Introduction to Clinical Pharmacology 9th Edition Test Bank

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Chapter 01: Pharmacology and the Nursing Process in LPN PracticeVisovsky: Introduction to Clinical Pharmacology, 9th EditionMULTIPLE CHOICE1.You are assessing the skin of a newly admitted patient and note a 2 inch area of redness at thesacrum. Which type of data are you collecting with this information?a.Objective datab.Inspectionc.Subjective datad.Alternative therapyANS:AObjective data are obtained by the healthcare provider during physical examination, or that aremeasurable (i.e., laboratory results).DIF:Cognitive Level: ApplyingREF:p. 32.Which part of the nursing process includes setting goals for the nursing care required whengiving drugs to a patient?a.Assessmentb.Planningc.Evaluationd.DiagnosisANS:BThe nursing process consists of five major steps in this order: assessment, diagnosis, planning,implementation, evaluation. It is in the planning step that the goals for nursing care related todrugs are set based upon data collected.DIF:Cognitive Level: RememberingREF:p. 43.When would it be appropriate to withhold a drug instead of giving it to a patient?a.When the order is written by handb.When any part of the drug order is unclearc.When the drug improves the patient’s symptomsd.When the order contains both the generic and trade name of the drugANS:BYou must use good judgment in carrying out a drug order. If, in your judgment, the order isunclear, or incorrect, it should be withheld (not given) until your concerns can be answered bythe patient’s healthcare provider.DIF:Cognitive Level: ApplyingREF:p. 44.Which action would you take to ensure that an order for a drug is accurate?a.Check the drug record with the Kardex file.b.Compare the order with the drug history.c.Compare the order to the patient’s reason for admission.d.Check the drug record with the original healthcare provider’s order.

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ANS:DOnce the healthcare provider orders the drug, you must verify that the order isaccurate. Thisis done by checking the drug chart or drug record with the healthcare provider’s originalorder.DIF:Cognitive Level: RememberingREF:p. 45.What do the nine “rights” of drug administration include?a.Right patient, drug, dose, route, time, reason, documentation, response, and right torefuseb.Right drug, diagnosis, time, patient, route, drug history, documents, and right torefusec.Right drug, amount, route, time, nurse, reason, route, diagnosis, anddocumentationd.Right dose, time, healthcare provider, patient, route, documentation, response, anddrugANS:AThere are nine “rights” of drug administration: you must identify the right patient, give theright drug at the right dose, right route, right time, for the right reason, using the rightdocumentation to record that the dose has been given, monitor the patient for the rightresponse, and note that the patient has the right to refuse a drug.DIF:Cognitive Level: RememberingREF:p. 56.Which action should you take to ensure that you are giving a drug to the right patient?a.Verifying the drug record with the patient name on the chartb.Verifying the patient’s room and bed number with the chartc.Asking the patient to state his or her birthdate and Social Security numberd.Asking the patient to state their name and birthdate, and then checking the patientsidentification braceletANS:DBefore giving any drug, two forms of patient identifications should be used to identify thecorrect patient. Each patient should be asked his or her name, and another form ofidentification, such as birthdate; then you should check the patient’s identification bracelet.DIF:Cognitive Level: ApplyingREF:p. 57.Which category of drugs should be given exactly on schedule in order to maintain a consistentlevel of the drug in the body?a.Steroidsb.Diureticsc.Aspirin productsd.AnticoagulantsANS:DCertain drugs must be given at specific time interval (right time). Anticoagulants must begiven at the same time each day to maintain a therapeutic blood level in order to prevent bloodclots.DIF:Cognitive Level: ApplyingREF:p. 7

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8.Which nursing action isnotappropriate when giving drugs to a patient?a.Leaving the drug at the patient’s bedside to take when he/she awakensb.Asking the patient if he or she has any allergies to drugsc.Checking a drug reference to verify the action of the drugd.Explaining to the patient the possible side effects of the drugANS:AIt is never permissible to leave drugs at the patient’s bedside. As the nurse, you areresponsible for witnessing the patient taking the drug(s), or documentation of the patient’srefusal.DIF:Cognitive Level: ApplyingREF:p. 109.Which of the following nursing actions is an example of evaluating patient responses to drugtherapy?a.Documenting the fact that the patient refused the drugb.Making sure you have assembled all necessary equipmentc.Taking the patient’s blood pressure before giving an antihypertensived.Taking the temperature of a patient an hour after giving an antipyreticANS:DEvaluation is the process of determining the right response of the patient to the drug given.The correct response to an antipyretic is a reduction in fever.DIF:Cognitive Level: KnowingREF:p. 910.Which statement is considered to be an example of objective data gathered in the assessmentof a patient who will be receiving drugs for the treatment of an injury?a.The patient’s skin is warm and dry to touch.b.The patient tells you “I have pain in my lower back.”c.The patient states he is having trouble catching his breath.d.The patient checks off “no history of drug allergies” on the health form.ANS:AObjective data are physical findings the nurse can see during careful inspection, palpation,percussion, and auscultation.DIF:Cognitive Level: KnowingREF:p. 311.You are interviewing a patient to obtain a current drug history. What information should bepart of this report?a.The color of each drug in pill formb.The names and dosages of each drugc.The major health conditions of the patientd.The nursing diagnoses that come from the collected informationANS:BIn the interview to obtain a current and accurate drug history, the names of each drug and, ifpossible, the dosage of each drug are recorded.DIF:Cognitive Level: ApplyingREF:p. 3

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12.A patient you are caring for is prescribed 30 units of NPH insulin to be given subcutaneously.You know that insulin is considered a “high-alert drug.” What nursing action would youperform to give a high-alert drug safely?a.Call the healthcare provider to double check the order.b.Ensure an insulin level is drawn before giving the drug.c.Have another nurse check the order and dosage before giving it.d.Refuse to give this drug, as it can only be given by a registered nurse.ANS:CMany institutions have policies that require two nurses to double check the order and dosagesof high-alert drugs to reduce the risk of error and adverse effects for the patient. This isespecially important if the drug dose needs to be calculated.DIF:Cognitive Level: ApplyingREF:p. 813.You are about to give the prescribed drugs to a patient in your care. When you approach thepatient with the drugs, the patient refuses to take one of the drugs. What is your best action?a.Ask the pharmacy if there is a substitute drug for the one the patient refused.b.Acknowledge to patient’s right to refuse, no other action is needed.c.Let the patient know the consequences of refusing the drug.d.Notify the charge nurse or healthcare provider.ANS:DNever record drugs that were not given or record them before they are given. If a patient doesnot receive the drug for any reason, notify the nurse in charge or the healthcare provideraccording to your healthcare setting policies.DIF:Cognitive Level: ApplyingREF:p. 814.You have given the antibiotic penicillin as prescribed to a patient with no reported drugallergies. Thirty minutes after receiving the drug, the patient notifies you that he/she hasdeveloped hives and swelling of the lips. What is your best first action?a.Call the pharmacy and report this as an adverse reaction to the drug.b.Immediately give epinephrine to counter the drug reaction.c.Reassure the patient that this is a typical side effect of the drug.d.Report the findings to the RN or healthcare provider and remain with the patient.ANS:DIf you suspect the patient is having an adverse effect, such as an allergic reaction, report thisimmediately to the RN or healthcare provider. Remain with the patient, monitoring forchanges in breathing or vital signs, until the RN or healthcare provider arrives with additionalorders to be carried out.DIF:Cognitive Level: ApplyingREF:p. 915.You are working on a very busy 35-bed hospice unit. The RN you are working with just got anew admission and hands you a syringe with “pain drug” in it. He/she asks you to give thisdrug to a specified patient. What is your most appropriate action?a.Assist the RN by giving the drug as requested for this one time only.b.Refuse to give a drug that is not for a patient you are assigned to care for.

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c.Refuse, but prepare another dose of the drug yourself, and give as prescribed.d.Assist the RN as directed, as under the RN’s supervision, this practice is permitted.ANS:CYou are never to give a drug prepared by another nurse, even during a busy time or during anemergency. To meet all the patient safety standards covered by the “9 Rights,” you arerequired to give only drugs you have prepared.DIF:Cognitive Level: ApplyingREF:p. 716.You are evaluating the response of a patient 30 minutes after receiving an antihypertensivedrug. Upon assessment of the patient’s blood pressure, you note the patient has becomehypotensive. What type of drug effect is this patient experiencing?a.An adverse effect of the drugb.A side effect of the drugc.A therapeutic effect of the drugd.An allergic reaction to the drugANS:AAn adverse effect is seen when patients do not respond to drugs in the way they should, ordevelop new signs or symptoms. When a patient has an adverse effect, you should report thisimmediately to the RN or healthcare provider.DIF:Cognitive Level: KnowingREF:p. 9MULTIPLE RESPONSE1.Before giving a drug to a patient which steps should you take to ensure safe drugadministration? (Select all that apply.)a.Use two forms of patient identification.b.Ask the patient about any drug allergies.c.Check the drug before removing it from the unit-dose cart.d.Check the dose before preparing or measuring the drug.e.Check the drug just before you open it and give it to the patient.f.Document the drug given before you enter into the patient’s room.ANS:A, B, C, D, EThe nurse needs to use two forms of identification to ensure the drug is given to the rightpatient. The nurse should read the drug label at least three times: (1) before taking the drugfrom the unit-dose cart or shelf, (2) before preparing or measuring the prescribed dose of drug,and (3) before giving it to the patient. Asking about drug allergies is important if thisinformation is not available, or if drugs associated with allergic reactions, such as antibiotics,are given.DIF:Cognitive Level: ApplyingREF:p. 102.You are taking the drug history from a patient. Which of the following information should becollected as part of this interview? (Select all that apply.)a.Allergies to any drugsb.Alcohol or recreational drug usec.The time of day preferred for taking drugs

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d.The use of nutritional supplements or herbse.The strategies you will use to care for the patientf.The illness or symptoms for which the drug is neededANS:A, B, D, FThe patient’s drug history consists of symptoms or diseases for which a drug is needed, thenames, and dosages of all drugs, alcohol or recreational drug history, and alternativetreatments, such as nutritional or herbal therapies.DIF:Cognitive Level: ApplyingREF:p. 33.When evaluating a patient’s response to s drug, which factors should you should consider?(Select all that apply.)a.The clarity of all written drug ordersb.The expected side effects of the drugc.The reason the drug was prescribedd.The therapeutic effects of the druge.The timing of the prescribed drugf.The adverse effects of the drugANS:B, D, EThe three factors to be considered in evaluating responses to drug therapy are the therapeuticeffects, expected side effects, and adverse effects.DIF:Cognitive Level: RememberingREF:p. 9

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Chapter 02: Legal, Regulatory, and Ethical Aspects of Drug AdministrationVisovsky: Introduction to Clinical Pharmacology, 9th EditionMULTIPLE CHOICE1.Which of the following scenarios may be a sign of possible drug diversion on a unit?a.A patient is dissatisfied with the drug administration schedule.b.A patient receiving oral antibiotics has an excess amount of pills.c.A patient is unaware that the nurse mixed a drug in applesauce.d.A patient receiving opioids reports increased pain.ANS:DDrug diversion is defined as the illegal transfer of regulated drugs (like narcotics) from thepatient for whom it was prescribed, to another person, such as a nurse, for their own (orothers) use. Drug diversion should also be suspected if patients continually report pain despiteappropriate drug treatment, and if inaccurate narcotic counts are noted.DIF:Cognitive Level: RememberingREF:pp. 13-142.Which of the following is an example of psychological dependence (addiction) to a drug?a.Symptoms of drug withdrawalb.Pain, confusion, and seizuresc.An intense mental desire for certain drugsd.Shaking and an increased heart rate after taking a drugANS:CPsychological dependence, oraddiction, is a mental desire associated with taking certainsubstances, such as cocaine or alcohol. Symptoms of mental dependence such as anxiety,anger, or depression can occur with psychological dependence.DIF:Cognitive Level: RememberingREF:p. 123.You have obtained a liquid narcotic for a patient in pain from the unit’s locked cabinet.However, the dose was accidentally spilled before to giving it to the patient. What is the bestaction to take at this point?a.Ask another nurse to cosign the inventory record describing the situation.b.Immediately obtain another dose from the narcotic control system.c.Document the occurrence in the drug record.d.Clean up the spill and notify the supervisor.ANS:AAccounting for controlled substances is a legal requirement. If the drug is accidentallydropped, contaminated, or spilled two nurses must sign the inventory report and describe thesituation.DIF:Cognitive Level: KnowingREF:p. 144.As you arrive to work, a nurse from the previous shift tells you that she has completed thenarcotic count for your shift. What action should be taken?a.There is no need for any additional action as this is the standard procedure.

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b.Accept the keys to the narcotic cabinet and recount the drugs yourself.c.Recount the narcotics again with a nurse from the previous shift.d.Recount the drugs yourself at the end of your shift.ANS:CAt the end of each shift, the contents of the locked cabinet are counted together by one nursefrom each shift in order to verify the narcotics count. If not done properly, the nurse risksbeing held accountable for any shortages or discrepancies, and may be found guilty offalsifying the narcotic count records.DIF:Cognitive Level: ApplyingREF:p. 145.A one-time order for a controlled substance drug has been written for a patient you are caringfor. However, the drug ordered is available only in a larger dose than is needed. What shouldyou do with the remaining drug?a.Give the full dose that is available.b.Flush the remaining drug in the toilet of the patient’s bathroom.c.Save the remaining drug in case the patient needs it again.d.Have another nurse witness the wasting of the leftover drug, and documentaccording to policy.ANS:DIf the ordered dose is smaller than the dose provided (so that some drug must be discarded),two nurses witness the wasting of the drug and sign the controlled substance inventory reportaccording to institution policy.DIF:Cognitive Level: KnowingREF:p. 146.An elderly patient in an assisted living home requests an over-the-counter cough preparationfor a mild couch she is experiencing. What is your best response?a.“I do not have any of this drug for you at this time, but can give you a dose fromanother patient’s supply.”b.“I will bring it to you right away, but I must keep it with your other prescriptiondrugs.”c.“I will need to contact your healthcare provider for an order before I can give thisdrug to you.”d.“You may have this, but your family will need to bring it in for you.”ANS:COver-the-counter (OTC) drugs do not require a prescription for purchase, but a healthcareprovider’s order is required before it can be given by the LPN/LVN in an institutional setting.OTC drugs may interact with a patient’s prescribed drugs, especially in the elderly.DIF:Cognitive Level: ApplyingREF:p. 157.Which of the following orders is an example of a single drug order?a.Atenolol 50 mg orally dailyb.Morphine sulfate 4 mg IV statc.Cefazolin 1 g IV 8 a.m. before surgeryd.Tramadol 50 mg orally as needed for painANS:C

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A single drug order is a drug that is scheduled to be given at a specified time for one doseonly.DIF:Cognitive Level: KnowingREF:p. 168.Diphenhydramine 50 mg IV push is ordered by the healthcare provider to be given “stat.”When should this drug be given?a.Immediatelyb.As need upon the patient’s requestc.Within one hour of receiving the orderd.When you have completed giving the oral drugs firstANS:AAstatorder is a type of drug order that is to be given immediately.DIF:Cognitive Level: KnowingREF:p. 169.You are giving drugs to the patients assigned to you when you realize that you gave a drug tothe wrong patient. What action should you take?a.Evaluate the patient’s condition and notify the healthcare provider.b.Submit a report only if the patient has an adverse reaction.c.Inform the patient and complete an incident report.d.Document the occurrence in the patient record.ANS:AWhen it is discovered that an error has been made, you should immediately evaluate thepatient for any adverse reactions and notify the healthcare provider as soon as possible. Anincident report should be completed and the supervisor notified.DIF:Cognitive Level: ApplyingREF:p. 19MULTIPLE RESPONSE1.Which of the following drugs is considered a high-alert drug? (Select all that apply.)a.Percocetb.Insulinc.Heparind.Herceptine.Potassiumf.IndomethacinANS:B, C, ECategories of common high-alert drugs can be remembered using the acronym “PINCH.”Pisfor potassium,Iis for insulin,Nis for narcotics (opioids),Cis for cancer chemotherapy drugs,andHis for heparin or any drug type that interferes with blood clotting.DIF:Cognitive Level: RememberingREF:p. 19

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2.Which of the following actions should you take before you give a drug mixed into food or themixing of drugs with food or drink must be documented in the patients care plan, and on thedrug administration chart to address the legal aspects of this practice a drink? (Select all thatapply.)a.Check a drug handbook.b.Inform the patient or family.c.Inform the healthcare provider.d.Thoroughly crush pills with an enteric coating.e.Document the mixing of drugs in food or drink in the chart.f.Give the prescribed drug mixed in food during a regular patient meal.ANS:A, B, C, ECovert drug administration is discouraged. Therefore, nurses are under obligation to informthe healthcare provider, who ordered the drug, and the patient or family. Some drugs may notbe mixed with certain foods or drinks, or may not be crushed, so checking the drug handbookis a necessary step to ensure patient safety. The mixing of drugs with food or drink must bedocumented in the patients care plan, and on the drug administration chart to address the legalaspects of this practice.DIF:Cognitive Level: ApplyingREF:p. 123.Which steps should you take to identify possible drug errors in a patient’s drug orders? (Selectall that apply.)a.Call the pharmacy.b.Clarify anything that is unreadablec.Ask the patient about the drug.d.Reconcile the drug list with an old drug record.e.Clarify vague orders with the healthcare provider.f.Check the original written order with the healthcare provider.ANS:A, B, E, FChecking with a reliable source, such as the pharmacist, clarifying vague orders or anythingthat is difficult to read (if handwritten) and checking the originalwritten order are all ways toavoid drug errors.DIF:Cognitive Level: ApplyingREF:p. 174.Which levels of regulation must you adhere to when giving drugs to a patient? (Select all thatapply.)a.City Regulationsb.State Regulationsc.County Regulationsd.Federal Regulationse.Institutional Regulationsf.Health Insurance RegulationsANS:B, D, ENurses who areresponsible for giving drugs to patients in their care have three levels ofregulations to follow: federal (describes and controls), state (regulates who dispenses), andindividual hospital or agency (additional guidelines or policies).

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DIF:Cognitive Level: RememberingREF:pp. 14-165.A narcotic control system is used in any hospital or agency. Which of the following arespecial regulations applied for control of narcotics that you must follow? (Select all thatapply.)a.Narcotics are stored in a special locked cabinet.b.Narcotic control is the responsibility of everyone on the unit.c.Narcotics may be borrowed from patient to patient for emergency use.d.You may return unused narcotics to the patient’s family upon discharge.e.You are responsible for signing out every narcotic drug used for a patient.f.An inventory of the narcotics on a unit must be kept and verified by two nurses.ANS:A, E, FNarcotics are stored in special, limited-access, locked cabinets. A nurse records all controlledsubstance drug during the shift. The inventory report form is completed before the drug isremoved from the cabinet.DIF:Cognitive Level: ApplyingREF:pp. 12-136.A discrepancy in the narcotics inventory for morphine 5 mg/mL vials is discovered when thenarcotics count is performed. The count is short by one vial. Which of the following stepsshould you take to reconcile the count? (Select all that apply.)a.No action needs to be taken for small discrepancies.b.Notify the nursing supervisor and the pharmacy of the discrepancy.c.Identify if any nurse forgot to record any of the narcotics removed.d.Ask only the nurses who used narcotics about the drugs they have given.e.Check drug records to reconcile if narcotics given and not signed for.f.Notify the security department of the institution if drug diversion is suspected.ANS:B, C, E, FAll nurses must be asked about narcotics that may have been given. Steps must beretraced tosee if someone forgot to record any drug. Patient charts might also be checked to see if drugwas given that was not signed for on the inventory report. If errors in the report cannot befound, both the pharmacy and the nursing service office must be notified. If drug diversion issuspected, the hospital administrator and security police are usually contacted.DIF:Cognitive Level: ApplyingREF:pp. 12-14

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Chapter 03: Principles of PharmacologyVisovsky: Introduction to Clinical Pharmacology, 9th EditionMULTIPLE CHOICE1.Which is always true regarding the generic name for a drug?a.It is the same in any country.b.It is capitalized when written.c.It is similar to the chemical name.d.It is assigned by a specific manufacturer.ANS:AThe generic name is the common drug name used. This name is the same in all countries. Thegeneric drug name is written in lower-case letters, whereas the trade name or brand name of adrug is capitalized.DIF:Cognitive Level: RememberingREF:p. 232.What is the difference between the generic and the trade names of drugs?a.The generic name is approved and owned by the Federal Drug StandardsCommittee.b.The generic name represents the proprietary name given by a drug company.c.The trade name is one that is registered to a specific drug manufacturer.d.The trade name, or chemical name, represents the chemicals in the drug.ANS:CThe trade name is the proprietary or brand name for the drug, and is registered to a specificdrug company.DIF:Cognitive Level: RememberingREF:p. 233.Which statement is true about the way drugs and receptor sites work?a.The drug attaches to a receptor site and activates it.b.The drug prevents activation of the receptor site.c.The receptor site is activated, allowing DNA replication to occur.d.The receptor sites are activated once the drug leaves the receptor site.ANS:AThe drug attaches to the receptor site and activates the receptor.DIF:Cognitive Level: KnowingREF:p. 234.What response would you expect in a patient given a drug that is considered an antagonist?a.Positive and negative activation of cell receptorsb.A complete activation of cell receptorsc.A partial activation of cell receptorsd.No activation of cell receptorsANS:DWhen a drug attaches at a drug receptor site but does not activate or unlock it, there is noincrease in cell activity and the drug is an antagonist.

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DIF:Cognitive Level: KnowingREF:p. 245.A patient is given a drug that is a known agonist. How would you expect this drug to work?a.This drug works by attaching to the receptor site to activate it.b.This drug works by deactivation of all cellular receptor sites.c.This drug works to partially block receptor sites.d.This drug works by interacting with other drugs.ANS:AA drug agonist works by activating or unlocking receptors, and has the same actions as thebody’s own chemicals.DIF:Cognitive Level: KnowingREF:p. 246.You are giving an oral drug to a patient. For this drug to be utilized by the body, whichmechanism is the first to be involved in that process?a.Excretionb.Absorptionc.Metabolismd.DistributionANS:BAbsorption involves the way a drug enters the body and passes into the body and tissues. Drugabsorption is the first step and it takes place through the processes of diffusion, filtration, andosmosis.DIF:Cognitive Level: KnowingREF:p. 247.You are giving an oral drug to a patient who asks you to explain the reason for taking waterwith a tablet. What is your best response?a.“Water is important for proper metabolism.”b.“Juice or milk can keep it from dissolving.”c.“Water helps to dissolve the drug.”d.“Water keeps the drug potent.”ANS:CAll drugs must be dissolved in body fluid before they enter body tissues. When the patienttakes water with a tablet, it not only helps in swallowing but also helps dissolve the drug andincrease its solubility.DIF:Cognitive Level: UnderstandingREF:p. 248.Which drug route would you expect to be the most rapidly absorbed?a.Subcutaneous injectionb.Intravenous injectionc.Rectal suppositoryd.Sublingual tabletANS:BDrugs injected intravenously into the bloodstream have the fastest action.

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DIF:Cognitive Level: RememberingREF:p. 249.What is the process by which molecules move from a region of higher concentration to one oflower concentration?a.Diffusionb.Osmosisc.Filtrationd.SolubilityANS:AIn diffusion, molecules move from a region of higher concentration to one of lowerconcentration.DIF:Cognitive Level: RememberingREF:p. 2510.A 62-year old male patient with liver disease asks you why he is receiving a drugintravenously rather than by mouth. What is your best response?a.“Many oral drugs are inactivated as you get older.”b.“Your liver disease impairs the transformation of a drug into its active form.”c.“Intravenous drugs reduce toxicity to the liver through first-pass metabolism.”d.“Individuals with liver disease have a genetic impairment that prevents drugactivation.”ANS:BMany drugs must be activated by enzymes before they can be used in the body. Thisbiotransformation happens in the liver. Liver disease impairs this process.DIF:Cognitive Level: ApplyingREF:pp. 25-2611.A patient who is beginning a new cholesterol-lowering drug tells you he plans to take thisdrug in the evening with his usual glass of grapefruit juice. What is your best response?a.“The vitamin C in grapefruit juice enhances the action of cholesterol-loweringdrugs.”b.“The acid environment of grapefruit juice promotes drug metabolism.”c.“Taking grapefruit juice can reduce the effectiveness of the drug.”d.“Taking grapefruit juice can increase the absorption of the drug.”ANS:CGrapefruit juice affects (usually reduces) the absorption of many drugs such as antihistamines,cholesterol-lowering drugs, HIV drugs, and transplant drugs.DIF:Cognitive Level: ApplyingREF:p. 2612.You give a patient 400 mg of an oral drug at noon. This drug has a half-life of 2 h. At whattime will 100 mg remain?a.2:00 p.m.b.6:00 p.m.c.8:00 p.m.d.4:00 p.m.ANS:D

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With a half-life of 2 h, the amount of drug remaining in the blood decreases by 50% every 2 h.So, when 400 mg are given at noon, by 2:00 p.m., 200 mg remain; by 4:00 p.m., 100 mgremain.DIF:Cognitive Level: UnderstandingREF:p. 2613.When teaching a patient about a new drug that has been prescribed, the patient asks you toexplain the difference between a side effect and an adverse reaction. What is your bestresponse?a.Both side effects and adverse reactions are mild.b.Both side effects and adverse reactions are severe.c.Side effects are mild, and adverse effects are severe.d.Side effects are severe, and adverse reactions are mild.ANS:CSide effects are usually seen as mild but annoying responses to a drug. Adverse reactions, oradverse effects, usually imply more severe symptoms or problems that develop because of thedrug.DIF:Cognitive Level: ApplyingREF:p. 2714.A patient tells you that she is experiencing sleepiness after taking a drug prescribed for backpain. What is your best response?a.“You are having a severe drug interaction.”b.“You are having an expected drug side effect.”c.“You are having the desired effect of this drug.”d.“You are having an idiosyncratic response to this drug”.ANS:BDrugs may influence many body systems at the same time, so the effect of the drug is oftennot restricted to the desired action. Side effects are usually seen as mild but annoyingresponses to the drug. In the case of many drugs for pain, sleepiness is an expected side effect.DIF:Cognitive Level: ApplyingREF:p. 2715.A patient who was given intravenous penicillin for a severe infection develops hives, itching,and facial swelling immediately after the infusion. What type of drug reaction is this patientexperiencing?a.An adverse reactionb.A paradoxical reactionc.An anaphylactic reactiond.A hypersensitivity reactionANS:DSome drugs (sulfa products, aspirin, and penicillin) can produce allergic (hypersensitivity)reactions that usually occur when an individual has taken the drug and the body has developedantibodies to it.DIF:Cognitive Level: KnowingREF:p. 2716.What information should be included in the teaching plan for a young woman who has begunon a 10-day course of oral antibiotic therapy for an infection?

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