KATZUNG'S BASIC AND
CLINICAL PHARMACOLOGY
16TH EDITION
• AUTHOR(S)TODD W.
VANDERAH
TEST BANK
,Question 1
A nurse is explaining why a newly approved medication
continues to be monitored after it becomes available to the
public. Which statement best describes the primary purpose of
post-marketing surveillance?
A. To determine the medication's chemical structure
B. To identify uncommon or delayed adverse effects that may
not have appeared during preapproval studies
C. To establish the medication's initial recommended dosage
D. To compare the medication with all available alternatives
before prescribing
Correct Answer: B
Rationale:
Post-marketing surveillance helps identify rare, long-term, or
previously unrecognized adverse effects that may not have
been detected during clinical trials because of limited sample
sizes or shorter follow-up periods. Option A is incorrect because
chemical structure is determined during drug development.
Option C is incorrect because dosage recommendations are
established before approval based on clinical studies. Option D
is incorrect because comparative effectiveness research may
occur later but is not the primary purpose of post-marketing
surveillance.
,Question 2
A nurse is caring for a client receiving an oral medication with
extensive first-pass metabolism. Which outcome should the
nurse anticipate?
A. More drug reaches the systemic circulation unchanged
B. The medication is completely eliminated before absorption
C. A significant portion of the drug is metabolized before
reaching systemic circulation
D. The medication bypasses hepatic metabolism entirely
Correct Answer: C
Rationale:
First-pass metabolism refers to metabolism occurring primarily
in the liver before a drug reaches the systemic circulation,
reducing the amount of active drug available. Option A is the
opposite of first-pass metabolism. Option B is incorrect because
some drug generally reaches the circulation. Option D is
incorrect because oral medications typically pass through the
portal circulation before entering systemic circulation.
Question 3
A nurse reviews a provider's prescription for a medication with
a narrow therapeutic index. Which nursing action is the highest
priority?
, A. Encourage the client to increase fluid intake without
limitation
B. Administer the medication at any convenient time each day
C. Monitor ordered laboratory values and assess for signs of
toxicity
D. Instruct the client to discontinue the medication if mild
adverse effects occur
Correct Answer: C
Rationale:
Medications with a narrow therapeutic index have a small
margin between therapeutic and toxic concentrations, making
careful monitoring essential. Option A may not be appropriate
for all medications. Option B ignores the importance of
consistent administration and monitoring. Option D could place
the client at risk because medications should not be
discontinued without provider guidance unless severe reactions
occur.
Question 4
A client asks why a generic medication was substituted for a
brand-name medication. Which response by the nurse is most
appropriate?
CLINICAL PHARMACOLOGY
16TH EDITION
• AUTHOR(S)TODD W.
VANDERAH
TEST BANK
,Question 1
A nurse is explaining why a newly approved medication
continues to be monitored after it becomes available to the
public. Which statement best describes the primary purpose of
post-marketing surveillance?
A. To determine the medication's chemical structure
B. To identify uncommon or delayed adverse effects that may
not have appeared during preapproval studies
C. To establish the medication's initial recommended dosage
D. To compare the medication with all available alternatives
before prescribing
Correct Answer: B
Rationale:
Post-marketing surveillance helps identify rare, long-term, or
previously unrecognized adverse effects that may not have
been detected during clinical trials because of limited sample
sizes or shorter follow-up periods. Option A is incorrect because
chemical structure is determined during drug development.
Option C is incorrect because dosage recommendations are
established before approval based on clinical studies. Option D
is incorrect because comparative effectiveness research may
occur later but is not the primary purpose of post-marketing
surveillance.
,Question 2
A nurse is caring for a client receiving an oral medication with
extensive first-pass metabolism. Which outcome should the
nurse anticipate?
A. More drug reaches the systemic circulation unchanged
B. The medication is completely eliminated before absorption
C. A significant portion of the drug is metabolized before
reaching systemic circulation
D. The medication bypasses hepatic metabolism entirely
Correct Answer: C
Rationale:
First-pass metabolism refers to metabolism occurring primarily
in the liver before a drug reaches the systemic circulation,
reducing the amount of active drug available. Option A is the
opposite of first-pass metabolism. Option B is incorrect because
some drug generally reaches the circulation. Option D is
incorrect because oral medications typically pass through the
portal circulation before entering systemic circulation.
Question 3
A nurse reviews a provider's prescription for a medication with
a narrow therapeutic index. Which nursing action is the highest
priority?
, A. Encourage the client to increase fluid intake without
limitation
B. Administer the medication at any convenient time each day
C. Monitor ordered laboratory values and assess for signs of
toxicity
D. Instruct the client to discontinue the medication if mild
adverse effects occur
Correct Answer: C
Rationale:
Medications with a narrow therapeutic index have a small
margin between therapeutic and toxic concentrations, making
careful monitoring essential. Option A may not be appropriate
for all medications. Option B ignores the importance of
consistent administration and monitoring. Option D could place
the client at risk because medications should not be
discontinued without provider guidance unless severe reactions
occur.
Question 4
A client asks why a generic medication was substituted for a
brand-name medication. Which response by the nurse is most
appropriate?
