exam 1

Question 1

after successfully completing the pharmacology course, a student nurse tells the instructor that he is glad this difficult course is finished. What is the best response from the nursing instructor?

a. “It might be over, but now you will start your clinical courses and apply your knowledge.”
b. “if you think this course was hard, you should try the graduate level.”
c. “Learning is an ongoing process in pharmacology; we must continue to stay up to date.”
d. “Learning difficult Material is always painful, but it is necessary.”

Answer 1

c. “Learning is an ongoing process in pharmacology; we must continue to stay up to date.”

Question 2

The nurse is using a drug handbook to determine the indications for the drug furosemide (Lasix). The term indications is defined as the:

a. way a drug works on the target organs.
b. amount of the drug to be administered.
c. conditions for which the drug is approved.
d. reason that the drug should not be given.

Answer 2

c. conditions for which the drug is approved.

Question 3

A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a long half-life of four (4) days. Based on this half-life, the medication will most likely be prescribed.

a. once a day
b. twice a day
c. three times a day
d. four times a day

Answer 3

a. once a day

Question 4

Which principle best describes what the nurse is expected to understand when administering medication to a client?

a. the pharmacotherapeutics for all of the medications that the client is recieving
b. the most common side effects of the drug’s prototype
c. the trade and generic names for all of the medications
d. the cost of the drug therapy

Answer 4

a. the pharmacotherapeutics for all of the medications that the client is recieving

Question 5

Nursing students must memorize the generic names of drugs. What is the primary reason that generic names are used by health care providers over chemical and trade names?

a. a drug can have more than one chemical and trade name.
b. there is only one generic name for each drug, ant it is easier to remember than the chemical name.
c. the trade names do not reflect the action of the drug as the generic name does.
d. nursing students should actually strive to learn both the generic and trade names to avoid confusion with cliets.

Answer 5

b. there is only one generic name for each drug, ant it is easier to remember than the chemical name.

Question 6

What can pharmacodynamics be defined as?

a. the mechanisms by which drugs affect the body
b. complying with one’s medication regimen as prescribed
c. taking multiple medications
d. the mechanisms by which the body handles the drug

Answer 6

a. the mechanisms by which drugs affect the body

Question 7

Bioavailability of a drug can be affected by many factors. Which factor does not affect the bioavailability of a drug?

a. inert ingredients
b. rate of absorption
c. safety margin
d. tablet compression

Answer 7

c. safety margin

Question 8

Before administering a drug, what pertinent information must the nurse obtain from the client?

a. physical assessment, medical history, previous medications, and learning capabilities.
b. medical history, growth and development level of client, and ability to pay for the medication
c. medical history, client’s growth and development level, and potential adverse effects of the medication
d. medical history, physical assessment, disease process, and learning needs

Answer 8

a. physical assessment, medical history, previous medications, and learning capabilities.

Question 9

A client is taking a medication for a condition whose indication is not listed and asks the nurse why the health care provider would prescribe this drug. What is the nurse’s best response?

a. “some medications may be used for conditions for which they have not been approved. this is called an ‘off-lavel’ indication”
b. “some medications may be used as a prototype drug for a specific condition and are not listed in the nursing drug handbook.”
c. “a medication can only be used for the specific condition for which it was approved.”
d. “this is a generic drug, and not all generic drugs are in the nursing drug handbook. only trade name drugs are listed.”

Answer 9

a. “some medications may be used for conditions for which they have not been approved. this is called an ‘off-lavel’ indication”

Question 10

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin [three] 3 years ago and developed a rash. which of the following is an appropriate nursing action?

a. administer the prescribed dose.
b. withold the medication.
c. ask the provider to change the prescription to an oral form.
d. administer an oral antihistamine at the same time.

Answer 10

b. withold the medication.

Question 11

A nurse in a provider’s office is reviewing the health care record of a client who is pregnant and is being seen for her first prenatal visit. which of the following immunizations can be administered safely to this client?

a. varicella vaccine
b. rubella
c. inactivated influenza vaccine
d. measles

Answer 11

c. inactivated influenza vaccine

Question 12

The nurse knows the governmental drug legislation requires the drug manufacturer to prove that a drug is both safe and:

a. free of adverse effects and potential reactions.
b. effective for a specified purpose.
c. reasonable in cost and easily accessible.
d. beneficial to various populations

Answer 12

b. effective for a specified purpose.

Question 13

Prior to administering a liquid medication to a client, the nurse notices that the medication color looks different than usual. Based on the observation the nurse should:

a. administer the medication.
b. consult the hospital pharmacist.
c. notify the health care provider.
d. call the poison control center.

Answer 13

b. consult the hospital pharmacist.

Question 14

a client is talking to the nurse and is expressing doubt about whether to take a drug that is advertised on television. the client does not believe that commercials for drugs tell the truth. the nurse’s response is based on what understanding?

a. advertisements are not legally binding and can be misleading.
b. all drugs must be advertised in media to inform the public.
c. manufacturers have some ability to change things when advertising drugs.
d. false claims of a drug’s therapeutic effect are prohibited by law.

Answer 14

d. false claims of a drug’s therapeutic effect are prohibited by law.

Question 15

A pharmaceutical representative comes to the primary care office and states that his company is marketing a new drug that does not need approval by the food and drug administration (FDA). what is the best response of the nurse?

a. “is this a drug in clinical trials? those are the only drugs that don’t have to have FDA approval.”
b. “is this an over-the-counter drug? over-the-counter drugs do not need FDA approval.”
c. “your company must be involved in academic research if the drug doesn’t need FDA approval.”
d. “any pharmaceutical company must have FDA approval before marketing a drug.”

Answer 15

d. “any pharmaceutical company must have FDA approval before marketing a drug.”

Question 16

the nurse explains to the client that during the food and drug administration (FDA) drug approval process, clinical investigators address concerns. what concerns are addressed?

a. whether a new drug applicaton (NDA) must be filed
b. the marketability of the drug
c. what the cost of the drug should be
d. whether or not the drug is safe

Answer 16

d. whether or not the drug is safe

Question 17

The client receiving a newly released medication is experiencing adverse effects. why does the nurse report these adverse effects as part of the postmarketing surveillance stage of the drug approval process?

a. the clinical trials are continuing to collect new data
b. individual client response is compared with the clinical trial data
c. the efficacy of the drug is determined for new drugs.
d. harmful effects in the larger population continue to be monitored.

Answer 17

d. harmful effects in the larger population continue to be monitored.

Question 18

clients enrolled in a clinical drug trial are told that they might receive a placebo drug as part of a control group. A client asks the nurse what a placebo is. what is the nurse’s best response?

a. “a placebo is a substance that has no therapeutic effect.”
b. “a placebo is a similar drug that is safe.”
c. “a placebo is a drug that has been tested before.”
d. “a placebo is an over-the-counter drug.”

Answer 18

a. “a placebo is a substance that has no therapeutic effect.”

Question 19

what are the four phases of pharmacokinetics that a drug goes through?

a. absorption, distribution, ionization, and metabolism
b. diffusion, bioavailability, metabolism, and excretion
c. absorption, distribution, metabolism, and excretion
d. active transport, ionization, diffusion, and excretion

Answer 19

c. absorption, distribution, metabolism, and excretion

Question 20

a client is receiving antibiotic treatment for a wound abscess. what does the nurse recognize that drug distribution to this area requires, in order to be effective?

a. the drug to be lipid soluble.
b. adequate blood perfusion to the area.
c. the drug to be bio-available in an acidic environment.
d. use of a topical antibiotic.

Answer 20

b. adequate blood perfusion to the area.

Question 21

When administering a drug-protein-bound drug to a client, what can the nurse expect?

a. duration of action will be prolonged
b. drug excretion will be accelerated
c. metabolism of the drug will be delayed
d. onset of drug action will be prolonged

Answer 21

a. duration of action will be prolonged

Question 22

what does the nurse anticipate about the medications ordered for a client with liver disease?

a. they will be in lower doses that normal.
b. they will be administered by the parenteral route.
c. they will need to be divided evenly throughout the day.
d. they will need to be given with an antacid.

Answer 22

a. they will be in lower doses that normal.

Question 23

the nurse determines that a client who is breast-feeding has understood teaching regarding medication use when the client makes which statement?

a. “I will be sure to take medications just before breast-feeding.”
b. “I know it is safe to take over-the-counter meds, but not presciption meds.”
c. “I will check with my health care provider before taking any medication.”
d. “I will only use herbal supplements while breast-feeding.”

Answer 23

c. “I will check with my health care provider before taking any medication.”

Question 24

A client has been started on a medication for postoperative pain. The nurse anticipates that the client will receive optimal pain relief when the plasma concentration of the drug

a. concentrates in the muscle tissue.
b. reaches a therapeutic range.
c. achieves a minimal effective concentration.
d. approaches a concentration.

Answer 24

b. reaches a therapeutic range.

Question 25

The nurse is reviewing the concept of a drug’s half-life for a student nurse, explaining that it is the time it takes for what to happen?

a. one-half of the drug to be absorbed
b. one-half of the drug to be eliminated by the body
c. the drug to elicit a therapeutic response
d. the drug to reach the target tissue

Answer 25

b. one-half of the drug to be eliminated by the body

Question 26

a client has been ordered a loading dose of a cardiac glycoside for an exacerbation of heart failure. when the client comments, “I usually take a much lower dose, “ how does the nurse respond?

a. giving a large dose will reduce the incidence of side effects.”
b. “you are being given a large dose in order to increase blood levels of the drug quickly.”
c. “the physician ordered this dose, so i need to administer it.”
d. “your usual dose is probably no longer effective for your condition, and you need to be on a higher dose now.”

Answer 26

b. “you are being given a large dose in order to increase blood levels of the drug quickly.”

Question 27

A client develops angioedema and difficulty swallowing after receiving an intravenous medication. The nurse recognizes this is characteristic of which effect?

a. a minor adverse effect
b. a life-threatening adverse effect
c. an unpredictable side effect
d. a reaction secondary to urticaria

Answer 27

b. a life-threatening adverse effect

Question 28

What signs and symptoms in a client does the nurse identify as an allergic reaction?

a. urticaria
b. photosensitivity
c. abdominal cramping
d. complaints of diarrhea

Answer 28

a. urticaria

Question 29

A client given zolpidem (Ambien) at 11 p.m. for sleeping awakens at 3 a.m. and is wide awake and agitated. The nurse reports the client has had which type of reaction?

a. allergic response
b. side effect
c. adverse effect
d. idiosyncratic reaction

Answer 29

d. idiosyncratic reaction

Question 30

A cient is concerned a drug she is taking might have teratogenic effects. Which response by the nurse is most appropriate?

a. “let me check the pregnancy risk category of the drug.”
b. “are you in your first trimester of pregnancy?”
c. “if your physician ordered the medication, it should be okay.”
d. “you should avoid taking any medications while pregnant.”

Answer 30

a. “let me check the pregnancy risk category of the drug.”

Question 31

When checking on the potential interactions of two drugs being administered at the same time, the nurse recognizes what principle?

a. drug drug interactions are more serious than drug-food interactions
b. only high potency drugs will have some type of interaction
c. drug interactions should always be avoided
d. some drug interactions can produce therapeutic effects

Answer 31

d. some drug interactions can produce therapeutic effects

Question 32

a nurse teaching a prenatal class is reinforcing precautions concerning the use of medications during pregnancy. the nurse determines the class needs further education when the students make which comments?

a. “there are some medications i cannot take because i am pregnant and they could hurt my baby.”
b. “I should consider all drugs to be harmful to my baby unless my doctor tells me it is okay.”
c. “i have to be very careful to let all my health providers know that i am pregnant before they prescribe medications for me.”
d. “once i am half way through my pregnancy, i wont need to worry about taking over-the-counter medications because the baby will be more fully formed.”

Answer 32

d. “once i am half way through my pregnancy, i wont need to worry about taking over-the-counter medications because the baby will be more fully formed.”

Question 33

A client asks the nurse why his dose of antihypertensive medication is different from his neighbor’s dose, stating, “we both take the exact same drug, but i take 60 mmg and he takes only 25 mg.” the nurse explains:

a. “if your neighbor is a lot younger than you, his dose might be a lot lower.”
b. “individuals often have widely different responses to the same medications and need different doses of the same medication.”
c. “if your neighbor takes a lot of other medications, he might need to take a lower dose of the medication than you.”
d. “if you are taking a generic brand of the medication, you will need a higher dose than you would of a brand name of the same medication”

Answer 33

b. “individuals often have widely different responses to the same medications and need different doses of the same medication.”

Question 34

The nursing instructor is teaching student nurses about how the median effective dose of a medication is related to clinical practice. Which statement reflects the correct understanding by the student?

a. “about 50% of clients will experience sever side effects from the drug.”
b. “about 50% of clients will not experience any effect from the drug.”
c. “some clients will respond differently, depending on their ethnic background.”
d. “some clients will require more or less than the average dose of the drug.”

Answer 34

d. “some clients will require more or less than the average dose of the drug.”

Question 35

Prior to administering medications, the nurse reviews the therapeutic index. the nurse recognizes this index is used to identify:

a. whether the health care provider has prescribed the best drug for the client.
b. when a client will begin to experience toxic drug effects.
c. interactions among the drugs the client is receiving.
d. clients who will need to have serum blood levels monitored.

Answer 35

d. clients who will need to have serum blood levels monitored.

Question 36

The nurse is discussing the difference between potency and efficacy with a client who has just received a prescription to treat congestive heart failure. The nurse determines learning has occurred when the client makes which statement?

a. “The best drug for me is the one with the greatest efficacy.”
b. “A drug with the greatest efficacy produces the least side effects.”
c. “low-potency drugs have efficacy and do not produce side effects.”
d. “The best drug for me is the one with the highest potency.”

Answer 36

a. “The best drug for me is the one with the greatest efficacy.”

Question 37

the nurse has taught a group of clients how their medications work in their bodies. which comment by a client reflects correct understanding of the teaching?

a. “ the normal function of a cell is enhanced or blocked by medications.”
b. “medications help the body produce new enzymes.”
c. “body tissue functions are changed by medications.”
d. “medications change the function of cells in the body.”

Answer 37

a. “ the normal function of a cell is enhanced or blocked by medications.”

Question 38

The nurse is teaching the client about a newly prescribed medication. which statement made by the client would indicate the need for further teaching?

a. “the liquid form of the drug will be absorbed faster than the tablets.”
b. “if i take more, I’ll have a better response.”
c. “Taking this drug with food will decrease how much drug gets into my system.”
d. “i can consult my health care provider if i experience unexpected adverse effects.”

Answer 38

b. “if i take more, I’ll have a better response.”

Question 39

While reviewing a drug manufacturer’s package insert, the nurse reads about the dose-response curve. the purpose of the dose-response curve is to illustrate the relationship between:

a. the amount of a drug administered and the degree of response it produces.
b. the prevalence of toxic effects in a given population.
c. the Degree of Response and Total duration of action of the drug.
d. the peak serum drug level when half the dose is administered.

Answer 39

a. the amount of a drug administered and the degree of response it produces.

Question 40

The nurse is preparing to discuss drug use during pregnancy with a group of nursing students. The main topic is the FDA drug classifications. Which of the following drugs should the nurse inform the students are the most detrimental to the fetus?

a. category A
b. category B
c. category C
d. category X

Answer 40

d. category X

Question 41

Drugs that are most likely to create drug interactions in pediatric patients are those with

a. low potency
b. wide therapeutic index
c. extensive protein binding.
d. effects on the skin

Answer 41

c. extensive protein binding.

Question 42

Which age-related change in the older client makes it necessary to reduce drug dosages?

a. decrease in total body fat
b. decrease in renal blood flow
c. increase in plasma protein levels
d. increase in total body water

Answer 42

b. decrease in renal blood flow

Question 43

the nurse knows that pregnancy affects the absorption, distribution, metabolism , and excretion of drugs. which one is the least affected by pregnancy?

a. distribution
b. metabolism
c. excretion
d. absorption

Answer 43

b. metabolism

Question 44

During a class about the use of medications during pregnancy, the nurse determines that additional information is required when a client makes which statement?

a. “exposure to some medications can result in my baby’s death or in Malformations.”
b. “The baby can only be harmed by medicaton during the first trimester.”
c. “if i breast-feed my baby, drugs can come through my breast milk.”
d. “it is important not to take over-the-counter (OTC) drugs during my pregnancy.”

Answer 44

b. “The baby can only be harmed by medicaton during the first trimester.”

Question 45

The nursing instructor is explaining the factors that impact the transfer of medications across the placenta. What factor would be responsible for higher concentrations of a drug being transferred to the fetus through the placenta?

a. low degree of metabolic activity of the placenta
b. increased blood flow to the palcenta
c. plasma drug level in the mother
d. increased blood volume of the mother

Answer 45

c. plasma drug level in the mother

Question 46

The pregnant client plans to breast-feed her baby. she asks the nurse about the use of her products during breast-feeding. what is the best response by the nurse?

a. “That should be fine as long as at least 12 hours pass between the time you use the product when you breast-feed”
b. “most drugs can be transferred to the infant during breast-feeding, so this is not recommended.”
c. “herbal products are considered natrual, so it should be fine to use them during breast-feeding.”
d. “be sure to check the label to see whether the herbal product can be used during breast-feeding.”

Answer 46

b. “most drugs can be transferred to the infant during breast-feeding, so this is not recommended.”

Question 47

What is one reason polypharmacy is prevalent in the elderly?

a. multiple medical problems can usually be treated with a single drug.
b. clients rarely see more than one prescriber.
c. clients might be taking multiple medications for their comorbidities
d. use of over-the-counter medications is uncommon in this age group

Answer 47

c. clients might be taking multiple medications for their comorbidities

Question 48

Why should the nurse ask the client about all medications the client takes, including over-the-counter and herbal medications?

a. minimizing the cost of medications is the highest priority
b. they might interact with each other or with prescribed medications
c. clients should not use over-the-counter or herbal medications
d. use of these agents must be reported to the food and drug administration

Answer 48

b. they might interact with each other or with prescribed medications

Question 49

A health care provider in a clinic writes several prescriptions for an older client. the nurse notices several medications are in the same class as drugs listed on the client’s intake form. What do you suggest the nurse do next?

a. set the prescriptions to the side and follow up on the issue at a later date
b. ask the primary health care provider if he was aware his client had been prescribed medications in the same drug class as those prescribed by the cardiologist
c. throw the prescriptions away
d. give them to the client

Answer 49

b. ask the primary health care provider if he was aware his client had been prescribed medications in the same drug class as those prescribed by the cardiologist

Question 50

A nurse working at a clinic notices that a client is having problems reading his prescrition bottles. sometimes the client take medications incorrectly because of difficulty reading the small print. what is a suggestion that the nurse can make to alleviate this problem?

a. put the medication in a zip-top bag with the instructions written on it in large print.
b. let the pharmacist get easy-open caps.
c. stop taking the medications as they are more likely to cause problems than to help if not taken correclty.
d. ask the pharmacist to provide labels with large print that explain how to take the medications.

Answer 50

d. ask the pharmacist to provide labels with large print that explain how to take the medications.