Basic Pharmacology For Nurses 17th Edition By Clayton-Test Bank
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Test Bank For Basic Pharmacology For Nurses 17th Edition By Clayton
ISBN-10 : 0323311121 ISBN-13 :978-0323311120
MULTIPLE CHOICE
1.The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority action?
| a. | Notify physician of allergic reaction. |
| b. | Notify physician of idiosyncratic reaction. |
| c. | Notify physician of potential teratogenicity. |
| d. | Notify physician of potential tolerance. |
ANS: A
An allergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria, which are easily identified. An idiosyncratic reaction occurs when something unusual or abnormal happens when a drug is first administered. A teratogenic reaction refers to the occurrence of birth defects related to administration of the drug. Tolerance refers to the body’s requirement for increasing dosages to achieve the same effects that a lower dose once did.
DIF: Cognitive Level: Application REF: Page 17 OBJ: 4
TOP:Nursing Process Step: Assessment
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Safety
2.The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after administration, the nurse finds the patient agitated and stating that “everyone is out to get me.” What is the term for this unusual reaction?
| a. | Desired action |
| b. | Adverse effect |
| c. | Idiosyncratic reaction |
| d. | Allergic reaction |
ANS: C
Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first administered. Patients typically exhibit an overresponsiveness to a medication related to diminished metabolism. These reactions are believed to be related to genetic enzyme deficiencies. Desired actions are expected responses to a medication. Adverse effects are reactions that occur in another system of the body; they are usually predictable. Allergic reactions appear after repeated medication dosages.
DIF: Cognitive Level: Knowledge REF: Page 18 OBJ: 4
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Patient Education; Clinical Judgment; Caregiving; Safety; Sensory Perception
3. Which is the best description of when drug interactions occur?
| a. | On administration of toxic dosages of a drug |
| b. | On an increase in the pharmacodynamics of bound drugs |
| c. | On the alteration of the effect of one drug by another drug |
| d. | On the increase of drug excretion |
ANS: C
Drug interactions may be characterized by an increase or decrease in the effectiveness of one or both of the drugs. The toxicity of one drug may or may not affect the metabolism of another one. Drug interactions may result from either increased or decreased pharmacodynamics. Drug interactions may result from either increased or decreased excretion.
DIF: Cognitive Level: Comprehension REF: Page 18 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Safety; Patient Education; Clinical Judgment
4. What occurs when two drugs compete for the same receptor site, resulting in increased activity of the first drug?
| a. | Desired action |
| b. | Synergistic effect |
| c. | Carcinogenicity |
| d. | Displacement |
ANS: D
The displacement of the first drug from receptor sites by a second drug increases the amount of the first drug because the more unbound drug is available. An expected response of a drug is the desired action. A synergistic effect is an effect of two drugs being greater than the effect of each chemical individually or the sum of the individual effects. Carcinogenicity is the ability of a drug to cause cells to mutate and become cancerous.
DIF: Cognitive Level: Comprehension REF: Page 19 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Safety; Patient Education
5. What do drug blood levels indicate?
| a. | They confirm if the patient is taking a generic form of a drug. |
| b. | They determine if the patient has sufficient body fat to metabolize the drug. |
| c. | They verify if the patient is taking someone else’s medications. |
| d. | They determine if the amount of drug in the body is in a therapeutic range. |
ANS: D
The amount of drug present may vary over time and the blood level must remain in a therapeutic range in order to obtain the desired result. Generic drugs do not necessarily produce a different drug blood level than proprietary medications. Body fat is not measured by drug blood levels. Drug blood levels only measure the amount of drug in the body; they do not determine the source of the medication.
DIF: Cognitive Level: Comprehension REF: Page 17 OBJ: 4
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety
6. What is the process by which a drug is transported by circulating body fluids to receptor sites?
| a. | Osmosis |
| b. | Distribution |
| c. | Absorption |
| d. | Biotransformation |
ANS: B
Distribution refers to the ways in which drugs are transported by the circulating body fluids to the sites of action (receptors), metabolism, and excretion. Osmosis is the process of moving solution across a semipermeable membrane to equalize the dilution on each side. Absorption is the process by which a drug is transferred from its site of entry into the body to the circulating fluids for distribution. Biotransformation, also called metabolism, is the process by which the body inactivates drugs.
DIF: Cognitive Level: Comprehension REF: Page 15 OBJ: 3
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety
7.Does the nurse assess which blood level to determine the amount of circulating medication in a patient?
| a. | Peak |
| b. | Trough |
| c. | Drug |
| d. | Therapeutic |
ANS: C
When a drug is circulating in the blood, a blood sample may be drawn and assayed to determine the amount of drug present; this is known as the drug blood level. Peak levels are only those drug blood levels that are at their maximum before metabolism starts to decrease the amount of circulating drug. Trough levels are only those drug blood levels that are at their minimum when metabolism has decreased the amount of circulating drug and before an increase caused by a subsequent dose of the medication. Therapeutic levels are only those within a prescribed range of blood levels determined to bring about effective action of the medication.
DIF: Cognitive Level: Comprehension REF: Page 17 OBJ: 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety
8. The nurse administers 50 mg of a drug at 6:00 AM that has a half-life of 8 hours. What time will it be when 25 mg of the drug has been eliminated from the body?
| a. | 8:00 AM |
| b. | 11:00 AM |
| c. | 2:00 PM |
| d. | 6:00 PM |
ANS: C
Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM. 8:00 AM is 2 hours after administration; the half-life is 8 hours. 11:00 AM is 4 hours after administration; the half-life is 8 hours. 6:00 PM is 12 hours after administration; the half-life is 8 hours.
DIF: Cognitive Level: Analysis REF: Page 15 OBJ: 2
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Elimination; Health Promotion
9. What will the nurse need to determine first in order to mix two drugs in the same syringe?
| a. | The absorption rate of the drugs |
| b. | Compatibility of the drugs |
| c. | Drug blood level of each drug |
| d. | Medication adverse effects |
ANS: B
Knowledge of absorption is important but not in order to mix drugs. In order to mix two drugs, compatibility is determined so there is no deterioration when the drugs are mixed in the same syringe. Drug level does not indicate if it is acceptable to mix medications in the same syringe. Adverse effects are important for the nurse to know, but not in order to mix drugs.
DIF: Cognitive Level: Application REF: Page 19 OBJ: 6
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Safety
10.A patient developed hives and itching after receiving a drug for the first time. Which instruction by the nurse is accurate?
| a. | Stop the medication and encourage the patient to wear a medical alert bracelet that explains the allergy. |
| b. | Explain to the patient that these are signs and symptoms of an anaphylactic reaction. |
| c. | Emphasize to the patient the importance to inform medical personnel that in the future a lower dosage of this drug is necessary. |
| d. | Instruct the patient that it would be safe to take the drug again because this instance was a mild reaction. |
ANS: A
This initial allergic reaction is mild, and the patient is more likely to have an anaphylactic reaction at the next exposure; a medical alert bracelet is necessary to explain the reaction. Signs and symptoms of an anaphylactic reaction are respiratory distress and cardiovascular collapse. A more severe reaction will occur at the next exposure, and the patient should not receive the drug again.
DIF: Cognitive Level: Application REF: Page 18 OBJ: 4
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Patient Education; Clinical Judgment; Safety
11.When obtaining a patient’s health history, which assessment data would the nurse identify as having the most effect on drug metabolism?
| a. | History of liver disease |
| b. | Intake of a vegetarian diet |
| c. | Sedentary lifestyle |
| d. | Teacher as an occupation |
ANS: A
Liver enzyme systems are the primary site for the metabolism of drugs. Intake of a vegetarian diet may affect absorption but not metabolism. Sedentary lifestyle and occupations could affect metabolism (exposure to environmental pollutants), but these do not have the most significant effect on metabolism.
DIF: Cognitive Level: Application REF: Page 16 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Patient Education; Clinical Judgment; Safety
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