KARCH’S FOCUS ON NURSING
PHARMACOLOGY
10TH EDITION
• AUTHOR(S)REBECCA G. TUCKER
TEST BANK
1)
Reference: Ch. 1 — Introduction to Drugs
Stem: A 68-year-old patient with newly diagnosed hypertension
is admitted for medication teaching. The nurse notes the
patient takes several OTC supplements and has reduced
appetite. Before administering the first dose of the prescribed
antihypertensive, what should the nurse do first?
A. Ask the patient to list all current prescription and OTC
medications and supplements.
B. Administer the medication and assess the blood pressure 1
hour after giving it.
,C. Notify the prescriber to reduce the initial dose because of
age.
D. Check the drug handbook for the medication’s half-life.
Correct answer: A
Rationale — Correct: Asking the patient to list all prescription,
OTC medications, and supplements is the first step to identify
potential interactions and polypharmacy that could affect safety
and efficacy. Chapter 1 emphasizes medication reconciliation
and comprehensive medication history before new drug
administration. This prevents harm from interactions or
duplicate therapy.
Rationale — Incorrect:
B. Waiting to assess after administration risks giving a drug that
could interact or cause harm — not the priority.
C. Automatic dose reduction without reviewing current meds
and individual factors is premature.
D. Checking half-life is useful but secondary to obtaining an
accurate medication list.
Teaching point: Always obtain a complete medication &
supplement list before initiating new 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 nurse prepares to give a newly ordered oral medication
that is subject to significant first-pass metabolism. The patient
asks why the drug is given orally rather than by injection. Which
explanation best reflects the pharmacokinetic concept the
nurse should use?
A. “Oral drugs are absorbed into the bloodstream directly
without liver involvement.”
B. “The liver breaks down some of the drug before it reaches
full effect; the route affects that process.”
C. “Oral drugs always act faster than injected drugs because
they go through the stomach.”
D. “Taking the drug by mouth reduces the chance of adverse
effects compared with injections.”
Correct answer: B
Rationale — Correct: This statement correctly describes first-
pass metabolism: orally administered drugs may be
metabolized by the liver before systemic circulation, reducing
bioavailability. Chapter 1 covers first-pass effect and how route
influences absorption and bioavailability.
Rationale — Incorrect:
A. Incorrect—oral drugs are absorbed via the GI tract and often
pass through the liver before systemic circulation.
C. Incorrect—oral drugs usually act slower than injections due
to absorption and first-pass.
, D. Incorrect—route does not inherently reduce adverse effect
risk; it changes absorption and bioavailability.
Teaching point: First-pass metabolism reduces oral drug
bioavailability; route selection affects systemic levels.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3)
Reference: Ch. 1 — Introduction to Drugs
Stem: A postoperative patient is prescribed an opioid analgesic.
The patient’s chart notes severe hepatic impairment. Which
nursing action best addresses pharmacokinetic concerns before
giving the opioid?
A. Administer full dose and monitor for pain relief.
B. Withhold the drug and request a nonnarcotic analgesic
instead.
C. Verify with the prescriber whether a reduced dose or
alternative is needed.
D. Give the drug and plan to monitor liver function tests next
week.
Correct answer: C
Rationale — Correct: Hepatic impairment affects drug
metabolism; the nurse should verify with the prescriber about
dose adjustment or alternative. Chapter 1 emphasizes
PHARMACOLOGY
10TH EDITION
• AUTHOR(S)REBECCA G. TUCKER
TEST BANK
1)
Reference: Ch. 1 — Introduction to Drugs
Stem: A 68-year-old patient with newly diagnosed hypertension
is admitted for medication teaching. The nurse notes the
patient takes several OTC supplements and has reduced
appetite. Before administering the first dose of the prescribed
antihypertensive, what should the nurse do first?
A. Ask the patient to list all current prescription and OTC
medications and supplements.
B. Administer the medication and assess the blood pressure 1
hour after giving it.
,C. Notify the prescriber to reduce the initial dose because of
age.
D. Check the drug handbook for the medication’s half-life.
Correct answer: A
Rationale — Correct: Asking the patient to list all prescription,
OTC medications, and supplements is the first step to identify
potential interactions and polypharmacy that could affect safety
and efficacy. Chapter 1 emphasizes medication reconciliation
and comprehensive medication history before new drug
administration. This prevents harm from interactions or
duplicate therapy.
Rationale — Incorrect:
B. Waiting to assess after administration risks giving a drug that
could interact or cause harm — not the priority.
C. Automatic dose reduction without reviewing current meds
and individual factors is premature.
D. Checking half-life is useful but secondary to obtaining an
accurate medication list.
Teaching point: Always obtain a complete medication &
supplement list before initiating new 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 nurse prepares to give a newly ordered oral medication
that is subject to significant first-pass metabolism. The patient
asks why the drug is given orally rather than by injection. Which
explanation best reflects the pharmacokinetic concept the
nurse should use?
A. “Oral drugs are absorbed into the bloodstream directly
without liver involvement.”
B. “The liver breaks down some of the drug before it reaches
full effect; the route affects that process.”
C. “Oral drugs always act faster than injected drugs because
they go through the stomach.”
D. “Taking the drug by mouth reduces the chance of adverse
effects compared with injections.”
Correct answer: B
Rationale — Correct: This statement correctly describes first-
pass metabolism: orally administered drugs may be
metabolized by the liver before systemic circulation, reducing
bioavailability. Chapter 1 covers first-pass effect and how route
influences absorption and bioavailability.
Rationale — Incorrect:
A. Incorrect—oral drugs are absorbed via the GI tract and often
pass through the liver before systemic circulation.
C. Incorrect—oral drugs usually act slower than injections due
to absorption and first-pass.
, D. Incorrect—route does not inherently reduce adverse effect
risk; it changes absorption and bioavailability.
Teaching point: First-pass metabolism reduces oral drug
bioavailability; route selection affects systemic levels.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3)
Reference: Ch. 1 — Introduction to Drugs
Stem: A postoperative patient is prescribed an opioid analgesic.
The patient’s chart notes severe hepatic impairment. Which
nursing action best addresses pharmacokinetic concerns before
giving the opioid?
A. Administer full dose and monitor for pain relief.
B. Withhold the drug and request a nonnarcotic analgesic
instead.
C. Verify with the prescriber whether a reduced dose or
alternative is needed.
D. Give the drug and plan to monitor liver function tests next
week.
Correct answer: C
Rationale — Correct: Hepatic impairment affects drug
metabolism; the nurse should verify with the prescriber about
dose adjustment or alternative. Chapter 1 emphasizes
