ATI Pharmacology Made Easy 4.0 ~ Introduction to Pharmacology

A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A. Adverse effect B. Paradoxical effect C. Therapeutic effect D. Toxicity

A. Adverse effect Rationale: A. Adverse effects are the unintended and unexpected effects of a drug, which can range from mildly annoying to life-threatening, such as an anaphylactic reaction. B. Paradoxical effects are the opposite of the intended or desired effect of a drug, such as a drug intended to aid with sedation causing increased excitability in certain clients. C. A therapeutic effect is the intended benefit of the drug for the client. D. Toxicity occurs when the client receives a drug in excessive dosages. Manifestations of toxicity differ between drugs.

A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (Select all that apply.) A. Periodic laboratory tests are essential to measure serum drug levels. B. Monitoring for indications of toxicity is important. C. Taking the drug with an inducing agent will increase the possibility of toxicity. D. Taking the smallest effective dose is crucial. E. Increasing fluid intake is recommended to avoid toxicity.

A. Periodic laboratory tests are essential to measure serum drug levels. B. Monitoring for indications of toxicity is important. D. Taking the smallest effective dose is crucial. Rationale: A. Clients who are taking drugs that have a high potential for toxicity should undergo regular monitoring of serum drug levels to be certain the drug level stays within the therapeutic range. B. Drugs that have a high potential for toxicity can quickly build up to toxic levels in the blood, resulting in effects that can be irreversible or life-threatening. Therefore, the nurse should monitor for manifestations of toxicity particular to the drug the client is taking. C. Inducing agents are drugs that have the effect of increasing the metabolism of drugs they are combined with, thereby reducing their efficacy and blood levels. Inducing agents can be prescribed to allow clients to take a lower dose of a drug, so the chances of drug toxicity are lessened. D. It is optimal to use the lowest effective dose of a drug to achieve therapeutic effects because doing so helps minimize the risk for toxicity. E. Increasing fluids will not reduce the risk for drug toxicity. Increasing fluids can change the urine's specific gravity, but it will not alter glomerular filtration, passive tubular reabsorption, or active tubular secretion, which are the three mechanisms by which drugs are excreted renally.

A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A. Pharmacologic action B. Chemical stability C. Route D. Adverse effects

A. Pharmacologic action Rationale: A. The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action. B. The nurse should identify that knowledge of how a drug should be stored and handled to maintain maximum effectiveness is referred to as chemical stability. C. The nurse should identify that route refers to the method of administering the drug, such as oral, topical, or parenterally. D. The nurse should identify that adverse effects refer to the unintended and undesired effects that drugs have on the body, which can range from annoying to life-threatening.

A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (Select all that apply.) A. The newborn's weight B. How much breast milk the newborn consumes each day C. Whether or not the benefits to the client outweigh the risks to the newborn D. The properties of the drug E. The route of administration of the drug

A. The newborn's weight B. How much breast milk the newborn consumes each day C. Whether or not the benefits to the client outweigh the risks to the newborn D. The properties of the drug Rationale: A. The nurse should consider the weight of the newborn when recommending a drug for a client who is breastfeeding. The lower the newborn's weight, the greater the effects of the drug absorbed via breast milk will be to the newborn. B. The nurse should consider the amount of breast milk the newborn consumes per day when recommending a drug for a client who is breastfeeding. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation. C. The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn. D. The nurse should consider the properties of the drug when recommending a drug for a client who is breastfeeding. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility. E. Over-the-counter drugs are available in various enteral and topical forms. Any drug, regardless of route, that has the potential for systemic absorption poses a potential risk to a newborn who is being breastfed.

A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all that apply.) A. They do not require the supervision of a nurse. B. They can interact with other drugs. C. They should be included in the client's drug history assessment. D. They are less effective than prescription drugs. E. They do not cause toxicity.

A. They do not require the supervision of a nurse. B. They can interact with other drugs. C. They should be included in the client's drug history assessment. Rationale: A. Over-the-counter drugs do not require a prescription or the supervision of a nurse. B. Many over-the-counter drugs interact with other drugs. C. Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies. D. Over-the-counter drugs can be as effective as prescription drugs. This varies with the individual client and drug. E. Over-the-counter drugs can cause toxicity in clients who have certain conditions or if clients take them in excess.

A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? A. Tolerance to the drug B. Drug interaction C. Drug toxicity D. Dependence on the drug

C. Drug toxicity Rationale: A. Tolerance to a drug develops when it is taken over an extended period of time and the body's response to the same dose of the drug decreases. B. A drug interaction occurs when a client is taking two or more drugs together, and it results in an increase or decrease in therapeutic effects or causes adverse drug interactions that could result in harm to the client. C. Drug toxicity develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. A client who has renal insufficiency might have delayed or impaired excretion of the drug. The drug dosage should be reduced if toxicity occurs. D. Dependence on a drug can develop when a client takes a drug over an extended period of time. If the client is dependent on the drug, withdrawal symptoms can occur when it is abruptly discontinued. Withdrawal is also called abstinence syndrome, and it can cause sweating, tremors, and nausea.

A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons? A. The IV form crosses the blood-brain barrier. B. The oral form has a decreased half-life. C. The oral form has decreased bioavailability because of the first-pass effect. D. The oral form has an increased rate of excretion.

C. The oral form has decreased bioavailability because of the first-pass effect. Rationale: A. This is not the reason why the oral dose is higher than the IV dose for nitroglycerin. Both the IV and oral forms of nitroglycerin, a lipid-soluble drug, can cross the blood-brain barrier. B. This is not the reason why the oral dose is higher than the IV dose for nitroglycerin. The method of administration does not affect the half-life of a drug, which is the amount of time it takes for the body to eliminate half of the drug. C. Oral doses are often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug. Enzymes in the liver metabolize drugs, making less of the drug available for use by the body. D. This is not the reason why the oral dose is higher than the IV dose for nitroglycerin. The rate of excretion of IV and oral drugs are generally the same.

A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching? A. "Adverse effects are the intended effects of the medication." B. "Adverse effects indicate a severe allergy to the medication." C. "Decrease your medication dose if adverse effects occur." D. "Contact your provider if adverse effects occur."

D. "Contact your provider if adverse effects occur." Rationale: A. An adverse effect is an unexpected or unintended effect of a drug, which can range from annoying to life-threatening. B. Adverse effects are a result of the drug's unintended or undesired effect on the body, but they do not always indicate an allergy to the drug. Clients might experience minor and annoying adverse effects, such as nausea or headache, without being allergic to the drug. C. Adverse effects can occur at therapeutic dose levels. The client should not decrease dosage without consulting their provider. D. Adverse effects can be severe and life-threatening. The client should contact their provider if adverse effects occur.

A nurse is caring for a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A. "This will increase the effects of normal cellular functions." B. "This prevents cells in your body from performing certain actions." C. "This prevents hormones in your body from attaching to cell receptor sites." D. "This minimizes the risk that the medications you take will become toxic."

A. "This will increase the effects of normal cellular functions." Rationale: A. Agonist drugs bind to cell receptors in the body and are targeted to a specific type of receptor. When they attach to the receptors, they perform the same action as a hormone or chemical would, increasing the effects of that hormone or chemical. For example, pharmacological insulin is administered to clients who have little to no insulin to mimic insulin's effects in the body. B. Antagonists are drugs that bind with a receptor and either block a response or precipitate a less than typical response. C. Competitive antagonists are drugs that bind with a receptor and prevent other drugs or chemicals in the body from attaching to cell receptors, which means they prevent or minimize certain effects. D. Agonist drugs do not affect the risk for toxicity of other drugs. They might produce undesirable effects if they are too effective, such as when a drug given to treat bradycardia increases the client's heart rate to the point of tachycardia.

A nurse is taking care of a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply.) A. Clients can achieve desired effects with the use of lower dosages. B. Taking the two drugs together can reduce the effects of one or both drugs. C. Taking the two drugs together can potentiate the effects of one or both drugs. D. The two drugs can produce an action neither would have produced alone. E. Both drugs have similar actions.

A. Clients can achieve desired effects with the use of lower dosages. E. Both drugs have similar actions. Rationale: A. When two or more drugs are given at the same time and have similar actions, an additive effect will occur. Clients can take some drugs together for their additive effects, so they can take lower doses of each drug. B. Drugs that interact together to cause reduced effects are antagonistic. C. Drugs that interact together to cause greatly increased effects are synergistic. D. Two drugs given together can produce a unique effect neither would have produced when taken alone. However, this is not an additive effect. E. Additive effects occur when two or more drugs with similar actions are taken at the same time.

A nurse is preparing to teach a client how to care for a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? A. Impaired cognitive level B. Language barrier C. Discomfort D. Repetition of teaching E. Unreadiness to learn

A. Impaired cognitive level B. Language barrier C. Discomfort E. Unreadiness to learn Rationale: A. A lack of understanding due to impaired cognitive and developmental levels can decrease the client's ability to learn. The nurse should adjust instructional methods to accommodate the client's developmental or cognitive level. B. If the nurse and the client speak different languages, this can affect the client's ability to learn. The nurse should provide written information in the language the client speaks and make arrangements for finding an interpreter if necessary. C. A client who is uncomfortable is not able to learn optimally. The nurse should ensure that the client is comfortable prior to giving instructions. D. Repeating important facts frequently and allowing clients to practice new skills often enhances learning. E. A client's readiness to learn is an essential part of the client's ability to learn. For example, a client who is experiencing denial or distress is not ready to learn.

When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for the drug in which of the following ways? A. It begins with a lower-case letter. B. It is listed in parentheses along with the trade name. C. There are both letters and numbers in the name. D. The chemical name is listed in parentheses before the generic name.

A. It begins with a lower-case letter. Rationale: A. Generic names are not capitalized. The brand, or trade name, is a drug's commercial name and is capitalized. B. Trade names, not generic names, are placed in parentheses. C. Letters and numbers are part of the chemical identifier of a drug, which relates to its chemical makeup, and are not found in the generic name. D. Drugs are rarely listed by their chemical name. Trade names, not chemical names, are placed in parentheses.

A nurse is caring for a client who arrived at the emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (Select all that apply.) A. Low blood pressure B. Wheezing C. Bradycardia D. Peripheral edema E. Difficulty swallowing

A. Low blood pressure B. Wheezing E. Difficulty swallowing Rationale: A. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. B. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Wheezing is an indication of bronchospasm and is treated using bronchodilators. C. Tachycardia, rather than bradycardia, is an indication of anaphylaxis. D. Angioedema, or facial swelling, rather than peripheral edema, is an indication of anaphylaxis. E. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.

A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? A. Therapeutic effect B. Adverse reaction C. Contraindication D. Precaution

A. Therapeutic effect Rationale: A. Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia. B. An adverse reaction is an unexpected or dangerous result of using a drug. C. A contraindication is a reason that a drug is withheld for a client due to the risk for causing harm. Contraindications are usually related to pre-existing client conditions, such as allergies, diseases, or organ failure. D. Precautions are noted prior to administering a drug and indicate a need to implement closer monitoring after drug administration or the need to give a reduced dose.

The nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? A. They have similar mechanisms of actions. B. They have the same half-life. C. They are administered by the same route. D. They have similar availability.

A. They have similar mechanisms of actions. Rationale: A. Drugs in the same class often share similar mechanisms of action, as well as assessment guidelines, interactions, and precautions. B. Drugs in the same class do not necessarily have the same half-life. C. Drugs in the same class are not necessarily administered by the same route. D. Drugs in the same class do not necessarily have the same availability.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? A. Adverse effects B. Contraindications C. Implementation D. Black box warning

B. Contraindications Rationale: A. The nurse should review the adverse effects and side effects section in the drug handbook to review possible reactions the client might experience while taking the drug. B. The nurse should review the contraindications section in the drug handbook to determine if a client can receive the drug. This section lists pre-existing diseases or clinical situations that could make it unsafe to administer a drug. C. The nurse should review the implementation section of the drug handbook to review specific nursing considerations when administering the drug. D. The nurse should review the black box warning section of the drug handbook to find alerts and information about severe adverse effects associated with a drug and ways to reduce harm to the client.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? A. Adverse effects B. Indications C. Pharmacokinetics D. Nursing implications

B. Indications Rationale: A. This section categorizes the adverse effects of a drug. B. The indications section provides information on conditions and diseases for which the drug is used. C. The pharmacokinetics section outlines how the drug is processed in the body through absorption, distribution, metabolism, and excretion, but it does not address the disease or conditions that the drug is used to treat. D. The nursing implications section explains how the nurse will apply the nursing process to the use of the drug.

A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? A. Contraindications B. Precautions C. Paradoxical effects D. Adverse effects

B. Precautions Rationale: A. Contraindications are pre-existing disease states or clinical situations that make a drug unsafe for a client to take. B. A precaution includes disease states, such as kidney disease, or clinical situations in which use of a drug involves particular risks or dosage modification might be necessary. C. Paradoxical effects are the opposite of the intended or desired effect of a drug, such as a drug intended to aid with sedation causing increased excitability in certain clients. D. An adverse effect is an unexpected or unintended effect of a drug, which can range from annoying to life-threatening.

A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? A. To determine drug-food interactions B. To determine if dosage modification is indicated C. To determine how the drug is absorbed D. To determine availability

B. To determine if dosage modification is indicated Rationale: A. The interactions section lists interactions the drug might have with other drugs, foods, or herbal remedies. B. The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age. C. Drug absorption is included in the pharmacokinetics section of the handbook. D. Formulations available are listed in a separate section and can be found on the Food and Drug Administration's website. Availability, including the strength and concentrations of dosage forms, is not relevant to client education.

A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? A. "Itching is an expected adverse effect of amoxicillin." B. "Itching can indicate amoxicillin toxicity." C. "Itching can indicate a hypersensitivity to amoxicillin." D. "Itching can result from dry skin, which is often caused by amoxicillin."

C. "Itching can indicate a hypersensitivity to amoxicillin." Rationale: A. Itching is not an expected adverse effect of amoxicillin. B. Itching does not indicate amoxicillin toxicity. C. Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillins. D. Dry skin is not an adverse effect of amoxicillin.

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? A. Liquid suspension B. Immediate-release capsule C. Extended-release tablet D. Powder form

C. Extended-release tablet Rationale: A. Absorption is rapid for drugs in a liquid form. Clients must take them at relatively frequent intervals. B. Absorption is rapid for drugs in an immediate-release form. Clients must take them at relatively frequent intervals. C. Extended-release tablets release the drug over an extended period of time. Clients can take them less frequently. D. Absorption is rapid for drugs in a powder form. Clients must take them at relatively frequent intervals.

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? A. "Drug absorption occurs in the stomach." B. "You should expect immediate absorption of the drug." C. "You should allow the tablet to dissolve in your mouth." D. "Do not crush or chew the tablet."

D. "Do not crush or chew the tablet." Rationale: A. Enteric-coated tablets are absorbed in the small intestine. B. Enteric coating slows the absorption of the drug. C. Dissolving an enteric-coated tablet in the mouth destroys its protective coating. D. Drugs that irritate the stomach are often covered with an enteric coating that does not dissolve until the drug enters the alkaline environment of the small intestine. Clients should not crush or chew enteric-coated drugs because this will damage the enteric coating.

A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? A. After the client has a definitive diagnosis B. On the day of discharge C. When the client's family members are present D. As soon as possible

D. As soon as possible Rationale: A. Instruction should begin before confirmation of the diagnosis. B. Instruction should begin before discharge to maximize the chance for the client to learn. C. Family members can participate, but the nurse should not delay instruction until family members arrive. D. Instruction should start at the beginning of care and when the client is receptive to learning.

A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following? A. Reduced drug absorption B. Drug dependence C. Altered drug distribution D. Drug toxicity

D. Drug toxicity Rationale: A. Grapefruit juice can increase the amount of the drug available for absorption. B. Drug dependence occurs when a client takes a drug over a period of time and develops a physiological and psychological dependence on it. Grapefruit juice should not affect a client's dependence on a drug. C. Distribution refers to the movement of a drug to the site of action. Grapefruit juice should not affect the distribution of a drug. D. Grapefruit juice can cause increased levels of certain drugs, such as sertraline, which can lead to drug toxicity. Clients should avoid drinking grapefruit juice while taking these drugs.

A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? A. Maternal bleeding B. Maternal blood clots C. Gestational diabetes mellitus D. Fetal malformation

D. Fetal malformation Rationale: A. Teratogenic drugs do not cause maternal bleeding. Anticoagulants can cause this effect. B. Teratogenic drugs do not cause maternal blood clots. Various hormonal preparations can increase the risk of this adverse effect. C. Teratogenic drugs do not cause gestational diabetes mellitus. Hormones produced during pregnancy can block the action of insulin, causing gestational diabetes mellitus. D. Teratogenic drugs can cause birth defects. Clients who are pregnant should not take these drugs.