS: D The decreased circulation that occurs with aging will affect transdermal drug absorption. Difficulty swallowing would not affect transdermal drugs being absorbed. Kidney function affects drug excretion. Changes in pigmentation would not affect transdermal drug absorption. DIF: Cognitive Level: Application REF: Page 23 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education; Development 9. Which intervention would be considered to reduce accumulation of a drug in a patient who has decreased liver function? a. Decreasing the time interval between dosages b. Reducing the dosage c. Administering the medication intravenously ______________________________________________________________________________________________ 17 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) d. Changing the drug to one that has a longer half-life ANS: B Dosages must be reduced to prevent accumulation. Decreasing the time interval between dosages would increase the accumulation of the drug. The intravenous route has the fastest absorption and with liver dysfunction would increase the accumulation of the drug. A similar drug with a longer half-life would stay in the system longer; with impaired liver function, the result would be increased accumulation. DIF: Cognitive Level: Comprehension REF: Page 24 | Page 25 OBJ: 2 TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education; Health Promotion 10. The nurse is teaching an elderly patient with difficulty swallowing about his medications. Which explanation by the nurse is most helpful? a. “Enteric coated tablets can be crushed and taken with applesauce.” b. “Tablets that are scored can be broken in half.” c. “Medications labeled ‘SR’ can be crushed.” d. “Avoid taking medications in liquid form.” ANS: B W W W. T B S M. W S It is acceptable to break scored tablets in half to facilitate swallowing of the medication. Enteric coated tables should never be crushed because of the effect on the absorption rate and potential for toxicity. Medications labeled “SR” indicate “sustained release” and should not be crushed because of the effect on the absorption rate. Medication in liquid form may be easier to swallow. WWW.TBSM.WS DIF: Cognitive Level: Application REF: Page 30 OBJ: 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Clinical Judgment; Safety; Patient Education 11. The nurse is administering an antibiotic intravenously. Which blood level determines the lowest amount of medication present in the patient? a. Peak b. Serum c. Therapeutic d. Trough ANS: D The lowest amount of a medication in the blood is the trough. The peak is the highest amount of medication in the blood. Serum level identifies the amount of medication present. Therapeutic levels identify the range in which a medication is effective. DIF: Cognitive Level: Knowledge REF: Page 27 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 12. Which patient would the nurse identify as having the lowest rate of absorption of enteral medications? ______________________________________________________________________________________________ 18 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ______________________________________________________________________________________________ Test Bank - Basic Pharmacology for Nurses, 17th Edition (Clayton, 2017) a. A 5-year-old boy b. An 18-year-old woman c. A 55-year-old man d. An 85-year-old woman ANS: A Males’ stomachs empty more rapidly; children have increased motility, resulting in decreased absorption time. As one gets older, gastrointestinal (GI) motility is decreased, allowing for increased absorption time; women have slower gastric emptying, resulting in more time for absorption. Males’ stomachs empty more rapidly; however, as one gets older, GI motility is decreased, resulting in an increase in absorption time. As one gets older, GI motility is decreased, allowing for increased absorption time; women have slower gastric emptying, resulting in more time for absorption. DIF: Cognitive Level: Application REF: Page 21 | Page 24 | Page 21 OBJ: 3|4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Development 13. What is the definition of cumulative effect of a drug? a. Drug toxicity related to overmedication W W W. T B S M. W S b. Drug buildup related to decreased metabolism c. The inability to control the ingestion of drugs d. The need for higher dosage to produce the same effect as previous lower dosages ANS: B Cumulative effects are related to diminished metabolism or excretion of a drug that causes it to accumulate. Cumulative effects can lead to drug toxicity. Toxicity occurs when adverse WWW.TBSM.WS effects are severe. Inability to control the ingestion of drugs is drug dependence. The need for higher dosage to produce the same effect as previous lower dosages is the definition of tolerance. DIF: Cognitive Level: Knowledge REF: Page 23 OBJ: 2 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety 14. Which patient, when compared with the general population, would require a larger dose or more frequent administration of a drug to attain a therapeutic response? a. A 29-year-old who has been diagnosed with kidney failure b. A 35-year-old obese male who is being evaluated for an exercise program c. A 52-year-old diagnosed with hypothyroidism and decreased metabolic rate d. A 72-year-old with decreased circulatory status ANS: B An obese individual would require a larger dose of a drug to attain a therapeutic response. An individual with kidney failure would require less medication because of decreased excretory ability. Individuals with decreased metabolic rate would metabolize drugs more slowly and require smaller doses or less frequent administration. Individuals with decreased circulation would require less medication. DIF: Cognitive Level: Application REF: Page 21 | Page 22 ______________________________________________________________________________________________ 19 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides Downloaded by: tianaashleyb | [email protected] Want to earn $1.236 Distribution of this document is illegal extra pe