Practice Questions for Exam 1

Question 1

In the older adult and those with renal dysfunction, the creatinine clearance is usually:​
A. substantially increased. ​

B. slightly increased.​

C. decreased.​

D. in the normal range.

Answer 1

C. decreased.​

Question 2

Adverse reactions and drug interactions occur frequently in the older adult due to which of the following: SELECT ALL THAT APPLY​

A. consumption of numerous drugs due to multiple chronic illnesses.​

B. drugs ordered by several health care providers.​

C. increased incidence of allergic responses.​

D. self-medication with OTC preparations.​

Answer 2

A. consumption of numerous drugs due to multiple chronic illnesses.​

B. drugs ordered by several health care providers.​

D. self-medication with OTC preparations.​

Question 3

Mr. Jones has liver and kidney disease. He is given a medication with a half-life of 30 hours. You expect the duration of action of this medication to:​

A. increase.​

B. decrease.​

C. remain unchanged.​

D. dissipate.​

Answer 3

A. increase.​

Question 4

Answer 4

Question 5

During the implementation phase of the nursing process, which action will the nurse perform when administering medications?

A.Switch the route of administration based on drug availability.

B.
Call the patient by name when entering the room to verify the drug is for the right person.

C.
Check the patient’s armband before administering the medication.

D.
Prepare medications for all patients first, then administer by room to manage time

Answer 5

Check the patient’s armband before administering the medication.

Question 6

For which activity is the nurse responsible during the evaluation phase of drug administration?
A.
Preparing and administering prescribed medications safely

B.
Planning measurable outcomes for the patient related to drug therapy

C.
Monitoring the patient continuously for therapeutic as well as adverse effects

D.
Gathering data in a drug and dietary history

Answer 6

C. Monitoring the patient continuously for therapeutic as well as adverse effects

Question 7

The nurse should include which information when evaluating the outcome after a patient’s medication has been administered?
A.
Dose of medication administered

B.
Time medication administered

C.
Patient allergies to medications

D.
Therapeutic effect of patient

Answer 7

D. Therapeutic effect of patient

Question 8

Which phase of the nursing process requires the nurse to establish a comprehensive baseline of data concerning a particular patient?
A.
Assessment

B.
Planning

C.
Implementation

D.
Evaluation

Answer 8

A Assessment

Question 9

When considering the various routes of drug elimination, the nurse is aware that elimination occurs mainly by which routes?
A.
Renal tubules and skin

B.
Skin and lungs

C.
Bowel and renal tubules

D.
Lungs and gastrointestinal tract

Answer 9

C Bowel and renal tubules

Question 10

The nurse recognizes that drugs given by which route will be altered by the first-pass effect?
A.
Oral

B.
Sublingual

C.
Subcutaneously

D.
Intravenous

Answer 10

A Oral

Question 11

A drug has a half life of 4 hours. If at 0800 the drug level is measure as 200 mg/L, at what time would the drug level be 50mg/L?

Answer 11

Correct Answer
1600
Explanation
The half-life of a drug is the time it takes for the concentration of the drug in the body to decrease by half. In this case, the drug has a half-life of 4 hours. This means that every 4 hours, the concentration of the drug will decrease by half.
Since the half-life is 4 hours, it would take 4 hours for the concentration to decrease by half from 200 mg/L to 100 mg/L. Another 4 hours would be needed for the concentration to decrease from 100 mg/L to 50 mg/L.

Therefore, it would take a total of 8 hours, which is equivalent to 1600, for the drug level to be 50mg/L.

Question 12

LIver and kidney function can effect half-life.
True/False

Answer 12

True

Question 13

.
A nurse educator is reviewing medications dosages and factors that influence medication metabolism with a group of nurses. Medication dosages may need to be decreased for which of the following reasons? (choose all that apply)
A.
Increased renal excretion

B.
Increased medication-metabolizing enzymes

C.
Liver failure

D.
Peripheral vascular disease

E.
Concurrent use of medication metabolized by the same pathway

Answer 13

C. Liver failure
E. Concurrent use of medication metabolized by the same pathway

Question 14

You are working in a nursing home caring for an 86-year-old stroke patient who complains of left knee pain
secondary to arthritis. The patient has right-sided weakness and difficulty swallowing with no gag reflex. You
review the patient’s MAR, and note the provider has prescribed acetaminophen 325 mg either per oral or per
rectal route. Which route would you choose and why?

Answer 14

1. The nurse should select the rectal route due to the patient’s difficulty swallowing to reduce the risk of aspiration.

Question 15

Mr. Johnson is a 92-year-old male admitted to the medical-surgical unit for severe pneumonia, and the provider prescribed gentamicin antibiotic therapy. Upon review of the order, you notice the initial dose is ordered
at less than the standard recommended dose. What is the rationale behind the decreased starting gentamicin
dose for this patient?

Answer 15

The initial dose is less than the standard recommended dose based on the Mr. Johnson’s age and the likelihood
that his kidney functioning is decreased. Decreased kidney function affects the metabolism and excretion of
gentamycin and could result in toxicities if the dose is too high.

Question 16

. Julia is a 56-year-old patient admitted to the cardiology unit with new-onset atrial fibrillation. She has been
prescribed amiodarone for her irregular heartbeat and is set to receive her first dose with her morning breakfast tray. When you arrive in the room, you notice that she has grapefruit juice on her breakfast meal tray. Is this a concern? Why? What is the nurse’s next action?

Answer 16

5. Amiodarone is metabolized by the enzymes in the intestines to its active form. Grapefruit juice contains
   compounds that slow down this process and affect the levels of this medication in the blood. The nurse should
   educate Julia about this interaction and encourage other beverage choices in the future that do not cause this interaction.

Question 17

Metabolism can be influenced by many factors within the body. If a patient has liver damage, the patient
may not be able to breakdown (metabolize) medications as efficiently. Dosages are calculated according to the liver’s ability to metabolize and the kidney’s ability to excrete.
When caring for a patient with cirrhosis, how does this condition impact the dosages prescribed for the
patient?

Answer 17

The biotransformations that take place in the liver are performed by the liver enzymes. Therefore, if the liver is
damaged, metabolism and excretion are impacted, resulting in the need for lower dosages to avoid toxicity

Question 18

When providing care for a patient who has chronic kidney disease, how does this disease impact medication excretion?

Answer 18

Kidney function is important because drugs and metabolites in the bloodstream are often filtered by the kidney.
In the kidney tubules, a portion of the drug undergoes reabsorption back into the bloodstream, and the remainder is excreted in the urine.