Flashcards in Quiz Questions Only WEEKS 1-5 Deck (44)
A nurse is preparing to administer epinephrine to a patient who is having a severe allergic reaction. Which route of administration should the nurse use to provide the fastest and most complete absorption of epinephrine?
Rationale: Intravenous administration results in the fastest and most complete absorption of a drug.
When preparing to administer a sustained-release capsule to a patient, the nurse understands that which of the following is true for sustained-release capsules?
- They are usually most costly than pills.
- They are rapidly absorbed.
- They need to be crushed for appropriate absorption to take place.
- They need to be taken at regular intervals throughout the day.
They are usually most costly than pills
Rationale: A capsule may cost more than a pill. Sustained-release formulations are capsules filled with tiny spheres that contain the actual drug; the individual spheres have coatings that dissolve at variable rates. Because some spheres dissolve more slowly than others, drug is released steadily throughout the day. These capsules should not be crushed. The primary advantage of sustained-release preparations is that they permit a reduction in the number of daily doses. These formulations have the additional advantage of producing relatively steady drug levels over an extended time (much like giving a drug by infusion). The major disadvantages of sustained-release formulations are their high cost and their potential for variable absorption.
The nurse identifies which patient as being at highest risk for slow drug metabolism?
- A 2-year-old boy who is prescribed an oral antibiotic
- A 14-year-old girl who takes four prescription drugs
- A 56-year-old man who has chronic hepatic disease
- A 76-year-old woman who has an elevated temperature
A 56-year-old man who has chronic hepatic disease
Rationale: Drug metabolism, which is also known as biotransformation, is the enzymatic alteration of drug structure. Most drug metabolism takes place in the liver.
Digoxin has a half-life of 36 to 48 hours. Because of the length of the half-life, the nurse expects dosing to occur how often?
- 4 times per day
- 3 times per day
- 2 times per day
- Once a day
Once a day
Rationale: The concept of the half-life tells us that, no matter what the amount of drug in the body may be, half (50%) will leave during a specified period of time (i.e., the half-life). The actual amount of drug that is lost during one half-life depends on just how much drug is present: The more drug that is in the body, the larger the amount lost during one half-life. If a long dosing interval were used, drug levels would fall below the minimum effective concentration between doses, and therapeutic effects would be lost. Conversely, if a drug has a long half-life, a long time can separate doses without a loss of benefits.
When teaching a patient who has a gastric ulcer about cimetidine (a histamine H2 antagonist) therapy, the nurse should include which information about antagonists?
- An antagonist causes a chemical reaction in the stomach.
- An antagonist activates receptors in the stomach lining.
- An antagonist prevents receptor activation in the stomach.
- An antagonist improves receptor sensitivity in the stomach.
An antagonist prevents receptor activation in the stomach.
A new drug is being considered for approval by the FDA. What is the first criteria that is considered as part of the approval process?
- ability to be reversed
- it does only what we want it to do
- there are no harmful effects
- the drug works, it does what it is supposed to do.
The drug works, it does what it is supposed to do.
Which of the following are part of the original “5 Rights” of Medication Safety? SATA MFrs
- right assessment
- right documentation
- right patient
- right route
- right time
- right patient
- right route
- right time
What is the difference between a medication technician and an RN who is giving a medication?
- Patient education
- Correct route of administration
- Accurate administration time
- Correct technique when administering medication
Prior to 1990’s who was excluded from clinical trials?
- individuals who are pregnant
- patients over the age of 65
- patients who have HIV/AIDS
- women and children
Women and children
What is the purpose of the Controlled Substances Act (1970) passed by Congress?
- Identify medications that have potential for abuse.
- Identify medications that should not be used for medicinal purposes.
- Differentiate life-threatening medications from those that are safe.
- Institute rules for use by patients of these substances.
Identify medications that have potential for abuse.
Which Controlled Substance Schedule is marijuana?
- Schedule I
- Schedule II
- Schedule III
- Schedule IV
The name acetaminophen is considered which type of name?
- brand name
- therapeutic classification
- chemical name
- generic name
What is phase 4 of drug approval?
- pre-clinical investigation
- testing on healthy individuals
- post-marketing surveillance
- review of the new drug application
True/false: If a drug is approved by the FDA, it is considered safe.
True/false: A generic drug and brand drug are exactly the same.
Rationale: The active ingredients should be the same, but inactive substances are different. The rate and extent of absorption can be different.
When a nursing student is discussing the medication ibuprofen with the clinical instructor, which description is most helpful?
- "Ibuprofen is a pain medication"
- "Ibuprofen is Motrin"
- "Ibuprofen is a non-steroidal anti-inflammatory (NSAID) medication that is used for pain management."
- "Ibuprofen, Advil is the same thing."
"Ibuprofen is a non-steroidal anti-inflammatory (NSAID) medication that is used for pain management."
Which name is used on NCLEX for drug names?
- brand name
- generic name
- chemical name
- therapeutic name
Which of the following drugs would be considered the least safe medication?
- ibuprofen (Motrin)
- acetaminophen (Tylenol)
- aluminum-magnesium hydroxide (Maalox)
- furosemide (Lasix)
Rationale: Going with the basis that OTC medications should be safer than prescription medications.
The drug acetaminophen has a half-life of 2 hours. The drug is ordered every 4 hours and the first dose was taken at 8am today. When will the drug become therapeutic (reach plateau) in the bloodstream?
- 4 pm today
- 10 am today
- 2 pm today
- 8 am tomorrow
4 pm today
If all of the following drugs are equal in their ability to provide relief of seasonal allergies. Which of the following is most potent?
- 10 mg cetirizine (Zyrtec)
- 4mg chlorpheniramine (Chlor-Trimeton)
- 25 mg diphenhydramine (Benadryl)
- 60 mg fexofenadine (Allegra)
4mg chlorpheniramine (Chlor-Trimeton)
A patient has chronic kidney disease stage 5. The nurse recognizes which aspect of pharmacokinetics is most impacted?
The nurse notices that the dosage for a medication is much larger when it is ordered via the oral route (Morphine sulfate 30 mg oral tablet) versus the IV route (Morphine sulfate 1mg IV). What explains this difference?
- half-life of the medication
- first pass effect
- therapeutic range
- potency of the medication
First pass effect
A patient has been given an agonist drug. What response does the nurse expect to occur after agonist drug binds with the receptor?
- Acceleration of body’s normal response.
- Binding but no intrinsic activity
- Blocking of body’s normal response.
- Mimic of the body’s normal response.
Mimic of the body’s normal response.
A drug is available over the counter. The nurse expects this medication to have what characteristic?
- Drug peak is close to the LD50
- LD50 that is close to the therapeutic dose
- Under the minimum effective concentration (MEC)
- Large therapeutic index
Large therapeutic index
Which of the following drugs has the quickest absorption?
- 8mg intravenous ondansetron (Zofran)
- 400 mg oral ibuprofen (Motrin)
- 0.4 mg sublingual nitroglycerin
- 1 inch 2.5% hydrocortisone topical cream
8mg intravenous ondansetron (Zofran)
A drug with a lot of interpatient variability, such a vancomycin has peak and trough levels ordered. The nurse understands that the trough level will provide what information?
- The highest drug concentration in the bloodstream.
- The point when the drug concentration drops below the minimum effective dose.
- The lowest drug concentration in the bloodstream prior to the next dose.
- The point whereby the drug plasma concentration is closest to the lethal dose.
The lowest drug concentration in the bloodstream prior to the next dose.
If a drug is bound to the protein albumin, how will this affect distribution of the drug?
- The drug will easily pass through cell membranes to the site of action.
- All of the drug will be bound to the protein and have no effect.
- Since albumin is a small molecule, it does not affect distribution.
- Only the free drug will have an effect at the site of action.
Only the free drug will have an effect at the site of action.
Which of the following will affect the distribution of a drug for a patient with brain cancer?
- Difficulty with lipid soluable drugs passing through a cell membrane.
- The ability for the drug to be excreted through saliva.
- Difficulty with protein bound medications exiting the vascular system.
- Blood brain barrier
Blood brain barrier
A patient has been on warfarin (Coumadin) a highly protein bound (99% protein bound) drug and has just been prescribed phenytoin (Dilantin) for a new onset seizure disorder. Why does this cause concern?
A. The potential for increased levels of warfarin or increased levels of phenytoin is possible.
B. Because of protein-binding this will alter the absorption of the medications.
C. Chemical instability will occur if both medications are given concurrently.
D. Protein-binding of both medications will accelerate the excretion of both medications.
The potential for increased levels of warfarin or increased levels of phenytoin is possible.