pharm exam 1 prep u questions

A nurse is teaching the client about the use of over-the-counter (OTC) drugs. Which statement best informs the client about their safe use?

"OTC drugs need to be taken with caution; they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.}

-A person can be allergic to any medication at any time. -Medications can react with over-the-counter medications to cause toxicity. -Medications can react with herbal supplements to cause adverse reactions. -Medications can react with other medications prescribed for the client.

The actual concentration that a drug reaches in the body involves which processes? (Select all that apply.)

-absorption from the site of entry -distribution to the active site -biotransformation in the liver -excretion from the body

The nurse is preparing to give an older adult client an IM injection. How will this client's history of heart failure affect the administration of this medication? (Select all that apply.)

-decreased absorption of the medication -abnormal blood concentrations of the medication

When a drug is discontinued, what percentage of that drug will remain in the body after three half-lives?

12.5%

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

The nurse is administering a drug to a client that has a half-life of approximately 36 hours. The nurse knows that this drug will be administered every:

24 hr

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

31 mg

Which statement best defines how a chemical becomes a drug?

A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.

What client is most likely to have impaired drug metabolism?

A client who has a diagnosis of hepatitis c

Which client is most likely to experience the benefits of the the placebo effect?

A client with an infection who states, "I know this antibiotic is going to work for me

A drug has been approved by the Food and Drug Administration. What study phase would occur next?

A drug has been approved by the Food and Drug Administration. What study phase would occur next?

teratogenic drugs

A teratogen is an agent that can disturb the development of the embryo or fetus. Teratogens halt the pregnancy or produce a congenital malformation (a birth defect). include ACE (angiotensin converting enzyme) inhibitors

Which factor should the nurse take into account when administering medications to older adults on the unit?

As a result of age-related changes, older adults face an increased risk of adverse medication effects.

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult?

Drug clearance is likely to be slower

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?

Elevated aspartate aminotransferase (AST) level

Genetic engineering allows scientists to produce human insulin by altering which type of bacteria?

Escherichia coli

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?

Excretion is likely to take place slowly

one of the phases of drug development is the post-marketing surveillance phase. Which activity is carried out during this phase?

Health care providers report adverse effects to FDA.

The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time?

Hydromorphone (Dilaudid) for pain

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice?

Integrating the new drug into the client's existing schedule promotes adherence

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic

A client diagnosed with diabetes mellitus has been started on insulin therapy to control glucose levels. The client does not want to take any medications that come from an animal source. What is the best response by the nurse?

Many forms of insulin, such as genetically engineered, do not use animal products.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values

A client in the ambulatory care clinic is experiencing shortness of breath and facial and throat edema while receiving a pegloticase infusion. What is the nurse's best action?

Notify emergency personnel.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

Stevens-Johnson syndrome

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

Teratogenicity

The nurse is reviewing a prescription for a medication with a client. On the prescription, the nurse read "DAW." What should the nurse teach the client?

The brand name of the drug must be dispensed.

What is the expected therapeutic outcome of the simultaneous administration of two medications?

The combined effects are greater than the effects of either one of the drugs alone

The nurse educates an older adult about the seven prescribed medications to prevent medication-related reactions and adverse effects. Which client statement indicates the need for further clarification?

The dietary supplement I used to take before admission to the hospital is all right to restart."

A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the health care provider prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission?

The laxatives can interact with and complicate prescribed drug therapy

What statement should the nurse include in a discussion to a community group about patent drugs?

The patent prevents other drug manufacturers from making or selling that drug

A nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose?

We want to make sure you get the benefits of the drug as quickly as possible.

A client is administered an oral contraceptive. What is the process that occurs between the time the drug enters the body and the time it enters the bloodstream?

absorbtion

A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics?

absorption

The nurse is explaining the pharmacokinetics of a drug being administered to a client. What is meant by the term "pharmakokinetics?"

actions of drugs

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply

all 3 answers- skeletal and limb abnormalities central nervous system alterations heart defects

After reviewing class material about the natural sources of drugs, the students demonstrate understanding of the material when they identify which as an example of a drug that is derived from inorganic compounds?

aluminum hydroxide

an elderly postsurgical client has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which medication that the nurse will administer has the slowest absorption?

an oral antidepressant that the client has been taking daily for several years

The nurse would assess a client receiving which medication for possible superinfection?

antibiotics

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should:

assess for factors that may reduce absorption

The nurse administers a medication to the client that induces the secondary action of hypoglycemia. What organ will be most acutely affected by inadequate circulating glucose?

brain

What information from the Kardex is likely to have the greatest implication in educating the client about antihistamine administration?

clients profession

A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by:

consulting a drug guide for compatibility.

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus

A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to

decreased blood flow to tissues and muscles

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate.

A 38-year-old client is obese and has abscesses around the inner thigh muscles. The client is receiving IV antibiotics, but no improvement has been seen. The client questions the nurse about the most likely cause for the drug therapy failure. The nurse explains that the:

distribution of the drug to the area of the abscesses is impaired

A client's most recent laboratory result indicate an elevated potassium level. What drug in this client's medication regimen should the care team consider discontinuing?

diuretic

Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?

epinephrine

A nurse has been administering a drug to a client intramuscularly (IM). The health care provider discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to:

first-pass effect.

client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of:

first-pass effect.

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:

grapefruit

Drugs injected intravenously (IV) reach their full strength in which timeframe?

immediatly

A drug is 100% bioavailable when it is administered by what routes?

intravenous

What drug administration route should be used to assure the best bioavailability as any particular drug?

intravenous

A client has been brought to the emergency department (ED) following a cold water incident. Which would be a potential effect of medication absorption from this clinical manifestation?

less than therapeutic effect

Which body organ is the most important site of biotransformation?

liver

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?

measures to alleviate any discomfort associated with adverse effects

What is the most frequently used drug administration route in clinical practice?

oral

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

ototoxicity from the ibuprofen

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisioning

A nurse is caring for an 81-year-old client in a long-term care facility who takes nine different medications each day. The client has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the client is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to:

polypharmacy decreasing the number of available protein-binding sites.

The nurse administers a loop diuretic to the client. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?

potassium

A client will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During client education about drug regimen, the nurse should prioritize teaching about:

potential adverse effects of the drugs that the client will be taking

After teaching a group of nursing students about drug classes and categories, the instructor determines that the teaching was successful when the students identify legend drugs as referred to as which medication?

prescription drugs

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity?

reduced efficiency of renal function

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

Penicillin causes bacterial cell death without disrupting normal human cell functioning. This is an example of:

selective toxicity.

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention?

serum drug level monitoring

The nurse is assessing a client who may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis?

shortness of breath

The nurse is administering medications and knows that there is a longer distribution time when the drug is intended for what area?

skin

How is pharmacodynamics best defined?

the action that the drug has on body cells

What is the relation between the activity level of older adults and the response to medication?

the older adult who is more physically active is less likely to have an adverse drug effect.

After teaching a group of students about the sources of drugs, the instructor determines that the students need additional teaching when they identify what as an example of a drug from a plant source?

thyroid hormone