principle pharm ch. 1-8 practice q's
A nurse is preparing to give an oral dose of drug X to treat a patient's high blood pressure. After giving the drug, the nurse finds that it reduces the blood pressure without serious harmful effects, but it also causes the patient to have nausea and a headache. Based on this information, which property of an ideal drug is this drug lacking? 1. Effectiveness 2. Safety 3. Selectivity 4. Ease of administration
*3. Selectivity * The drug is effective in lowering the blood pressure and safe in that it does not cause harmful effects. However, as do most drugs, it causes other effects besides the one response desired; therefore, it lacks selectivity. The oral form provides ease of administration.
The nurse is preparing to give a drug with certain properties. Which property of the drug is the most compelling indication that it should not be given? 1.The drug produces an unwanted side effect. 2.The drug is difficult to administer. 3.The drug's effects are reversible. 4.The drug is not effective for its intended purpose.
*4. The drug is not effective for its intended purpose* If a drug is not effective, there is no justification for giving it. Some drugs may be given even though they produce unwanted side effects or are difficult to administer. Reversible action is a desired property for most drugs.
When studying the effects of drugs in humans, the nurse is learning about what? Pharmacology Clinical pharmacology Therapeutics Effectiveness
*Clinical Pharmacology* Clinical pharmacology is the study of the effects of drugs in humans. Pharmacology can be defined as the study of drugs and their interactions with living systems. Therapeutics, also known as pharmacotherapeutics, is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy. The term effectiveness indicates that the drug elicits the intended response or responses.
The nurse teaches a patient not to consume alcohol with nitroglycerine, because the blood pressure often drops significantly when nitroglycerine is taken with alcohol. Which drug property does this illustrate? Chemical instability Drug interaction Reversible action Drug selectivity
*Drug Interaction * When two or more drugs are taken together, they can interact, causing either increased or decreased drug responses. In this case, alcohol would increase the nitroglycerine response. Chemical instability, reversible action, and drug selectivity are not related to this situation.
When studying the impact a drug has on the body, the nurse is reviewing what? The drug's pharmacokinetics The drug's selectivity The drug's pharmacodynamics The drug's predictability
*Drug's pharmacodynamics* Pharmacodynamics can be thought of as the impact of drugs on the body. Pharmacokinetics describes the movement of drugs through the body. Selectivity is the ability of a drug to elicit only the response for which it is given. Predictability is the degree of certainty about how a patient will respond to a certain drug.
Which statement by a new nurse indicates that further study is indicated? Effectiveness is the most important property a drug can have. There is no such thing as a safe drug. Drugs are defined as illegal substances. There is no such thing as a selective drug; all medications cause side effects.
*Drugs are defined as illegal substances* A drug is any chemical that can affect living processes. All the other statements are correct.
What is the objective of drug therapy? Provide maximum benefit with minimal harm Provide minimum benefit with maximum harm Provide total relief of symptoms regardless of harm Provide as much benefit as possible
*Provide maximum benefit with minimal harm* The objective of drug therapy is to provide maximum benefit with minimal harm. All drugs have the potential to produce side effects. Because drugs are not ideal, we must exercise skill and care if treatment is to result in more good than harm.
Why is it important for drugs to have ease of administration? a. Fewer administration errors b. Less risk of side effects c. Greater chemical stability d. Greater likelihood of reversibility
*a. Fewer administration of errors * Ease of administration increases convenience and adherence and can reduce administration errors. Ease of administration is not related to side effects, chemical stability, or reversibility.
A nurse prepares to administer acetaminophen [Tylenol] to a patient with an oral temperature of 101.7°F. Which preparation would the nurse expect to have the most rapid onset of action? A Tylenol elixir B Tylenol tablets C Tylenol capsules D Tylenol gel caps
A
The nurse is administering warfarin, an anticoagulant, to a patient with a low albumin level. Which effect of this medication should the nurse expect to observe? A Increased PT/INR levels B Deep vein thromboses C Reduced risk of bruising D Increased platelet aggregation Incorrect
A
The nurse should instruct a patient complaining of pain to do what to reduce fluctuations in drug levels? A "Take pain medication around the clock at specified intervals and doses." B "Take pain medication when the pain level reaches an 8 or 9 on a 1 to 10 scale." C "Take pain medication at night before bed and avoid daytime dosing because of drowsiness." D "Take pain medication after breakfast and dinner to reduce stomach upset."
A
When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient? A 3-week-old neonate B 12-year-old boy C 25-year-old woman D 15-month-old infant
A
Characteristics unique to each patient can influence pharmacokinetic and pharmacodynamic processes. What characteristics may determine the patient's response to a drug? (Select all that apply.) Age Gender Weight Mood Genetics
Age, Gender, weight, genetics Characteristics unique to each patient can influence pharmacokinetic and pharmacodynamic processes and, by doing so, can help determine the patient's response to a drug. Sources of individual variation include drug interactions; physiologic variables (eg, age, gender, weight); pathologic variables (especially diminished function of the kidneys and liver, the major organs of drug elimination); and genetic variables.
A new graduate nurse preparing to administer medications knows that which of the following is required for a drug to move through the body? A Selectivity and effectiveness B The ability to cross membranes C Development of an electric charge D A transporter protein
B
The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system, very little active drug is left in the general circulation as a result of what? A Therapeutic range B First-pass effect C Drug half-life D Plasma protein binding
B
The nurse is preparing to give a medication for pain. The label states that the drug is "lipid soluble." How soon should the nurse expect to observe the effects of the drug? A Slowly B Rapidly C Unpredictably D Variably Incorrect
B
1. What are the properties of an ideal drug? (Select all that apply.) a. Irreversible action b. Predictability c. Ease of administration d. Chemical stability e. A simple trade name
B, C, D
The nurse is preparing to administer an intravenous (IV) medication. What is the minimum injection time to reduce the risk of harm to the patient? A 10 seconds B 30 seconds C 60 seconds D 30 minutes
C
What does it mean when a drug is described as easy to administer? a. It can be stored indefinitely without need for refrigeration. b. It does not interact significantly with other medications. c. It enhances patient adherence to the drug regimen. d. It is usually relatively inexpensive to produce.
C
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, D, E
3. A patient tells the nurse that he was told by the prescriber that the analgesic he is taking is very effective. Which statement by the patient demonstrates an understanding of the drug's effectiveness? a. "I don't have to worry about toxicity, since it takes a large amount of this drug to cause an overdose." b."It has no side effects and doesn't interact with other drugs." c."I only have to take it every 12 hours." d."It might make me sleepy, and it lessens pain for several hours at a time."
D
For which reason should the nurse follow safe medication administration for intravenous (IV) medications? A The IV route can result in delayed absorption of the medication. B The IV route results in a delayed onset of action. C Control over the levels of drug in the body is unpredictable. D IV administration is irreversible.
D
The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of: a. clinical pharmacology. b. drug efficacy. c. pharmacokinetics. d. pharmacotherapeutics.
D
The nurse should provide which teaching point when administering an enteric-coated oral tablet to a patient? A "Chew the tablet before swallowing." B "Break the tablet in half before swallowing." C "Allow the tablet to be absorbed under the tongue." D "Swallow the tablet whole after double-checking the dose."
D
What is the ultimate concern for the nurse when administering a drug? Intensity of the response Dosage Incorrect Route of administration Timing of administration
Intensity of the response* The ultimate concern for the nurse when administering a drug is the intensity of the response, which is determined by the dosage size, route of administration, and timing of administration.
A patient is given a prescription for azithromycin (Zithromax) and asks the nurse why the dose on the first day is twice the amount of the dose on the next 4 days. Which reply by the nurse is correct? a. "A large initial dose helps to get the drug to optimal levels in the body faster." b. "The first dose is larger to minimize the first pass effect of the liver." c. "The four smaller doses help the body taper the amount of drug more gradually." d. "Tubular reabsorption is faster with initial doses, so more is needed at first."
a
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
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
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
patient tells the nurse that the oral drug that has been prescribed has caused a lot of stomach discomfort in the past. What will the nurse ask the prescriber? a. Whether a sublingual form of the medication can be given b. Whether the medication can be given by a parenteral route instead c. To order an enteric-coated form of the drug d. Whether the patient can receive a sustained-release preparation of the drug
c
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply? a. "This drug causes severe gastric upset if given orally." b. "This drug has a narrow therapeutic range, and the dose must be tightly controlled." c. "This drug is absorbed much too quickly in an oral form." d. "This drug would be inactivated by enzymes in the stomach."
d
