Chapter 2: Drugs and the Body
A client with a fever was administered 659 mg acetaminophen orally at 8:00. The nurse is aware that the half-life of acetaminophen is 2 hours. How much acetaminophen will be bioavailable at 12:00?
163
A client has not experienced the desired therapeutic effects of a med. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should do what? A) Assess for factors that may reduce absorption B) Review the client's electrolyte levels C) Assess the client for adverse effects D) Educate the client about drug-drug interactions
A
A client is receiving 250 mg of a drug that has a half-life of 12 hours. Approximately how much drug would main after 36 hours? A) 31 mg B) 16 mg C) 63 mg D) 125 mg
A
A nurse is to administer a new drug to a client. The entry in the nursing drug guide states that the drug is loosely bound to protein. The nurse should recognize what implication of this drug characteristic? A) The drug will have a short duration of action B) The drug's rate of excretion will be relatively slow C) The drug will be released very slowly D) There is an increased risk of drug-drug interactions
A
The half-life of a drug A) is determined by a balance of all pharmacokinetic processes. B) is a constant factor for all drugs taken by a patient. C) is influenced by the fat distribution of the patient. D) can be calculated with the use of a body surface nomogram.
A
The nurse is administering a drug that has selective toxicity. What effect will this have on a client? A) The drug will affect foreign cells, but not healthy body cells B) There is a narrow window between the therapeutic dose and a toxic dose C) There is an unknown, but significant, risk of adverse effects D) The drug will react with specific receptor sites, preventing the reaction of another chemical
A
Which client is most likely to be vulnerable to the effects of impaired drug absorption? A client: A) with irritable bowel syndrome B) with ischemic heart disease C) who has human immunodeficiency virus D) who receives peritoneal dialysis for acute kidney injury
A
Which client is most likely to experience the benefits of the placebo effect? A client: A) with an infection who states, "I know this antibiotic is going to work for me." B) who expresses skepticism about the need for medications C) who states, "I'm not the type of person who likes to take pills." D) with pain who says, "I hope this drug works faster than the first one you gave me."
A
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? A) "We want to customize the dose to your body weight." B) "We want to make sure you get the benefits of the drug as quickly as possible." C) "A loading dose will ensure that subsequent doses remain effective for as long as possible." D) "We need to see if your body responds to the drug in the proper."
B
A postsurgical client rates her pain at 10/10. The nurse confirms that there are standing orders for the administration of opioid analgesics as needed. What route of administration should the nurse choose to achieve the fasted effect? A) Oral B) Intravenous C) Subcutaneous D) Intramuscular
B
J.B. has Parkinson's disease that has been controlled for several years with levodopa. After he begins a health food regimen with lots of vitamin B6, his tremors return, and he develops a rapid heart rate, hypertension, and anxiety. The nurse investigating the problem discovers that vitamin B6 can speed the conversion of levodopa to dopamine in the periphery, leading to these problems. The nurse would consider this problem... a. a drug-laboratory test interaction. b. a drug-drug interaction. c. a cumulation effect. d. a sensitivity reaction.
B
Receptor sites: A) are a normal part of enzyme substrates B) are protein areas on cell membranes that react with specific chemicals C) can usually be stimulated by many different chemicals D) are responsible for all drug effects in the body
B
The nurse has administered a drug that requires energy to move the drug molecules into the cells that they are intended to affect. The nurse should recognize the presence of: A) Passive diffusion B) Active transport C) Protein binding D) Filtration
B
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? A) The client likely has impaired drug metabolism B) Excretion is likely to take place slowly C) Absorption will be increased because of fluid accumulation D) Distribution will be delayed, increasing the risk of adverse effects
B
The nurse is reviewing a client's health history and medication administration record. Which drug would most likely induce the effects of the cytochrome P450 enzyme system? A) Mexiletine B) Prednisone C) Quinidine D) Ketoconazole
B
When trying to determine why the desired therapeutic effect is not being seen with an oral drug the nurse should consider: A) the blood flow to muscle beds B) food altering the makeup of gastric juices C) the weight of the patient D) the temperature of the peripheral environment
B
A nurse has looked up a new drug in a drug guide and is reviewing characteristics of its absorption. Which processes may be involved in this drug's absorption? Select all that apply A) Distribution B) Passive diffusion C) Protein binding D) Filtration E) Active transport
B, D &E
Select all that apply: Drug-drug interactions are important considerations in clinical practice. When evaluating a patient for potential drug-drug interactions, what would the nurse expect to address? A) Bizzarre drug effects on the body B) The need to adjust drug dose or timing of administration C) The need for more drugs to balance the effects of the drugs being given D) A new therapeutic effect not encountered with either drug alone E) Increased adverse effects F) The use of herbal or alternate therapies
B, E, & F
A client with complex health needs to take a large number of meds. In order to reduce the likelihood of drug-food interactions, what should the nurse encourage the client to do? A) Avoid foods that contain high levels of tyramine B) Avoid food that is high in sodium or potassium C) Avoid driving grapefruit juice D) Eat several smaller meals daily rather than three larger meals
C
Chemotherapeutic agents are drugs that: A) are used only to treat cancers B) replace normal body chemicals that are missing because of the disease C) Interfere with foreign cell functioning causing cell death, such as invading microorganisms or neoplasms D) stimulate the normal functioning of a cell
C
During a health history, a client states "I started taking the medicine every 6 hours like I was told. But then I started taking it every 5 hours, then every 4 hours, and eventually every 2 hours." The nurse determines that this client is at risk for what? A) Tolerance B) Placebo effect C) Cumulation D) Interaction
C
Much of the biotransformation that occurs when a drug is taken occurs as part of a. the protein binding effect of the drug. b. the functioning of the renal system. c. the first-pass effect through the liver. d. the distribution of the drug to the reactive tissues.
C
The nurse is administering a drug that is known to be absorbed by passive diffusion. The nurse should plan care in the knowledge that this drug will: A) require energy in order to be drawn across the cell membrane B) be excreted much slower than a drug that is absorbed by active transport C) move from areas of high concentration to areas of low concentration D) enter all body cells at a similar rate, exerting a similar effect on each
C
The nurse understands that the dosage recommended by drug manufacturers is based on an individual weighing how much? A) 100 lb (45 kg) B) 175 lb (79 kg) C) 150 lb (68 kg) D) 125 lb (57 kg)
C
Select all that apply: When reviewing a drug to be given the nurse notes that the drug is excreted in the urine. What points should be included in the nurse's assessment of the patient? A) The patient's liver function test B) The patient's bladder tone C) The patient's renal function tests D) The patient's fluid intake E) Other drugs being taken that could affect the kidney F) The patient's intake and output for the day
C, D, & E
A client has developed a tolerance to a drug. How should the nurse address this when providing care? A) assess the client for signs and symptoms of adverse drug effects B) assess the client for sings and symptoms of an allergy to the drug C) Advocate for a change in the client's medication D) assess whether the client needs larger doses to achieve the effect
D
A client's drug level has reached critical concentration. What action should the nurse perform? A) Perform and emergency assessment B) Assess for signs of delayed drug excretion C) Assess for indications of impaired metabolism D) Assess for evidence of the expected therapeutic effects
D
A group of students are reviewing class material in preparation for a test. The students demonstrate a need for additional teaching when they identify what as part of phase 1 biotransformation A) Reduction B) Oxidation C) Hydrolysis D) Conjugation
D
An experienced nurse has observed that female clients sometimes experience a drug's effects for longer time than male clients of similar age and size. The nurse should attribute this to what factor? A) Men have more vascular muscle, so the drug effects will take longer to occur B) Women more often experience electrolyte imbalances, prolonging a drug's effect C) Men commonly lack certain enzyme systems that are necessary for metabolizing a drug D) Women have more fat cells, so drugs depositing in fat will have a prolonged effect
D
Selective toxicity is: A) the ability of a drug to seek out a specific bacterial species or microorganisms B) the ability of a drug to cause only specific adverse effects C) the ability of a drug to cause fetal damage D) the ability of a drug to attack only those systems found in foreign or abnormal cells
D
Which client is most likely to have impaired drug metabolism. A client who: A) requires dialysis for renal failure B) is dehydrated following several days of diarrhea C) is being treated for basal cell skin cancer D) has a diagnosis of hepatitis C
D
Which client is receiving a drug that is an agonist? A client: A) who is taking a selective-reuptake inhibitor B) who takes a beta blocker for hypertension C) whose depression is treated with a monoxide oxidase inhibitor D) who takes insulin several times daily for type 1 diabetes
D
Which client's medication should the nurse expect to be absorbed most slowly? A) A subcutaneous anticoagulant B) An intravenous antibiotic C) Intramuscular meperidine, given for pain D) Oral acetaminophen, given for a fever
D
True or false: Pharmacodynamics is the study of the unique differences in response to drugs that each person possess based on genetic makeup.
False
True or false: Clark's rule would be used to determine a child's body surface for dosage calculation
False; Used for pediatric dose
True or false: Drugs that are highly lipid soluble are more likely to pass through the blood-brain barrier and reach the central nervous system.
True
True or false: Most oral drugs are best taken on an empty stomach.
True
True or false: Urine acidity can play an important role in drug excretion.
True
The nurse is researching a new drug's pharmacokinetics in the nursing drug guide. What info should the nurse read about? Select all that apply A) Duration B) Drug half-life C) Selective toxicity D) Timing of peak effect E) Receptor antagonism
A, B, & D
Select all that apply: When considering the pharmacokinetics of a drug, what points would the nurse need to consider? A) How the drug will be absorbed B) The way the drug affects the body C) Receptor site activation and suppression D) How the drug will be excreted E) How the drug will be metabolized F) The half-life of the drug
A, D, E & F
