Evolve Ch. 2, 15, 16
A patient is given a drug that has a half-life of 8 hours. The peak level of this drug is 100 mg/L. What would be the concentration of the drug after two half-lives? Record your answer using a whole number. __________ mg
25
The nurse administers a drug to a patient that has a half-life of 6 hours. If the dose of the drug is 200 mg/L, what would be the concentration of the drug after 12 hours? Record your answer using a whole number. ________ mg/L
50
What is an alternate name for biotransformation of a drug?
Metabolism
A nurse is educating a patient who is prescribed warfarin (Coumadin). The nurse advises the patient to avoid taking aspirin (Ecotrin) and explains that taking both drugs together may cause excessive bleeding. What is this phenomenon called? a. Additive Effect b. Synergistic Effect c. Incompatibility d. Antagonistic Effect
a
During a cardiopulmonary resuscitation emergency, the nurse expects to administer which injectable, fast-acting medication? a. Epinephrine (Adrenalin) b. Naphazoline (Privine) c. Oxymetazoline (Afrin) d. Salmeterol (Serevent)
a
The nurse has administered bethanechol (Duvoid) to a patient with hypotonic bladder. After 45 minutes, the nurse finds that the patient is effectively responding to the medication. What did the nurse observe in the patient to reach this conclusion? a. The patient had micturition. b. The patient's blood pressure was reduced. c. The patient had reduced bowel sounds. d. The patient's respiratory rate was reduced.
a
The nurse is caring for a patient who has been prescribed a diuretic and a beta blocker for the treatment of hypertension. What is the effect of the combination of the drugs? a. Additive drug effect b. Increase in side effects c. Synergistic drug effect d. Antagonistic drug effect
a
The nurse is caring for a patient who is receiving a drug with a narrow therapeutic index. What is the most important nursing intervention for this patient? a. Monitor the patient's plasma drug level periodically b. Instruct the patient not to drive after taking the medication. c. Instruct the patient not to take the drug after a high-fat meal. d. Monitor the patient's serum albumin levels periodically.
a
The nurse is caring for a patient who is taking a cholinergic (parasympathomimetic) drug. Which assessment will indicate that the medication is having a desired effect? a. Increased gastrointestinal (GI) motility b. Mydriasis c. Urinary retention d. Vasoconstriction
a
The nurse monitors a patient prescribed dicyclomine (Bentyl) for which therapeutic effect? a. Decrease in GI motility b. Decrease in urinary frequency c. Increase in heart rate d. Increase in blood pressure
a
The nurse monitors a patient prescribed dicyclomine (Bentyl) for which therapeutic effect? a. Decrease in gastrointestinal (GI) motility b. Decrease in urinary frequency c. Increase in heart rate d. Increase in blood pressure
a
A patient has taken an enteric-coated medication with a large amount of food. How would this affect the bioavailability of the drug? a. It will become zero. b. It will be decreased. c. It will be increased. d. It will be unaffected.
b
The nurse reads that the half-life of the medication being administered is 12 hours. What interpretation will guide the nurse's care of this patient? a. This medication will be 50% eliminated in 12 hours, so the dosing will be spread apart. b. The medication will be administered every 6 hours to maintain consistent blood levels. c. The medication will not work for the first 12 hours. d. The patient will require two doses of the medication before there is an effect.
a
The nurse realizes that a drug administered by which route will require the most immediate evaluation of therapeutic effect? a. Intravenous b. Oral c. Subcutaneous d. Topical
a
The nurse should expect which assessment finding for a client taking a selective beta 1 receptor blocker? a. Pulse 62 b. Wheezing bilaterally c. Bounding radial pulse d. Irregular apical pulse
a
The nursing student asks the clinical instructor about anticholinergic medication effects. What is the instructor's best response? a. "Anticholinergics cause problems with urinary retention." b. "Anticholinergics increase saliva production and sweating." c. "In large doses, anticholinergics decrease muscle rigidity." d. "In small doses, anticholinergics increase the heart rate."
a
What does the nurse teach a patient who is prescribed enteric-coated tablets? a. "Do not chew or crush the tablet." b. "Place the tablet under the tongue." c. "Dissolve the tablet in water or milk." d. "Eat a high-fat meal before taking the medication."
a
Which is a characteristic of highly protein-bound drugs? a. They increase the risk of drug-drug interactions. b. They typically provide a short duration of action. c. They must be administered with 8 ounces of water. d. They have a decreased effect in patients with a low albumin level.
a
The nurse is teaching a patient to report any side effects after taking a prescribed drug. What should the nurse teach the patient about side effects? Select all that apply. a. "The drug should not be discontinued because of side effects." b. "The drug dose can be adjusted by the health care practitioner to reduce side effects should they occur." c. "Side effects are not expected as part of the drug therapy." d. "The drug may be interchanged with another one from the same class." e. "Side effects may be mild or severe and may include anaphylaxis."
a b d
The nurse obtains the patient's history to identify factors that may affect drug pharmacokinetics. Which patients who are on highly protein-bound drugs are likely to experience drug toxicity? Select all that apply. a. patient with liver cirrhosis b. patient with kidney disease c. patient who had gastric surgery d. patient with a nutritional deficiency e. patient with peripheral vascular disease
a b d
The nurse has administered several oral medications to the patient. Which factors will influence the absorption of these medications? Select all that apply. a. Presence of food in the stomach b. pH of the stomach c. Patient position upon intake of medication d. Form of drug preparation e. Pain f. Amount of saliva
a b d e
The nurse needs to be aware that which factors will affect the absorption of orally administered medications? Select all that apply. a. Presence of food in the stomach b. pH of the stomach c. Patient position upon intake of medication d. Form of drug preparation e. Time of day
a b d e
Arrange the processes of pharmacokinetics in the order of their occurrence. a. Absorption b. Biotransformation c. Distribution d. Excretion
a c b d
The client demonstrates understanding of the effects of adrenergic blocking drugs that must be reported to the health care provider immediately when listing which effects? Select all that apply. a. Chest pain b. Heart rate 70 c. Insomnia d. Excessive agitation e. Palpitations
a c d e
A nurse is reviewing information about a drug. The drug is absorbed in the mouth and after 12 hours, traces of the drug are found in urine and cerebrospinal fluid. What is this process called? a. Pharmaceutics b. Pharmacokinetics c. Pharmacodynamics d. Pharmacotherapeutics
b
A patient is taking a drug with a narrow therapeutic index (TI). What are the factors associated with this drug of which the nurse should be aware? a. There is less possibility of developing dependence. b. There is a high possibility that overdose events will occur. c. The drug will have low tolerance when compared to other drugs. d. The chances of side effects are low with this drug relative to other drugs.
b
A patient who has end-stage renal disease will begin antibiotic therapy for a pulmonary complication. What will the nurse expect the provider to do when ordering this drug for this patient? a. Increase the dose from the recommended dose. b. Initiate therapy with a lower than recommended dose. c. Prescribe an antibiotic with a low therapeutic index. d Administer the antibiotic with diuretic medications.
b
The nurse administers 650 mg of aspirin at 7 PM. The drug has a half-life of 3 hours. The nurse interprets this information to mean that 325 mg of the medication will have been eliminated from the patient's system by what time? a. 7 AM b. 10 PM c. 1 AM d. 10 AM
b
The nurse is caring for a patient who is receiving intravenous (IV) gentamicin. The health care provider requests the peak and trough levels of the drug for the patient. When should the nurse arrange for the blood sample to be drawn to obtain the trough level of the drug? a. One hour after the drug is administered b. Just before the next dose is administered c. 10 minutes after the drug is administered d. Immediately after the drug is administered
b
The nurse is caring for an elderly patient who has been prescribed oral tablets intended to be primarily absorbed in the stomach. What is the cause of delayed drug absorption in the patient? a. The drug requires an alkaline solution to disintegrate b. The drug disintegrates slowly in the gastrointestinal fluid c. The drug dissolves after it reaches the small intestine d. The drug disintegrates in a solution that has a pH of 5
b
The patient has been receiving dopamine in an intravenous infusion. The nurse notes that the health care provider has ordered phentolamine to be administered. What does the nurse recognize the patient is most likely experiencing? a. Overdosage b. Extravasation c. Anaphylaxis d. Toxicity
b
Which condition is treated with bethanechol (Urecholine) in a postoperative patient? a. Postoperative hypotension b. Urinary atony c. Respiratory atelectasis d. Postoperative ischemic colitis
b
Which is the highest priority intervention for a patient admitted with glaucoma? a. Teach the patient to wear glasses at all times. b. Administer pilocarpine. c. Keep lights very low. d. Teach the patient to stay out of sunlight
b
An elderly patient with an overactive bladder is treated with anticholinergic drugs. Which clinical presentations are suggestive of complications of anticholinergic drugs? Select all that apply. a. Diarrhea b. Dry mouth c. Tachycardia d. Blurred vision e. Bronchospasm
b c d
Which are safe routes of administration of epinephrine? Select all that apply. a. Oral b. Topical c. Inhalation d. Intracardiac e. Intravenous f. Subcutaneous
b c d e f
Drug half-life is defined as the amount of time required for 50% of a drug to do what? a. Be absorbed by the body b. Exert a response c. Be eliminated by the body d. Reach a therapeutic level
c
For which adverse reaction will the nurse monitor in a patient taking bethanechol (Urecholine) for treatment of urinary retention? a. Constipation b. Hypertension c. Syncope d. Mydriasis
c
The nurse is administering an injection to a patient and wants the medication to take effect as quickly as possible. Which injection site will the nurse select? a. Subcutaneous tissue b. Ventrogluteal c. Deltoid d. Dorsogluteal
c
The nurse is administering medications to a patient with chronic renal failure. What is the nurse's priority action? a. Administer all medications via the intravenous route. b. Assess drug levels daily. c. Assess the patient for medication toxicity. d. Hold medications if urinary output is low.
c
The nurse is caring for a patient who is undergoing treatment with an alpha-adrenergic drug. The nurse is monitoring daily laboratory test results on the patient. Because of the patient's treatment with the alpha-adrenergic drug, the nurse anticipates that the laboratory tests will show which result? a. Increased level of calcium b. Increased level of potassium c. Increased level of glucose d. Increased level of magnesium
c
The nurse is caring for a patient who needs an immediate drug response. Which type of drug is the health care provider most likely to prescribe for the patient? a. placebo b. oral drug c. loading dose d. high first-pass drug
c
The nurse is monitoring a patient's vital signs on each visit that the patient makes to a health clinic. The patient has started treatment with an adrenergic blocking drug. What is the nurse's highest priority? a. Count the patient's respiratory rate for one minute. b. Take the patient's temperature by both the oral and axillary routes. c. Measure both supine and standing blood pressures. d. Count the radial pulse for one full minute
c
The nurse recognizes that the patient who is taking an adrenergic blocking drug understands the importance of avoiding other substances that may interact with the medication when the patient makes which statement? a. "I should limit my fluid intake while taking this medication." b. "One glass of red wine with meals will not interfere with the medication." c. "I should avoid drinking my morning coffee while taking this drug." d. "There's no need to stop eating chocolate while I'm on this medication."
c
The patient has been ordered two drugs of the same class to be used for treatment of asthma. The patient asks the nurse, "Why do I have to use more than one medication to treat this? Isn't one enough?" What is the nurse's most appropriate response? a. "You need to ask your health care provider questions like that." b. "No, in this case, one drug is not enough to do what's needed for you." c. "Sometimes use of more than one drug will give a combined therapeutic effect." d. "I will arrange for the pharmacist to do a presentation for you."
c
What is the most accurate outcome criteria for the nurse to use when determining if a patient is responding appropriately to use of an adrenergic drug? a. Patient is able to correctly state three side effects of the medication. b. Patient is alert to time, person, and place and makes coherent conversation. c. Patient's respiratory rate is 16 breaths/minute and blood pressure is 130/72 mm Hg. d. Patient awakens easily during nurse's morning rounds and states, "I feel fine."
c
What is the ratio between a drug's therapeutic effects and toxic effects called? a. Tolerance b. Cumulative effect c. Therapeutic index d. Affinity
c
What system should the nurse assess to determine if bethanechol has had a therapeutic effect? a. Neurologic assessment b. Muscular assessment c. Urinary assessment d. Gastric assessment
c
Which assessment most assists the nurse in determining if bethanechol (Urecholine) has had a therapeutic effect? a. Neurologic assessment b. Muscular assessment c. Urinary assessment d. Gastric assessment
c
A client with a new prescription for propranolol (Inderal) tells the nurse he has a history of asthma. The nurse's priority action is to: a. teach the client how to take his blood pressure. b. tell the client to change positions slowly. c. inform the client to carry a rescue inhaler at all times. d. notify the client's health care provider.
d
A patient diagnosed with asthma just completed an albuterol nebulizer treatment. The patient tells the nurse, "I feel like my heart is fluttering, and my hands are very shaky." What is the nurse's most appropriate action? a. Notify the health care provider. b Hold the next albuterol treatment. c. Request a decreased dose of albuterol. d. Explain this sensation as a side effect.
d
A patient is administered 300 mg of ibuprofen. How many hours later will less than 1 mg of the ibuprofen remain in the patient's body? a. 8 hours b. 12 hours c. 15 hours d. 18 hours
d
A patient is admitted to the emergency department with a suspected cholinesterase inhibitor overdose. What is the nurse's primary action? a. Monitor urinary output. b. Insert a large-bore IV catheter. c. Attach patient to telemetry monitor. d. Administer ordered anticholinergic medication
d
A patient is admitted to the emergency department with a suspected cholinesterase inhibitor overdose. What is the nurse's primary action? a. Monitor urinary output. b. Insert a large-bore IV catheter. c. Attach patient to telemetry monitor. d. Administer ordered anticholinergic medication.
d
A patient who is scheduled for an endoscopy is administered atropine prior to the procedure. What is the reason for giving atropine to the patient? a. Atropine decreases the apical heart rate. b. Atropine increases intraocular pressure. c. Atropine increases frequency of urination. d. Atropine reduces salivation in the mouth.
d
A primary health care provider prescribes a combination therapy of hydrochlorothiazide (HydroDIURIL) and lisinopril (Zestril) for enhanced effects in the treatment of hypertension. Which effect attributes to this type of enhanced therapeutic action of drugs? a. Adverse effect b. Additive effect c. Antagonist effect d. Synergistic effect
d
In order to produce a sympathomimetic response, the nurse may administer which medication that is only available as a synthetic substance? a. Epinephrine b. Norepinephrine c. Dopamine d. Dobutamine
d
The nurse administers pilocarpine (Pilocar) ophthalmic drops to a patient. For which clinical indicator does the nurse monitor as a means of evaluating the therapeutic effectiveness of the ophthalmic treatment? a. Dilated pupils b. Dull, dry eyes c. Farsightedness d. Constricted pupils
d
The nurse arranges for blood to be drawn from the patient to indicate the highest plasma concentration of the drug at a specific time. As what is this type of specimen known? a. Trough drug level b. Therapeutic index c. Therapeutic range d. Peak drug level
d
The nurse is assessing a patient who is on cholinergic drug therapy. The nurse finds that the patient has abdominal cramps and hypotension and is at risk of cardiac arrest. According to the nurse, what is the possible reason for the patient's condition? a. The patient had an allergic reaction. b. The patient had a drug interaction. c. The patient had consumed alcohol. d. The patient had an overdose of the drug
d
The nurse is caring for a patient who has Parkinson's disease who is receiving anticholinergic drug therapy. What is the reason for prescribing this drug therapy to the patient? a. The drug increases the patient's apical heart rate. b. The drug decreases gastrointestinal secretions. c. The drug decreases the urinary bladder spasms. d. The drug decreases muscle rigidity and tremors.
d
The nurse is caring for a patient who has been receiving pain medication over the last 24 hours. The patient states that the medication is no longer relieving his pain as it did yesterday. What does the nurse attribute this statement to? a. Tolerance b. Toxic effect c. Placebo effect d. Tachyphylaxis
d
The nurse is preparing to administer bethanechol (Urecholine) to a patient. Which information in the patient's history prompts the nurse to collaborate with the primary health care provider before giving the drug? a. Constipation b. Hypertension c., Psoriasis d. Asthma
d
The patient has been found to have been given an overdose of morphine. Naloxone is given to block the narcotic response. As what is the effect achieved when naloxone is administered known? a. Synergistic b. Additive c. Negative d. Antagonistic
d
The patient is scheduled to receive an enteric-coated tablet immediately after a meal. The nurse will choose which food to include as part of the patient's meal? a. Hot dogs b. Avocados c. Salami d. Skim milk
d
What is a clinical indicator of parasympathetic nervous system stimulation? a. Dilation of the pupils b. Retention of urine c. Dilation of the bronchi d. Slowing of the heart rate
d
Which drug is classified as an adrenergic antagonist? a. Propofol (Diprivan) b. Milrinone (Primacor) c. Epinephrine (Adrenaline) d. Propranolol (Inderal)
d
Which finding is a therapeutic effect of atropine (generic)? a. Miosis b. Lethargy c. Hypertension d. Increased heart rate
d
Which outcome would be most appropriate to establish for patients taking beta1 agonists? a. Relaxation of uterine smooth muscle b. Relaxation of bronchial smooth muscle c. Increased resistance of peripheral vessels d. Increased contractility of myocardium
d
