Pharmacology Quiz 1
It is expected that the nurse will question the health care provider if a drug with a t½ of >24 hours is ordered to be given more than how often? a. Once daily b. Every other day c. Twice weekly d. Once weekly
a. Once daily
A drug-induced birth defect. a. Teratogenic effect b. Mechanism of action c. Therapeutic index d. Half-life
a. Teratogenic effect
You were told that Tom, the radiology tech, called you regarding some lab value of your patient, Mr. Lee (89 years old). Tom is going to take Mr. Lee for CT scan. Which of the following lab value would Tom be most interested? a. Serum potassium b. Urine creatinine clearance c. Hemoglobin d. Serum magnesium level
b. Urine creatinine clearance
Medication dosages may need to be decreased for which of the following reasons? 1. Increased medication-metabolizing enzymes 2. Liver failure 3. Peripheral vascular disease 4. Chronic renal insufficiency a. 1 and 3 b. 1, 2 and 3 c. 2 and 4 d. 1, 2, 3 and 4
c. 2 and 4
A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time? a. Immediately before conception b. During the first trimester c. During the second trimester d. During the third trimester
b. During the first trimester
Which following conditions will always decrease drug absorption by oral route: a. Diarrhea b. Food in stomach c. Liver failure d. Colon resection
a. Diarrhea
A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings? a. They indicate that a drug should not be given except in life-threatening circumstances. b. They provide detailed information about the adverse effects of the drug. c. They alert prescribers to measures to mitigate potential harm from side effects. d. They provide information about antidotes in the event that toxicity occurs.
c. They alert prescribers to measures to mitigate potential harm from side effects. Black box warnings are used to alert providers to potential side effects and to ways to prevent or reduce harm from these side effects. The black box warning is placed on any drug that, although useful, has serious side effects; this is a way to keep drugs on the market while protecting patients. Many of these drugs are used in situations that are not life threatening. The black box warning provides a concise summary and not a detailed explanation of drug side effects. The black box warning does not include antidotes to toxicity
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? a. "This route allows more rapid absorption of the drug." b. "This route is safer, less expensive, and more convenient." c. "This route is the best way to control serum drug levels." d. "This route prevents inactivation of the drug by digestive enzymes."
b. "This route is safer, less expensive, and more convenient." Parenteral routes include the intravenous, intramuscular, and subcutaneous routes. Enteral routes include oral administration, including pills and liquid suspensions. Enteral routes are safer, cheaper, and easier to use. Parenteral routes are used when rapid absorption, precise control of plasma drug levels, and prevention of digestive inactivation are important.
A patient receives 60 mg of a drug at noon, 6 PM, and midnight. The drug has a half-life of 6 hours. How much of the drug remains in the patient at 6 AM the next day? a. 15mg b. 52.5 mg c. 67.5 mg d. 90 mg
b. 52.5 mg Noon 6pm 12am 6am 60mg 30mg 15mg 7.5mg 60mg 30mg 15mg 60mg 30mg TOTAL 52.5mg
A provider has written an order for a medication: drug × 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau? a. 2:00 AM b. 8:00 AM c. 2:00 PM d. 8:00 PM
b. 8:00 AM It takes 4 half-lives for 94% drug reaching plateau (steady state or therapeutic state). It takes 5 half-lives for 97% drug reaching plateau (steady state or therapeutic state). Most pharmacology textbooks consider the drug level of 97% as the steady state like what I said yesterday in class. But ATI uses 4 half-lives (94% plateau) to measure steady state. To keep consistency, let's use 4 half-lives to figure out this question. It takes 4 half-lives for a drug to reach plateau (steady state or therapeutic state). In this case, the half-life of this drug is 6 hours, it will take 4 x 6 = 24 hrs to reach plateau. It would be at 8:00 AM the following day (Wednesday) if the drug is given at 8:00am on Tuesday.
The nurse notices that one of the client's drugs has a low therapeutic index. What is the most important nursing implication of this? a. A wide margin of safety b. A narrow margin of safety c. Measured 1 hour after administration d. Measured 10 minutes after administration
b. A narrow margin of safety
How the medication produces the desired therapeutic effect a. Teratogenic effect b. Mechanism of action c. Therapeutic index d. Half-life
b. Mechanism of action
A patient is taking a drug that has known toxic side effects. What will the nurse do? a. Discontinue the drug at the first signs of toxicity. b. Ensure that complete blood counts are ordered periodically. c. Monitor the function of all organs potentially affected by the drug. d. Teach the patient how to treat the symptoms if they develop.
c. Monitor the function of all organs potentially affected by the drug. When a drug is administered that has known toxic side effects, the nurse is responsible for monitoring all organ systems potentially affected by the drug. Not all toxic side effects warrant discontinuation of the drug, and a nurse cannot discontinue a drug without an order from the provider. Complete blood counts are indicated only for drugs that affect the blood. Some drugs need to be discontinued, so teaching a patient to treat symptoms is not correct in all cases.
A nurse consults a drug manual before giving a medication to an 80-year-old patient. The manual states that older-adult patients are at increased risk for hepatic side effects. Which action by the nurse is correct? a. Contact the provider to discuss an order for pretreatment laboratory work. b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of adverse effects. c. Notify the provider that this drug is contraindicated for this patient. d. Request an order to give the medication intravenously so that the drug does not pass through the liver.
A. Contact the provider to discuss an order for pretreatment laboratory work. The drug manual indicates that this drug should be given with caution to elderly patients. Getting information about liver function before giving the drug establishes baseline data that can be compared with post-treatment data to determine whether the drug is affecting the liver. Giving the correct dose at the correct interval helps to minimize risk, but without baseline information, the effects cannot be determined. The drug is not contraindicated.
The prescriber has ordered an antibiotic for a patient with a bacterial infection. The nurse provides patient education at discharge and instructs the patient to take the drug on an empty stomach. When should the patient take the drug? (Select all that apply.) a. 1 hour or more before a meal b. Only after an 8-hour fast c. Only after the patient has missed a meal d. At least 2 hours after a meal e. Shortly before a meal
a. 1 hour or more before a meal d. At least 2 hours after a meal The absorption of some drugs can be significantly reduced by food; these drugs should be taken on an empty stomach, which is 1 hour or more before a meal or at least 2 hours after a meal. An 8-hour fast is not necessary; the patient does not need to miss a meal to take the medication; and it is not reasonable to have the patient on thin liquids for 12 hours.
Which patients are at increased risk for adverse drug events? (Select all that apply.) a. A 2-month-old infant taking a medication for gastroesophageal reflux disease b. A 23-year-old female taking an antibiotic for the first time c. A 40-year-old male who is intubated in the intensive care unit and taking antibiotics and cardiac medications d. A 7-year-old female receiving insulin for diabetes e. An 80-year-old male taking medications for COPD
a. A 2-month-old infant taking a medication for gastroesophageal reflux disease (Yes, very young) c. A 40-year-old male who is intubated in the intensive care unit and taking antibiotics and cardiac medications (Yes, sick) e. An 80-year-old male taking medications for COPD (Yes, very old)
A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction? a. A 30-year-old man with kidney disease b. A 75-year-old woman with cystitis c. A 50-year-old man with an upper respiratory tract infection d. A 9-year-old boy with an ear infection
a. A 30-year-old man with kidney disease The individual with impaired kidney function would be at risk of having the drug accumulate to a toxic level because of potential excretion difficulties. Cystitis is an infection of the bladder and not usually the cause of excretion problems that might lead to an adverse reaction from a medication. A respiratory tract infection would not predispose a patient to an adverse reaction, because drugs are not metabolized or excreted by the lungs. A 9-year-old boy would not have the greatest predisposition to an adverse reaction simply because he is a child; nor does an ear infection put him at greater risk.
A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives information about the drug's pharmacologic classification?" Which is the correct response? a. Amoxicillin b. Tylenol c. Cipro d. Motrin
a. Amoxicillin Amoxicillin is the generic name, and the suffix "-cillin" indicates that it belongs to the penicillin class of antibiotics. Tylenol, Cipro, and Motrin are all trade names without segments that indicate their pharmacologic class.
A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, what will the nurse do first? a. Ask whether the patient has taken this antibiotic for other infections b. Question the patient about allergies to other medications c. Request an order for a lower dose of the antibiotic d. Request an order for an antihistamine
a. Ask whether the patient has taken this antibiotic for other infections The nurse needs to assess whether the patient is truly allergic to this drug. Allergic reactions require previous exposure to the drug, so the nurse should ask whether the patient has taken this antibiotic before. Obtaining a history of drug allergies and of reactions to medications also is important, but not as important as finding out about possible allergic reactions to a drug about to be given. Antihistamines sometimes are given when patients must take a drug to which they are allergic.
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) a. Binding of one or both agents will be reduced. b. Plasma levels of free drug will rise. c. Plasma levels of free drug will fall. d. The increase in free drug will intensify effects. e. The increase in bound drug will intensify effects.
a. Binding of one or both agents will be reduced. b. Plasma levels of free drug will rise. d. The increase in free drug will intensify effects. When two drugs bind to the same site on plasma albumin, coadministration of those drugs produces competition for binding. As a result, binding of one or both agents is reduced, causing plasma levels of free drug to rise. The increase in free drug can intensify the effect.
The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patient's high blood pressure. The nurse takes the patient's vital signs and finds that the blood pressure is 128/80 mm Hg and the heart rate is 60 beats per minute. What does the nurse do first before giving this drug? a. Check the order for prescriber specific instructions on when the drug should be given. b. Notify the prescriber and ask if the drug should be given. c. Reassess the blood pressure and heart rate. d. Give the drug exactly as prescribed.
a. Check the order for prescriber specific instructions on when the drug should be given.
A nurse is concerned about renal function in an 84-year-old patient who is taking several medications. What will the nurse assess? a. Creatinine clearance b. Sodium levels c. Potassium levels d. Serum creatinine
a. Creatinine clearance The proper index of renal function in older adults is creatinine clearance, which indicates renal function in older patients whose organs are undergoing age-related deterioration. Sodium and potassium levels are not indicative of renal function. Serum creatinine levels do not reflect kidney function in older adults because lean muscle mass, which is the source of creatinine in serum, declines and may be low even with reduced kidney function.
An elderly client is taking a drug that is highly protein-bound (98%). Several days later, he also begins taking a second drug that is also 98% protein-bound and competes for the same albumin binding sites. The effect of the first drug would be: a. Increased b. Decreased c. No change expected d. Unknown
a. Increased Question: Issues with patient taking two highly protein-bound drugs (drug A and drug B) Example: A patient has been taking drug A (highly protein-bound) for a while, now he is prescribed another highly protein-bound drug (drug B). How does new drug affect drug A's effects? Drug B will increase the effects of Drug A because the newcomers will force Drug A out of the binding sites and become free and active. Mechanism of action: The 2nd drug forces the first drug out of the binding site to become free and active more free active drugs are available to take actions for the first drug increase the effects of the first drug On the other hand, if the patient is taking two highly protein-bond drugs, removal of one will decrease the effects of the other one (we addressed this during week 1 lecture using Spencer's story) Mechanism of action: Patient takes two highly protein-bound drugs (Drug C and Drug D) discontinue drug D Drug C immediately bind with the unoccupied "seats" (binding sites on each protein molecule) on protein until all the seats are taken less active or free form of drug C available to take action Drug C's effect decrease due to less active drug available to take actions.
A patient is brought to the emergency department in a state of extreme, uncontrolled anxiety. Why would an IV (Intravenous) benzodiazepine be the drug of choice in this situation? a. It has a rapid onset of action. b. There is no risk of physical dependence. c. This is a drug category shown to cure the disorder. d. It also helps treat associated depression.
a. It has a rapid onset of action. The patient is clearly in a state of extreme, uncontrolled anxiety. Benzodiazepines are the drug of choice for acute episodes of anxiety because of their rapid onset of action. Benzodiazepines do not have a very short half-life. Benzodiazepines are associated with physical dependence. Benzodiazepines do not cure generalized anxiety, nor do any other drugs.
The prescriber orders a new drug over the telephone for a nursing home patient who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse to obtain from the prescriber? a. "How many refills are needed?" b. "Do you want the drug given orally or intravenously?" c. "Which brand of drug should be given, or is this a generic drug? d. "Does this drug need to be given with a meal or on an empty stomach?"
b. "Do you want the drug given orally or intravenously?"
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.) a. Affinity and intrinsic activity are dependent properties. b. Affinity refers to the strength of the attraction between a drug and its receptor. c. Drugs with high affinity are strongly attracted to their receptors. d. Drugs with low affinity are strongly attracted to their receptors. e. The affinity of a drug for its receptors is reflected in its potency.
b. Affinity refers to the strength of the attraction between a drug and its receptor. c. Drugs with high affinity are strongly attracted to their receptors. e. The affinity of a drug for its receptors is reflected in its potency. Affinity refers to the strength of the attraction between a drug and its receptor. Drugs with high affinity are strongly attracted to their receptors, and the affinity of a drug and its receptors is reflected in its potency. Affinity and intrinsic activity are independent properties. Drugs with low affinity are weakly attracted to their receptors.
A nurse is reviewing a patient's medical record before administering a medication. Which factors can alter the patient's physiologic response to the drug? (Select all that apply.) a. Ability to swallow pills b. Age c. Genetic factors d. Gender e. Height
b. Age c. Genetic factors d. Gender Age, genetic factors, and gender influence an individual patient's ability to absorb, metabolize, and excrete drugs; therefore, these factors must be assessed before a medication is administered. A patient's ability to swallow pills, although it may determine the way a drug is administered, does not affect the physiologic response. Height does not affect response; weight and the distribution of adipose tissue can affect the distribution of drugs.
Mr. Spencer is taking warfarin after his orthopedic surgery. He lost 35 pounds due to decreased appetite during his recovery. He is more likely to be admitted to ED for a. Constipation b. GI bleed c. Hypertensive crisis d. Deep venous thrombosis (DVT)
b. GI bleed
When administering medications to infants, it is important to remember which of the following? (Select all that apply.) a. Breast-feeding infants are more likely to develop toxicity when given lipid-soluble drugs. b. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. c. Infants have immature livers, which slows drug metabolism. d. Infants are more sensitive to medications that act on the central nervous system (CNS). e. Oral medications are contraindicated in infants, because PO administration requires a cooperative patient.
b. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. c. Infants have immature livers, which slows drug metabolism. d. Infants are more sensitive to medications that act on the central nervous system (CNS). Immature renal function causes infants to excrete drugs more slowly, and infants are at risk for toxicity until renal function is well developed. Infants' livers are not completely developed, and they are less able to metabolize drugs efficiently. Because the blood-brain barrier is not well developed in infants, caution must be used when administering CNS drugs. Lipid-soluble drugs may be excreted in breast milk if the mother is taking them, but breast-feeding does not affect medications given directly to the infant. Oral medications may be given safely to infants as long as they are awake and can swallow the drug.
What occurs when a drug binds to a receptor in the body? a. It alters the receptor to become nonresponsive to its usual endogenous molecules. b. It increases or decreases the activity of that receptor. c. It gives the receptor a new function. d. It prevents the action of the receptor by altering its response to chemical mediators.
b. It increases or decreases the activity of that receptor. When a drug binds to a receptor, it mimics or blocks the actions of the usual endogenous regulatory molecules, either increasing or decreasing the rate of the physiologic activity normally controlled by that receptor. It does not alter the activity of the receptor and does not give the receptor a new function
A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names? a. They are approved by the FDA and are easy to remember. b. They are assigned by the U.S. Adopted Names Council. c. They clearly identify the drug's pharmacologic classification. d. They imply the efficacy of the drug and are less complex.
b. They are assigned by the U.S. Adopted Names Council. Nonproprietary, or generic, names are assigned by the U.S. Adopted Names Council, which ensures that each drug has only one name. Trade names, or brand names, are approved by the FDA and are easier to remember. Some nonproprietary names contain syllables that identify the classification, although not all do. Drug names are not supposed to identify the use for the drug, although some brand names do so.
Mary is drinking 1.5 litter cranberry juice daily to prevent urinary tract infection. She is also using the full strength ASA (325 mg) to ease her arthritic pain. What symptom do you think Mary would complaint most? a. Diarrhea b. Constipation c. Bruise easily d. Hot flash
c. Bruise easily
A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by: a. Antagonists produced by the body that compete with the drug for receptor sites. b. Decreased selectivity of receptor sites, resulting in a variety of effects. c. Desensitization of receptor sites by continual exposure to the drug. d. Synthesis of more receptor sites in response to the medication.
c. Desensitization of receptor sites by continual exposure to the drug. Continual exposure to an agonist would cause the cell to become less responsive or desensitized. The body does not produce antagonists as a response to a medication. Receptor site selectivity is determined by physiologic factors and not by the substances that bind to them. Medications do not cause more receptors to be produced.
Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's response to the medication? (Select all that apply) a. Chemical stability of the medication b. Ease of administration c. Family medical history d. Patient's age e. Patient's diagnosis
c. Family medical history d. Patient's age e. Patient's diagnosis The family medical history can indicate genetic factors that may affect a patient's response to a medication. Patients of different ages can respond differently to medications. The patient's illness can affect how drugs are metabolized. The chemical stability of the medication and the ease of administration are properties of drugs.
A drug that has "high affinity" means that the drug: a. Causes a strong reaction at the receptor. b. Is not strongly attracted to the receptor. c. Is strongly attracted (bound) to the receptor. d. Is not very potent.
c. Is strongly attracted (bound) to the receptor. Affinity refers to the strength of the attraction between a drug and its receptor. Drugs with high affinity are strongly attracted to their receptors, and the affinity of a drug and its receptors is reflected in its potency. Affinity and intrinsic activity are independent properties. Drugs with low affinity are weakly attracted to their receptors.
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's: a. Drug receptor sites. b. Hypersensitivity potential. c. Metabolism of drugs. d. Psychosocial response.
c. Metabolism of drugs. The most common source of genetic variation in drug response is related to alterations in drug metabolism and is determined by genetic codes for various drug-metabolizing isozymes. There are known genetic differences in codes for drug target sites, but these are not as numerous as those for metabolic isozymes. Hypersensitivity potential is also genetically determined, but variations produce differences in adverse reactions to drugs and not in drug effectiveness. Psychosocial responses vary for many, less measurable reasons, such as individual personalities and variations in cultures.
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? a. Administer the drug at intervals longer than the drug half-life. b. Administer this medication intravenously. c. Monitor plasma drug levels. d. Teach the patient that maximum drug effects will occur within a short period.
c. Monitor plasma drug levels. A drug with a narrow therapeutic range is more difficult to administer safely, because the difference between the minimum effective concentration and the toxic concentration is small. Patients taking these medications must have their plasma drug levels monitored closely to ensure that they are getting an effective dose that is not toxic. Administering medications at longer intervals only increases the time required to reach effective plasma drug levels. Drugs that have a narrow therapeutic range may be given by any route and do not differ from other medications in the amount of time it takes to take effect, which is a function of a drug's half-life and dosing frequency.
A health care provider prescribes simvastatin (Zocor) 40 mg PO every day at bedtime. The nurse should recognize this as which of the following types of order? a. Single order b. Stat order c. Routine order d. Standing order
c. Routine order
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? a. A loading dose was not given. b. The drug was not completely dissolved in the IV solution. c. The patient is taking another medication that binds to serum albumin. d. The medication is being given at a frequency that is longer than its half-life.
c. The patient is taking another medication that binds to serum albumin. Gentamicin binds to albumin, but only weakly and, in the presence of another drug that binds to albumin, can rise to toxic levels in blood serum. A loading dose increases the initial amount of a drug and is used to bring drug levels to the desired plateau more quickly. A drug that is not completely dissolved carries a risk of causing embolism. A drug given at a frequency longer than the drug half-life will likely be at subtherapeutic levels and not at toxic levels
It is a concept used to measure safety of drugs, and it is the ratio of the lethal dose divided by the therapeutic dose for 50% of population. a. Teratogenic effect b. Mechanism of action c. Therapeutic index d. Half-life
c. Therapeutic index
A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require ____ doses of drug ____. a. lower; X b. lower; Y c. higher; X d. higher; Y
c. higher; X An inducing agent stimulates the synthesis of CYP isozymes, which may increase the metabolism of other drugs as much as two- to threefold, thereby lowering the level of those drugs in the body and requiring higher doses to maintain drug effectiveness.
A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching? a."I should avoid taking acetaminophen while taking this drug." b. "I will need periodic evaluation of aspartate aminotransferase and alanine aminotransferase levels." c. "If I experience nausea, vomiting, or abdominal pain, I should call my provider." d. "Routine testing and early detection of problems will prevent liver failure."
d. "Routine testing and early detection of problems will prevent liver failure." Drug-induced liver injury can progress from undetectable to advanced between routine tests; therefore, routine testing does not always prevent liver failure. Patients taking known hepatotoxic drugs should avoid other drugs, such as acetaminophen, that can cause liver damage. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are liver enzymes that are routinely monitored when a patient is taking hepatotoxic drugs. Nausea, vomiting, and abdominal pain are all signs of liver injury and should be reported
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider? a. 250 mg/5 mL-375 mg PO twice daily b. 250 mg/5 mL-250 mg PO three times daily c. 500 mg/5 mL-250 mg PO three times daily d. 500 mg/5 mL-375 mg PO twice daily
d. 500 mg/5 mL-375 mg PO twice daily To promote adherence to a drug regimen in children, it is important to consider the size and timing of the dose. In this case the preparation containing 500 mg/5 mL means that a smaller volume can be given, which is more palatable to a child. Twice daily dosing is more convenient for parents, especially when a child is in day care or school; it also helps prevent the problem of the medication being left either at home or at school. Classic NCLEX question, every given piece of information is critical clue that leads you to the right answer. If the information about "the child attends day care" is not provided, both B and D are correction. But, after adding the information of "the child attending day care", D is more appropriate and desired answer than B.
A nurse is reviewing a medication administration record before administering medications. Which order will the nurse implement? a. Furosemide [Lasix] 20 mg QD PO b. Furosemide [Lasix] 20 mg qd PO c. Furosemide [Lasix] 20 mg daily d. Furosemide [Lasix] 20 mg PO daily
d. Furosemide [Lasix] 20 mg PO daily The correct answer is a complete order; it contains the medication, dose, route, and time. QD is no longer an accepted abbreviation; it should be written out as "daily" or "every day." The order of "20 mg daily" does not specify the route to be used.
The nurse reviews the client's medication regimen, including the interval of drug dosage, which is related to which of the following? a. Stimulation of receptors b. Trough level c. Therapeutic index d. Half-life
d. Half-life
This concept defines the time span needed to eliminate 50% of drug dose a. Teratogenic effect b. Mechanism of action c. Therapeutic index d. Half-life
d. Half-life
The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: a. Decrease the gastric absorption of aspirin. b. Decrease the lipid solubility of aspirin. c. Increase the serum protein binding of aspirin. d. Increase the urinary excretion of aspirin.
d. Increase the urinary excretion of aspirin. We discussed this phenomenon in class. A alkaline urine or elevating urinary pH increase elimination of acidic drug, aspirin. Elevating the pH of the blood and urine does not affect PH level in stomach, therefore, does not affect absorption of aspirin in the stomach. Elevating the pH of the blood and urine does not affect lipid solubility or protein binding neither.
Which of the following nursing actions would be most appropriate for ensuring client safety with a medication that has a low therapeutic index? a. Monitoring a patient's urine output b. Assessing vital signs hourly c. Maintaining strict isolation precautions d. Monitoring serum peak and trough levels
d. Monitoring serum peak and trough levels
The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of which topic? a. Clinical pharmacology b. Drug efficacy c. Pharmacokinetics d. Pharmacotherapeutics
d. Pharmacotherapeutics Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent conditions. Clinical pharmacology is concerned with all aspects of drug-human interactions. Drug efficacy measures the extent to which a given drug causes an intended effect. Pharmacokinetics is the study of the impact of the body on a drug.
The literature about a drug found in the drug monograph identifies that the drug is POTENT. This means the drug: a. Requires high doses to produce its effects. b. Is very likely to cause adverse effects. c. Produces strong effects at any dose. d. Produces its effect at low doses.
d. Produces its effect at low doses.
A nurse is preparing to give medications to four older patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects? a. Obese patient b. Patient with decreased serum creatinine c. Patient with chronic diarrhea d. Thin patient with a chronically low appetite
d. Thin patient with a chronically low appetite The patient who is thin and has a poor appetite has an increased risk of malnutrition, with significant lowering of serum albumin. This can result in increased free drug levels of protein-bound drugs and can lead to drug toxicity. Obesity, which involves increased adipose tissue, would cause lipid-soluble drugs to deposit in adipose tissue (sequestration), with a resulting reduction of drug effects. Decreased serum creatinine in an older adult patient may just be a function of a decrease in lean body mass and not of renal function (UCC is most accurate indicator of renal dysfunction). Chronic diarrhea would accelerate the passage of medications through the GI tract and reduce absorption.
