Pharmacology: A Patient-Centered Nursing Process Approach 9th Edition Test Bank

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Chapter 01: Drug Development and Ethical ConsiderationsMcCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th EditionMULTIPLE CHOICE1.The nurse is obtaining consent from a subject newly recruited for a clinical drug trial thatwill last for 6 months. All subjects will be given gift certificates for participating. Onesubject says, “Well, I guess if the drug doesn’t work, I’ll just have to put up with thesymptoms for 6 months.” What will the nurse tell the subject?a.“Participation for the duration of the study is required.”b.“Participation may end at any time without penalty.”c.“Withdrawal from the study may end at any time, but the gift certificate will not begiven.”d.“You can request placement in the treatment group.”ANS:BAll participants have the right to autonomy, which is the right to self-determination. Patientshave the right to refuse to participate or to withdraw from a study at any time withoutpenalty. Patients generally are not allowed to choose participation in either the treatment orthe control group.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 3TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Management of Client Care2.The nurse is assisting with a clinical drug trial in which the side effects of two effectivedrugs are being compared. A patient who would benefit from either drug has elected towithdraw from the study, and the nurse assists with the paperwork to facilitate this. This isan example ofa.autonomy.b.beneficence.c.justice.d.veracity.ANS:AAll participants have the right to autonomy, which is the right to self-determination. Patientshave the right to refuse to participate or to withdraw from a study at any time withoutpenalty even if the health care provider disagrees with that choice.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 3TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care3.During a clinical drug trial for a new medication, researchers note a previously unknownserious adverse effect occurring in more than 50% of subjects. The study is discontinued.Which ethical principle is being exercised?a.Beneficenceb.Justicec.Respect for personsd.Veracity

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ANS:ABeneficence is the duty to do good and to not harm others. Once a serious adverse effect isnoted in a majority of subjects, researchers have an ethical obligation to stop the study.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care4.In a 5-year experimental clinical trial to investigate a new cancer treatment, researchers inthe second year note overwhelming improvement in almost all of the subjects in thetreatment group. The lead researcher elects to continue the study. Which ethical principle isbeing violated?a.Beneficenceb.Justicec.Respect for personsd.VeracityANS:BThe principle of justice requires that all people be treated fairly, including equal access tohealth care for all. Once a benefit is demonstrated, it should be available to all participants.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care5.The nurse is enrolling subjects for a double-blind experimental study. One patient asks thenurse to explain the role of the experimental group. The nurse will explain that subjects inthe experimental group in this type of studya.are selected for participation in that group.b.have unique baseline characteristics.c.receive a placebo.d.receive the treatment being evaluated.ANS:DIn a double-blind experimental study, subjects in the experimental group receivethetreatment or drug under study. They are randomly assigned and not selected. They shouldhave similar baseline characteristics to those in the control group. They do not receive aplacebo.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 6TOP:Nursing Process: Nursing Intervention: Patient TeachingMSC:NCLEX: Management of Client Care6.The nurse is obtaining signatures on consent forms for participation in a clinical drug trial.One patient says, “I’m not sure I want to do this, but I need the cash.” The nurse will takewhich action?a.Ask the patient to clarify concerns.b.Reinforce that cash is given to all subjects equally.c.Report this statement to the party named on the consent.d.Review the elements of the study and obtain consent.ANS:C

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If a nurse suspects that a patient is being coerced to participate in the study, the nurse shouldreport this to the party named on the informed consent. When a patient verbalizesparticipation based on a financial reward, there is an element of coercion.DIF:Cognitive Level: Applying (Application)REF:p. 3TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Management of Client Care7.Which is the characteristic of preclinical in vivo testing?a.A comparison of experimental and control data in animalsb.A study conducted in a test tube in a laboratoryc.A study that determines the effects of the placebo in human participantsd.A study to assess the seriousness of the disease to be treatedANS:APreclinical in vivo testing is performed in animals or other living organisms. In vitro studiesoccur in test tubes. Safe therapeutic dose studies are part of clinical research. Prior toclinical trials, an assessment is made of the disease and its seriousness.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care8.Many drugs marketed in the 1980s may not be effective in a majority of the population. Thenurse understands that this is because these drugsa.did not pass through the appropriate phases of clinical trials.b.did not require human subject protections and are invalid.c.were not tested on women, minorities, or children.d.were tested on healthy subjects only.ANS:CDrug research was historically done only with Caucasian males, causing uncertainty as tothe validity of the research results.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care9.The nurse is assisting with data collection in a study of drug effects in healthy subjects. Thenurse assists with blood and urine collection to determine serum drug levels and thepresence of metabolites in the urine. Which phase of a drug study does this represent?a.Phase Ib.Phase IIc.Phase IIId.Phase IVANS:APhase I drug trials are performed to assess safety and to identify the pharmacokinetics, suchas metabolism and elimination, of drugs in healthy subjects.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care

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10.The nurse is enrolling subjects for a clinical drug trial in which subjects will be randomlyassigned to either a treatment or a placebo group. The pills in both groups will be inidentical packaging with identical appearance. The group that receives the intervention is thea.control group.b.experimental group.c.dependent group.d.independent group.ANS:BThe experimental group in a drug trial is the group that receives the drug being tested. Thecontrol group may receive no drug, a different drug, a placebo, or the same drug with adifferent dose, route, or frequency of administration. Dependent and independent are notterms to describe groups in a study; they denote the variables.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 6TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care11.The nurse is assisting with a clinical drug trial to test the safe dose of an analgesicmedication and learns that subjects have been told that the study is about measuring theanalgesic effects. Which ethical principle has been violated?a.Beneficenceb.Justicec.Respect for personsd.VeracityANS:DVeracity requires health care professionals to tell the truth.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 3TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care12.A clinical drug trial is concluding a study of pharmacokinetics and safety of a drug inhealthy individuals. The nurse will assist enrollment of participants into the next phase ofthe study and will include which subjects?a.Healthy subjectsb.Healthy and ill subjectsc.Subjects with the disease the drug will treatd.Subjects with other diseasesANS:CAfter Phase I studies demonstrating drug safety and pharmacokinetics have been completed,the drug is tested on subjects who have the disease the drug will treat.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 6TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Management of Client Care

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13.Before marketing a new drug that has been approved for use based on clinical effectivenessand safety, the manufacturer wishes to study the potential new uses for the drug. This is anexample of which phase of study?a.Phase Ib.Phase IIc.Phase IIId.Phase IVANS:DPhase IV studies are performed to examine potential new indications for approved drugs.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 4TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care14.Which statement about the safety and efficacy of medications in children is accurate?a.Children cannot give consent, so clinical drug trials are not performed on children.b.Children can only be subjects in quasi-experimental clinical studies.c.Data from adult clinical drug trials can be extrapolated to children.d.Federal law requires that drugs for children be tested on children.ANS:DThe U.S. Food and Drug Administration (FDA) Modernization Act of 1997 requires thatdrugs intended for use in children be tested on children.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 8TOP:Nursing Process: N/AMSC:NCLEX: Management of Client Care15.The nurse is preparing to administer a schedule II injectable drug and is drawing up half ofthe contents of a single-use vial. Which nursing action is correct?a.Ask another nurse to observe and cosign wasting the remaining drug from the vial.b.Keep the remaining amount in the patient’s drawer to give at the next dose.c.Record the amount unused in the patient’s medication record.d.Dispose of the vial with the remaining drug into a locked collection box.ANS:ASchedule II drugs are controlled substances, and all must be accounted for. When wasting aportion of a drug, another nurse should observe and cosign that a drug was wasted.DIF:Cognitive Level: Applying (Application)REF:p. 8TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies16.A patient is prescribed a medication and asks the nurse if the drug is available in a genericform. The nurse understands that a generic medication will have a name thata.is a registered trademark.b.is always capitalized.c.is related to the drug’s chemical structure.d.is nonproprietary.ANS:D

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The generic name is the official, nonproprietary name for a drug. The brand name is thetrademark name and is always capitalized. The chemical name describes the chemicalstructure of the drug.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 11TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies17.A patient receives a prescription on which the provider has noted that a generic medicationmay be given. The patient asks the nurse what this means. What will the nurse tell thepatient about generic drugs?a.They contain the same inert ingredients as brand-name drugs.b.They have chemical structures that are identical to proprietary drugs.c.They tend to be less expensive than brand-name drugs.d.They undergo extensive testing before they are marketed.ANS:CGeneric drugs are approved by the FDA if they are proved to be bioequivalent to thebrand-name drug. They tend to be less expensive because manufacturers of these drugs donot have to do the extensive testing required of brand-name drugs before marketing. Theyare not identical to brand-name drugs and often have different inert ingredients.DIF:Cognitive Level: Applying (Application)REF:p. 11TOP:Nursing Process: Nursing Intervention: Patient TeachingMSC:NCLEX: Management of Client Care18.The nurse reviews information about a drug and notes the initials “United StatesPharmacopeia (USP)” after the drug’s official name. The nurse understands that thisdesignation indicates the druga.is a controlled substance.b.is approved by the FDA.c.is available in generic form.d.meets quality and safety standards.ANS:DThe “USP”designation is given to drugs that have met high standards for therapeutic use,patient safety, quality, purity, strength, packaging safety, and dosage form by the UnitedStates Pharmacopoeia National Formulary. The FDA classifies controlled substances withRoman numerals from I to V. The USP designation does not indicate FDA approval. TheUSP designation does not indicate generic availability.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 7TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies19.The nurse is preparing to give a medication to a child. The child’s parent asks whether thedrug is safe for children. How will the nurse respond to the parent?a.“Drugs are tested on adults and safe doses for children are based on weightscompared to adult weights.”b.“Drugs are deemed safe for children over time when repeated use proves

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effectiveness and safety.”c.“Drugs are tested for both efficacy and safety in children in order to be marketedfor pediatric use.”d.“Drugs are tested on children in postmarketing studies and on a limited basis.”ANS:CThe Pediatric Research Equity Act requires drug manufacturers to test drugs on children.DIF:Cognitive Level: Applying (Application)REF:p. 9TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies20.Which law(s) govern all drug administration by nurses?a.Drug Regulation and Reform Actb.FDA Amendments Actc.Nurse Practice Actsd.The Controlled Substances ActANS:CEach state’s Nurse Practice Act identifies how nurses administer medications. The other actsgovern how drugs are marketed and tested.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 9TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies21.A patient is taking methadone as part of a heroin withdrawal program. The nurseunderstands that, in this instance, methadone is classified as which drug schedule?a.C-Ib.C-IIc.C-IIId.C-VANS:BMethadone is a category II drug, with a high potential for drug abuse.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 9TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies22.The nurse is preparing to administer a combination drug containing acetaminophen andcodeine. The nurse knows that this drug is classified as which drug schedule?a.C-IIb.C-IIIc.C-IVd.C-VANS:BCodeine is normally a category II drug, except when it is part of a combination product suchas with acetaminophen, making it a category III drug.

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DIF:Cognitive Level: Understanding (Comprehension)REF:p. 9TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesMULTIPLE RESPONSE1.Which are responsibilities of the FDA? (Select all that apply.)a.To ensure a drug has accurate labeling.b.To ensure a drug is affordable.c.To ensure a drug is effective.d.To ensure a drug is free from adverse reactions.e.To ensure a drug is tested for harmful effects.ANS:A, C, EThe FDA ensures that drugs are labeled correctly, that they are tested and proven effectivefor the conditions they are marketed to treat, and that they are tested for harmful effects. TheFDA does not ensure affordability or freedom from adverse reactions, although these mustbe noted in drug information materials.DIF:Cognitive Level: Understanding (Comprehension)REF:pp. 8-9TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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Chapter 02: Pharmacokinetics, Pharmacodynamics, and PharmacogeneticsMcCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th EditionMULTIPLE CHOICE1.Which drug will go through a disintegration process after it is administered?a.Intramuscular (IM) cephalosporinsb.Intravenous (IV) vasopressorsc.Oral analgesicsd.Subcutaneous antiglycemicsANS:CWhen drugs are administered parenterally, there is no disintegration process, which occurswhen a drug becomes a solution that can cross the biologic membrane.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 16TOP:Nursing Process: AssessmentMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies2.The nurse is preparing to administer an oral medication and wants to ensure a rapid drugaction. Which form of the medication will the nurse administer?a.Capsuleb.Enteric-coated pillc.Liquid suspensiond.TabletANS:CLiquid drugs are already in solution, which is the form necessary for absorption in thegastrointestinal (GI) tract. The other forms must disintegrate into small particles and thendissolve before being absorbed.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 16TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies3.The nurse is teaching a patient who will be discharged home with a prescription for anenteric-coated tablet. Which statement by the patient indicates understanding of theteaching?a.“I may crush the tablet and put it in applesauce to improve absorption.”b.“I should consume acidic foods to enhance absorption of this medication.”c.“I should expect a delay in onset of the drug’s effects after taking the tablet.”d.“I should take this medication with high-fat foods to improve its action.”ANS:C

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Enteric-coated tablets resist disintegration in the acidic environment of the stomach anddisintegrate when they reach the small intestine. There is usually some delay in onset ofactions after taking these medications. Enteric-coated tablets should not be crushed orchewed, which would alter the time and location of absorption. Acidic foods will notenhance the absorption of the medication. The patient should not eat high-fat food beforeingesting an enteric-coated tablet because high-fat foods decrease the absorption rate.DIF:Cognitive Level: Applying (Application)REF:p. 16TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies4.A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must begiven by subcutaneous injection instead of by mouth. The nurse will explain that this isbecausea.absorption is diminished by the first-pass effects in the liver.b.absorption is faster when insulin is given subcutaneously.c.digestive enzymes in the GI tract prevent absorption.d.the oral form is less predictable with more adverse effects.ANS:CInsulin, growth hormones, and other protein-based drugs are destroyed in the small intestineby digestive enzymes and must be given parenterally. Because insulin is destroyed bydigestive enzymes, it would not make it to the liver for metabolism with a first-pass effect.Subcutaneous tissue has fewer blood vessels, so absorption is slower in such tissue. Insulinis given subcutaneously because it is desirable to have it absorb slowly.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 17TOP:Nursing Process: Nursing Intervention: Patient TeachingMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies5.The nurse is preparing to administer an oral medication that is water soluble. The nurseunderstands that this druga.must be taken on an empty stomach.b.requires active transport for absorption.c.should be taken with fatty foods.d.will readily diffuse into the GI tract.ANS:BWater-soluble drugs require a carrier enzyme or protein to pass through the GI membrane.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 17TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies6.A nurse is preparing to administer an oral drug that is best absorbed in an acidicenvironment. How will the nurse give the drug?a.On an empty stomachb.With a full glass of waterc.With foodd.With high-fat food

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ANS:CFood can stimulate the production of gastric acid, so medications requiring an acidicenvironment should be given with a meal. High-fat foods are useful for drugs that are lipidsoluble.DIF:Cognitive Level: Applying (Application)REF:p. 17TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies7.The nurse is preparing an injectable drug and wants to administer it for rapid absorption.How will the nurse give this medication?a.IM into the deltoid muscleb.IM into the gluteal musclec.Subcut into abdominal tissued.Subcut into the upper armANS:ADrugs given IM are absorbed faster in muscles that have more blood vessels, such as thedeltoid, rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routesare used when absorption needs to be slower and more sustained.DIF:Cognitive Level: Applying (Application)REF:p. 17TOP:Nursing Process: PlanningMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies8.The nurse is reviewing medication information with a nursing student prior to administeringan oral drug and notes that the drug has extensive first-pass effects. Which statement by thestudent indicates a need for further teaching about this medication?a.“The first-pass effect means the drug may be absorbed into systemic circulationfrom the intestinal lumen.”b.“The first-pass effect means the drug may be changed to an inactive form andexcreted.”c.“The first-pass effect means the drug may be changed to a metabolite, which maybe more active than the original.”d.“The first-pass effect means the drug may be unchanged as it passes through theliver.”ANS:BDrugs that undergo first-pass metabolism are absorbed into the portal vein from theintestinal lumen and go through the liver, where they are either unchanged or aremetabolized to an inactive or a more active form.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 17TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies9.The nurse prepares to change a patient’s medication from an IV to an oral form and notesthat the oral form is ordered in a higher dose. The nurse understands that this is due todifferences in

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a.bioavailability.b.pinocytosis.c.protein binding.d.tachyphylaxis.ANS:AOral drugs may have less bioavailability because a lower percentage of the drug reaches thesystemic circulation. Pinocytosis refers to the process by which cells carry a solute across amembrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapiddecrease in response to drugs that occurs when tolerance develops quickly.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 17TOP:Nursing Process: AssessmentMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies10.The nurse is preparing to administer a drug and learns that it binds to protein at a rate of90%. The patient’s serum albumin level is low. The nurse will observe the patient fora.decreased drug absorption.b.decreased drug interactions.c.decreased drug toxicity.d.increased drug effects.ANS:DDrugs that are highly protein-bound bind with albumin and other proteins, leaving less freedrug in circulation. If a patient has a low albumin, the drug is not bound, and there is morefree drug to cause drug effects. There would be increased absorption, increased interactionswith other drugs, and increased toxicity.DIF:Cognitive Level: Applying (Application)REF:p. 18TOP:Nursing Process: EvaluationMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies11.The nurse is administering two drugs to a patient and learns that both drugs are highlyprotein-bound. The nurse may expecta.decreased bioavailability of both drugs.b.decreased drug effects.c.decreased drug interactions.d.increased risk of adverse effects.ANS:DTwo drugs that are highly protein-bound will compete for protein-binding sites, leavingmore free drug in circulation and an increased risk of adverse effects as well as increasedbioavailability, increased drug effects, and increased drug interactions.DIF:Cognitive Level: Applying (Application)REF:p. 18TOP:Nursing Process: EvaluationMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies12.A patient has been taking a drug that has a protein-binding effect of 75%. The provider addsa new medication that has a protein-binding effect of 90%. The nurse will expect

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a.decreased drug effects of the first drug.b.decreased therapeutic range of the first drug.c.increased drug effects of the first drug.d.increased therapeutic range of the first drug.ANS:CAdding another highly protein-bound drug will displace the first drug from protein-bindingsites and release more free drug, increasing the drug’s effects. This does not alter thetherapeutic range, which is the serum level between drug effectiveness and toxicity.DIF:Cognitive Level: Applying (Application)REF:p. 18TOP:Nursing Process: Nursing Intervention/EvaluationMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies13.The nurse gives a medication to a patient with a history of liver disease. The nurse willmonitor this patient fora.decreased drug effects.b.increased drug effects.c.decreased therapeutic range.d.increased therapeutic range.ANS:BLiver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting thedrug-metabolizing enzymes in the liver. When the drug metabolism rate is decreased, excessdrug accumulation can occur and lead to toxicity.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: Assessment/Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies14.The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be leftin the body in 24 hours if no additional drug is given?a.Noneb.50 mgc.100 mgd.200 mgANS:CEight hours after the drug is given, there will be 400 mg left. Eight hours after that (16hours), there will be 200 mg left. At 24 hours, there will be 100 mg left.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: EvaluationMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies15.If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a Monday,when will a steady state be achieved?a.0800 on Tuesdayb.0800 on Wednesdayc.0800 on Thursday

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d.0800 on FridayANS:BSteady-state levels occur at 3 to 5 half-lives. Wednesday at 0800 is 4 half-lives from theoriginal dose.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: EvaluationMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies16.The nurse is preparing to administer a drug that is ordered to be given twice daily. The nursereviews the medication information and learns that the drug has a half-life of 24 hours. Whatwill the nurse do next?a.Administer the medication as orderedb.Contact the provider to discuss daily dosingc.Discuss every-other-day dosing with the providerd.Hold the medicationANS:BA drug with a longer half-life should be given at longer intervals to avoid drug toxicity.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: PlanningMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies17.The nurse is caring for a patient who has taken an overdose of aspirin several hours prior.The provider orders sodium bicarbonate to be given. The nurse understands that this drug isgiven for which purpose?a.To counter the toxic effects of the aspirinb.To decrease the half-life of the aspirinc.To increase the excretion of the aspirind.To neutralize the acid of the aspirinANS:CAspirin is a weak acid and is more readily excreted in alkaline urine. Sodium bicarbonatealkalizes the urine. It does not act as an antidote to aspirin, decrease the half-life, orneutralize its pH.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: PlanningMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies18.The nurse is preparing to administer a drug that is eliminated through the kidneys. The nursereviews the patient’s chart and notes that the patient has increased serum creatinine andblood urea nitrogen (BUN). The nurse will perform which action?a.Administer the drug as ordered.b.Anticipate a shorter than usual half-life of the drug.c.Expect decreased drug effects when the drug is given.d.Notify the provider and discuss giving a lower dose.ANS:D

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Increased creatinine and BUN indicate decreased renal function, so a drug that is eliminatedthrough the kidneys can become toxic. The nurse should discuss a lower dose with theprovider. The drug will have a longer half-life and will exhibit increased effects withdecreased renal function.DIF:Cognitive Level: Applying (Application)REF:p. 19TOP:Nursing Process: Nursing InterventionMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies19.The nurse understands that the length of time needed for a drug to reach the minimumeffective concentration (MEC) is thea.duration of action.b.onset of action.c.peak action time.d.time response curve.ANS:BThe onset of action is the time it takes to reach the MEC. Duration of action isthe length oftime a drug has a pharmacologic effect. Peak action time occurs when the drug reaches itshighest blood level. The time response curve is an evaluation of the other three measures.DIF:Cognitive Level: Remembering (Knowledge)REF:p. 20TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies20.The nurse administers albuterol to a patient who has asthma. The albuterol acts bystimulating beta2-adrenergic receptors to cause bronchodilation. The nurse understands thatalbuterol is a beta-adrenergica.agonist.b.antagonist.c.inhibitor.d.depressant.ANS:AAn agonist medication is one that stimulates a certain type of cell to produce a response.DIF:Cognitive Level: Understanding (Comprehension)REF:p. 21TOP:Nursing Process: N/AMSC:NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies21.The nurse is explaining to the patient why a nonspecific drug has so many side effects.Which statement by the patient indicates a need for further teaching?a.“Non-specific drugs can affect specific receptor types in different body tissues.”b.“Non-specific drugs can affect a variety of receptor types in similar body tissues.”c.“Non-specific drugs can affect hormone secretion as well as cellular functions.”d.“Non-specific drugs require higher doses than specific drugs to be effective.”ANS:B

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