Chapter 4

A client tells a nurse that he is on many medications and asks how they all get to the right places. What are the best responses by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - "It depends on how much protein you have in your body." - "It depends on the health of your kidneys." - "It depends on whether they are fat based or water based." - "It depends on the amount of blood flow to your body tissues." - "It depends on the health of your liver."

"It depends on how much protein you have in your body." "It depends on whether they are fat based or water based." "It depends on the amount of blood flow to your body tissues."

A client asks a nurse how medications are distributed within the body. What among the below would be the nurse's response? - "The blood-brain barrier inhibits rapid crossing of all medications." - "Body organs with high levels of blood flow are more difficult organs to which to deliver drugs." - "Medications that are lipid-soluble are more completely distributed." - "Drug-protein complexes must form prior to crossing capillary membranes."

"Medications that are lipid-soluble are more completely distributed."

Prior to administering a newly prescribed antibiotic, a nurse asks a client if any other drugs have been taken today. The patient responds, "Why do you need to know?" Which of the below indicate nursing responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - "I need to be certain you are not taking another antibiotic." - "Some drugs block the action of others." - "Some drugs increase the activity of other drugs." - "The antibiotic I am about to give you is a prodrug." - "We don't want to increase first-pass effect."

"Some drugs block the action of others." "Some drugs increase the activity of other drugs."

A client is receiving lithium (Eskalith) and asks the nurse why their blood has to be drawn so often. What is the best response by the nurse? - "To detect side effects before they become a problem." - "To be sure the medication is working properly." - "To determine if your body is responding as it should." - "To be sure you have the correct amount of medication in your system."

"To be sure you have the correct amount of medication in your system."

A client prescribed a loading dose to be followed by a lower maintenance dose asks the nurse why the maintenance dose is lower. Which response should the nurse provide the client? - "The initial dose shortens the half-life, so the medication would work more quickly." - "We always give medications this way; the healthcare provider did not make a mistake." - "You had a larger dose initially so that the medication would work more quickly." - "Giving a larger dose initially will reduce the chance of side effects."

"You had a larger dose initially so that the medication would work more quickly."

A nurse is teaching a client the importance of taking the medication as prescribed. Client teaching is guided by the nurse's knowledge of which principles of pharmacokinetics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - A medication taken by injection must cross the membranes of the gastrointestinal tract to get to the bloodstream before it can be distributed throughout the body. - A drug may be exposed to several physiological processes while en route to target cells. - Liver enzymes may chemically change the drug. - Excretion organs such as kidneys and intestines must be healthy enough to eliminate the drug. - Many processes to which drugs are exposed are destructive, thereby helping facilitate the drug's movement throughout the body.

A drug may be exposed to several physiological processes while en route to target cells. Liver enzymes may chemically change the drug. Excretion organs such as kidneys and intestines must be healthy enough to eliminate the drug. Many processes to which drugs are exposed are destructive, thereby helping facilitate the drug's movement throughout the body.

A nursing student asks a nurse what the categories of pharmacokinetics are. What is the nurse's best response? 1. Diffusion 2. Ingestion 3. Absorption 4. Movement

Absorption

A nurse is administering aspirin to a client. Aspirin is ionized as it enters the small intestine. The nurse understands which of the following is correct regarding absorption of aspirin in the small intestine. - Absorption is decreased. - Absorption is increased. - Ionization has nothing to do with the absorption rate. - Aspirin must travel past the small intestine for absorption to occur.

Absorption is decreased.

A client asks a nurse why a large dose of a drug was administered first followed by a lower dose of the same drug later. What is the nurse's best response? - Prevent a toxic concentration of the drug - Achieve a therapeutic dose more quickly - Decrease the side effects of this drug - Increase the absorption rate of this drug

Achieve a therapeutic dose more quickly

A healthcare provider prescribes aspirin to a client complaining of a severe headache. Which action by the nurse will result in the fastest relief of the client's headache? - Administer the aspirin with an alkaline food, like cottage cheese. - Administer the aspirin in an enteric-coated formulation. - Administer the aspirin with a high-fat food, like peanut butter. - Administer the aspirin on an empty stomach.

Administer the aspirin on an empty stomach.

The nurse is reviewing the role of diffusion in the distribution of medications with a nursing student. The nurse understands that drugs that can be distributed by simple diffusion include those with which of the below characteristics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - Large molecules - Ionization - Water-soluble agents - Alcohol - Urea

Alcohol Urea

A nurse administers a drug to a client. Following ingestion, the drug crosses a membrane from an area of higher concentration to an area of lower concentration. The nurse understands that this is an example of which of the following? - Active transport - Osmosis - Diffusion - Metabolism

Diffusion

A nurse is reviewing excretion of medications with a student nurse. The nurse understands that the student nurse understands the teaching when the student nurse states that medications can be excreted by which route(s)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Fecal 2. Gastric 3. Glandular 4. Pulmonary 5. Renal

Fecal Glandular 4. Pulmonary 5. Renal

A nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - How drugs move from the site of administration to circulating fluids - How drugs are converted to a form that is easily removed from the body - How drugs change body illnesses and pathogens - How drugs are transported throughout the body - How drugs are removed from the body

How drugs move from the site of administration to circulating fluids How drugs are converted to a form that is easily removed from the body How drugs are transported throughout the body How drugs are removed from the body

The patient is scheduled to receive a medication that is an enzyme inducer of the P450 system. What best describes the effect of this medication on the patient? - In time, the patient will experience no effect from other medications. - In time, the patient will experience increased effects from other medications. - In time, the patient will experience a reduced effect from this medication. - In time, the patient will experience an increased effect from this medication.

In time, the patient will experience a reduced effect from this medication.

A nurse is preparing to administer medications to a client. The nurse understands that which substance has the lowest rate of crossing renal tubular membranes and would therefore be excreted in the urine? - Lipid-soluble drugs - Volatile drugs - Ionized drugs - Non-ionized drugs

Ionized drugs

A nurse is caring for a client with meningitis who is receiving a water-soluble drug. The client asks the nurse why the healthcare provider changed the prescription to a lipid-soluble drug. What is the best response by the nurse? - Lipid-soluble drugs are better because of protein binding. - Lipid-soluble drugs are more effective in treating the client's illness. - Lipid-soluble drugs are better because they have fewer side effects. - Lipid-soluble drugs are more effective because they are excreted at a slower rate.

Lipid-soluble drugs are more effective in treating the client's illness.

A nursing student asks a nurse which organ is the most responsible for the first-pass effect. What is the nurse's best response? 1. Bladder 2. Kidneys 3. Liver 4. Stomach

Liver

A nursing mother asks a nurse if it is all right to take St. John's wort for mild depression. What is the best response by the nurse? - "No, it will probably cause your baby to have more allergies." - "No, because it might decrease the amount of milk you produce." - "No, it could be excreted in your milk and affect the baby." - "No, it will affect the taste of your milk, and your baby might reject nursing."

No, it could be excreted in your milk and affect the baby."

A nurse administers medications by various routes of delivery. The nurse recognizes which route of administration requires higher dosages of drugs to achieve a therapeutic effect? - Intravenous route - Oral route - Rectal route - Sublingual route

Oral route

A nurse is reviewing enzymatic activity that changes a medication to a less active form with a nursing student. The nurse knows the teaching is effective if the nursing student responds that which of the following is an example of this concept? - Pharmacodynamics - Active transport - Pharmacokinetics - Diffusion

Pharmacokinetics

A client asks a nurse why he experiences a metallic taste after taking certain medications. The nurse explains that some medications are secreted by glandular activity. The nurse would identify which substances as examples of this excretion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. Saliva Sweat Breast milk Urine Feces

Saliva Sweat Breast milk

A client comes to the emergency department following an overdose of aspirin, which is an acidic drug. The nurse should anticipate administering which of the following? - Intravenous fluids to flush the kidneys - Ammonium chloride to increase metabolism in the liver - Sodium bicarbonate to alter the client's serum pH - Intravenous proteins to bind the aspirin

Sodium bicarbonate to alter the client's serum pH

A nursing instructor is reviewing how medications are secreted with a nursing student. Which statement is accurate regarding medications that end up being secreted in bile? - All medications secreted in bile are excreted in the feces. - Some medications are excreted in the feces while others can be recirculated to the liver many times. - Most medications secreted in bile are metabolized in the gallbladder. - Generally, medications are not secreted in the bile.

Some medications are excreted in the feces while others can be recirculated to the liver many times.

A client who has received an oral medication for treatment of hives asks the nurse, "How long will it be before my skin clears and quits itching?" Which concepts should the nurse consider when formulating a response? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. - The amount of time between administration and the drug taking effect is known as onset of action. - Peak plasma levels rarely occur with oral medications. - Duration of action is the amount of time a drug is effective. - Peak plasma level is dependent on the drug's plasma half-life (t1/2). - Drugs with short half-lives are ineffective in treating systemic illnesses.

The amount of time between administration and the drug taking effect is known as onset of action. Duration of action is the amount of time a drug is effective.

A client is admitted to the hospital in chronic renal failure and several drugs are prescribed. What best describes the nurse's assessment of this client? - The client's liver may compensate for renal failure so the drugs may be effective. - The client may have drug toxicity from all the drugs. - The client may have drug toxicity only if the drugs are excreted by the kidneys. - The client may have decreased effectiveness of the drugs.

The client may have drug toxicity from all the drugs.

The patient is malnourished and has a low serum albumin. A nurse is caring for a client with a low serum albumin level. The healthcare provider has ordered aspirin, which is a highly protein-bound drug. Which evaluation by the nurse best describes the effect this will have on the client? - The client will be at risk of experiencing a decreased effectiveness of the drug. - The client will be at risk of experiencing toxic effects of the drug. - The client's kidneys will excrete the drug at a faster rate. - The client's liver will metabolize the drug at a faster rate.

The client will be at risk of experiencing toxic effects of the drug.

A client is receiving a drug that is excreted in the bile. What will the best nursing assessment of the effect of this drug on the patient include? - The effect of the drug will be a prolonged action. - The effect of the drug will be increased side effects. - The effect of the drug will be decreased side effects. - The effect of the drug will be decreased.

The effect of the drug will be a prolonged action.

Which assessment finding reflects a therapeutic range for a medication? - No serious adverse effects are experienced following administration. - The indication for administration was achieved without serious side effects. - A pre-specified amount (in mL) was administered. - The medication was effective, but the patient experienced a lethal dysrhythmia.

The indication for administration was achieved without serious side effects.

A nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement? - "We can safely take the drug for at least 6 months beyond the expiration date." - "We don't need to worry about storage of the drug, it won't lose potency." - "We should not take our medications with milk or dairy products." - "We need to be careful about taking the medication with certain foods."

We need to be careful about taking the medication with certain foods."