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Lehne's Pharmacology

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Lehne's Pharmacology

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1) A nurse is preparing to give an oral dose of drug X to treat a patient's high blood pressure. After giving the drug, the nurse finds that it reduces the blood pressure without serious harmful effects, but it also causes the patient to have nausea and a headache. Based on this information, which property of an ideal drug is this drug lacking?
  1. Effectiveness
  2. Safety
  3. Selectivity
    The drug is effective in lowering the blood pressure and safe in that it does not cause harmful effects. However, as do most drugs, it causes other effects besides the one response desired; therefore, it lacks selectivity. The oral form provides ease of administration.
  4. Ease of administration
2) The nurse is preparing to give a drug with certain properties. Which property of the drug is the most compelling indication that it should not be given?
  1. The drug produces an unwanted side effect.
  2. The drug is difficult to administer.
  3. The drug's effects are reversible.
  4. The drug is not effective for its intended purpose.
3) Why is it important for drugs to have ease of administration?
  1. Fewer administration errors
  2. Less risk of side effects
  3. Greater chemical stability
  4. Greater likelihood of reversibility
4) The nurse teaches a patient not to consume alcohol with nitroglycerin, because the blood pressure often drops significantly when nitroglycerin is taken with alcohol. Which drug property does this illustrate?
  1. Chemical instability
  2. Drug interaction
    When two or more drugs are taken together, they can interact, causing either increased or decreased drug responses. In this case, alcohol would increase the nitroglycerin response. Chemical instability, reversible action, and drug selectivity are not related to this situation.
  3. Reversible action
  4. Drug selectivity
5) When studying the impact a drug has on the body, the nurse is reviewing what?
  1. The drug's pharmacokinetics
  2. The drug's selectivity
  3. The drug's pharmacodynamics
  4. The drug's predictability
6) When studying the effects of drugs in humans, the nurse is learning about what?
  1. Pharmacology
    Clinical pharmacology is the study of the effects of drugs in humans. Pharmacology can be defined as the study of drugs and their interactions with living systems. Therapeutics, also known as pharmacotherapeutics, is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy. The term effectiveness indicates that the drug elicits the intended response or responses.
  2. Clinical pharmacology
    Clinical pharmacology is the study of the effects of drugs in humans. Pharmacology can be defined as the study of drugs and their interactions with living systems. Therapeutics, also known as pharmacotherapeutics, is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy. The term effectiveness indicates that the drug elicits the intended response or responses.
  3. Therapeutics
  4. Effectiveness
7) Which statement by a new nurse indicates that further study is indicated?
  1. Effectiveness is the most important property a drug can have.
  2. There is no such thing as a safe drug.
  3. Drugs are defined as illegal substances.
  4. There is no such thing as a selective drug; all medications cause side effects.
8) What is the ultimate concern for the nurse when administering a drug?
  1. Intensity of the response
  2. Dosage
  3. Route of administration
  4. Timing of administration
9) What is the objective of drug therapy?
  1. Provide maximum benefit with minimal harm
  2. Provide minimum benefit with maximum harm
  3. Provide total relief of symptoms regardless of harm
  4. Provide as much benefit as possible
10) The nurse is preparing to administer a dose of penicillin. Before administering the medication, the nurse assesses the patient's allergy history. Which aspect of drug therapy does this represent?
  1. Making PRN (as needed) decisions
  2. Evaluating therapeutic effects
  3. Ensuring proper dosage
  4. Identifying high-risk patients
11) The nurse is preparing to administer a medication with the following order: "Aldomet 250 mg daily." What should the nurse do?
  1. Administer the medication as it was given last time.
  2. Administer the medication by mouth.
  3. Verify the order with the prescriber.
  4. Ask the patient how this medication is usually given.
12) Which aspect of drug therapy indicates to the nurse whether a drug is having a beneficial effect?
  1. Performing a preadministration assessment
  2. Evaluating therapeutic responses
  3. Minimizing adverse effects
  4. Managing toxicity
13) The nurse is managing the care of a group of patients with cancer who will be receiving chemotherapy. The nurse defines goals, sets priorities, identifies interventions, and establishes criteria for evaluating success. Which phase of the nursing process does this represent?
  1. Assessment
  2. Planning
  3. Implementation
  4. Evaluation
14) he nurse identifies what as the goal of drug therapy in the treatment of patients?
  1. Cure of the disease
  2. Follow-up with the prescriber
  3. Correct administration technique
  4. Production of maximum benefit with minimum harm
15) A diabetic patient is taught the signs and symptoms of hypoglycemia with insulin use. The patient knows to eat fast-acting carbohydrates. This is an example of what goal?
  1. Minimizing adverse effects
  2. Promoting therapeutic effects
  3. Minimizing adverse interactions
  4. Managing toxicity
16) When questioning a patient about his or her allergic reaction to a drug, the nurse should ask for what additional information?
  1. The dose taken
  2. The type of reaction
  3. Who gave the drug
  4. What was eaten with the drug
17) Which legislation set rules for the manufacture and distribution of drugs considered to have the potential for abuse?
  1. Food, Drug, and Cosmetic Act of 1938
  2. Harris-Kefauver Amendments of 1962
  3. Controlled Substances Act of 1970
  4. Food and Drug Administration Modernization Act of 1997
18) What is a result of the Prescription Drug User Fee Act (PDUFA) of 1992?
  1. New drugs reach the market sooner than ever before.
  2. Controlled substances are categorized into schedules.
  3. Drugs for acquired immunodeficiency syndrome (AIDS) receive accelerated approval.
  4. More research is conducted on drug safety in children.
19) hich is a true statement about new drug development in the United States?
  1. Development and testing of new drugs take about 3 to 5 years.
  2. About 50% of drugs undergoing clinical trials gain approval.
  3. Randomized controlled trials are the best way to assess drug therapy.
  4. The cost of developing a new drug is usually around $1 million.
20) N-acetyl-para-aminophenol is an example of which type of drug name?
  1. Proprietary
  2. Chemical
  3. Generic
  4. Trade
21) A new medication becomes available for treatment of a debilitating neurologic disease. What would the nurse expect about the safety of the drug?
  1. The drug is safe for administration to children.
  2. The drug has been tested in pregnant women.
  3. All possible adverse effects have been identified by animal testing.
  4. The drug has passed the FDA approval process.
22) Why are trade names much easier to say and remember than generic names?
  1. The FDA assigns every drug's generic name.
  2. Trade names must be the same regardless of which drug company manufactures the drug.
  3. Companies have a marketing advantage when the trade name is easier to recognize.
  4. Trade names improve oral and written communication in the healthcare system.
23) Which term is commonly used for nonprescription drugs?
  1. Legend
  2. Generic
  3. Over-the-counter
  4. Pharmaceutical
24) A new graduate nurse preparing to administer medications knows that which of the following is required for a drug to move through the body?
  1. Selectivity and effectiveness
  2. The ability to cross membranes
  3. Development of an electric charge
  4. A transporter protein
25) The nurse is preparing to give a medication for pain. The label states that the drug is "lipid soluble." How soon should the nurse expect to observe the effects of the drug?
  1. Slowly
  2. Rapidly
  3. Unpredictably
  4. Variably
26) A nurse prepares to administer acetaminophen [Tylenol] to a patient with an oral temperature of 101.7°F. Which preparation would the nurse expect to have the most rapid onset of action?
  1. Tylenol elixir
  2. Tylenol tablets
  3. Tylenol capsules
  4. Tylenol gel caps
27) The nurse should provide which teaching point when administering an enteric-coated oral tablet to a patient?
  1. "Chew the tablet before swallowing."
  2. "Break the tablet in half before swallowing."
  3. "Allow the tablet to be absorbed under the tongue."
  4. "Swallow the tablet whole after double-checking the dose."
28) When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient?
  1. A 3-week-old neonate
  2. A 12-year-old boy
  3. A 25-year-old woman
  4. A 15-month-old infant
29) For which reason should the nurse follow safe medication administration for intravenous (IV) medications?
  1. The IV route can result in delayed absorption of the medication.
  2. The IV route results in a delayed onset of action.
  3. Control over the levels of drug in the body is unpredictable.
  4. IV administration is irreversible.
30) The nurse is preparing to administer an intravenous (IV) medication. What is the minimum injection time to reduce the risk of harm to the patient?
  1. 10 seconds
  2. 30 seconds
  3. 60 seconds
  4. 30 minutes
31) The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system, very little active drug is left in the general circulation as a result of what?
  1. Therapeutic range
  2. First-pass effect
  3. Drug half-life
  4. Plasma protein binding
32) The nurse should instruct a patient complaining of pain to do what to reduce fluctuations in drug levels?
  1. "Take pain medication around the clock at specified intervals and doses."
  2. "Take pain medication when the pain level reaches an 8 or 9 on a 1 to 10 scale."
  3. "Take pain medication at night before bed and avoid daytime dosing because of drowsiness."
  4. "Take pain medication after breakfast and dinner to reduce stomach upset."
33) .
  1. The nurse understands that the dose-response relationship is graded and should expect to observe what response?
  2. Once a drug is given, the response is predictably all-or-nothing.
  3. The response is maintained at a specific level when the therapeutic objective is achieved.
  4. As the dosage increases, the response becomes progressively greater.
34) The nurse demonstrates the concept of maximal efficacy by administering which drug for a headache that the patient describes as a "mild dullness" and as a 2 on a 1 to 10 scale?
  1. Meperidine [Demerol]
  2. Pentazocine [Talwin]
  3. Aspirin
  4. Morphine sulfate
35) Which statement by the nursing student indicates a need for further instruction about drug selectivity?
  1. "Botulinum toxin is very selective and therefore very safe for administration."
  2. "Selective drug action is made possible by many types of receptors in the body."
  3. "The more selective a drug is, the fewer side effects it will produce."
  4. "Even though a drug is selective, it can produce nonselective results."
36) Which drug property is most enhanced by the presence of many different types of receptors throughout the body?
  1. Potency
  2. Safety
  3. Selectivity
  4. Convenience
37) The drug dobutamine acts as an agonist of norepinephrine (NE) receptors. Which effect is the nurse most likely to observe in a patient receiving this medication?
  1. Increased heart rate
  2. Atrioventricular heart block
  3. Sinus bradycardia
  4. Reduced cardiac output
38) The nurse prepares to give a drug that will prevent receptor activation. Which term would describe this drug?
  1. Antagonist
    An antagonist is a drug that prevents receptor activation. An agonist is a molecule that activates receptors. A selective drug has only the desired response but may not activate receptors. A potent drug requires a lower dose to achieve its effect.
  2. Selective
  3. Agonist
    An antagonist is a drug that prevents receptor activation. An agonist is a molecule that activates receptors. A selective drug has only the desired response but may not activate receptors. A potent drug requires a lower dose to achieve its effect.
  4. Potent
39) Why does the nurse administer naloxone to a patient receiving morphine sulfate who has a respiratory rate of 8 breaths per minute?
  1. Naloxone causes hypersensitivity of the opioid receptors.
  2. Naloxone prevents the activation of opioid receptors.
  3. Naloxone is a partial agonist, requiring a lesser dose to achieve pain relief.
  4. Naloxone is an agonist, leading to desensitization of the opioid receptors.
40) Why does the nurse monitor the patient closely when administering a drug with a low therapeutic index?
  1. The average lethal dose of the drug is much higher than the therapeutic dose.
  2. The dose required to produce a therapeutic response in 50% of patients is low.
  3. The highest dose needed to produce a therapeutic effect is close to the lethal dose.
  4. There is a low variability of responses to this drug.
41) The nursing student learns that not all drugs produce effects binding to a receptor. Which drugs do not act through receptors?
  1. Antacids
  2. Analgesics
  3. Antihistamines
  4. Steroid hormones
42) The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug?
  1. It is very potent.
  2. It has a low efficacy.
  3. It is probably lethal.
  4. It is relatively safe.
43) Which response would the nurse anticipate when giving two drugs that have a potentiative effect, such as meperidine and Phenergan?
  1. increased pain relief
  2. Increased nausea and vomiting
  3. Decreased itching
  4. Increased alertness
44) The nurse is concerned with minimizing adverse drug-drug interactions for the patient. Which drug characteristic could result in the most serious consequences from a drug-drug interaction?
  1. Low therapeutic range
  2. High biologic half-life
  3. Low potency
  4. First-pass effect
45) The nurse is teaching a patient prescribed felodipine (Plendil) for the treatment of hypertension. Which statement is the most appropriate for the nurse to include in the teaching session?
  1. "Avoid grapefruit juice while you are taking this medication."
  2. "Do not eat foods high in tyramine such as aged cheese."
  3. "Herbal agents can help this drug work more effectively."
  4. "This drug is free of dangerous drug interactions."
46) Before administrating the dosage of a prescribed medication, the nurse observes precipitation formation of the intravenous (IV) solution. What is the priority nursing action?
  1. Verify the prescription.
  2. Discard the IV solution.
  3. Prepare another dose to administer.
  4. Check the expiration date of the drug.
47) The nurse reviews all of the patient's prescriptions. Which prescribed medications may cause a detrimental potentiative drug interaction?
  1. Aspirin and warfarin
  2. Sulbactam and ampicillin
  3. Propranolol and albuterol
  4. Isoniazid and rifampin
48) The nurse is caring for a patient who is experiencing a respiratory rate of 6 breaths per minute as a result of a large dose of pain medication. Which term most accurately describes this reaction?
  1. Side effect
  2. Toxicity
    Toxicity is the degree of detrimental physiologic effects caused by excessive drug dosing. A side effect is a nearly unavoidable secondary drug effect produced at a therapeutic dose. An allergic reaction is an immune response. An idiosyncratic effect is an uncommon drug response resulting from a genetic predisposition.
  3. Allergic reaction
  4. Idiosyncratic effect
49) The nurse is reviewing the laboratory value for a patient prescribed atorvastatin [Lipitor]. Which laboratory value is most useful for monitoring this drug?
  1. Aspartate aminotransferase (AST)
  2. Blood urea nitrogen (BUN)
  3. International normalized ratio (INR)
  4. C-reactive protein (CRP)
50) The nurse is monitoring for adverse drug reactions (ADRs) of assigned patients. Which patient is most at risk for the development of drug toxicity?
  1. A 30-year-old man admitted for altered mental status
  2. A 55-year-old woman with abnormal arterial blood gas values
  3. A 70-year-old woman with an elevated creatinine level
  4. A laboring 25-year-old woman with a positive Homans' sign
51) The nurse is preparing a staff education inservice about specific safety measures that reduce patient medication errors. Which measure improves safety for patients during care transition?
  1. Medication reconciliation
  2. MEDWATCH program
  3. Risk Evaluation and Mitigation Strategy
  4. Regional Medication Safety Program
52) Which nursing action results in the most common cause of fatal medication errors?
  1. Miscalculation of dosage
  2. Miscommunication of drug orders
  3. Misreads the healthcare provider's handwriting
  4. Administers a drug intravenously (IV) instead of intramuscular (IM)
53) The nurse is caring for a 12-year-old boy who weighs 72 pounds. The healthcare provider should make the most precise dosage adjustments for this patient's medications based on what?
  1. Body surface area
  2. Body mass index
  3. Body weight
  4. Body fat percentage
54) The healthcare provider prescribes a medication that is renally eliminated for a patient with acute renal failure. The nurse recognizes the patient is at risk for which altered drug response?
  1. Increased drug excretion
  2. Decreased drug levels in the blood
  3. Development of drug toxicity
  4. Increased tolerance to the medication
55) A nursing student is caring for a patient who has been taking morphine sulfate for pain for 2 weeks. The nursing student shows an understanding of pharmacodynamic tolerance by describing it to the instructor in what way?
  1. "It is a form of tolerance that is a reduction in drug responsiveness brought on by repeated dosing over a short period."
  2. "It affects the minimum effective concentration."
  3. "It is a drug response caused by psychologic factors, not by biochemical or physiological properties."
  4. "It is a condition in which the patient requires increased doses of morphine sulfate to achieve pain relief."
56) The nurse is caring for a group of female patients receiving medication therapy. Which factor is of greatest concern with regard to drug therapy in these patients?
  1. Most drug research has been carried out exclusively in male subjects.
  2. Hormonal differences make managing drug therapy more difficult in most women.
  3. Overall, women tend to be less compliant with medication therapy.
  4. Women tend to be caregivers and may not take time to care for themselves.
57) Which test is most affected when a patient is taking warfarin?
  1. Prothrombin time
    Prothrombin time is a blood test that measures the time it takes for the plasma in blood to clot. A patient on an anticoagulant medication would have a prolonged prothrombin time because anticoagulants slow blood clotting.
  2. Red blood cell count
  3. White blood cell count
  4. Hematocrit
58) A patient has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing?
  1. An idiosyncratic drug effect on the bone marrow
  2. Iatrogenic disease of the kidneys
  3. Drug toxicity of the liver
  4. An allergic reaction
59) The drug the nurse is about to give induces P-glycoprotein (PGP). What outcome should the nurse expect when this drug is given with other drugs?
  1. Increased levels of other drugs
  2. Increased side effects of other drugs
  3. Reduced absorption of other drugs
  4. Reduced drug elimination

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