Pharm Practice Questions
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 large initial dose helps to get the drug to optimal levels in the body faster."
A postoperative patient is being discharged home with acetaminophen/hydrocodone [Lortab] for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct?
"Taking the two medications together poses a risk of drug toxicity."
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?
"This drug would be inactivated by enzymes in the stomach."
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?
"This route is safer, less expensive, and more convenient."
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?
The patient is taking another medication that binds to serum albumin.
A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names?
They are assigned by the U.S. Adopted Names Council
A nursing student asks a nurse about pharmaceutical research and wants to know the purpose of randomization in drug trials. The nurse explains that randomization is used to do what?
To ensure that differences in outcomes are the result of treatment and not differences in subjects
A 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?
Whether an enteric-coated form of the drug is available
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
Monitor plasma drug levels.
An adult male patient is 1 day postoperative from a total hip replacement. On a pain scale of 0 to 10, with 10 being the greatest pain, the patient reports a pain level of 10. Which medication would be most appropriate for the nurse to administer to this patient?
6 mg morphine sulfate intravenously
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?
8:00 AM
A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction?
A 30-year-old man with kidney disease
A postoperative patient has orders for morphine sulfate 1 to 2 mg IV every 1 hour PRN for severe pain and acetaminophen-hydrocodone [Lortab] 7.5 mg PO every 4 to 6 hours PRN for moderate pain. The patient reports pain at a level of 8 on a scale of 1 to 10, with 10 being the worst pain. Which action by the nurse is appropriate?
Administer morphine sulfate 2 mg IV and evaluate the patient's pain in 15 to 30 minutes.
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its 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. The affinity of a drug for its receptors is reflected in its potency.
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?
Age Genetic factors Gender
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?
Amoxicillin
Which drugs will not be affected by interpatient variability?
Antiseptics applied to the skin to slow bacterial growth Antacids to help with the discomfort of heartburn Chelating agents that remove metal compounds from the body
A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not working. What will the nurse do?
Ask the patient about the number and frequency of tablets taken.
A patient has been receiving an antibiotic with a small therapeutic index for 10 days. Upon assessment, the nurse notes an increase in the drug's side effects. What would be the nurse's priority action?
Ask the prescriber to order a plasma drug level test.
A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse teaching this patient about home management should begin by doing what?
Asking the patient to demonstrate how to measure and administer insulin
The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration?
Assessing the patient's pain level 15 to 30 minutes after giving the medication
Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct?
At this stage of drug development, the safety and usefulness of the medication is unknown."
A patient is receiving digoxin twice daily. When assessing the patient before giving a dose, the nurse counts a pulse of 60 beats per minute and learns that the patient is experiencing nausea. The nurse consults a drug manual and verifies that the ordered dose is correct. What should the nurse do?
Contact the prescriber to report the symptoms.
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?
Contact the provider to discuss an order for pretreatment laboratory work.
A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10 (10 being the most extreme pain). The prescriber has ordered acetaminophen [Tylenol] 650 mg PO every 6 hours PRN pain. What will the nurse do?
Contact the provider to request a different analgesic medication.
The FDA Amendments Act (FDAAA) was passed in 2007 to address which aspect of drug safety?
Evaluating drug safety information that emerges after a drug has been approved and is in use
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?
Family medical history Patient's age Patient's diagnosis
A patient is taking a drug that does not bind to albumin. Which aspect of renal drug excretion is affected by this characteristic?
Glomerular filtration
A patient has been receiving intravenous penicillin for pneumonia for several days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a temperature of 38.5°C (101°F). Which is the correct action by the nurse?
Hold the next dose and notify the prescriber of the symptoms.
When administering medications to infants, it is important to remember which of the following?
Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. Infants have immature livers, which slows drug metabolism. Infants are more sensitive to medications that act on the central nervous system (CNS).
A patient tells the nurse that an analgesic he will begin taking may cause drowsiness and will decrease pain up to 4 hours at a time. Based on this understanding of the drug's effects by the patient, the nurse will anticipate which outcome?
Improved compliance with the drug regimen
What is a desired outcome when a drug is described as easy to administer?
It enhances patient adherence to the drug regimen.
What occurs when a drug binds to a receptor in the body?
It increases or decreases the activity of that receptor.
A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?
It is selective to receptors that regulate more than one body process.
A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain. The last dose was 3 mg given 2 hours ago. The patient is asleep, and the nurse notes a heart rate of 86 beats per minute and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?
Naloxone [Narcan] to block the effects of the morphine
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?
Pharmacotherapeutics
The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process?
Planning
The nurse is teaching a patient about taking warfarin and asks if the patient takes aspirin. This assessment by the nurse reflects a knowledge of which type of drug interaction?
Potentiative effects
What are the properties of an ideal drug?
Predictability Ease of administration Chemical stability
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of morphine sulfate. The nurse understands that the naloxone is effective because of which action?
Preventing activation of opioid receptors through antagonist actions
The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process?
Questioning the patient about over-the-counter medications
A patient asks a nurse why drugs that have been approved by the FDA still have unknown side effects. What will the nurse tell the patient?
Subjects in drug trials do not always represent the full spectrum of possible patients.
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer "2 puffs every 4 hours as needed for coughing or wheezing." The patient reports feeling jittery sometimes when taking the medication, and she doesn't feel that the medication is always effective. Which action is outside the nurse's scope of practice?
Suggesting that the patient use one puff to reduce side effects
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely?
Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body.
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:
desensitization of receptor sites by continual exposure to the drug.
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:
increase the urinary excretion of aspirin.
A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:
recycled via the enterohepatic recirculation to remain in the body longer.