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  • Language: English
  • ISBN-10: 0323057802
  • ISBN-13: 978-0323057806      9780323057806

 

Clayton: Basic Pharmacology for Nurses, 15th Edition

 

Chapter 1: Definitions, Names, Standards, and Information Sources

 

Test Bank

 

MULTIPLE CHOICE

 

  1. What is the name under which a drug is listed by the U.S. Food and Drug Administration (FDA)?
A. Brand
B. Nonproprietary
C. Official
D. Trademark

 

 

ANS:   C

 

  Feedback
A The brand name, or trademark, is the name given to a drug by its manufacturer.
B The nonproprietary, or generic, name is provided by the USAN Council.
C The official name is the name under which a drug is listed by the FDA.
D The trademark, or brand name, is the name given to a drug by its manufacturer.

 

 

DIF:    Cognitive Level: Knowledge             REF:    2

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which source contains information specific to nutritional supplements?
A. USP Dictionary of USAN & International Drug Names
B. Natural Medicines Comprehensive Database
C. United States Pharmacopoeia/National Formulary (USP-NF)
D. Drug Interaction Facts

 

 

ANS:   C

 

  Feedback
A USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA-approved drugs; it does not include nutritional supplements.
B Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements.
C United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements.
D Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements.

 

 

DIF:    Cognitive Level: Knowledge             REF:    3

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. What is the most comprehensive reference available to research a drug interaction?
A. Drug Facts and Comparisons
B. Drug Interaction Facts
C. Handbook on Injectable Drugs
D. Martindale—The Complete Drug Reference

 

 

ANS:   B

 

  Feedback
A Drug Facts and Comparisons is not the most comprehensive source.
B First published in 1983, this reference is the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with clinical and scientific expertise.
C Handbook on Injectable Drugs is not the most comprehensive source.
D Martindale—The Complete Drug Reference is not the most comprehensive source.

 

 

DIF:    Cognitive Level: Comprehension       REF:    4

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug?
A. Manufacturer’s section
B. Brand and Generic Name section
C. Product Category section
D. Product Information section

 

 

ANS:   B

 

  Feedback
A The Manufacturer’s section is a roster of manufacturers.
B A physician’s order would include the brand and/or generic name of the drug. The alphabetic index in the PDR would make this section the most user-friendly. Based on a physician’s order, manufacturer’s information and classification information would not be known.
C The Product Category section lists products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and antibiotics.
D The Product Information section contains reprints of the package inserts for the major products of manufacturers.

 

 

DIF:    Cognitive Level: Comprehension       REF:    5

TOP:    Nursing Process Step: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which is the most useful drug reference source for patients?
A. American Drug Index
B. American Hospital Formulary
C. Health on the Net Foundation
D. Physicians’ Desk Reference

 

 

ANS:   C

 

  Feedback
A The American Drug Index is not appropriate for patient use.
B The American Hospital Formulary is not appropriate for patient use.
C The Health on the Net Foundation is the most appropriate source for patients to obtain drug information. It is the leading organization to promote and guide the deployment of useful and reliable online medical and health information and its appropriate and efficient use.
D The Physicians’ Desk Reference is not appropriate for patient use.

 

 

DIF:    Cognitive Level: Knowledge             REF:    7

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
A. Federal Food, Drug, and Cosmetic Act (1938)
B. Durham-Humphrey Amendment (1952)
C. Controlled Substances Act (1970)
D. Kefauver-Harris Drug Amendment (1962)

 

 

ANS:   A

 

  Feedback
A The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety.
B The Durham-Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner.
C  The Controlled Substances Act addresses only controlled substances and their categorization.
D The Kefauver-Harris Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products before marketing them.

 

 

DIF:    Cognitive Level: Knowledge             REF:    7

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall?
A. I
B. II
C. III
D. IV

 

 

ANS:   B

.

 

  Feedback
A Schedule I drugs have high potential for abuse and no recognized medical use.
B Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical dependence.
C Schedule III drugs have some potential for abuse. Use may lead to low-to-moderate physical dependence or high psychological dependence.
D Schedule IV drugs have low potential for abuse. Use may lead to limited physical or psychological dependence.

 

 

DIF:    Cognitive Level: Application             REF:    7

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?
A. List smallpox as a health orphan disease.
B. Omit the preclinical research phase.
C. Extend the clinical research phase.
D. Fast-track the investigational drug.

 

 

ANS:   D

 

  Feedback
A Orphan diseases are not researched in a priority manner.
B Preclinical research is not omitted.
C Extending any phase of the research would mean a longer time to develop a vaccine.
D The FDA must ensure that all phases of the preclinical and clinical research phase have been completed in a safe manner. Once the Investigational New Drug Application has been approved, the drug can receive highest priority within the agency, which is called fast tracking. A smallpox outbreak would become a priority concern in the world.

 

 

DIF:    Cognitive Level: Knowledge             REF:    10

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which statement is true about over-the-counter (OTC) drugs?
A. They are not listed in the USP-NF.
B. A prescription from a health care provider is needed.
C. They are sold without a prescription.
D. They are known only by their brand names.

 

 

ANS:   C

 

  Feedback
A OTC drugs are listed in the USP-NF.
B Prescription drugs require an order by a health professional who is licensed to prescribe, such as a physician, nurse practitioner, physician assistant, or dentist.
C OTC medications do not require a prescription.
D A variety of names, both generic and trade, can be used for individual drugs sold OTC.

 

 

DIF:    Cognitive Level: Comprehension       REF:    2

TOP:    Nursing Process Step: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which is the most authoritative reference for medications that are injected?
A. Parenteral Drug Handbook
B. Handbook on Injectable Drugs
C. Drugs and Injections Quarterly
D. Handbook of Nonprescription Drugs

 

 

ANS:   B

 

  Feedback
A There is not a reference by this name, and not all parenteral drugs are injected.
B The Handbook on Injectable Drugs is the most comprehensive reference available on the topic of compatibility of injectable drugs. It is a collection of monographs for more than 300 injectable drugs that are listed alphabetically by generic name.
C There is no reference by this name.
D This only has information about medications that do not require a prescription.

 

 

DIF:    Cognitive Level: Comprehension       REF:    4

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug’s classification?
A. Abuse potential for this drug is low.
B. Psychological dependency is likely.
C. There is a high potential for abuse.
D. This drug is not a controlled substance.

 

 

ANS:   A

 

  Feedback
A Lomotil, a Schedule V drug, has an abuse potential of limited physical or psychological dependence liability compared with drugs in Schedule IV. Because abuse potential is low, a prescription may not be required.
B Psychological dependency is not likely with a Schedule V drug.
C The abuse potential is low with a Schedule V drug.
D Schedule V drugs are classified as controlled substances.

 

 

DIF:    Cognitive Level: Knowledge             REF:    8

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

MULTIPLE RESPONSE

 

  1. The nurse is caring for a patient newly diagnosed with type 1 diabetes mellitus. Which approaches to therapeutic methods are considered in this patient’s treatment? (Select all that apply.)
A. Therapeutic drugs
B. Concentrated carbohydrate diet
C. Family-centered care
D. Regular daily exercise and activity
E. Daily baths

 

 

ANS:   A, B, D

 

  Feedback
Correct Therapeutic methods include drug therapy.

Therapeutic methods include diet therapy.

Therapeutic methods include physiotherapy and psychological therapy.

Incorrect Therapeutic methods do not include family-centered care.

Therapeutic methods do not include daily baths.

 

 

DIF:    Cognitive Level: Application             REF:    1

TOP:    Nursing Process Step: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient’s current medications or prescriptions. All the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resources are appropriate to use in determining the medication names and doses? (Select all that apply.)
A. Martindale—The Complete Drug Reference
B. Physicians’ Desk Reference, Section 4
C. Senior citizens’ center
D. Patient’s home pharmacy

 

 

ANS:   B, D

 

  Feedback
Correct The Physicians’ Desk Reference, Section 4, has full-color images of commonly dispensed tablets and capsules.

The patient’s pharmacy would have an accurate account of all the medications the client is currently taking.

Incorrect Martindale—The Complete Drug Reference has written information on medication and would not be an appropriate resource.

The senior citizens’ center is not likely to have specific patient medication information.

 

 

DIF:    Cognitive Level: Application             REF:    5

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

Chapter 2: Principles of Drug Action and Drug Interactions

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s best 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

 

  Feedback
A Allergic reactions are a hypersensitivity and manifest with hives and/or urticaria and are easily identified.
B An idiosyncratic reaction occurs when something unusual or abnormal happens when a drug is first administered.
C A teratogenic reaction refers to the occurrence of birth defects related to administration of the drug.
D Tolerance refers to the body’s requirement for increasing dosages to achieve the same effects that a lower dose once did.

 

 

DIF:    Cognitive Level: Comprehension       REF:    21

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse administers an initial dose of a steroid to a patient with asthma. A half hour 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

 

  Feedback
A Desired actions are expected responses to a medication.
B Adverse effects are reactions that occur in another system of the body; they are usually predictable.
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.
D Allergic reactions appear after repeated medication dosages

 

 

DIF:    Cognitive Level: Comprehension       REF:    21

TOP:    Nursing Process Step: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. What is the definition of cumulative effect of a drug?
A. Drug toxicity related to overmedication
B. Drug buildup related to decreased metabolism
C. The inability to control the ingestion of drugs
D. The need for higher dosage to produce the same effect as previous lower dosages

 

 

ANS:   B

 

  Feedback
A Toxicity occurs when adverse effects are severe.
B Cumulative effects are related to diminished metabolism or excretion of a drug that causes it to accumulate. Cumulative effects can lead to drug toxicity.
C Inability to control the ingestion of drugs is drug dependence.
D The need for higher dosage to produce the same effect as previous lower dosages is the definition of tolerance.

 

 

DIF:    Cognitive Level: Knowledge             REF:    23

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which best describes 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 increase of drug excretion

 

 

ANS:   C

 

  Feedback
A Toxicity of one drug may or may not affect the metabolism of another one.
B Drug interactions may result from either increased or decreased pharmacodynamics.
C Drug interactions may be characterized by an increase or decrease in the effectiveness of one or both of the drugs.
D Drug interactions may result from either increased or decreased excretion.

 

 

DIF:    Cognitive Level: Comprehension       REF:    23

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. 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

 

  Feedback
A An expected response of a drug is the desired action.
B A synergistic effect is the effect of two drugs being greater than the effect of each chemical individually, or the sum of the individual effects.
C Carcinogenicity is the ability of a drug to cause cells to mutate and become cancerous.
D The displacement of the first drug from receptor sites by a second drug increases the amount of the first drug because more unbound drug is available.

 

 

DIF:    Cognitive Level: Comprehension       REF:    23-24

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. What do drug blood levels indicate?
A. Confirm if the patient is taking a generic form of a drug
B. Determine if the patient has sufficient body fat to metabolize the drug
C. Verify if the patient is taking someone else’s medications
D. Determine if the amount of drug in the body is in a therapeutic range

 

 

ANS:   D

 

  Feedback
A Generic drugs do not necessarily produce a different drug blood level than proprietary medications.
B Body fat is not measured by drug blood levels.
C Drug blood levels only measure the amount of drug in the body; they do not determine the source of the medication.
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.

 

 

DIF:    Cognitive Level: Comprehension       REF:    20

TOP:    Nursing Process Step: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. 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

 

  Feedback
A Osmosis is the process of moving solution across a semipermeable membrane to equalize the dilution on each side.
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.
C Absorption is the process by which a drug is transferred from its site of entry into the body to the circulating fluids for distribution.
D Biotransformation, also called metabolism, is the process by which the body inactivates drugs.

 

 

DIF:    Cognitive Level: Comprehension       REF:    18

TOP:    Nursing Process Step: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse assesses which blood level to determine the amount of circulating medication in a patient?
A. Peak
B. Trough
C. Drug
D. Therapeutic

 

 

ANS:   C

 

  Feedback
A Incorrect A: Peak levels are only those drug blood levels that are at their maximum before metabolism starts to decrease the amount of circulating drug.
B 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.
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.
D 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:    20

TOP:    Nursing Process Step: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which patient, when compared with the general population, would require a larger dose or more frequent administration of a drug to attain a therapeutic response?
A. A 29-year-old who has been diagnosed with kidney failure
B. A 35-year-old obese male who is being evaluated for an exercise program
C. A 52-year-old diagnosed with hypothyroidism and decreased metabolic rate
D. A 72-year-old with decreased circulatory status

 

 

ANS:   B

 

  Feedback
A An individual with kidney failure would require less medication due to decreased excretory ability.
B An obese individual would require a larger dose of a drug to attain a therapeutic response.
C Individuals with decreased metabolic rate would metabolize drugs more slowly and require smaller doses or less frequent administration
D Individuals with decreased circulation would require less medication.

 

 

DIF:    Cognitive Level: Application             REF:    22

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. 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

 

  Feedback
A 8:00 AM is 2 hours after administration; the half-life is 8 hours.
B 11:00 AM is 4 hours after administration; the half-life is 8 hours.
C Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM.
D 6:00 PM is 12 hours after administration; the half-life is 8 hours.

 

 

DIF:    Cognitive Level: Application             REF:    20

TOP:    Nursing Process Step: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. What will the nurse need to determine first in order to mix two drugs in the same syringe?
A. Absorption rate of the drugs
B. Compatibility of the drugs
C. Drug blood level of each drug
D. Medication adverse effects

 

 

ANS:   B

 

  Feedback
A Knowledge of absorption is important but not in order to mix drugs.
B In order to mix two drugs, compatibility is determined so there is no deterioration when the drugs are mixed in the same syringe.
C Drug level does not indicate if it is acceptable to mix medications in the same syringe.
D Adverse effects are important for the nurse to know, but not in order to mix drugs.

 

 

DIF:    Cognitive Level: Application             REF:    24

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. 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

 

  Feedback
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.
B Signs and symptoms of an anaphylactic reaction are respiratory distress and cardiovascular collapse.
C A more severe reaction will occur at the next exposure, and the patient should not receive the drug again.
D This mild allergic reaction is a warning not to take the drug again because, upon the next exposure to the drug, the patient is more likely to have an anaphylactic reaction.

 

 

DIF:    Cognitive Level: Application             REF:    21-22

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. 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

 

  Feedback
A Liver enzyme systems are the primary site for metabolism of drugs.
B Intake of a vegetarian diet may affect absorption but not metabolism.
C Sedentary lifestyle does not affect metabolism the most.
D Occupations could affect metabolism (exposure to environmental pollutants), but this is not the most significant effect on metabolism.

 

 

DIF:    Cognitive Level: Application             REF:    19

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

MULTIPLE RESPONSE

 

  1. Which statements about liberation of drugs are true? (Select all that apply.)
A. A drug must be dissolved in body fluids before it can be absorbed into body tissues.
B. A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption into the bloodstream for transport to the site of action.
C. The process of converting the drug into a soluble form can be controlled to a certain degree by the dosage form.
D. Converting the drug to a soluble form can be influenced by administering the drug with or without food in the patient’s stomach.
E. Elixirs take longer to be liberated from the dosage form.

 

 

ANS:   A, B, C, D

 

  Feedback
Correct Regardless of the route of administration, a drug must be dissolved in body fluids before it can be absorbed into body tissues.

Before a solid drug taken orally can be absorbed into the bloodstream for transport to the site of action, it must disintegrate and dissolve in the GI fluids and be transported across the stomach or intestinal lining into the blood.

The process of converting a drug into a soluble form can be partially controlled by the pharmaceutical dosage form used (e.g., solution, suspension, capsules, and tablets with various coatings).

The conversion process can also be influenced by administering the drug with or without food in the patient’s stomach.

Incorrect Elixirs are already drugs dissolved in a liquid and do not need to be liberated from the dosage form.

 

 

DIF:    Cognitive Level: Comprehension       REF:    18

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which are routes of drug excretion? (Select all that apply.)
A. Gastrointestinal (GI) tract; feces
B. Genitourinary (GU) tract; urine
C. Lymphatic system
D. Circulatory system; blood/plasma
E. Respiratory system; exhalation

 

 

ANS:   A, B, E

 

  Feedback
Correct The GI system is a primary route for drug excretion

The GU system does function in the excretion of drugs.

The respiratory system does function in the excretion of drugs.

Incorrect The lymphatic system is involved with drug distribution, not drug excretion.

The circulatory system is involved with drug distribution, not drug excretion.

 

 

DIF:    Cognitive Level: Knowledge             REF:    19

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which routes enable drug absorption more rapidly than the subcutaneous route? (Select all that apply.)
A. Intravenous route
B. Intramuscular route
C. Inhalation/sublingual
D. Intradermal route
E. Enteral route

 

 

ANS:   A, B, C

 

  Feedback
Correct Intravenous route of administration enables drug absorption more rapidly than the subcutaneous route.

Intramuscular route of administration enables drug absorption more rapidly due to greater blood flow per unit weight of muscle.

Inhalation/sublingual route of administration enables drug absorption more rapidly than the subcutaneous route.

Incorrect Intradermally administered drugs are absorbed more slowly due to the limited available blood supply in the dermis.

Enterally administered drugs are absorbed more slowly due to the biotransformation process.

 

 

DIF:    Cognitive Level: Comprehension       REF:    18

TOP:    Nursing Process Step: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse recognizes that which factors would contribute to digoxin toxicity in a 92-year-old patient? (Select all that apply.)
A. Taking the medication with meals
B. Prolonged half-life of the drug digoxin
C. Impaired renal function
D. Diminished mental capacity

 

 

ANS:   B, C

 

  Feedback
Correct Impaired renal and hepatic function in older adults impairs metabolism and excretion of drugs, thus prolonging the half-life of a medication.

Impaired renal and hepatic function in older adults impairs metabolism and excretion of drugs, thus prolonging the half-life of a medication.

Incorrect Food would decrease the absorption of the drug.

Diminished mental capacity does not contribute to drug toxicity unless it is due to administration errors.

 

 

DIF:    Cognitive Level: Application             REF:    22

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

  1. Which statements about variables that influence drug action are true? (Select all that apply.)
A. An older adult will require increased dosage of a drug to achieve the same therapeutic effect as that seen in a younger person.
B. Body weight can affect the therapeutic response of a medication.
C. Chronic smokers may metabolize drugs more rapidly than nonsmokers.
D. A patient’s attitude and expectations affect the response to medication.
E. Reduced circulation causes drugs to absorb more rapidly.

 

 

ANS:   B, C, D

 

  Feedback
Correct Body weight can affect response to medications; typically, obese patients require an increase in dosage and underweight patients a decrease in dosage.

Chronic smoking enhances metabolism of drugs.

Attitudes and expectations play a major role in an individual’s response to drugs.

Incorrect Older adults require decreased dosages of drugs to achieve a therapeutic effect.

Decreased circulation causes drugs to absorb more slowly.

 

 

DIF:    Cognitive Level: Comprehension       REF:    22

TOP:    Nursing Process Step: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

  1. Which factors affect drug actions? (Select all that apply.)
A. Teratogenicity
B. Age
C. Body weight
D. Metabolic rate
E. Illness

 

 

ANS:   B, C, D, E

 

  Feedback
Correct Age may contribute to a variable response to a medication.

Body weight may contribute to a variable response to a medication.

Metabolic rate may contribute to a variable response to a medication.

Illness may contribute to a variable response to a medication.

Incorrect Teratogenicity does not contribute to a variable response to a medication.

 

 

DIF:    Cognitive Level: Comprehension       REF:    22

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity