Pharmacology Exam #1

Question 1

It is expected that the nurse will question the health care provider if a drug with a t½ of >24 hours is ordered to be given more than how often

Answer 1

Once daily

Question 2

The nurse notices that one of the client’s drugs has a low therapeutic index. What is the most important nursing implication of this?

Answer 2

a NARROW margin of safety

Question 3

Which of the following nursing actions would be most appropriate for ensuring client safety with a medication that has a low therapeutic index?

Answer 3

Monitoring serum peak and trough levels

Question 4

The nurse reviews the client’s medication regimen, including the interval of drug dosage, which is related to which of the following?

Answer 4

Half-life

Question 5

An elderly client is taking a drug that is highly protein-bound (98%). Several days later, he also begins taking a second drug that is also 98% protein-bound and competes for the same albumin binding sites. The effect of the first drug would be:

Answer 5

Increased

Question 6

A patient is brought to the emergency department in a state of extreme, uncontrolled anxiety. Why would an IV (Intravenous) benzodiazepine be the drug of choice in this situation?

Answer 6

It has a rapid onset of action.

Question 7

A drug that has “high affinity” means that the drug:

Answer 7

Is strongly attracted (bound) to the receptor

Question 8

Drug A (taken first), decreases the peristaltic activity of the gastrointestinal tract. Drug B (taken later), is a drug to treat heart irregularity. Which of the following is generally correct? 1. This is setting the stage for a pharmacokinetic drug-drug interaction. 2. The stage is set for a pharmacodynamic drug-drug interaction. 3. The heart medication will have more time for absorption in the gastrointestinal tract. (The effect of the heart medication will be greater.) 4. The heart medication will have less time for absorption in the gastrointestinal tract.

Answer 8

1. and 3.

Question 9

Most drugs are metabolized in the:

Answer 9

Liver

Question 10

St. John’s wort must be used with caution or avoided in elderly patients because it:

Answer 10

induces hepatic drug-metabolizing enzymes (P450 enzyme inducer), which can accelerate the metabolism of other drugs taken by the elderly patient and reduce the effectiveness of those drugs.

Question 11

TRUE or FALSE: The drug given rectally is only considered as the percutaneous route.

Answer 11

FALSE: (1.5 inch to anus→ enteral). “Rectally” can mean percutaneous OR enteral!

Question 12

The literature about a drug found in the drug monograph identifies that the drug is POTENT. This means the drug:

Answer 12

Produces its effect at low doses

Question 13

Mr. Spencer is taking warfarin after his orthopedic surgery. He lost 35 pounds due to decreased appetite during his recovery. He is more likely to be admitted to ED for:

Answer 13

GI bleed

Question 14

Mary is drinking 1.5 litter cranberry juice daily to prevent urinary tract infection. She is also using the full strength ASA (325 mg) to ease her arthritic pain. What symptom do you think Mary would complaint most?

Answer 14

Bruise easily: Cranberry juice prolongs Aspirin’s effect by making urine acidic and inhibiting the elimination of Aspirin.

Question 15

Medication dosages may need to be decreased for which of the following reasons?

Answer 15

Liver failure and Chronic renal insufficiency

Question 16

A health care provider prescribes simvastatin (Zocor) 40 mg PO every day at bedtime. The nurse should recognize this as which of the following types of order?

Answer 16

Routine order

Question 17

A patient receives 60 mg of a drug at noon, 6 PM, and midnight. The drug has a half-life of 6 hours. How much of the drug remains in the patient at 6 AM the next day?

Answer 17

52.5 mg

Noon = 60mg
6PM = 30 mg + 60 mg = 90mg
midnight = 15mg + 30mg + 60mg = 45mg
6AM = 7.5mg + 15mg + 30mg = 52.5mg (BEFORE 6am dose)

Question 18

You were told that Tom, the radiology tech, called you regarding some lab value of your patient, Mr. Lee (89 years old). Tom is going to take Mr. Lee for CT scan. Which of the following lab value would Tom be most interested?

Answer 18

Urine creatinine clearance (because it measures renal function, which is needed to clear out the contrast die involved in a CT.)

Question 19

Which following conditions will always decrease drug absorption by oral route:

Answer 19

Diarrhea

Question 20

The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patient’s high blood pressure. The nurse takes the patient’s vital signs and finds that the blood pressure is 128/80 mm Hg and the heart rate is 60 beats per minute. What does the nurse do first before giving this drug?

Answer 20

Check the order for prescriber specific instructions on when the drug should be given .

Question 21

An older adult client who is hospitalized reports an inability to sleep at night. The client is given a hypnotic medication at 2200. The next morning the client is drowsy and wants to sleep instead of eating breakfast. The nurse is aware that this effect is most likely due to

Answer 21

reduced hepatic function.

Question 22

Which administration technique does the nurse use to give a 2-year-old child ear drops?

Answer 22

Pull the earlobe down and back.

Question 23

The prescriber orders a new drug over the telephone for a nursing home patient who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse to obtain from the prescriber?

Answer 23

“Do you want the drug given orally or intravenously?”

Question 24

TRUE or FALSE: A patient is to receive an acetaminophen (Tylenol) suppository for an elevated temperature of 102.8° F. The nurse must put on sterile gloves.

Answer 24

FALSE: