Pharmacology Exam One Practice Questions
What is the primary site of metabolism? A. Lung. B. Kidney. C. Liver. D. None of the above.
C. Liver.
The nurse is showing the parent of a 2-year-old child how to administer eardrops. Which are correct statements?
1. Pull down on auricle 2. Position child's head with affected ear up
The first-pass effect or presystemic metabolism, a drug is extensively metabolized in the liver, with only part of the drug dose reaching the systemic circulation for distribution to sites of action. The first-pass effect occurs when some drugs are given by which of the following routes? A. Orally. B. Parentally. C. Rectally. D. Intravenously. A. Orally. Mrs. Geonity is prescribed a medication, and the provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. She asks you what the rationale is for the dosage changes. How should you respond? A. "Dosage determines whether the drug actions may be therapeutic or toxic." B. "Dosage varies based on the brand name." C. "Your generic drug does not work as efficiently, and the physician increased
A. "Dosage determines whether the drug actions may be therapeutic or toxic."
After listening to the nurse explain the use of the PO version of tretinoin (isotretinoin - Accutane) to a 19 year-old female client, the client demonstrates understanding of the most important point by making which statement at the end of the teaching session: A. "Have a pregnancy test prior to beginning therapy and use two forms of contraception." B. "Apply thick layer of isotretinoin twice a day." C. "Keep lips moist and lubricated to prevent inflammation." D. "Increase exposure to sun for added benefit."
A. "Have a pregnancy test prior to beginning therapy and use two forms of contraception."
Which statement indicates the postmenopausal client with osteoporosis understands the medication teaching concerning alendronate (Fosamax)? A. "I take the medication with 6-8 ounces of tap water." B. "I may experience some heartburn when taking this medication." C. "I do not use sunscreen when working outside in my yard." D. "I drink orange juice when I take the medication at breakfast."
A. "I take the medication with 6-8 ounces of tap water."
The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the prescribed timolol (Timoptic) blocker when the clients makes which statement: A. "This eye drop will reduce the intraocular pressure." B. "I can stop using the eyedrop once my intraocular pressure is normal." C. "The medicine will help to increase my intraocular pressure." D. "This eyedrop is the only treatment available for glaucoma."
A. "This eyedropwill reduce the intraocular pressure." Rationale: Ophthalmic beta-blockers such as timolol are administered to reduce intraocular pressure by decreasing production of aqueous humor. The medication must be continued as a lifelong therapy to maintain a stable intraocular pressure.
The client with liver dysfunction experiences toxicity to a drug following administration of several doses. This adverse reaction may have been prevented if the nurse had followed which phase of the nursing process? A. Assessment of liver enzyme labs. B. Evaluation for toxic effects of the drug. D. Planning of when to draw liver enzyme labs. D. Implementation of the antidote of the drug.
A. Assessment of liver enzyme labs.
A client enters the emergency clinic with the following symptoms: difficulty walking, pain in his toes, and aches in his feet. The nurse would anticipate giving which of the following medications to treat his acute gout episode? A. Colchicine. B. Allopurinol. C. Tylenol. D. Ibuprofen.
A. Colchicine.
When a newly admitted client is placed on heparin intravenously, the nurse acknowledges that heparin is effective for preventing new clot formation in clients who have which disorder(s)? (Select all that apply.) A. Deep Venous Thrombosis (DVT). B. Chronic Obstructive Pulmonary Disease (COPD). C. Pneumonia. D. Ruptured Spleen. E. Pulmonary Embolism (PE).
A. Deep Venous Thrombosis (DVT). E. Pulmonary Embolism (PE)
The prescription, distribution, storage, and use of Schedule drugs are closely monitored by the: A. Drug Enforcement Agency (DEA). B. Federal Drug Administration (FDA). C. Pharmaceutical companies. D. American DA.
A. Drug Enforcement Agency (DEA).
Enzyme that metabolizes drugs in the liver as well as nutrients and other endogenous substances: A. Hepatic microsomal enzyme system (P450). B. Drug-protein complexes. C. Affinity. D. First-pass effect.
A. Hepatic microsomal enzyme system (P450).
The client with renal calculi was prescribed allopurinol (Zyloprim) for uric acid stone calculi. Which medication teaching should the nurse discuss with the client? A. Inform the client to report chills, fever, muscle aches, and any skin rashes/blisters to the healthcare provider. B. Instruct the client to avoid driving or other activities that require alertness. C. Explain the importance of not eating breads, cereals, and fruits. D. Tell the client that the medication must be taken on an empty stomach.
A. Inform the client to report chills, fever, muscle aches, and any skin rashes/blisters to the healthcare provider.
The client using latanoprost eye drops for treatment of glaucoma calls the ophthalmology clinic after noting a brown pigmentation of the iris. Which nursing action is most appropriate? A. Instruct the client to come to the clinic to have the eyes and medication evaluated. B. Schedule an appointment for the client to see an internist for liver function studies. C. Tell the client that the pigmentation is from the latanoprost but will eventually regress. D. Recommend that the client wear sunglasses when outdoors to decrease iris pigmentation.
A. Instruct the client to come to the clinic to have the eyes and medication evaluated. Rationale: A side effect of latanoprost (Xalatan), a prostaglandin, includes a heightened brown pigmentation of the iris, which stops progressing when latanoprost is discontinued.
A nurse is caring for a cancer patient receiving subcutaneous morphine sulfate for pain. Which of the following nursing actions is most important in the care of this patient? A. Monitor respiratory rate. B. Monitor heart rate. C. Monitor temperature. D. Monitor urine output.
A. Monitor respiratory rate.
A patient with multiple partial-thickness burns is ordered tramadol as needed. The nurse assesses the effectiveness of this medication by monitoring the client's: A. Numeric pain rating. B. Oxygen saturation. C. Wound healing. D. Anxiety and restlessness.
A. Numeric pain rating.
The first-pass effect or presystemic metabolism, a drug is extensively metabolized in the liver, with only part of the drug dose reaching the systemic circulation for distribution to sites of action. The first-pass effect occurs when some drugs are given by which of the following routes? A. Orally. B. Parentally. C. Rectally. D. Intravenously.
A. Orally.
The process of drug movement to achieve drug action. The four processes are absorption, distribution, metabolism (biotransformation), and excretion (elimination). A. Pharmacokinetics. B. Pharmacodynamics. C. Onset of action. D. Duration of action.
A. Pharmacokinetics.
The strength of a drug at a specified concentration or dose: A. Potency. B. Efficacy. C. Maintenance dose. D. Therapeutic dose.
A. Potency.
Naloxone (Narcan) is administered to a client with severe respiratory depression and suspected drug overdose. After 20 minutes, the client remains unresponsive. The most likely explanation for this is: A. The client did not use an opioid drug. B. The drug overdose is irreversible. C. The client is resistant to this drug. D. The dose of naloxone was inadequate.
A. The client did not use an opioid drug.
The nurse working in the postanesthesisa care unit (PACU) is recovering a male client after an exploratory laproscopic procedure and administers the prescribed morphine sulfate intravenously. Five minutes later the nurse assess the client's respiratory rate and it is 8 breaths per minute. Which intervention should the nurse anticipate admnistering? A. The prn naloxone (Narcan). B. Asking another nurse to come and assess the client. C. Re-assessing the client's respiratory status in 30 minutes. D. Administering the client's albuterol inhaler.
A. The prn naloxone (Narcan).
A client is prescribed Colchicine. After taking three doses, the client complains of nausea, vomiting, and loose bowel stools. Which of the following should the client do? A. Withhold the medication and notify the healthcare provider. B. Skip the next dose and then continue taking the medication the next day. C. Continue taking the medication as these symptoms will go away. D. Cut the next dose in half.
A. Withhold the medication and notify the healthcare provider.
The mother of a client who has been diagnosed with head lice has completed the application of permethrin (Nix) shampoo. Which of the following is the next step the nurse should teach the mother regarding the treatment of head lice: A. "Check the heads of your child's friends before allowing them to play together." B. "Remove all nits from the hair shaft with a nit comb or a fine-tooth comb." C. "You are fine now; just watch your child for a reinfection." D. "Keep your child's hair short so it will be easier to treat next time."
B. "Remove all nits from the hair shaft with a nit comb or a fine-tooth comb."
A patient takes morphine sulfate 40 mg PO twice daily, for the management of chronic pain. Which intervention should be added to the plan of care to minimize the gastrointestinal adverse effects? A. Take an antacid with each dose. B. Take the medication on an empty stomach. C. Increase fluid and fiber in the diet. D. Eat foods high in lactobacilli.
C. Increase fluid and fiber in the diet.
A drug is 100% bioavailable when it is administered by which of the following routes? A. Oral. B. Parenteral. C. Intravenous. D. Rectal.
C. Intravenous.
Half-life determines what two things?
Frequency of administration and dosages
Potency Vs. Efficacy
Potency: -Strength of a drug at a specified concentration or dose. -A drug that is more potent will produce its therapeutic effect at a lower dose, compared to another drug in the same class. Efficacy: -Greatest maximal response that can be produced from a particular drug.
Bioavailability
The rate and extent to which the active ingredient is absorbed from a drug product and becomes available at the site of drug action to produce its effect
An 18-year-old has an external ear infection to be treated with eardrops. The nurse correctly instructs the patient to angle the ear
Up and back
Which factor is most important for the nurse to assess when evaluating the effectiveness of a client's drug therapy: A. Client's promise to comply with drug therapy. B. Client's satisfaction with the drug. C. Cost of the medication. D. Evidence of therapeutic benefit.
evidence of therapeutic benefit Once phamacotherapy is initiated, ongoing assessment is conducted to determine the presence of therapeutic effects or adverse effects.
Most important organ for unchanged drug/drug metabolite elimination. A. Liver. B. Lung. C. Kidney. D. None of the above.
C. Kidney.
Timolol (Timoptic), beta-adrenergic agent, may be used to treat glaucoma. The nurse should teach the clients and family to: A. Monitor blood glucose. B. Monitor respiratory rate. C. Monitor pulse and blood pressure. D. Monitor urine output.
C. Monitor pulse and blood pressure.
Colchicine is prescribed for a client with gout. The nurse reviews the client's record, knowing that this medication would be used in caution in which of the following medical condition? A. Amyloidosis. B. Scarlet Fever. C. Aplastic anemia. D. Behcet disease.
C. Aplastic anemia
An adult client with a history of obesity, asthma, peripheral vascular disease, and migraine headaches tells the nurse she saw an advertisement in a magazine for a drug for migraine headaches: "The drug was Imitrex; it looked very effective, and I wonder why my provider hasn't talked to me about using it for my headaches." What is the nurse's best response to this question about sumatriptan (Imitrex)? A. "You have asthma, so you cannot use the drug." B. "Your peripheral vascular disease is a contraindication for the drug." C. "I think it would be good for you. Bring in the ad." D. "Once you lose some weight, the drug will be perfect for you."
B. "Your peripheral vascular disease is a contraindication for the drug."
Which patient should NOT be prescribed alendronate (Fosamax) for osteoporosis? A. A female patient being treated for high blood pressure with an ACE inhibitor. B. A patient on bed rest who must maintain a supine position. C. A patient on a calorie restricted diet. D. A patient who is allergic to iodine/shellfish.
B. A patient on bed rest who must maintain a supine position. Response Feedback: Alendronate can cause significant gastrointestinal side effects, such as esophageal irritation, so it should not be taken if a patient must stay in supine position. It should be taken upon rising in the morning with 8 ounces of water on an empty stomach to increase absorption. The patient should not eat or drink for 30 minutes after administration and should not lie down. ACE inhibitors are not contraindicated with alendronate and there is no iodine allergy relationship.
Before administering drugs by the enteral route, the nurse should evaluate which of the following? A. Patency of the injection port. B. Ability of the client to swallow medications. C. Ability of the client to lie supine. D. Compatibility of the drug with IV fluid.
B. Ability of the client to swallow medications.
A nurse is preparing to administer a heparin injection to a client for prevention of deep vein thrombosis while hospitalized. What is an essential nursing intervention? A. Rub the administration site after injecting. B. Administer the medication into the subcutaneous tissue. C. Draw up the medication in an intramuscular (IM) syringe with a 22-gauge, 1-½ inch needle. D. Utilize the Z-track method to inject the medication.
B. Administer the medication into the subcutaneous tissue.
Timolol (Timoptic), beta-adrenergic agent, may be used to treat glaucoma. The nurse should teach the clients and family to: A. Monitor urine output. B. Monitor temperature. C. Monitor pulse and blood pressure. D. Monitor respiratory rate.
C. Monitor pulse and blood pressure.
A client has been treated for chronic open-angle glaucoma for 5 years asks the nurse, "How does glaucoma damage my eyesight." The nurse's reply should be based on the knowledge that open-angle glaucoma: A. Leads to detatchment of the retina. B. Causes increased intraocular pressure and damage to the optic nerve. C. Results from chronic eye inflammation. D. Is caused by decreased blood flow to the retina.
B. Causes increased intraocular pressure and damage to the optic nerve.
A client is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout? A. Probenecid. B. Colchicine. C. Allopurinol. D. Sulfinpyrazone.
B. Colchicine.
The names of therapeutic classifications usually reflect which of the following? A. Actions of the medication. B. Conditions for which the medication is used. C. Possible adverse reactions to the medications. D. Possible generic names for the medication.
B. Conditions for which the medication is used.
The client diagnosed with low back pain is prescribed morphine sulfate. Which intervention should the nurse implement? A. Tell the client that it is okay to get out of bed without assistance. B. Discuss with the healthcare provider to start the client on a stool softener. C. Inform the client to rise quickly from a supine position. D. Administer anticonvulsant medication around the clock.
B. Discuss with the healthcare provider to start the client on a stool softener.
Drugs delivered to the gastrointestinal (GI) tract, either orally (PO) or through nasogastric or gastrostomy tubes: A. Parenteral route. B. Enteral route. C. Rectal route. D. Intramuscular route.
B. Enteral route.
When teaching the client who is receiving allopurinol, what should the nurse encourage the client to do? A. Take medication 2 hours before meals. B. Have routine eye exams every 6 months to 1 year. C. Eat more meat. D. Increase Vitamin C intake.
B. Have routine eye exams every 6 months to 1 year.
A drug is 100% bioavailable when it is administered by which of the following routes? A. Oral. B. Intravenous. C. Parental. D. Rectal.
B. Intravenous.
The client diagnosed with chronic obstructive pulmonary disease (COPD) is prescribed morphine sulfate. Which statement is the scientific rationale for prescribing this medication to a client with COPD? A. Morphine will depress the respiratory drive. B. Morphine causes mild dilation of the bronchi and improves breathing in clients who have COPD. C. Morphine causes bronchoconstriction and decreased sputum. D. Morphine is not addicting, so it can be given routinely intravenously.
B. Morphine causes mild dilation of the bronchi and improves breathing in clients who have COPD.
Administration of drugs by routes other than enteral or topical: A. Enteral route. B. Parenteral route. C. Gastrostomy route. D. Nasogastric route.
B. Parenteral route.
A client uses timolol maleate (Timoptic) eye drops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by: A. Dilating the canals of Schlemm. B. Reducing aqueous humor formation. C. Constricting the pupils. D. Improving the ability of the ciliary muscle to contract.
B. Reducing aqueous humor formation.
A client uses timolol maleate (Timoptic) eye drops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by: A. Improving the ability of the ciliary muscle to contract. B. Reducing aqueous humor formation. C. Constricting the pupils. D. Dilating the canals of Schlemm.
B. Reducing aqueous humor formation.
Drugs are classified according to which of the following features? A. Name. B. Therapeutic uses. C. Side Effects. D. Actions.
B. Therapeutic uses.
The nurse is discussing skin care with a teenaged client who has MILD acne. Which medication or treatment should the nurse discuss with the client? A. Applying Vitamin E oil directly to the acne pimples to keep them moist. B. Washing the face and neck morning and night with benzoyl peroxide. C. Injections of Clostridium botulinum into the acne lesions. D. Taking isotretinoin (Accutane) by mouth daily.
B. Washing the face and neck morning and night with benzoyl peroxide.
The client diagnosed with a head injury after a skiing accident is ordered to have a head CT scan. The client is requesting to receive morphine sulfate IV prior to being transported to the radiology department. What teaching should the nurse include when discussing the administration of morphine sulfate to the client? A. Explain to the client that fentanyl will work best to control pain. B.Explain to the client that morphine sulfate is contraindicated because this could put the client at potential risk of increased cerebrospinal fluid (CSF) pressure. C. Morphine sulfate cannot be taken with any other routine medications; therefore, the client should not receive the drug. D.Inform the client that an intravenous line (IV) will be started prior to the procedure and the client can receive the morphine sulfate at that time.
B.Explain to the client that morphine sulfate is contraindicated because this could put the client at potential risk of increased cerebrospinal fluid (CSF) pressure.
The client with renal calculi (stones) was prescribed allopurinol (Zyloprim) for uric acid stone calculi. Which statement warrants intervention by the nurse? A. "I had to take two Tylenol because of my headache." B. "I do not drink wine or any type of alcoholic drinks." C. "I drink at least one glass of water per day." D. "My joints ache, but I make sure I avoid taking aspirin when I have renal stones."
C. "I drink at least one glass of water per day."
The nurse is teaching a client about safe drug administration when using topical permethrin for the treatment of scabies. The nurse determines that instruction has been effective when the client states: A. "I need to sign a consent for this medication." B. "I should cover the area with a clean cloth when applying the medication." C. "I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion." D. "I need to rinse off the topical medication after it has been on my skin for a few days."
C. "I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion."
The nurse cares for a client diagnosed with gout. The nurse instructs the client about allopurinol (Zyloprim). Which statement by the client indicates to the nurse the need for further instruction? A. "I should take the medication with meals to decrease upset stomach." B. "It will take at least 2 to 3 weeks for my gout symptoms to improve." C. "It will be necessary for me to decrease my fluid intake now." D. "This medication increases the excretion of uric acid through the kidneys."
C. "It will be necessary for me to decrease my fluid intake now."
Benzocaine has been recommended to a 17-year-old patient for treatment of mild sunburn. What should the patient be taught about using this product? A. It may be used on superficial and partial-thickness sunburns. B. Warming the lotion under warm water will prevent a chilled sensation when applied. C. A small test area should be used if the drug has not been used before to assess for an allergy. D. Cover the treated area with a light dressing wrapped in plastic wrap to keep if from rubbing off.
C. A small test area should be used if the drug has not been used before to assess for an allergy.
A client has been treated for chronic open-angle glaucoma for 5 years asks the nurse, "How does glaucoma damage my eyesight." The nurse's reply should be based on the knowledge that open-angle glaucoma: A. Results from chronic eye inflammation. B. Leads to detachment of the retina. C. Causes increased intraocular pressure and damage to the optic nerve. D. Is caused by decreased blood flow to the retina.
C. Causes increased intraocular pressure and damage to the optic nerve.
Which agent below is most likely to cause serious respiratory depression as a potential adverse reaction? A. Hydrocodone. B. Pentazocine. C. Fentanyl. D. Nalmefene.
C. Fentanyl.
Mechanism whereby drugs are absorbed, enter into the hepatic portal circulation, and are inactivated by the liver before they reach the general circulation: A. Bioavailability. B. Half-life (t 1/2). C. First-pass effect. D. Pro-drug.
C. First-pass effect.
The nurse administers morphine sulfate 4 mg intravenously to a client for the treatment of severe back pain. Which of the following assessments requires immediate nursing interventions? A. Pain is unrelieved in 15 minutes. B. The client is drowsy. C. Respiratory rate 7 breaths per minute. D. Blood pressure 110/70 mmHg
C. Respiratory rate 7 breaths per minute.
Allopurinol (Zyloprim) is prescribed for a client for the treatment of gout. The nurse is providing medication instructions and the nurse teaches the client: A. Take the medication on an empty stomach. B. A rash is a normal side effect of the medication. C. The effect of the medication will happen immediately. D. Limit the use of Vitamin C.
D. Limit the use of Vitamin C.
The nurse is teaching a client about safe drug administration when using topical permethrin for the treatment of scabies. The nurse determines that instruction has been effective when the client states: A. "I need to sign a consent for this medication." B. "I need to rinse off the topical medication after it has been on my skin for a few days." C. "I should cover the area with a clean cloth when applying the medication." D. "I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion."
D. "I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion."
The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the prescribed timolol (Timoptic) blocker when the clients makes which statement: A. "The medicine will help to increase my intraocular pressure." B. "I can stop using the eyedrop once my intraocular pressure is normal." C. "This eyedrop is the only treatment available for glaucoma." D. "This eyedrop will reduce the intraocular pressure."
D. "This eyedrop will reduce the intraocular pressure."
Miss Batten is prescribed topical retinoids - tretinoin for her moderate acne. She returns to the office 1 week later, disappointed because she does not see improvement in her condition. You explain to the client that improvement may not be seen for up to how many weeks? A. 1 week. B. 2-3 days. C. 5 days. D. 2-8 weeks.
D. 2-8 weeks.
The nurse should assess clients with chronic open-angle glaucoma for: A. Colored light flashes. B. Excessive lacrimation. C. Eye pain. D. Decreasing peripheral vision.
D. Decreasing peripheral vision.
After a nurse provided instructions about timolol (Timoptic) to a client with a history of chronic heart disease, the client asks, "How can these eye drops affect my heart?" The nurse's best response includes which of the following information? A. Clients are at risk if timolol is given at the same time as the oral medications taken for cardiac disease. B. This medication does not have any effects on the cardiac system. C. Clients are only at risk if the prescribed ophthalmic medication is pulmonary-selective. D. If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents.
D. If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents.
After a nurse provided instructions about timolol (Timoptic) to a client with a history of chronic heart disease, the client asks, "How can these eye drops affect my heart?" The nurse's best response includes which of the following information? A. This medication does not have any effects on the cardiac system. B. Clients are only at risk if the prescribed ophthalmic medication is pulmonary-selective. C. Clients are at risk if timolol is given at the same time as the oral medications taken for cardiac disease. D. If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents.
D. If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents.
The charge nurse on an orthopedic unit is transcribing orders for a client diagnosed with 2/10 back pain. Which health care provider order should the charge nurse question? A. tramadol (Ultram), centrally acting nonopioid analgesic, 50 mg PO every 6-8 hours PRN. B. CBC and CMP (complete metabolic panel) lab work. C. Carisoprodol (SOMA), a muscle relaxant, PO, twice daily. D. Morphine sulfate, an opioid agonist, 10 mg IV Push every hour.
D. Morphine sulfate, an opioid agonist, 10 mg IV Push every hour.
The postmenopausal client is prescribed alendronate (Fosamax) to help prevent osteoporosis. Which information should the nurse discuss with the client? A. Eat a meal prior to taking the medication. B. Drink half a glass of water when taking the medication. C. Chew the tablet thoroughly before swallowing the medication. D. Remain upright 30 minutes after taking the medication.
D. Remain upright 30 minutes after taking the medication.
Which of the following DEA regulated Drug Schedules correctly list the highest to the lowest potential for abuse: A. Schedule I, IV, III, V, II B. Schedule V, IV, III, II, I C. Schedule V, II, III, I, IV D. Schedule I, II, III, IV, V
D. Schedule I, II, III, IV, V
