NCLEX ABRAMS' CLINICAL DRUG
THERAPY QUESTIONS AND ANSWERS
1.1nThennursenisncaringnfornanwomannwhonhasnstrongnbeliefsnaboutnnotnputting
nanythingnunnaturalnintonhernbody.nItnisnmostnaccuratentonsaynthatnmostnmoder
nnmedicationsnare
A.nnaturalnproductsnderivednfromnplants
B.nnaturalnproductsnderivednfromnminerals
C.nsyntheticnproductsnmanufacturedninnlaboratories
D.nsyntheticnmodificationsnofnnaturalnproductsn-nans-C.n
Rationale:nAlthoughnmostnolderndrugsnoriginatednasnplants,nminerals,nornothernn
aturalnproducts,nnewerndrugsnarenmainlynsynthetic.nSyntheticndrugsnarenstandardi
zednandnthereforenmorenconsistentninntheirncharacteristicsnandneffectsnthannnatur
alnproducts.
1.2nThennursenisntakingncarenofnanmannwhonisnconfusednaboutnthendifferentnm
edicationsnhenisnprescribed.nHennotesnthatnsomenofnthendrugnnamesnhavenchan
gednovernthencoursenofntimenhenhasnbeenntakingnthem.nWhenncounselingnhim,
nitnisnmostnimportantntonkeepnthenfollowingnstatementninnmind:
A.nAndrugncannbelongntononlynonengroupnornclassification.
B.nAnprototypendrugnisnthenstandardnbynwhichnsimilarndrugsnarencompared.
C.nDrugngroupsnandnprototypesnchangenfrequently,nandnknowledgenaboutnanprot
otypencannotnguidenknowledgenaboutnotherndrugsninnthensamenclass.
D.nThengenericnnamenofnandrugnchangesnamongnmanufacturers.n-nans-B.n
Rationale:nThenfirstndrugntonbendevelopedninnangroupnisnusuallynconsiderednthe
nprototypenornmainnexamplenofnthengroup,nandnsimilarndrugsnthatnarendevelope
dnlaternarencomparedntonthenprototype.nKnowledgenofnthenprototypendrugncannh
elpnthennursenunderstandnthenactionsnofnotherndrugsninnthenclass.nMostndrugsn
cannbelongntonmultiplengroupsn(e.g.,nantherapeuticngroup,nanchemicalngroup),nde
pendingnonnvariousncharacteristics.nDrugngroupsnandnprototypesnarenusuallynquit
enstable,nandnmostnnewndrugsnfitnintonanknownnclassification.nThentradenornbra
ndnnamenchangesnamongnmanufacturers,nbutnthengenericnnamenstaysnthensame
.
1.3nInnunderstandingnthenusenofncontrollednsubstancesnfornpatients,nitnisnimporta
ntnthatnthennursenknowsnthatncontrolledndrugsnare
A.ncategorizednaccordingntonprescriptionnornnonprescriptionnstatus
B.nregulatednbynstatenandnlocalnlawsnmorenthannfederalnlaws
C.nthosenthatnmustndemonstratenhighnstandardsnofnsafety
D.nschedulednaccordingntonmedicalnusenandnpotentialnfornabusen-nans-D.n
,Rationale:nControllednornscheduledndrugsnarencategorizednbynfederalnlawnaccordi
ngntonusenandnabusenpotential.nThesendrugsnhavenregulationsnthatngovernnpres
cribing,ndispensing,nadministering,nandnrecord-
keeping.nAlmostnallnscheduledndrugsnrequirenprescriptionsn(i.e.,ncannotnlegallynbe
nsoldnovernthencounter).nBasicnlawsnarenfederal,nandnstatesnandnlocalncommunit
iesnmaynenactnadditionalnlaws.
1.4nAnpatientnisnaskingnwhatnthendifferencenisnbetweennanprescriptionnforn800n
mgnofnanmedicationnthatncannbenpurchasednonnannOTCnbasisnasnan200-
mgntablet.nTonaddressnthisnissue,nitnisnimportantnthatnthennursenknowsnthatnOT
Cndrugs
A.narenconsiderednsafenfornanynconsumerntonuse
B.narennotnavailablenforntreatmentnofnmostncommonlynoccurringnsymptoms
C.noftenndifferninnindicationsnfornusenandnrecommendedndosagesnfromntheirnpre
scriptionnversions
D.narenpaidnfornbynmostninsurancenpoliciesn-nans-C.n
Rationale:nUsesnmaynbendifferent,nandnrecommendedndosagesnofnover-the-
countern(OTC)ndrugsnarenusuallynlowernthannprescriptionnversions.nLabelsnofnOT
Cndrugsncontainnanlistingnofnpeoplenwhonshouldnnotnusenthendrugs,nandnthendr
ugsnarennotnsafenforneveryone.nManynOTCndrugsnarenavailablentontreatncoldnsy
mptoms,nheartburn,nconstipation,nandnotherncommonnproblems.nInsurancencompa
niesndonnotnpaynfornOTCndrugs.
1.5nAnmannisnverynupsetnwithnandrugnrecallnofnanmedicationnhenhasnbeenntaki
ngnfornanlongntime.nHenstatesnthatnhenfeelsnlikenhencannnonlongerntrustnanyon
entonprotectnhim.nInnresponsentonhisnquestionsnaboutnthenprocessnofndrugndeve
lopment,nitnisnimportantntonknownthatnwithnannewndrug,nthenU.S.nFoodnandnDru
gnAdministrationn(FDA)nisnresponsiblenfor
A.ntestingnthendrugnwithnanimals
B.ntestingnthendrugnwithnhealthynpeople
C.nmarketingnthendrugntonhealthncarenproviders
D.nevaluatingnthendrugnfornsafetynandneffectivenessn-nans-D.n
Rationale:nThenU.S.nFoodnandnDrugnAdministrationnreviewsnstudiesnreportednbyn
others,nmainlynpharmaceuticalncompanies,nandndeterminesnwhethernandrugnisnsuf
ficientlynsafenandneffectiventonbenmarketed.nThendrugnmanufacturernisnresponsibl
enforntestingnthendrugn(innanimalsnandnpeople)nandnmarketingnthendrug.
1.6nError-
reductionnstrategiesnduringnmedicationnadministrationnincludenwhichnofnthenfollowi
ng?n(Selectnallnthatnapply.)
A.nquietnzonensignsnatnentrancentonthenmedicationnroom
B.nprotocolsnandnchecklistnoutliningnmedicationnadministration
C.nwearingnofnansashnornvestntonsignalnothersntonavoidninterruptionsnofnthennur
senduringnmedicationnadministration
D.ncarryingnseveralnpatients'nprescannednmedicationsnonnantrayn-nans-
A,nB,nandnC.n
, Rationale:nAllnofnthesenstrategies,nexceptnforncarryingnseveralnclients'nprescanned
nmedicationsnonnancart,npotentiallynreducenthenrisknofnmedicationnerror.nThenwo
rk-
aroundnofnremovingnmorenthannonenclient'snmedicationnfromnannautomatednmedi
cationndispensingnsystemncouldnleadntonthenadministrationnofnthenwrongnmedicati
onntonanclient.
2.1nAnnursenpractitionern(NP)nhasnjustnchangednanpatient'snmedicationnfromnan
noralnformntonanpatchnformulationntonavoidnthenfirst-
passneffect.nThenNPnhasnexplainednitntonthenpatient,nbutnthenpatientnstillnhasnq
uestionsnandnasksnthennursentonexplainnagainnwhatnisnmeantnbynthenfirst-
passneffect.nThennursenwouldnbenmostncorrectninnexplainingnthatnthisnhasntondo
nwithnhow
A.ndrugsninitiallynbindntonplasmanproteins
B.ninitialnrenalnfunctionnisninvolvedninndrugnexcretion
C.nthenwayndrugsnfirstnreachntheirntargetncells
D.ninitialnmetabolismnofnannoralndrugnoccursnbeforenitnreachesnthensystemicncirc
ulationn-nans-D.n
Rationale:nThen"first-
passneffect"ninvolvesnmetabolismnofnannoralndrugninnthenlivernsonthatnonlynanpo
rtionnofnandrugndosenreachesnthensystemicncirculationnandnbecomesnavailablento
nactnonntargetntissuesnorntonbeneliminatednfromnthenbody.nDrugnbindingntonplas
manproteinsnaffectsndrugndistribution;nannincreasednamountnofndrugnhasntonbena
bsorbednbeforeneffectiventherapeuticnlevelsnofnunboundndrugnarenreached.
2.2nAnnursenisnreadingnanresearchnreportnaboutnusenofnanmedicationnthatndesc
ribesnthenpharmacokineticsnofnanparticularnmedicationnthatnanpatientnisntaking.nP
harmacokineticsninvolves
A.ndrugneffectsnonnhumanncells
B.ndrugnbindingnwithnreceptors
C.ndrugnabsorption,ndistribution,nmetabolism,nandnelimination
D.ndrugnstimulationnofnnormalncellnfunctionsn-nans-C.n
Rationale:nPharmacokineticsninvolvesnmovementnofnandrugnthroughnthenbodynan
dnitsnelimination.nDrugnbindingnwithnreceptorsnandndrugneffectsnonncellsnarenph
armacodynamicnprocesses.nDrugnstimulationnofnnormalncellnfunctionsndescribesna
nnagonistndrug.
2.3nAnnursenisncaringnfornanmannwhonhasnworseningnliverndisease.nInnmonitori
ngnhisnmedication,nitnisnimportantntonknownthatnanpatientnwithnliverndiseasenma
ynhavenimpairedndrug
A.nabsorption
B.ndistribution
C.nmetabolism
D.nexcretionn-nans-C.n
THERAPY QUESTIONS AND ANSWERS
1.1nThennursenisncaringnfornanwomannwhonhasnstrongnbeliefsnaboutnnotnputting
nanythingnunnaturalnintonhernbody.nItnisnmostnaccuratentonsaynthatnmostnmoder
nnmedicationsnare
A.nnaturalnproductsnderivednfromnplants
B.nnaturalnproductsnderivednfromnminerals
C.nsyntheticnproductsnmanufacturedninnlaboratories
D.nsyntheticnmodificationsnofnnaturalnproductsn-nans-C.n
Rationale:nAlthoughnmostnolderndrugsnoriginatednasnplants,nminerals,nornothernn
aturalnproducts,nnewerndrugsnarenmainlynsynthetic.nSyntheticndrugsnarenstandardi
zednandnthereforenmorenconsistentninntheirncharacteristicsnandneffectsnthannnatur
alnproducts.
1.2nThennursenisntakingncarenofnanmannwhonisnconfusednaboutnthendifferentnm
edicationsnhenisnprescribed.nHennotesnthatnsomenofnthendrugnnamesnhavenchan
gednovernthencoursenofntimenhenhasnbeenntakingnthem.nWhenncounselingnhim,
nitnisnmostnimportantntonkeepnthenfollowingnstatementninnmind:
A.nAndrugncannbelongntononlynonengroupnornclassification.
B.nAnprototypendrugnisnthenstandardnbynwhichnsimilarndrugsnarencompared.
C.nDrugngroupsnandnprototypesnchangenfrequently,nandnknowledgenaboutnanprot
otypencannotnguidenknowledgenaboutnotherndrugsninnthensamenclass.
D.nThengenericnnamenofnandrugnchangesnamongnmanufacturers.n-nans-B.n
Rationale:nThenfirstndrugntonbendevelopedninnangroupnisnusuallynconsiderednthe
nprototypenornmainnexamplenofnthengroup,nandnsimilarndrugsnthatnarendevelope
dnlaternarencomparedntonthenprototype.nKnowledgenofnthenprototypendrugncannh
elpnthennursenunderstandnthenactionsnofnotherndrugsninnthenclass.nMostndrugsn
cannbelongntonmultiplengroupsn(e.g.,nantherapeuticngroup,nanchemicalngroup),nde
pendingnonnvariousncharacteristics.nDrugngroupsnandnprototypesnarenusuallynquit
enstable,nandnmostnnewndrugsnfitnintonanknownnclassification.nThentradenornbra
ndnnamenchangesnamongnmanufacturers,nbutnthengenericnnamenstaysnthensame
.
1.3nInnunderstandingnthenusenofncontrollednsubstancesnfornpatients,nitnisnimporta
ntnthatnthennursenknowsnthatncontrolledndrugsnare
A.ncategorizednaccordingntonprescriptionnornnonprescriptionnstatus
B.nregulatednbynstatenandnlocalnlawsnmorenthannfederalnlaws
C.nthosenthatnmustndemonstratenhighnstandardsnofnsafety
D.nschedulednaccordingntonmedicalnusenandnpotentialnfornabusen-nans-D.n
,Rationale:nControllednornscheduledndrugsnarencategorizednbynfederalnlawnaccordi
ngntonusenandnabusenpotential.nThesendrugsnhavenregulationsnthatngovernnpres
cribing,ndispensing,nadministering,nandnrecord-
keeping.nAlmostnallnscheduledndrugsnrequirenprescriptionsn(i.e.,ncannotnlegallynbe
nsoldnovernthencounter).nBasicnlawsnarenfederal,nandnstatesnandnlocalncommunit
iesnmaynenactnadditionalnlaws.
1.4nAnpatientnisnaskingnwhatnthendifferencenisnbetweennanprescriptionnforn800n
mgnofnanmedicationnthatncannbenpurchasednonnannOTCnbasisnasnan200-
mgntablet.nTonaddressnthisnissue,nitnisnimportantnthatnthennursenknowsnthatnOT
Cndrugs
A.narenconsiderednsafenfornanynconsumerntonuse
B.narennotnavailablenforntreatmentnofnmostncommonlynoccurringnsymptoms
C.noftenndifferninnindicationsnfornusenandnrecommendedndosagesnfromntheirnpre
scriptionnversions
D.narenpaidnfornbynmostninsurancenpoliciesn-nans-C.n
Rationale:nUsesnmaynbendifferent,nandnrecommendedndosagesnofnover-the-
countern(OTC)ndrugsnarenusuallynlowernthannprescriptionnversions.nLabelsnofnOT
Cndrugsncontainnanlistingnofnpeoplenwhonshouldnnotnusenthendrugs,nandnthendr
ugsnarennotnsafenforneveryone.nManynOTCndrugsnarenavailablentontreatncoldnsy
mptoms,nheartburn,nconstipation,nandnotherncommonnproblems.nInsurancencompa
niesndonnotnpaynfornOTCndrugs.
1.5nAnmannisnverynupsetnwithnandrugnrecallnofnanmedicationnhenhasnbeenntaki
ngnfornanlongntime.nHenstatesnthatnhenfeelsnlikenhencannnonlongerntrustnanyon
entonprotectnhim.nInnresponsentonhisnquestionsnaboutnthenprocessnofndrugndeve
lopment,nitnisnimportantntonknownthatnwithnannewndrug,nthenU.S.nFoodnandnDru
gnAdministrationn(FDA)nisnresponsiblenfor
A.ntestingnthendrugnwithnanimals
B.ntestingnthendrugnwithnhealthynpeople
C.nmarketingnthendrugntonhealthncarenproviders
D.nevaluatingnthendrugnfornsafetynandneffectivenessn-nans-D.n
Rationale:nThenU.S.nFoodnandnDrugnAdministrationnreviewsnstudiesnreportednbyn
others,nmainlynpharmaceuticalncompanies,nandndeterminesnwhethernandrugnisnsuf
ficientlynsafenandneffectiventonbenmarketed.nThendrugnmanufacturernisnresponsibl
enforntestingnthendrugn(innanimalsnandnpeople)nandnmarketingnthendrug.
1.6nError-
reductionnstrategiesnduringnmedicationnadministrationnincludenwhichnofnthenfollowi
ng?n(Selectnallnthatnapply.)
A.nquietnzonensignsnatnentrancentonthenmedicationnroom
B.nprotocolsnandnchecklistnoutliningnmedicationnadministration
C.nwearingnofnansashnornvestntonsignalnothersntonavoidninterruptionsnofnthennur
senduringnmedicationnadministration
D.ncarryingnseveralnpatients'nprescannednmedicationsnonnantrayn-nans-
A,nB,nandnC.n
, Rationale:nAllnofnthesenstrategies,nexceptnforncarryingnseveralnclients'nprescanned
nmedicationsnonnancart,npotentiallynreducenthenrisknofnmedicationnerror.nThenwo
rk-
aroundnofnremovingnmorenthannonenclient'snmedicationnfromnannautomatednmedi
cationndispensingnsystemncouldnleadntonthenadministrationnofnthenwrongnmedicati
onntonanclient.
2.1nAnnursenpractitionern(NP)nhasnjustnchangednanpatient'snmedicationnfromnan
noralnformntonanpatchnformulationntonavoidnthenfirst-
passneffect.nThenNPnhasnexplainednitntonthenpatient,nbutnthenpatientnstillnhasnq
uestionsnandnasksnthennursentonexplainnagainnwhatnisnmeantnbynthenfirst-
passneffect.nThennursenwouldnbenmostncorrectninnexplainingnthatnthisnhasntondo
nwithnhow
A.ndrugsninitiallynbindntonplasmanproteins
B.ninitialnrenalnfunctionnisninvolvedninndrugnexcretion
C.nthenwayndrugsnfirstnreachntheirntargetncells
D.ninitialnmetabolismnofnannoralndrugnoccursnbeforenitnreachesnthensystemicncirc
ulationn-nans-D.n
Rationale:nThen"first-
passneffect"ninvolvesnmetabolismnofnannoralndrugninnthenlivernsonthatnonlynanpo
rtionnofnandrugndosenreachesnthensystemicncirculationnandnbecomesnavailablento
nactnonntargetntissuesnorntonbeneliminatednfromnthenbody.nDrugnbindingntonplas
manproteinsnaffectsndrugndistribution;nannincreasednamountnofndrugnhasntonbena
bsorbednbeforeneffectiventherapeuticnlevelsnofnunboundndrugnarenreached.
2.2nAnnursenisnreadingnanresearchnreportnaboutnusenofnanmedicationnthatndesc
ribesnthenpharmacokineticsnofnanparticularnmedicationnthatnanpatientnisntaking.nP
harmacokineticsninvolves
A.ndrugneffectsnonnhumanncells
B.ndrugnbindingnwithnreceptors
C.ndrugnabsorption,ndistribution,nmetabolism,nandnelimination
D.ndrugnstimulationnofnnormalncellnfunctionsn-nans-C.n
Rationale:nPharmacokineticsninvolvesnmovementnofnandrugnthroughnthenbodynan
dnitsnelimination.nDrugnbindingnwithnreceptorsnandndrugneffectsnonncellsnarenph
armacodynamicnprocesses.nDrugnstimulationnofnnormalncellnfunctionsndescribesna
nnagonistndrug.
2.3nAnnursenisncaringnfornanmannwhonhasnworseningnliverndisease.nInnmonitori
ngnhisnmedication,nitnisnimportantntonknownthatnanpatientnwithnliverndiseasenma
ynhavenimpairedndrug
A.nabsorption
B.ndistribution
C.nmetabolism
D.nexcretionn-nans-C.n
