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 hospitalized patient is prescribed a new
medication. During medication reconciliation the nurse notes
the patient uses a complementary herbal product daily. The
patient asks whether it’s “safe to keep taking” the herb with the
new drug. What should the nurse do first?
A. Tell the patient to stop the herb immediately.
B. Document the herb on the medication list and check for
known interactions.
C. Reassure the patient that herbal products are harmless and
,continue the drug.
D. Call pharmacy and ask them to withhold the new medication
until provider review.
Correct answer: B
Rationale — Correct (B): Documenting complementary/herbal
products and checking for interactions is the immediate nursing
action aligned with safe medication reconciliation. Karch
emphasizes that nonprescription and herbal products must be
treated as potential sources of drug interactions and should be
investigated before making clinical decisions. This step
preserves patient safety while gathering information.
Rationale — Incorrect:
A. Stopping the herb without assessing interactions or
consulting the prescriber is premature and may harm
therapeutic continuity.
C. Assuming herbal safety is incorrect — many herbs have
powerful pharmacologic effects and interactions.
D. Withholding the new medication before verifying an
interaction is premature; first document and evaluate
interaction potential.
Teaching point: Always document herbal/OTC products and
check for interactions before 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 nurse prepares to give an oral drug and notes the
prescription lists a brand name unfamiliar to the nurse. The
medication’s generic name is available in the MAR. Which
nursing action is most appropriate before administering?
A. Give the brand-name medication as ordered; brand names
always equal generic.
B. Verify the generic and brand name equivalence using a
reliable drug reference and document.
C. Convert the dose by halving it because brand and generic
potencies differ.
D. Ask the patient whether they prefer brand or generic and
give their choice.
Correct answer: B
Rationale — Correct (B): Verifying equivalence using a trusted
reference is the correct safety action. Karch stresses that nurses
must confirm generic and brand names (many drugs have
multiple brand names) to ensure correct drug and dose prior to
administration.
Rationale — Incorrect:
A. Administering without verification risks error—brand and
generic names may be different formulations or strengths.
C. Arbitrary dose conversion is unsafe; potency is not routinely
halved between brand and generic.
, D. Patient preference is secondary to safety; nurse must verify
identity and equivalence first.
Teaching point: Confirm generic/brand equivalence with a
reliable reference before administering.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3
Reference: Ch. 1 — Introduction to Drugs
Stem: A patient with chronic liver disease is starting a
medication known for extensive hepatic metabolism. Which
nursing assessment is most important before administration?
A. Baseline creatinine level.
B. Baseline liver function tests and signs of hepatic dysfunction.
C. Baseline hemoglobin A1c.
D. Baseline blood pressure only.
Correct answer: B
Rationale — Correct (B): For drugs extensively metabolized in
the liver, assessing hepatic function (labs and clinical signs) is
essential to predict altered metabolism and toxicity. Karch
highlights organ dysfunction as a major determinant of drug
metabolism and dosing adjustments.
Rationale — Incorrect:
A. Creatinine assesses renal, not hepatic, clearance—less
immediately relevant for hepatic metabolism.
PHARMACOLOGY
10TH EDITION
• AUTHOR(S)REBECCA G. TUCKER
TEST BANK
1
Reference: Ch. 1 — Introduction to Drugs
Stem: A 68-year-old hospitalized patient is prescribed a new
medication. During medication reconciliation the nurse notes
the patient uses a complementary herbal product daily. The
patient asks whether it’s “safe to keep taking” the herb with the
new drug. What should the nurse do first?
A. Tell the patient to stop the herb immediately.
B. Document the herb on the medication list and check for
known interactions.
C. Reassure the patient that herbal products are harmless and
,continue the drug.
D. Call pharmacy and ask them to withhold the new medication
until provider review.
Correct answer: B
Rationale — Correct (B): Documenting complementary/herbal
products and checking for interactions is the immediate nursing
action aligned with safe medication reconciliation. Karch
emphasizes that nonprescription and herbal products must be
treated as potential sources of drug interactions and should be
investigated before making clinical decisions. This step
preserves patient safety while gathering information.
Rationale — Incorrect:
A. Stopping the herb without assessing interactions or
consulting the prescriber is premature and may harm
therapeutic continuity.
C. Assuming herbal safety is incorrect — many herbs have
powerful pharmacologic effects and interactions.
D. Withholding the new medication before verifying an
interaction is premature; first document and evaluate
interaction potential.
Teaching point: Always document herbal/OTC products and
check for interactions before 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 nurse prepares to give an oral drug and notes the
prescription lists a brand name unfamiliar to the nurse. The
medication’s generic name is available in the MAR. Which
nursing action is most appropriate before administering?
A. Give the brand-name medication as ordered; brand names
always equal generic.
B. Verify the generic and brand name equivalence using a
reliable drug reference and document.
C. Convert the dose by halving it because brand and generic
potencies differ.
D. Ask the patient whether they prefer brand or generic and
give their choice.
Correct answer: B
Rationale — Correct (B): Verifying equivalence using a trusted
reference is the correct safety action. Karch stresses that nurses
must confirm generic and brand names (many drugs have
multiple brand names) to ensure correct drug and dose prior to
administration.
Rationale — Incorrect:
A. Administering without verification risks error—brand and
generic names may be different formulations or strengths.
C. Arbitrary dose conversion is unsafe; potency is not routinely
halved between brand and generic.
, D. Patient preference is secondary to safety; nurse must verify
identity and equivalence first.
Teaching point: Confirm generic/brand equivalence with a
reliable reference before administering.
Citation: Tucker, R. G. (2026). Karch’s Focus on Nursing
Pharmacology (10th ed.). Ch. 1.
3
Reference: Ch. 1 — Introduction to Drugs
Stem: A patient with chronic liver disease is starting a
medication known for extensive hepatic metabolism. Which
nursing assessment is most important before administration?
A. Baseline creatinine level.
B. Baseline liver function tests and signs of hepatic dysfunction.
C. Baseline hemoglobin A1c.
D. Baseline blood pressure only.
Correct answer: B
Rationale — Correct (B): For drugs extensively metabolized in
the liver, assessing hepatic function (labs and clinical signs) is
essential to predict altered metabolism and toxicity. Karch
highlights organ dysfunction as a major determinant of drug
metabolism and dosing adjustments.
Rationale — Incorrect:
A. Creatinine assesses renal, not hepatic, clearance—less
immediately relevant for hepatic metabolism.
