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lippincott Pharmacology Illustrated Reviews 7th Edition Whalen Test Bank Full ACCESS Test Bank From Link Below https://nursylab.com/products/lippincott-pharmacology-illustrat ed-reviews-7th-edition-whalen-test-bank/ TestBank Directly From The publisher, 100% Verified Answers. COVERS ALL CHAPTERS. Download Immediately
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Pharmacology Illustrated Reviews 7th Edition Whalen Test Bank
O M
Chapter 1: Pharmacokinetics
1. Which drugs will go through a pharmaceutic phase after it is administered?
LD
a. Intramuscular cephalosporins
.C
MULTIPLE CHOICE
O R
b. Intravenous vasopressors c. Oral analgesics
W
d. Subcutaneous antiglycemics
KS
ANS: C
When drugs are administered parenterally, there is no pharmaceutic phase, which occurs when a
N
drug becomes a solution that can cross the biologic membrane.
ST
TOP: NURSING PROCESS: Assessment
BA
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3
TE
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. The nurse is preparing to administer an oral medication and wants to ensure a rapid drug a. Capsule
U
ANS: C
.N
d. Tablet
R
c. Liquid suspension
SI
b. Enteric-coated pill
N
G
action. Which form of the medication will the nurse administer?
W W W
Liquid drugs are already in solution, which is the form necessary for absorption in the GI tract.
The other forms must disintegrate into small particles and then dissolve before being absorbed. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3
TOP: NURSING PROCESS: Nursing Intervention MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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3. The nurse is teaching a patient who will be discharged home with a prescription for an entericcoated tablet. Which statement by the patient indicates understanding of the teaching? a. I may crush the tablet and put it in applesauce to improve absorption. b. I should consume acidic foods to enhance absorption of this medication.
O M
c. I should expect a delay in onset of the drugs effects after taking the tablet. d. I should take this medication with high-fat foods to improve its action.
.C
ANS: C
LD
Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of actions
O R
after taking these medications. Enteric-coated tablets should not be crushed or chewed, which
W
would alter the time and location of absorption. Acidic foods will not enhance the absorption of the medication. The patient should not to eat high-fat food before ingesting an enteric-coated
KS
tablet, because high-fat foods decrease the absorption rate.
BA
TOP: NURSING PROCESS: Nursing Intervention
N
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 3
ST
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
TE
4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be given by subcutaneous injection instead of by mouth. The nurse will explain that this is because
G
a. absorption is diminished by the first-pass effects in the liver.
N
b. absorption is faster when insulin is given subcutaneously.
SI
c. digestive enzymes in the gastrointestinal tract prevent absorption.
R
d. the oral form is less predictable with more adverse effects.
U
ANS: C
.N
Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine by
W W W
digestive enzymes and must be given parenterally. Because insulin is destroyed by digestive enzymes, it would not make it to the liver for metabolism with a first-pass effect. Subcutaneous
tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin is given subcutaneously because it is desirable to have it absorb slowly. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3 TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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5. The nurse is preparing to administer an oral medication that is water-soluble. The nurse understands that this drug a. must be taken on an empty stomach. b. requires active transport for absorption.
O M
c. should be taken with fatty foods. d. will readily diffuse into the gastrointestinal tract.
.C
ANS: B
O R
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 4
LD
Water-soluble drugs require a carrier enzyme or protein to pass through the GI membrane.
TOP: NURSING PROCESS: Nursing Intervention
KS
W
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 6. A nurse is preparing to administer an oral drug that is best absorbed in an acidic environment.
N
How will the nurse give the drug?
BA
a. On an empty stomach b. With a full glass of water
ST
c. With food
TE
d. With high-fat food ANS: C
G
Food can stimulate the production of gastric acid so medications requiring an acidic environment
SI
N
should be given with a meal. High-fat foods are useful for drugs that are lipid soluble.
R
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 4
U
TOP: NURSING PROCESS: Nursing Intervention
.N
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
W W W
7. The nurse is preparing an injectable drug and wants to administer it for rapid absorption. How
will the nurse give this medication? a. IM into the deltoid muscle b. IM into the gluteal muscle c. SubQ into abdominal tissue d. SubQ into the upper arm ANS: A
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Drugs given IM are absorbed faster in muscles that have more blood vessels, such as the deltoid, rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routes are used when absorption needs to be slower and more sustained.
O M
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 4
LD
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
.C
TOP: NURSING PROCESS: Planning
8. The nurse is reviewing medication information with a nursing student prior to administering student indicates a need for further teaching about this medication?
O R
an oral drug and notes that the drug has extensive first-pass effects. Which statement by the
W
a. The first-pass effect means the drug may be absorbed into systemic circulation from the
KS
intestinal lumen.
b. The first-pass effect means the drug may be changed to an inactive form and excreted.
N
c. The first-pass effect means the drug may be changed to a metabolite, which may be more
BA
active than the original.
d. The first-pass effect means the drug may be unchanged as it passes through the liver.
ST
ANS: A
TE
Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal
N
or a more active form.
G
lumen and go through the liver where they are either unchanged or are metabolized to an inactive
SI
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 4
R
TOP: NURSING PROCESS: Nursing Intervention
.N
U
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 9. The nurse prepares to change a patients medication from an intravenous to an oral form and
W W W
notes that the oral form is ordered in a higher dose. The nurse understands that this is due to differences in a. bioavailability. b. pinocytosis. c. protein binding. d. tachyphylaxis. ANS: A
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Oral drugs may have less bioavailability because a lower percentage of the drug reaches the systemic circulation. Pinocytosis refers to the process by which cells carry a solute across a membrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapid decrease
O M
in response to drugs that occurs when tolerance develops quickly.
TOP: NURSING PROCESS: Assessment
LD
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
.C
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 4
O R
10. The nurse is preparing to administer a drug and learns that it binds to protein at a rate of 90%. The patients serum albumin level is low. The nurse will observe the patient for
W
a. decreased drug absorption.
KS
b. decreased drug interactions. c. decreased drug toxicity.
N
d. increased drug effects.
BA
ANS: D
Drugs that are highly protein-bound bind with albumin and other proteins, leaving less free drug
ST
in circulation. If a patient has a low albumin, the drug is not bound, and there is more free drug
G
drugs, and increased toxicity.
TE
to cause drug effects. There would be increased absorption, increased interactions with other
N
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 5
SI
TOP: NURSING PROCESS: Evaluation
U
R
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
.N
11. The nurse is administering two drugs to a patient and learns that both drugs are highly protein-bound. The nurse may expect
W W W
a. decreased bioavailability of both drugs. b. decreased drug effects. c. decreased drug interactions. d. increased risk of adverse effects. ANS: D Two drugs that are highly protein-bound will compete for protein-binding sites, leaving more
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free drug in circulation and an increased risk of adverse effects as well as increased bioavailability, increased drug effects, and increased drug interactions. DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 5
O M
TOP: NURSING PROCESS: Evaluation
.C
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
LD
12. A patient has been taking a drug that has a protein-binding effect of 75%. The provider adds a new medication that has a protein-binding effect of 90%. The nurse will expect
O R
a. decreased drug effects of the first drug. b. decreased therapeutic range of the first drug.
W
c. increased drug effects of the first drug.
KS
d. increased therapeutic range of the first drug. ANS: C
N
Adding another highly protein-bound drug will displace the first drug from protein-binding sites
BA
and release more free drug increasing the drugs effects. This does not alter the therapeutic range,
ST
which is the serum level between drug effectiveness and toxicity.
TE
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 5 TOP: NURSING PROCESS: Nursing Intervention/Evaluation
N
G
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
SI
13. The nurse gives a medication to a patient with a history of liver disease. The nurse will monitor this patient for
U
R
a. decreased drug effects.
.N
b. increased drug effects. c. decreased therapeutic range.
W W W
d. increased therapeutic range. ANS: B
Liver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting the drugmetabolizing enzymes in the liver. When the drug metabolism rate is decreased, excess drug accumulation can occur and lead to toxicity.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 6 TOP: NURSING PROCESS: Assessment/Nursing Intervention MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
O M
14. The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be left in the body in 24 hours if no additional drug is given?
.C
a. None
LD
b. 50 mg c. 100 mg
O R
d. 200 mg ANS: C
W
Eight hours after the drug is given, there will be 400 mg left. Eight hours after that (16 hours),
KS
there will be 200 mg left. At 24 hours, there will be 100 mg left.
BA
TOP: NURSING PROCESS: Evaluation
N
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 6
ST
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
TE
15. If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a Monday, when will a steady state be achieved?
R
d. 0800 on Friday
SI
c. 0800 on Thursday
N
b. 0800 on Wednesday
G
a. 0800 on Tuesday
U
ANS: B
W W W
dose.
.N
Steady-state levels occur at 3 to 5 half-lives. Wednesday at 0800 is 4 half-lives from the original
DIF: COGNITIVE LEVEL: Applying (Application) REF: Pages 6-7 TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 16. The nurse is preparing to administer a drug that is ordered to be given twice daily. The nurse reviews the medication information and learns that the drug has a half-life of 24 hours. What will the nurse do next?
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a. Administer the medication as ordered. b. Contact the provider to discuss daily dosing. c. Discuss every-other-day dosing with the provider. ANS: B
.C
A drug with a longer half-life should be given at longer intervals to avoid drug toxicity.
O M
d. Hold the medication and notify the provider.
LD
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 12 TOP: NURSING PROCESS: Planning
O R
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
W
17. The nurse is caring for a patient who has taken an overdose of aspirin several hours prior.
KS
The provider orders sodium bicarbonate to be given. The nurse understands that this drug is given for which purpose?
d. To neutralize the acid of the aspirin
TE
ANS: C
ST
c. To increase the excretion of the aspirin
BA
b. To decrease the half-life of the aspirin
N
a. To counter the toxic effects of the aspirin
Aspirin is a weak acid and is more readily excreted in alkaline urine. Sodium bicarbonate
G
alkalizes the urine. It does not act as an antidote to aspirin, decrease the half-life, or neutralize its
SI
N
pH.
R
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 7
U
TOP: NURSING PROCESS: Planning
.N
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
W W W
18. The nurse is preparing to administer a drug that is eliminated through the kidneys. The nurse
reviews the patients chart and notes that the patient has increased serum creatinine and blood
urea nitrogen (BUN). The nurse will perform which action? a. Administer the drug as ordered. b. Anticipate a shorter than usual half-life of the drug. c. Expect decreased drug effects when the drug is given. d. Notify the provider and discuss giving a lower dose.
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ANS: D Increased creatinine and BUN indicate decreased renal function so a drug that is eliminated through the kidneys can become toxic. The nurse should discuss a lower dose with the provider. The drug will have a longer half-life and will exhibit increased effects with decreased renal
O M
function.
.C
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 7
LD
TOP: NURSING PROCESS: Nursing Intervention
O R
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
19. The nurse understands that the length of time needed for a drug to reach the minimum
W
effective concentration (MEC) is the
KS
a. duration of action. b. onset of action.
N
c. peak action time.
BA
d. time response curve. ANS: B
ST
The onset of action is the time it takes to reach the MEC. Duration of action is the length of time
TE
a drug has a pharmacologic effect. Peak action time occurs when the drug reaches its highest
G
blood level. The time response curve is an evaluation of the other three measures.
N
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: dm 7
SI
TOP: NURSING PROCESS: N/A
U
R
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
.N
20. The nurse administers albuterol to a patient who has asthma. The albuterol acts by stimulating beta2-adrenergic receptors to cause bronchodilation. The nurse understands that
W W W
albuterol is a beta-adrenergic a. agonist. b. antagonist. c. inhibitor. d. depressant. ANS: A An agonist medication is one that stimulates a certain type of cell to produce a response.
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DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 8 TOP: NURSING PROCESS: N/A MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
O M
21. The nurse is explaining to the patient why a nonspecific drug has so many side effects. a. Nonspecific drugs can affect specific receptor types in different body tissues.
LD
b. Nonspecific drugs can affect a variety of receptor types in similar body tissues.
.C
Which statement by the patient indicates a need for further teaching?
c. Nonspecific drugs can affect hormone secretion as well as cellular functions.
O R
d. Nonspecific drugs require higher doses than specific drugs to be effective. ANS: D
W
Nonspecific drugs can act on one type of receptor but in different body tissues, or a variety of
KS
receptor types, or act on hormones to produce effects. Nonspecific drugs do not require higher
N
doses.
BA
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 8 TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
TE
ST
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 22. The nurse is preparing to give a dose of gentamicin to a patient and notes that the most recent
G
serum gentamicin trough level was 2 mcg/mL. What will the nurse do next?
N
a. Administer the drug as ordered.
SI
b. Administer the drug and monitor for adverse effects.
R
c. Notify the provider to discuss decreasing the dose.
U
d. Notify the provider to report a toxic drug level.
.N
ANS: D
W W W
The trough drug level for gentamicin should be less than 2 mcg/mL. The nurse should not administer the drug and should notify the provider of the toxic level. DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 10
TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
23. The nurse is preparing to administer the first dose of digoxin (Lanoxin) to a patient and notes that the dose ordered is much higher than the usual recommended dose. Which action will the
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nurse perform? a. Administer the dose as ordered. b. Give the dose and monitor for toxicity. c. Hold the dose until reviewing it with the provider.
O M
d. Refuse to give the dose. ANS: A
LD
.C
Digoxin requires a loading dose when first prescribed. DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 10
O R
TOP: NURSING PROCESS: Nursing Intervention
W
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
KS
24. The nurse administers a narcotic analgesic to a patient who has been receiving it for 1 day after orthopedic surgery. The patient reports no change in pain 30 minutes after the medication is
N
given. The nurse recognizes that this patient is exhibiting
BA
a. drug-seeking behavior. b. drug tolerance.
ST
c. the placebo effect.
TE
d. tachyphylaxis. ANS: D
G
Tachyphylaxis is a rapid decrease in response, or acute tolerance. Tolerance to drug effects can
N
occur with narcotics, requiring increased doses in order to achieve adequate drug effects. Nurses
SI
often mistake drug-seeking behavior for drug tolerance. The placebo effect occurs when the
U
R
patient experiences a response with an inactive drug.
W W W
.N
Chapter 2: Drug–Receptor Interactions and Pharmacodynamics 1. Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
A)
A 35-year-old woman with cervical cancer
B)
A 41-year-old man with kidney stones
C)
A 50-year-old man with cirrhosis of the liver
D)
A 62-year-old woman in acute renal failure
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Ans:
C Feedback:
.C
O M
The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
30 minutes
B)
1 hour
C)
2 hours
D)
3 hours
Ans:
B
BA
N
KS
W
A)
O R
LD
2. A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
ST
Feedback:
N
G
TE
Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2) if the body can properly metabolize and excrete the drug. After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range. In 30 minutes the drug level would be 37.5 units/mL, whereas in 3 hours the drug level would be 6.25.
W W W
.N
U
R
SI
3. A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
A)
The impact of the placebo effect on the patients response.
B)
The accumulative effect of the drug if it has been taken for many years.
C)
The impact of the warmer environment on the patients physical status.
D)
Problems with patient compliance with the drug regimen while on vacation.
Ans:
C Feedback:
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.C
O M
Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patients blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
B)
Allergic reactions to medications
C)
Drugdrug interactions
D)
Critical concentrations of medications in the body
Ans:
C
O R
Spending large amounts of money on medications
N
KS
W
A)
LD
4. An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
BA
Feedback:
R
SI
N
G
TE
ST
It is important that all health care providers have a complete list of the patients medications to avoid drugdrug interactions caused by one provider ordering a medication, unaware of another medication the patient is taking that could interact with the new prescription. Using the same pharmacist for all prescriptions will also help to prevent this from happening. Informing the provider of all medications taken will not reduce costs of medications, which is best accomplished by requesting generic medications. Allergies should be disclosed to all health care providers as well, but this is not why it is important to provide a complete list of medications taken. Critical concentrations are desirable because that is the amount of drug needed to cause a therapeutic effect, or, in other words, to have the effect the drug is prescribed for.
W W W
A)
.N
U
5. A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructors best response? A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
B)
A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
C)
A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
D)
A drug that reacts with receptor sites to block normal stimulation, producing no effect
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lippincott Pharmacology Illustrated Reviews 7th Edition Whalen Test Bank Full ACCESS Test Bank From Link Below https://nursylab.com/products/lippincott-pharmacology-illustrat ed-reviews-7th-edition-whalen-test-bank/ TestBank Directly From The publisher, 100% Verified Answers. COVERS ALL CHAPTERS. Download Immediately
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