Unit 1: ATI Intro to Pharm
Definition of metabolism
The change of a drug into a more or less potent or more soluble for after it passes through the liver, kidneys, intestinal mucosa, or other body part.
Definition of duration of action
The length of time the drug's therapeutic effect lasts.
Definition of distribution
The movement of a drug by the circulatory system to its intended site of action.
Definition of absorption
The movement of a drug from the site of administration into the circulatory system.
Definition of trough drug level
The point in time when a drug is at its lowest level in the body.
Definition of excretion
The removal of the drug or its metabolites through the kidneys, gastrointestinal tract, skin, or lungs.
Definition of peak drug level
The time it takes a drug to demonstrate its full therapeutic effect.
Definition of onset of action
The time it takes for a drug to demonstrate a therapeutic response.
A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A. Adverse effect B. Paradoxical effect C. Therapeutic effect D. Toxicity
A Adverse effects are the unintended and unexpected effects of a drug, which can range from mildly annoying to life-threatening, such as an anaphylactic reaction.
A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A. "This will increase the effects of normal cellular functions." B. "This prevents cells in your body from performing certain actions." C. "This prevents hormones in your body from attaching to cell receptor sites." D. "This minimizes the risk that the medications you take will become toxic."
A Agonist drugs bind to cell receptors in the body and are targeted to a specific type of receptor. When they attach to the receptors, they perform the same action as a hormone or chemical would, increasing the effects of that hormone or chemical. For example, pharmacological insulin is administered to clients who have little to no insulin to mimic insulin's effects in the body.
A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? A. Therapeutic effect B. Adverse reaction C. Contraindication D. Precaution
A Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia.
A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? A. They have similar mechanisms of actions. B. They have the same half-life. C. They are administered by the same route. D. They have similar availability.
A Drugs in the same class often share similar mechanisms of action, as well as assessment guidelines, interactions, and precautions.
When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways A. It begins with a lower-case letter. B. It is listed in parentheses along with the trade name. C. There are both letters and numbers in the name. D. The chemical name is listed in parentheses before the generic name.
A Generic names are not capitalized. The brand, or trade name, is a drug's commercial name and is capitalized.
An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with aging? A. Reduced hepatic blood flow B. Increased glomerular filtration rate C. Reduced body fat D. Increased gastric motility
A Older clients may be at risk for drug toxicity due to delayed drug metabolism related to reduced hepatic blood flow and decreased liver enzyme production. Other physiologic changes in older adults are decreased blood flow to the kidneys and reduced glomerular filtration rate, increased body fat, decreased cardiac output, decreased gastric emptying, and slowed peristalsis.
A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their potential for which of the following? A. Serious adverse reactions B. Drug tolerance C. Drug dependence D. Interactions with other drugs
A Some drugs are unsafe for clients with certain characteristics or disorders or because they eat certain foods or take certain drugs as they have the potential to cause serious or life-threatening adverse effects. Drug tolerance is a decreased response to a drug over a period of time. Drug dependence is a physiologic or psychologic need for a drug. A drug interaction is an alteration in the expected pharmacologic action of a drug that results from an interaction with another drug.
A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A. Pharmacologic action B. Chemical stability C. Route D. Adverse effects
A The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action.
A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply) A. Clients can achieve desired effects with the use of lower dosages. B. Taking the two drugs together can reduce the effects of one or both drugs. C. Taking the two drugs together can potentiate the effects of one or both drugs. D. The two drugs can produce an action neither would have produced alone. E. Both drugs have similar actions.
A and E Clients can achieve desired effects with the use of lower dosages is correct. When two or more drugs are given at the same time and have similar actions, an additive effect will occur. Clients can take some drugs together for their additive effects, so they can take lower doses of each drug. Taking the two drugs together can reduce the effects of one or both drugs is incorrect. Drugs that interact together to cause reduced effects are antagonistic. Taking the two drugs together can potentiate the effects of one or both drugs is incorrect. Drugs that interact together to cause greatly increased effects are synergistic. The two drugs can produce an action neither would have produced alone is incorrect. Two drugs given together can produce a unique effect neither would have produced when taken alone. However, this is not an additive effect. Both drugs have similar actions is correct. Additive effects occur when two or more drugs with similar actions are taken at the same time.
A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over the counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (Select all that apply). A. The newborn's weight B. How much breast milk the newborn consumes each day C. Whether or not the benefits to the client outweigh the risks to the newborn D. The properties of the drug E. The route of administration of the drug
A, B, C, and D The newborn's weight is correct. The nurse should consider the weight of the newborn when recommending a drug for a client who is breastfeeding. The lower the newborn's weight, the greater the effects of the drug absorbed via breastmilk will be to the newborn. How much breast milk the newborn consumes each day is correct. The nurse should consider the amount of breast milk the newborn consumes per day when recommending a drug for a client who is breastfeeding. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation. Whether or not the benefits to the client outweigh the risks to the newborn is correct. The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn. The properties of the drug is correct. The nurse should consider the properties of the drug when recommending a drug for a client who is breastfeeding. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility. The route of administration of the drug is incorrect. Over-the-counter drugs are available in various enteral and topical forms. Any drug, regardless of route, that has the potential for systemic absorption poses a potential risk to a newborn who is being breastfed.
A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply) A. Initiate oxygen therapy to support respiratory function B. Administer epinephrine to increase blood pressure. C. Give diphenhydramineine to stop histamine release D. Establish and maintain an open airway to ensure oxygenation E. Administer a drug agonist to neutralize the allergic reaction.
A, B, C, and D When a client has an anaphylactic reaction, your priority is to establish an open airway and then administer oxygen immediately. Give epinephrine to increase blood pressure and diphenhydramine to stop the release of histamine. Do not administer a drug agonist, because it would elicit an action in the body instead of blocking an action.
A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn. (Select all that apply) A. Impaired cognitive level B. Language barrier C. Discomfort D. Repetition of teaching E. Unreadiness to learn
A, B, C, and E Impaired cognitive level is correct. A lack of understanding due to impaired cognitive and developmental levels can decrease the client's ability to learn. The nurse should adjust instructional methods to accommodate the client's developmental or cognitive level. Language barrier is correct. If the nurse and the client speak different languages, this can affect the client's ability to learn. The nurse should provide written information in the language the client speaks and make arrangements for finding an interpreter if necessary. Discomfort is correct. A client who is uncomfortable is not able to learn optimally. The nurse should ensure that the client is comfortable prior to giving instructions. Repetition of teaching is incorrect. Repeating important facts frequently and allowing clients to practice new skills often enhances learning. Unreadiness to learn is correct. A client's readiness to learn is an essential part of the client's ability to learn. For example, a client who is experiencing denial or distress is not ready to learn.
Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply) A. Body surface area B. Age C. Weight D. Developmental level E. Drug properties
A, B, C, and E To avoid toxicity, overdose, or undertreatment, primary care providers adjust drugs for children based on their body surface area, weight, drug properties such as metabolism and excretion. The child's developmental level may determine the method of administration, but not the dose.
A nurse is obtaining a client's health history and discovers that client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all that apply) A. They do not require the supervision of a nurse. B. They can interact with other drugs. C. They should be included in the client's drug history assessment. D. They are less effective than prescription drugs. E. They do not cause toxicity.
A, B, and C They do not require the supervision of a nurse is correct. Over-the-counter drugs do not require a prescription or the supervision of a nurse. They can interact with other drugs is correct. Many over-the-counter drugs interact with other drugs. They should be included in the client's drug history assessment is correct. Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies. They are less effective than prescription drugs is incorrect. Over-the-counter drugs can be as effective as prescription drugs. This varies with the individual client and drug. They do not cause toxicity is incorrect. Over-the-counter drugs can cause toxicity in clients who have certain conditions or if clients take them in excess.
A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (Select all that apply). A. Periodic laboratory tests are essential to measure serum drug levels. B. Monitoring for indications of toxicity is important. C. Taking the drug with an inducing agent will increase the possibility of toxicity. D. Taking the smallest effective dose is crucial. E. Increasing fluid intake is recommended to avoid toxicity.
A, B, and D Periodic laboratory tests are essential to measure serum drug levels is correct. Clients who are taking drugs that have a high potential for toxicity should undergo regular monitoring of serum drug levels to be certain the drug level stays within the therapeutic range. Monitoring for indications of toxicity is important is correct. Drugs that have a high potential for toxicity can quickly build up to toxic levels in the blood, resulting in effects that can be irreversible or life-threatening. Therefore, the nurse should monitor for manifestations of toxicity particular to the drug the client is taking. Taking the drug with an inducing agent will increase the possibility of toxicity is incorrect. Inducing agents are drugs that have the effect of increasing the metabolism of drugs they are combined with, thereby reducing their efficacy and blood levels. Inducing agents can be prescribed to allow clients to take a lower dose of a drug, so the chances of drug toxicity are lessened. Taking the smallest effective dose is crucial is correct. It is optimal to use the lowest effective dose of a drug to achieve therapeutic effects because doing so helps minimize the risk for toxicity. Increasing fluid intake is recommended to avoid toxicity is incorrect. Increasing fluids will not reduce the risk for drug toxicity. Increasing fluids can change the urine's specific gravity, but it will not alter glomerular filtration, passive tubular reabsorption, or active tubular secretion, which are the three mechanisms by which drugs are excreted
A nurse is caring for a client who arrived at the emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (Select all that apply). A. Low blood pressure B. Wheezing C. Bradycardia D. Peripheral edema E. Difficulty swallowing
A, B, and E Low blood pressure is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. Wheezing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Wheezing is an indication of bronchospasm and is treated using bronchodilators. Bradycardia is incorrect. Tachycardia, rather than bradycardia, is an indication of anaphylaxis. Peripheral edema is incorrect. Angioedema, or facial swelling, rather than peripheral edema, is an indication of anaphylaxis. Difficulty swallowing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.
A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? A. Contraindications B. Precautions C. Paradoxical effects D. Adverse effects
B A precaution includes disease states, such as kidney disease, or clinical situations in which use of a drug involves particular risks or dosage modification might be necessary.
A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? A. Adverse effects B. Indications C. Pharmacokinetics D. Nursing implications
B The indications section provides information on conditions and diseases for which the drug is used.
A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? A. Adverse effects B. Contraindications C. Implementation D. Black box warning
B The nurse should review the contraindications section in the drug handbook to determine if a client can receive the drug. This section lists pre-existing diseases or clinical situations that could make it unsafe to administer a drug.
A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? A. To determine drug-food interactions B. To determine if dosage modification is indicated C. To determine how the drug is absorbed D. To determine availability
B The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age.
A client asks you about the difference between a generic drug and a trad- or brand0 name drug. Which of the following are true regarding generic drugs? (Select all that apply) A. Have the potential for abuse and dependence B. Have the same chemical composition as the brand-name drug C. May have several brand names D. May have several generic names E. Are usually less expensive than a brand-name drug
B, C, and E Generic and trade name drugs have the same chemical composition and the safe effects. Generic drugs are usually less expensive than brand-name drugs. Each drug has only one generic name. The trade name is the brank or proprietary name the manufacturer gives a drug, so various manufacturers give the same drug different brand names. Brand names also differ with the various formulations or routes the same manufacturer provides. There is no difference in abuse potential between a generic and a brand-name drug.
You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a client's postoperative pain. Which of the following actions describes the action of an agonist on a receptor? A. Destroys the receptor B. Competes with the receptor C. Activates the receptor D. Blocks the receptor
C Agonists bind with receptor sites on a cell and activate them to produce a response. In contrast, antagonist block drugs from receptor sites, blocking the drug's intended reaction. Antagonists that compete with an agonist for cell receptor sites are called competitive antagonists. Drugs typically do not destroy the receptor sites on cells.
A nurse is caring for a client who has a history of renal insufficiency and it taking lithium. The nurse should monitor the client for which of the following? A. Tolerance to the drug B. Drug interaction C. Drug toxicity D. Dependence on the drug
C Drug toxicity develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. A client who has renal insufficiency might have delayed or impaired excretion of the drug. The drug dosage should be reduced if toxicity occurs.
A nurse is caring for a client who is having difficulty remembering to take their prescribed drug 3 times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? A. Liquid suspension B. Immediate-release capsule C. Extended-release tablet D. Powder form
C Extended-release tablets release the drug over an extended period of time. Clients can take them less frequently.
A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? A. "Itching is an expected adverse effect of amoxicillin." B. "Itching can indicate amoxicillin toxicity." C. "Itching can indicate a hypersensitivity to amoxicillin." D. "Itching can result from dry skin, which is often caused by amoxicillin."
C Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillin.
A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons? A. The IV form crosses the blood-brain barrier. B. The oral form has a decreased half-life. C. The oral form has decreased bioavailability because of the first-pass effect. D. The oral form has an increased rate of excretion.
C Oral doses are often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug. Enzymes in the liver metabolize drugs, making less of the drug available for use by the body.
You are helping a client learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning? A. Verbally quiz a family member B. Instruct the client to complete a written test C. Have the client demonstrate an insulin injection D. Ask the client several key questions about the procedure.
C The best way to evaluate a client's ability to perform a skill is through a return of demonstration of that skill. Involving the family members and asking the client questions may help them retain the information and reinforce their learning, but they do not confirm the client's ability to perform the procedure.
You are talking with a client about taking tetracycline along with an antacid. You tell the client not to take these 2 drugs at the same time because the antacid can reduce the absorption of tetracycline. When one drug reduced the effect of another drug, it is.... A. An allergic reaction B. A synergistic effect C. An antagonistic effect D. An adverse reaction
C When one drug reduced the effect of another drug, it is an antagonistic effect. When the client's body responds to a drug by releasing histamine and causing itching and hives, the client is having an allergic reaction to a drug. Drugs that interact, causing greatly increased or exaggerated effect, are acting synergistically. The nontherapeutic unintended effects of a drug that occur at a therapeutic dose are side or adverse effects or reactions.
A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching? A. "Adverse effects are the intended effects of the medication." B. "Adverse effects indicate a severe allergy to the medication." C. "Decrease your medication dose if adverse effects occur." D. "Contact your provider if adverse effects occur."
D Adverse effects can be severe and life-threatening. The client should contact their provider if adverse effects occur.
A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? A. "Drug absorption occurs in the stomach." B. "You should expect immediate absorption of the drug." C. "You should allow the tablet to dissolve in your mouth." D. "Do not crush or chew the tablet."
D Drugs that irritate the stomach are often covered with an enteric coating that does not dissolve until the drug enters the alkaline environment of the small intestine. Clients should not crush or chew enteric-coated drugs because this will damage the enteric coating.
A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following? A. Reduced drug absorption B. Drug dependence C. Altered drug distribution D. Drug toxicity
D Grapefruit juice can cause increased levels of certain drugs, such as sertraline, which can lead to drug toxicity. Clients should avoid drinking grapefruit juice while taking these drugs.
A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? A. After the client has a definitive diagnosis B. On the day of discharge C. When the client's family members are present D. As soon as possible
D Instruction should start at the beginning of care and when the client is receptive to learning.
A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can should which of the following? A. Maternal bleeding B. Maternal blood clots C. Gestational diabetes mellitus D. Fetal malformation
D Teratogenic drugs can cause birth defects. Clients who are pregnant should not take these drugs.
