Nclex review Exam 1

Question 1

A nurse is preparing to give an oral dose of drug X to treat a patient’s high blood pressure. After giving the drug, the nurse finds that it not only reduces the blood pressure without serious harmful effects, but it also causes the patient to have nausea and headache. Based on this information, which property of an ideal drug is this drug lacking?

Effectiveness
Safety
Selectivity
Ease of administration

Answer 1

Selectivity

Question 2

The nurse is preparing to give a drug with certain properties. Which property of the drug is the most compelling indication that it should not be given?
The drug produces an unwanted side effect.
The drug is difficult to administer.
The drug’s effects are reversible.
The drug is not effective for its intended purpose.

Answer 2

The drug is not effective for its intended purpose

Question 3

Why is it important for drugs to have ease of administration?
  Fewer administration errors
  Less risk of side effects
  Greater chemical stability
  Greater likelihood of reversibility

Answer 3

Fewer administration errors

Question 4

The nurse teaches a patient not to consume alcohol with nitroglycerine, because the blood pressure often drops significantly when nitroglycerine is taken with alcohol. Which drug property does this illustrate?
  Chemical instability
  Drug interaction
  Reversible action
  Drug selectivity

Answer 4

Drug interaction

Question 5

When studying the impact a drug has on the body, the nurse is reviewing what?
  The drug’s pharmacokinetics
  The drug’s selectivity
  The drug’s pharmacodynamics
  The drug’s predictability

Answer 5

The drugs pharmacodynamics

Question 6

When studying the effects of drugs in humans, the nurse is learning about what?
  Pharmacology
  Clinical pharmacology
  Therapeutics
  Effectiveness

Answer 6

clinical pharmacology

Question 7

Which statement by a new nurse indicates that further study is indicated?
Effectiveness is the most important property a drug can have.
There is no such thing as a safe drug.
Drugs are defined as illegal substances.
There is no such thing as a selective drug; all medications cause side effects.

Answer 7

drugs are defined as illegal substances

Question 8

What is the ultimate concern for the nurse when administering a drug?
  Intensity of the response
  Dosage
  Route of administration
  Timing of administration

Answer 8

intensity of response

Question 9

What is the objective of drug therapy?
To provide maximum benefit with minimal harm
To provide minimum benefit with maximum harm
To provide total relief of symptoms regardless of harm
To provide as much benefit as possible

Answer 9

to provide maximum benefit with minimal harm

Question 10

Characteristics unique to each patient can influence pharmacokinetic and pharmacodynamic processes. What characteristics may determine the patient’s response to a drug? (Select all that apply.)
  Age
  Gender
  Weight
  Mood
  Genetics

Answer 10

age, gender, weight, genetics

Question 11

The nurse is preparing to administer a dose of penicillin. Before administering the medication, the nurse assesses the patient’s allergy history. Which aspect of drug therapy does this represent?
  Making PRN (as needed) decisions
  Evaluating therapeutic effects
  Ensuring proper dosage
  Identifying high-risk patients

Answer 11

identifying high risk patients

Question 12

The nurse is preparing to administer a medication with the following order: “Aldomet 250 mg daily.” What should the nurse do?
Administer the medication as it was given last time.
Administer the medication by mouth.
Verify the order with the prescriber.
Ask the patient how this medication is usually given.

Answer 12

Verifying the order with the prescriber

Question 13

Which aspect of drug therapy indicates to the nurse whether a drug is having a beneficial effect?
Performing a preadministration assessment
Evaluating therapeutic responses
Minimizing adverse effects
Managing toxicity

Answer 13

Evaluating therapeutic responses

Question 14

he nurse is managing the care of a group of patients with cancer who will be receiving chemotherapy. The nurse defines goals, sets priorities, identifies interventions, and establishes criteria for evaluating success. Which phase of the nursing process does this represent?
  Assessment
  Planning
  Implementation
  Evaluation

Answer 14

Planning

Question 15

The nurse identifies which as the goal of drug therapy in the treatment of patients?
Cure of the disease
Follow-up with the prescriber
Correct administration technique
Production of maximum benefit with minimum harm

Answer 15

Production of maximum benefit with minimum harm

Question 16

A diabetic patient is taught the signs and symptoms of hypoglycemia with insulin use. The patient knows to eat fast-acting carbohydrates. This is an example of which goal?
  Minimizing adverse effects
  Promoting therapeutic effects
  Minimizing adverse interactions
  Managing toxicity

Answer 16

Minimizing adverse effects

Question 17

When questioning a patient about his or her allergic reaction to a drug, the nurse should ask for which additional information?
  The dose taken
  The type of reaction
  Who gave the drug
  What was eaten with the drug

Answer 17

The type of reaction

Question 18

The nurse is obtaining a drug history for a patient admitted to the unit. The nurse obtains information about past and present health histories, currently used prescription drugs, behavioral factors, and use of over-the-counter (OTC) drugs. What other information does the nurse need to obtain? (Select all that apply.)
Use of recreational drugs and substances
Usual sleep patterns and disturbances
Highest level of education completed
Use of herbal remedies
Self-treatment with complementary and alternative drugs

Answer 18

use of recreational drug and substances
use of herbal remedies
self-treatment with complementary and alternative drugs

Question 19

Which statements about medication administration would the nurse identify as true? (Select all that apply.)

All drugs have the potential to produce undesired effects.
Drug therapy often can be enhanced by nonpharmacologic measures.
Patients taking two drugs are not likely to have a drug interaction.
Nurses’ knowledge of pharmacology is more important for standing orders than for PRN medications.
Patient adherence is essential in achieving the therapeutic objective of medications.

Answer 19

All drugs have the potential to produce undesired effects
drug therapy often can be enhanced by nonpharmacologic measures
patient adherence is essential…

Question 20

hen educating patients about their medications, the nurse includes information about which topics? (Select all that apply.)
  What to do if a dose is missed
  The duration of treatment
  Prescription of drug coverage
  The method of drug storage
  Symptoms of adverse effects

Answer 20

what to do if a dose is missed
the duration of treatment
the method of drug storage
symptoms of adverse effects

Question 21

Which legislation sets rules for the manufacture and distribution of drugs considered to have the potential for abuse?
Food, Drug, and Cosmetic Act of 1938
Harris-Kefauver Amendments of 1962
Controlled Substances Act of 1970
Food and Drug Administration Modernization Act of 1997

Answer 21

Controlled Substances Act of 1970

Question 22

What is a result of the Prescription Drug User Fee Act (PDUFA) of 1992?
New drugs reach the market sooner than ever before.
Controlled substances are categorized into schedules.
Drugs for acquired immunodeficiency syndrome (AIDS) receive accelerated approval.
More research is conducted on drug safety in children.

Answer 22

New drugs reach the market sooner than ever before.

Question 23

Which is a true statement about new drug development in the United States?
Development and testing of new drugs take about 3 to 5 years.
About 50% of drugs undergoing clinical trials gain approval.
Randomized controlled trials are the best way to assess drug therapy.
The cost of developing a new drug is usually around $1 million.

Answer 23

Randomized controlled trials are the best way to assess drug therapy.

Question 24

N-acetyl-para-aminophenol is an example of which type of drug name?
  Proprietary
  Chemical
  Generic
  Trade

Answer 24

Chemical

Question 25

A new medication becomes available for treatment of a debilitating neurologic disease. What would the nurse expect about the safety of the drug?
The drug is safe for administration to children.
The drug has been tested in pregnant women.
All possible adverse effects have been identified by animal testing.
The drug has passed the FDA approval process.

Answer 25

The drug has passed the FDA approval process.

Question 26

Why are trade names much easier to say and remember than generic names?
The FDA assigns every drug’s generic name.
Trade names must be the same regardless of which drug company manufactures the drug.
Companies have a marketing advantage when the trade name is easier to recognize.
Trade names improve oral and written communication in the healthcare system.

Answer 26

Companies have a marketing advantage when the trade name is easier to recognize

Question 27

Which term is commonly used for nonprescription drugs?
  Legend
  Generic
  Over-the-counter
  Pharmaceutical

Answer 27

OTC

Question 28

Which is a true statement about new drug development? (Select all that apply.)

Preclinical testing of drugs is always performed in healthy, nonpregnant adults.
Drug trials require that those involved don’t know which subjects are receiving the drug or control.
During preclinical testing, drugs are evaluated for toxicities, kinetic properties, and useful effects.
When a new drug is released, all adverse effects are known.

Answer 28

Drug trials require that those involved don’t know which subjects are receiving the drug or control.
During preclinical testing, drugs are evaluated for toxicities, kinetic properties, and useful effects.

Question 29

Which statements about over-the-counter (OTC) drugs would the nurse identify as true? (Select all that apply.)
Most illnesses initially are treated with an OTC agent.
More prescription drugs than OTC agents are administered each year in the United States.
The average home medicine cabinet contains eight OTC preparations.
Forty percent of Americans take at least one OTC drug every 2 days.
Some drugs that originally were sold by prescription are now OTC.

Answer 29

Most illnesses initially are treated with an OTC agent
Forty percent of Americans take at least one OTC drug every 2 days.
Some drugs that originally were sold by prescription are now OTC.

Question 30

Which statements about the Family Smoking Prevention and Tobacco Control Act (2009) would the nurse identify as true? (Select all that apply.)
All ingredients in tobacco products must be listed on the warning label.
A gradual reduction of nicotine to nonaddictive levels is required.
Marketing to youth is prohibited.
Harmful additives are restricted.
Purchasers of tobacco products must be age 21 years or older.

Answer 30

All ingredients in tobacco products must be listed on the warning label.
A gradual reduction of nicotine to nonaddictive levels is required.
Marketing to youth is prohibited.
Harmful additives are restricted

Question 31

A new graduate nurse preparing to administer medications knows that which of the following is required for a drug to move through the body?
  Selectivity and effectiveness
  The ability to cross membranes
  Development of an electric charge
  A transporter protein

Answer 31

The ability to cross membranes

Question 32

The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?
  Slowly
  Rapidly
  Unpredictably
  Variably

Answer 32

Rapidly

Question 33

The nurse is administering warfarin, an anticoagulant, to a patient with a low albumin level. Which effect of this medication should the nurse expect to observe?
  Increased PT/INR levels
  Deep vein thromboses
  Reduced risk of bruising
  Increased platelet aggregation

Answer 33

Increased PT/INR levels

Question 34

A nurse prepares to administer acetaminophen [Tylenol] to a patient with an oral temperature of 101.7°F. Which preparation would the nurse expect to have the most rapid onset of action?
  Tylenol elixir
  Tylenol tablets
  Tylenol capsules
  Tylenol gel caps

Answer 34

Tylenol elixir

Question 35

The nurse should provide which teaching point when administering an enteric-coated oral tablet to a patient?
“Chew the tablet before swallowing.”
“Break the tablet in half before swallowing.”
“Allow the tablet to be absorbed under the tongue.”
“Swallow the tablet whole after double-checking the dose.”

Answer 35

“Swallow the tablet whole after double-checking the dose.”

Question 36

When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient?
  A 3-week-old neonate
  A 12-year-old boy
  A 25-year-old woman
  A 15-month-old infant

Answer 36

3-week-old neonate

Question 37

For which reason should the nurse follow safe medication administration for intravenous (IV) medications?
The IV route can result in delayed absorption of the medication.
The IV route results in a delayed onset of action.
Control over the levels of drug in the body is unpredictable.
IV administration is irreversible.

Answer 37

IV administration is irreversible.

Question 38

The nurse is preparing to administer an intravenous (IV) medication. What is the minimum injection time to reduce the risk of harm to the patient?
  10 seconds
  30 seconds
  60 seconds
  30 minutes

Answer 38

60 seconds

Question 39

The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system, very little active drug is left in the general circulation as a result of what?
  Therapeutic range
  First-pass effect
  Drug half-life
  Plasma protein binding

Answer 39

First-pass effect

Question 40

The nurse should instruct a patient complaining of pain to do what to reduce fluctuations in drug levels?
“Take pain medication around the clock at specified intervals and doses.”
“Take pain medication when the pain level reaches an 8 or 9 on a 1 to 10 scale.”
“Take pain medication at night before bed and avoid daytime dosing because of drowsiness.”
“Take pain medication after breakfast and dinner to reduce stomach upset.”

Answer 40

Take pain medication around the clock at specified intervals and doses.

Question 41

The nurse understands that the dose-response relationship is graded and should expect to observe which response?
Once a drug is given, the response is predictably all-or-nothing.
The response is maintained at a specific level when the therapeutic objective is achieved.
As the dosage increases, the response becomes progressively greater.
A graded response is based on relative potency and maximal efficacy.

Answer 41

As the dosage increases, the response becomes progressively greater.

Question 42

The nurse demonstrates the concept of maximal efficacy by administering which drug for a headache that the patient describes as a “mild dullness” and as a 2 on a 1 to 10 scale?
  Meperidine [Demerol]
  Pentazocine [Talwin]
  Aspirin
  Morphine sulfate

Answer 42

Aspirin

Question 43

Which statement by the nursing student indicates a need for further instruction about drug selectivity?
“Botulinum toxin is very selective and therefore very safe for administration.”
“Selective drug action is made possible by many types of receptors in the body.”
“The more selective a drug is, the fewer side effects it will produce.”
“Even though a drug is selective, it can produce nonselective results.”

Answer 43

Botulinum toxin is very selective and therefore very safe for administration.

Question 44

hich drug property is most enhanced by the presence of many different types of receptors throughout the body?
  Potency
  Safety
  Selectivity
  Convenience

Answer 44

Selectivity

Question 45

he drug dobutamine acts as an agonist of norepinephrine (NE) receptors. Which effect is the nurse most likely to observe in a patient receiving this medication?
  Increased heart rate
  Atrioventricular heart block
  Sinus bradycardia
  Reduced cardiac output

Answer 45

Increased heart rate

Question 46

he nurse prepares to give a drug that will prevent receptor activation. Which term would describe this drug?
  Antagonist
  Selective
  Agonist
  Potent

Answer 46

Antagonist

Question 47

Why does the nurse administer naloxone to a patient receiving morphine sulfate who has a respiratory rate of 8 breaths per minute?
Naloxone causes hypersensitivity of the opioid receptors.
Naloxone prevents the activation of opioid receptors.
Naloxone is a partial agonist, requiring a lesser dose to achieve pain relief.
Naloxone is an agonist, leading to desensitization of the opioid receptors.

Answer 47

Naloxone prevents the activation of opioid receptors

Question 48

Why does the nurse monitor the patient closely when administering a drug with a low therapeutic index?
The average lethal dose of the drug is much higher than the therapeutic dose.
The dose required to produce a therapeutic response in 50% of patients is low.
The highest dose needed to produce a therapeutic effect is close to the lethal dose.
There is a low variability of responses to this drug.

Answer 48

The highest dose needed to produce a therapeutic effect is close to the lethal dose

Question 49

The nursing student learns that not all drugs produce effects binding to a receptor. Which drugs do not act through receptors?
  Antacids
  Analgesics
  Antihistamines
  Steroid hormones

Answer 49

Antacids

Question 50

The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug?
  It is very potent.
  It has a low efficacy.
  It is probably lethal.
  It is relatively safe.

Answer 50

It is relatively safe.