KARCH’S FOCUS ON NURSING
PHARMACOLOGY
10TH EDITION
• AUTHOR(S)REBECCA G. TUCKER
TEST BANK
1)
Reference: Ch. 1 — Introduction to Drugs
Stem: A 72-year-old woman is admitted after a fall. Her
medication list includes digoxin (Lanoxin) and a recently started
antibiotic by mouth for a urinary tract infection. On assessment
she has an irregular pulse of 48 beats/min and reports nausea
and visual halos. Which action should the nurse take first?
A. Hold the digoxin and notify the prescriber.
B. Give the antibiotic with a snack to reduce nausea.
C. Obtain a serum digoxin level and potassium.
D. Arrange for an ECG to evaluate the slow, irregular rhythm.
,Correct Answer: C
Rationale — Correct: Obtaining serum digoxin and potassium
first will rapidly clarify whether the patient has digoxin toxicity
(nausea, visual halos, bradyarrhythmia) and whether
hypokalemia is present, which exacerbates toxicity. Karch
emphasizes the nurse’s role in assessing drug effects and
monitoring labs before further interventions.
Rationales — Incorrect:
A. Holding the drug may be necessary but should follow data
that confirm toxicity; immediate objective labs guide safe
action.
B. Giving the antibiotic with a snack addresses nausea but
misses potentially life-threatening digoxin toxicity.
D. An ECG is useful, but lab values (digoxin level, K⁺) are higher
priority to identify drug toxicity and correct electrolyte
contributors.
Teaching point: Check suspected drug levels and electrolytes
before holding or changing therapy.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
2)
Reference: Ch. 1 — Introduction to Drugs
,Stem: A new graduate nurse reviews the medication policy and
asks why bioavailability differs between two formulations of the
same drug. Which short explanation best fits the nurse’s
teaching?
A. “Bioavailability depends only on the drug’s chemical name.”
B. “Bioavailability is the fraction of an administered dose that
reaches systemic circulation.”
C. “All oral drugs have identical bioavailability to IV drugs.”
D. “Bioavailability is the same for brand and generic products
always.”
Correct Answer: B
Rationale — Correct: Bioavailability is defined as the fraction of
an administered dose reaching systemic circulation in an active
form; formulation, route (oral vs IV), first-pass metabolism, and
excipients affect it. Karch’s introductory chapter defines these
fundamental pharmacokinetic concepts that nurses must
understand.
Rationales — Incorrect:
A. Chemical name doesn’t determine bioavailability;
formulation and route do.
C. Oral drugs often have lower and variable bioavailability
compared with IV because of absorption and first-pass
metabolism.
D. Generic and brand products are bioequivalent within
regulatory limits, but absolute bioavailability can still differ due
to formulation differences in some cases.
, Teaching point: Bioavailability = fraction of dose reaching
circulation; route matters.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3)
Reference: Ch. 1 — Introduction to Drugs
Stem: A nurse is teaching a patient about an OTC analgesic that
the patient takes daily for headaches. Which statement by the
patient warrants immediate correction by the nurse?
A. “It’s safe because I can buy it without a prescription.”
B. “I should read the label for maximum daily dose.”
C. “I’ll tell my prescriber about taking it with my blood pressure
medicine.”
D. “I’ll stop it and call the clinic if stomach pain or black stools
develop.”
Correct Answer: A
Rationale — Correct: OTC availability does not guarantee safety
for all patients; Karch underscores that OTC drugs can cause
harm (e.g., GI bleeding, interactions) and require nurse teaching
about risks and interactions. Patient belief that OTC equals safe
is dangerous.
Rationales — Incorrect:
B. Reading label for maximum dose is appropriate.
PHARMACOLOGY
10TH EDITION
• AUTHOR(S)REBECCA G. TUCKER
TEST BANK
1)
Reference: Ch. 1 — Introduction to Drugs
Stem: A 72-year-old woman is admitted after a fall. Her
medication list includes digoxin (Lanoxin) and a recently started
antibiotic by mouth for a urinary tract infection. On assessment
she has an irregular pulse of 48 beats/min and reports nausea
and visual halos. Which action should the nurse take first?
A. Hold the digoxin and notify the prescriber.
B. Give the antibiotic with a snack to reduce nausea.
C. Obtain a serum digoxin level and potassium.
D. Arrange for an ECG to evaluate the slow, irregular rhythm.
,Correct Answer: C
Rationale — Correct: Obtaining serum digoxin and potassium
first will rapidly clarify whether the patient has digoxin toxicity
(nausea, visual halos, bradyarrhythmia) and whether
hypokalemia is present, which exacerbates toxicity. Karch
emphasizes the nurse’s role in assessing drug effects and
monitoring labs before further interventions.
Rationales — Incorrect:
A. Holding the drug may be necessary but should follow data
that confirm toxicity; immediate objective labs guide safe
action.
B. Giving the antibiotic with a snack addresses nausea but
misses potentially life-threatening digoxin toxicity.
D. An ECG is useful, but lab values (digoxin level, K⁺) are higher
priority to identify drug toxicity and correct electrolyte
contributors.
Teaching point: Check suspected drug levels and electrolytes
before holding or changing therapy.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
2)
Reference: Ch. 1 — Introduction to Drugs
,Stem: A new graduate nurse reviews the medication policy and
asks why bioavailability differs between two formulations of the
same drug. Which short explanation best fits the nurse’s
teaching?
A. “Bioavailability depends only on the drug’s chemical name.”
B. “Bioavailability is the fraction of an administered dose that
reaches systemic circulation.”
C. “All oral drugs have identical bioavailability to IV drugs.”
D. “Bioavailability is the same for brand and generic products
always.”
Correct Answer: B
Rationale — Correct: Bioavailability is defined as the fraction of
an administered dose reaching systemic circulation in an active
form; formulation, route (oral vs IV), first-pass metabolism, and
excipients affect it. Karch’s introductory chapter defines these
fundamental pharmacokinetic concepts that nurses must
understand.
Rationales — Incorrect:
A. Chemical name doesn’t determine bioavailability;
formulation and route do.
C. Oral drugs often have lower and variable bioavailability
compared with IV because of absorption and first-pass
metabolism.
D. Generic and brand products are bioequivalent within
regulatory limits, but absolute bioavailability can still differ due
to formulation differences in some cases.
, Teaching point: Bioavailability = fraction of dose reaching
circulation; route matters.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3)
Reference: Ch. 1 — Introduction to Drugs
Stem: A nurse is teaching a patient about an OTC analgesic that
the patient takes daily for headaches. Which statement by the
patient warrants immediate correction by the nurse?
A. “It’s safe because I can buy it without a prescription.”
B. “I should read the label for maximum daily dose.”
C. “I’ll tell my prescriber about taking it with my blood pressure
medicine.”
D. “I’ll stop it and call the clinic if stomach pain or black stools
develop.”
Correct Answer: A
Rationale — Correct: OTC availability does not guarantee safety
for all patients; Karch underscores that OTC drugs can cause
harm (e.g., GI bleeding, interactions) and require nurse teaching
about risks and interactions. Patient belief that OTC equals safe
is dangerous.
Rationales — Incorrect:
B. Reading label for maximum dose is appropriate.
