Chapter 2 - Drugs and the Body

Question 1

Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess
for an alteration in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure

Answer 1

C) A 50-year-old man with cirrhosis of the liver

Question 2

A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this
drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug
is given. How long will it take for the blood level to reach the non-toxic range?
A) 30 minutes
B) 1 hour
C) 2 hours
D) 3 hours

Answer 2

B) 1 hour

Question 3

A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic
complaining of ​dizzy spells and weakness.​ While conducting the admission assessment, the patient tells
the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood
pressures and no adverse effects. Since his move, he has been having problems and he feels that the
drug is no longer effective. The clinic nurse knows that one possible reason for the change in the
effectiveness of the drug could be what?
A) The impact of the placebo effect on the patient’s response.
B) The accumulative effect of the drug if it has been taken for many years.
C) The impact of the warmer environment on the patient’s physical status.
D) Problems with patient compliance with the drug regimen while on vacation.

Answer 3

C) The impact of the warmer environment on the patient’s physical status.

Question 4

An important concept taught by the nurse when providing medication teaching is the need to provide a
complete list of medications taken to health care providers to avoid what?
A) Spending large amounts of money on medications
B) Allergic reactions to medications
C) Drug​drug interactions
D) Critical concentrations of medications in the body

Answer 4

C) Drug​drug interactions

Question 5

A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is
the instructor’s best response?
A) A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a
different receptor site
B) A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
C) A drug that interacts directly with receptor sites to cause the same activity that a natural chemical
would cause at that site
D) A drug that reacts with receptor sites to block normal stimulation, producing no effec

Answer 5

C) A drug that interacts directly with receptor sites to cause the same activity that a natural chemical
would cause at that site

Question 6

A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive
the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral
dose?
A) Passive diffusion
B) Active transport
C) Glomerular filtration
D) First-pass effect

Answer 6

D) First-pass effect

Question 7

A nurse is working as a member of a research team involved in exploring the unique response to drugs
each individual displays based on genetic make-up. What is this area of study is called?
A) Pharmacotherapeutics
B) Pharmacodynamics
C) Pharmacoeconomics
D) Pharmacogenomics

Answer 7

D) Pharmacogenomics

Question 8

The	nurse	uses	what	term	to	describe	the	drug	level	required	to	have	a	therapeutic	effect?
A) Critical	concentration
B) Dynamic	equilibrium
C) Selective	toxicity
D) Active	transport

Answer 8

A) Critical concentration

Question 9

The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student
asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the
students to affect absorption of the IM administration of drugs?
A) Perfusion of blood to the subcutaneous tissue
B) Integrity of the mucous membranes
C) Environmental temperature
D) Blood flow to the gastrointestinal tract

Answer 9

C) Environmental temperature

Question 10

A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the
nurse’s priority action?
A) Wash her hands before handling the medications.
B) Consult a drug guide for compatibility.
C) Question the patient concerning drug allergies.
D) Identify the patient by checking the armband and asking the patient to state his name

Answer 10

B) Consult a drug guide for compatibility.

Question 11

The	patient	is	taking	a	drug	that	affects	the	body	by	increasing	cellular	activity.	Where	does	this	drug
work	on	the	cell?
A) Receptor	sites
B) Cell	membrane
C) Golgi	body
D) Endoplasmic	reticulum

Answer 11

A) Receptor sites

Question 12

Several processes enable a drug to reach a specific concentration in the body. Together they are called
dynamic equilibrium. What are these processes? (Select all that apply.)
A) Distribution to the active site
B) Biotransformation
C) Absorption from the muscle
D) Excretion
E) Interaction with other drugs

Answer 12

A) Distribution to the active site
B) Biotransformation
D) Excretion

Question 13

A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) 25
as possible, the nurse needs to consider what?
A) Pharmacotherapeutics
B) Pharmacokinetics
C) Pharmacoeconomics
D) Pharmacogenomics

Answer 13

B) Pharmacokinetics

Question 14

The nurse is explaining how medications work to a group of peers and explains that disruption of a
single step in any enzyme system disrupts what?
A) Cell life
B) Cell membrane
C) Cell receptor sites
D) Cell function

Answer 14

D) Cell function

Question 15

The processes involved in dynamic equilibrium are key elements in the nurse’s ability to determine
what?
A) Dosage scheduling
B) Amount of solution for mixing parenteral drugs
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) 26
C) Timing of other drugs the patient is taking
D) How long the patient has to take the dru

Answer 15

A) Dosage scheduling

Question 16

What	factor	influences	drug	absorption?
A) Kidney	function
B) Route	of	administration
C) Liver	function
D) Cardiovascular	function

Answer 16

B) Route of administration

Question 17

What	does	the	lipid	solubility	of	the	drug	influence?
A) Absorption	of	the	drug
B) Metabolism	of	the	drug
C) Excretion	of	the	drug
D) Distribution	of	the	drug

Answer 17

D) Distribution of the drug

Question 18

The nursing students are learning about the half-life of drugs. A student asks the instructor to explain half-life. What is the instructor’s best response?
A) Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved.
B) Half-life is the amount of time it takes for the drug to be metabolized by the body.
C) Half-life is the amount of time it takes for half of the drug to reach peak level in the body.
D) Half-life of a drug is the time it takes for the drug to reach half its potential peak level in the body.

Answer 18

A) Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved.

Question 19

The patient is taking a 2-mg dose of ropinerol XR. The drug has a half-life of 12 hours. How long will
it be before only 0.25 mg of this drug remains in the patient’s system?
A) 24 hours
B) 36 hours
C) 48 hours
D) 60 hours

Answer 19

B) 36 hours

Question 20

The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The
patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per
injection. If the patient takes an injection on Monday, how much of the drug would still be in the
patient’s system when she takes her next injection on Wednesday, assuming the half-life of the drug is
24 hours?
A) 22 mcg
B) 16.5 mcg
C) 11 mcg
D) 5.5 mcg

Answer 20

C) 11 mcg

Question 21

The patient is a 6-year-old child who is taking 125 mg of amoxicillin every 6 hours. Assuming that the
half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child’s body at the time of
the next administration of the drug?
A) 62.5 mg
B) 46.875 mg
C) 31.25 mg
D) 15.625 mg

Answer 21

C) 31.25 mg

Question 22

A drug with a half-life of 4 hours is administered at a dosage of 100 mg. How much of the drug will be
in the patient’s system 8 hours after administration?

A) 75 mg
B) 50 mg
C) 37.5 mg
D) 25 mg

Answer 22

D) 25 mg

Question 23

The nurse administers amoxicillin 500 mg. The half-life of this drug is approximately 1 hour. At what
point would the drug level in the body be 62.5 mg if the drug was not administered again?
A) 1 hours after the original dose
B) 2 hours after the original dose
C) 3 hours after the original dose
D) 4 hours after the original dose

Answer 23

C) 3 hours after the original dose

Question 24

The nurse is caring for a patient who is receiving gentamicin, 250 mg and fluconazole (Diflucan), 500
mg at the same time. The nurse knows that if these two drugs competed with each other for proteinbinding sites, what would this do?
A) Make the patient gentamicin deficient
B) Make the patient fluconazole deficient
C) Counteract any positive benefit the drugs would have
D) Alter the effectiveness of both drugs

Answer 24

D) Alter the effectiveness of both drugs

Question 25

The student nurse asks the instructor why a patient with a central nervous system infection is receiving
antibiotics that will not cross the blood​brain barrier. What is the instructor’s most correct response?
A) A severe infection alters the blood​brain barrier to allow the drug to cross.
B) A medication that is water soluble is more likely to cross the blood-brain barrier.
C) Antibiotics are the exception to the blood​brain barrier and cross easily.
D) An infection that spreads outside the central nervous system helps drugs cross the barrier

Answer 25

A) A severe infection alters the blood​brain barrier to allow the drug to cross.

Question 26

The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the
medication taken actually reaches the tissue due to what process?
A) Distribution
B) First-pass effect
C) Reduced absorption
D) Gastrointestinal circulation

Answer 26

B) First-pass effect

Question 27

What needs to happen to the protein​drug complex for the drugs to reach the cells where the drug can
act?
A) The protein​drug complex must break itself into smaller pieces to enter the capillaries.
B) The binding site on the protein picks up a chemical to make it soluble in the serum.
C) The drug must break away from the protein-binding site and float freely.
D) The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.

Answer 27

C) The drug must break away from the protein-binding site and float freely.

Question 28

he nurse is reviewing the results of the patient’s laboratory tests. What must the nurse keep in mind when reviewing these results related to medication administration?

A) The patient’s emotional response to the disease process
B) The timing of the last dose of medication relative to when blood was drawn
C) The possibility of a drug​laboratory test interaction
D) A change in the body’s responses or actions related to the dru

Answer 28

C) The possibility of a drug​laboratory test interaction

Question 29

A patient has come to the clinic and been diagnosed with Lyme disease. The physician has ordered oral
tetracycline. What is important for the nurse to include in the teaching plan about tetracycline? (Select
all that apply.)
A) Do not take the drug with anything high in sodium content to keep from producing a state of
hypernatremia in the body.
B) Do not take the drug with foods or other drugs that contain calcium.
C) Do not take the drug at the same time you take an iron supplement or with foods that are high in iron content.
D) Avoid exposure to the sun when taking this drug as it can turn your skin purple.
E) Avoid eating bananas at the same time you take this drug as the potassium content of the
tetracycline can produce hyperkalemia in the body.

Answer 29

B) Do not take the drug with foods or other drugs that contain calcium.
C) Do not take the drug at the same time you take an iron supplement or with foods that are high in iron content.

Question 30

A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug​drug
interaction. What is the nurse’s first and best means of avoiding this problem?
A) Consult a drug guide.
B) Call the pharmacist.
C) Contact the provider.
D) Ask another nurse.

Answer 30

A) Consult a drug guide.

Question 31

The nurse promotes optimal drug effectiveness by doing what? (Select all that apply.)
A) Incorporate basic history and physical assessment factors into the plan of care.
B) Evaluate the effectiveness of drugs after they have been administered.
C) Modify the drug regimen to modify adverse or intolerable effects.
D) Minimize the number of medications administered to patients.
E) Examine factors known to influence specific drugs if they are to be effective.

Answer 31

A) Incorporate basic history and physical assessment factors into the plan of care.
B) Evaluate the effectiveness of drugs after they have been administered.
C) Modify the drug regimen to modify adverse or intolerable effects.
E) Examine factors known to influence specific drugs if they are to be effective.

Question 32

The nurse administers a specific medication to an older adult patient every 4 hours. The patient has a
history of chronic renal failure. Why would this patient be at risk for toxic drug levels?
A) Cumulative effect
B) First-pass effect
C) Drug interactions
D) Cross-tolerance effect

Answer 32

A) Cumulative effect

Question 33

The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to
relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the
patient’s pain and a larger dose is needed to have the same effect. How might the nurse explain why
this is happening?
A) Tolerance
B) Cumulation
C) Interactions
D) Addiction

Answer 33

A) Tolerance

Question 34

While administering a medication that the nurse has researched and found to have limited effectiveness,
the patient tells the nurse, ​I have read all about this drug and it is such a wonder drug. I’m so lucky my
doctor prescribed it because I just know it will treat my problem.​ The nurse suspects this drug will be
more effective than usual for this patient because of what effect?
A) Cumulative effect
B) First-pass effect
C) Placebo effect
D) Cross-tolerance effec

Answer 34

C) Placebo effect

Question 35

The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what
factors in this patient could extend the drug’s half-life? (Select all that apply.)
A) Gastrointestinal disease
B) Kidney disease
C) Liver disease
D) Cardiovascular disease
E) Route of administration

Answer 35

B) Kidney disease
C) Liver disease
D) Cardiovascular diseas