Chapter 01
1. BASIC CONCEPTS A patient tells you that she is allergic to the drug her health care provider just prescribed.
What is your best first response or action? [Multiple Choice]
a. Ask her to describe the allergic response she had previously to this drug. ✔
b. Ask her whether she received the drug she was allergic to by mouth or by injection.
c. Thank her for the information and ask the health care provider to prescribe something else.
d. Tell her that the health care provider will also prescribe an antidote that will prevent an allergic response to the
prescribed drug.
ANS: A
Many patients do not understand the difference between a side effect, an allergy, and an adverse effect. She may
really have had an allergic reaction or perhaps just experienced a side effect that would not preclude her receiving
this drug again. It is important to find out just what the reaction involved in order to determine whether she
should receive this drug.
2. BASIC CONCEPTS When a patient takes 400 mg of an oral drug that has a half-life of 2 hours at noon, at which
time will the patient’s blood drug level first be less than 40 mg? [Multiple Choice]
a. 2:00 p.m.
b. 6:00 p.m.
c. 8:00 p.m. ✔
d. Midnight
ANS: C
With a half-life of 2 hours, the amount of drug remaining in the blood decreases by 50% every 2 hours. So, when
400 mg are given at noon, by 2:00 p.m., 200 mg remain; by 4:00 p.m., 100 mg remain; by 6:00 p.m., 50 mg
remain; by 8:00 p.m., 25 mg remain; by 10:00 p.m., 12.5 mg remain, and by midnight, 6.25 mg remain.
3. BASIC CONCEPTS How are intrinsic drugs different from extrinsic drugs? [Multiple Choice]
a. Intrinsic drugs are made by the body, whereas extrinsic drugs are made outside the body. ✔
b. Intrinsic drugs are administered by the parenteral route, whereas extrinsic drugs are administered by the oral
route.
c. Extrinsic drugs can only be applied to the skin or mucous membranes, whereas intrinsic drugs are taken
internally.
,d. Extrinsic drugs require a prescription for administration, whereas intrinsic drugs are available over-the-counter.
ANS: A
Intrinsic drugs are the hormones, enzymes, and other chemicals made by the body that change cell activity.
Extrinsic drugs are manufactured from chemical, animal, or plant sources and must have a means of entering the
body in order to change cell activity.
4. BASIC CONCEPTS Which drug administration route is the least predictable? [Multiple Choice]
a. Enteral ✔
b. Intravenous
c. Transdermal
d. Subcutaneous
ANS: A
Many issues within an individual patient’s gastrointestinal system can affect drug absorption and, to some extent,
drug metabolism. In addition, any food or beverages taken at the same time as an oral drug also affect drug
absorption.
5. BASIC CONCEPTS A patient who has a serious chronic disorder (epilepsy) has been taking a drug to control it
that has a moderate likelihood of increasing the risk for birth defects or fetal damage. She tells you that she
would like to have a child. What is your best response? [Multiple Choice]
a. Tell her that taking any drug during pregnancy is not recommended.
b. Suggest that she use a reliable method of contraception and consider adoption.
c. Warn her that her condition will get worse if she stops taking the prescribed drug.
d. Counsel her to discuss her wishes with her health care provider to evaluate her specific risks and possible
pregnancy outcomes. ✔
ANS: D
The patient must be able to make an informed decision about pregnancy and drug therapy. It is the responsibility
of the health care provider who prescribes the drugs to help her understand the risks and any alternative therapy
choices. It is also helpful to have a pharmacist involved in such a discussion. It is not the responsibility of the nurse
or other health care professional to provide this information but all have an obligation to help her meet with her
health care provider for this discussion.
6. BASIC CONCEPTS Which action could make a drug more potent? [Multiple Choice]
a. Slow drug absorption
,b. Slow drug elimination ✔
c. Normal drug elimination
d. Fast drug elimination
ANS: B
Any condition that keeps a drug active inside the body longer can increase its potency. Slow drug elimination
allows a drug to remain longer in the body. Normal or fast elimination does not. Slow drug absorption does not
contribute to potency.
7. BASIC CONCEPTS In the United States, which group is responsible for enforcing established standards for drug
manufacturing? [Multiple Choice]
a. U.S. Pharmacopeia
b. National Institutes of Health
c. Food and Drug Administration ✔
d. Association of Pharmaceutical Manufacturers
ANS: C
The standards for drug manufacture are established by the U.S. Pharmacopeia. These standards are enforced by
the Food and Drug Administration. Neither the National Institutes of Health nor the Association of Pharmaceutical
Manufacturers has any authority to enforce drug standards.
8. BASIC CONCEPTS Which drug or drug class is a “high alert” drug? [Multiple Choice]
a. Penicillin
b. Insulin ✔
c. NSAIDs
d. Calcium
ANS: B
A high alert drug is one in which harm is likely to result if given at the wrong dose, to the wrong patient, or not
given to the correct patient. Drugs classified as high alert drugs include potassium, narcotics (opioids), insulin,
cancer chemotherapy drugs, and heparin (or any drug that strongly affects blood clotting). Penicillin, NSAIDs, and
calcium are not considered high alert drugs.
9. BASIC CONCEPTS Which statement about agonist and antagonist drugs is true? [Multiple Choice]
a. The target tissues for these types of drugs are invading bacteria and viruses.
, b. Both agonist and antagonist drugs must interact with receptors to produce their intended responses. ✔
c. Antagonist drugs produce only intended responses and agonist drugs produce both intended responses and
side effects.
d. These types of drugs are less likely to cause allergic responses than drugs that are neither agonists nor
antagonists.
ANS: B
Agonist drugs excite a receptor to produce their intended responses on a cell or tissue in the same way that a
naturally occurring substance does. Antagonist drugs produce their intended responses by binding to and
blocking receptors.
10. Which body tissues or fluids are routes of drug elimination? (select all that apply) [Multiple Response]
a. Bone marrow
b. Heart
c. Liver ✔
d. Lungs ✔
e. Ovary
f. Saliva ✔
g. Tears ✔
ANS: C, D, F, G
The liver and kidneys are the main sites of drug metabolism and drug elimination. The lungs are able to eliminate
drugs that are easily turned into gases (vaporized). Although only a small amount of any drug can be expected to
be in the saliva or tears, they are an excretion and elimination route. The bone marrow, heart, and ovaries are not
true excretory organs.
11. BASIC CONCEPTS How are the terms drug and medication different in the health care environment? [Multiple
Choice]
a. Medications must be prescribed, whereas drugs are available over-the-counter.
b. Medications are used to treat health problems, whereas drugs can be misused.
c. Drugs are always illegal, whereas medications are legal.
d. There is no difference between these two terms. ✔
ANS: D
1. BASIC CONCEPTS A patient tells you that she is allergic to the drug her health care provider just prescribed.
What is your best first response or action? [Multiple Choice]
a. Ask her to describe the allergic response she had previously to this drug. ✔
b. Ask her whether she received the drug she was allergic to by mouth or by injection.
c. Thank her for the information and ask the health care provider to prescribe something else.
d. Tell her that the health care provider will also prescribe an antidote that will prevent an allergic response to the
prescribed drug.
ANS: A
Many patients do not understand the difference between a side effect, an allergy, and an adverse effect. She may
really have had an allergic reaction or perhaps just experienced a side effect that would not preclude her receiving
this drug again. It is important to find out just what the reaction involved in order to determine whether she
should receive this drug.
2. BASIC CONCEPTS When a patient takes 400 mg of an oral drug that has a half-life of 2 hours at noon, at which
time will the patient’s blood drug level first be less than 40 mg? [Multiple Choice]
a. 2:00 p.m.
b. 6:00 p.m.
c. 8:00 p.m. ✔
d. Midnight
ANS: C
With a half-life of 2 hours, the amount of drug remaining in the blood decreases by 50% every 2 hours. So, when
400 mg are given at noon, by 2:00 p.m., 200 mg remain; by 4:00 p.m., 100 mg remain; by 6:00 p.m., 50 mg
remain; by 8:00 p.m., 25 mg remain; by 10:00 p.m., 12.5 mg remain, and by midnight, 6.25 mg remain.
3. BASIC CONCEPTS How are intrinsic drugs different from extrinsic drugs? [Multiple Choice]
a. Intrinsic drugs are made by the body, whereas extrinsic drugs are made outside the body. ✔
b. Intrinsic drugs are administered by the parenteral route, whereas extrinsic drugs are administered by the oral
route.
c. Extrinsic drugs can only be applied to the skin or mucous membranes, whereas intrinsic drugs are taken
internally.
,d. Extrinsic drugs require a prescription for administration, whereas intrinsic drugs are available over-the-counter.
ANS: A
Intrinsic drugs are the hormones, enzymes, and other chemicals made by the body that change cell activity.
Extrinsic drugs are manufactured from chemical, animal, or plant sources and must have a means of entering the
body in order to change cell activity.
4. BASIC CONCEPTS Which drug administration route is the least predictable? [Multiple Choice]
a. Enteral ✔
b. Intravenous
c. Transdermal
d. Subcutaneous
ANS: A
Many issues within an individual patient’s gastrointestinal system can affect drug absorption and, to some extent,
drug metabolism. In addition, any food or beverages taken at the same time as an oral drug also affect drug
absorption.
5. BASIC CONCEPTS A patient who has a serious chronic disorder (epilepsy) has been taking a drug to control it
that has a moderate likelihood of increasing the risk for birth defects or fetal damage. She tells you that she
would like to have a child. What is your best response? [Multiple Choice]
a. Tell her that taking any drug during pregnancy is not recommended.
b. Suggest that she use a reliable method of contraception and consider adoption.
c. Warn her that her condition will get worse if she stops taking the prescribed drug.
d. Counsel her to discuss her wishes with her health care provider to evaluate her specific risks and possible
pregnancy outcomes. ✔
ANS: D
The patient must be able to make an informed decision about pregnancy and drug therapy. It is the responsibility
of the health care provider who prescribes the drugs to help her understand the risks and any alternative therapy
choices. It is also helpful to have a pharmacist involved in such a discussion. It is not the responsibility of the nurse
or other health care professional to provide this information but all have an obligation to help her meet with her
health care provider for this discussion.
6. BASIC CONCEPTS Which action could make a drug more potent? [Multiple Choice]
a. Slow drug absorption
,b. Slow drug elimination ✔
c. Normal drug elimination
d. Fast drug elimination
ANS: B
Any condition that keeps a drug active inside the body longer can increase its potency. Slow drug elimination
allows a drug to remain longer in the body. Normal or fast elimination does not. Slow drug absorption does not
contribute to potency.
7. BASIC CONCEPTS In the United States, which group is responsible for enforcing established standards for drug
manufacturing? [Multiple Choice]
a. U.S. Pharmacopeia
b. National Institutes of Health
c. Food and Drug Administration ✔
d. Association of Pharmaceutical Manufacturers
ANS: C
The standards for drug manufacture are established by the U.S. Pharmacopeia. These standards are enforced by
the Food and Drug Administration. Neither the National Institutes of Health nor the Association of Pharmaceutical
Manufacturers has any authority to enforce drug standards.
8. BASIC CONCEPTS Which drug or drug class is a “high alert” drug? [Multiple Choice]
a. Penicillin
b. Insulin ✔
c. NSAIDs
d. Calcium
ANS: B
A high alert drug is one in which harm is likely to result if given at the wrong dose, to the wrong patient, or not
given to the correct patient. Drugs classified as high alert drugs include potassium, narcotics (opioids), insulin,
cancer chemotherapy drugs, and heparin (or any drug that strongly affects blood clotting). Penicillin, NSAIDs, and
calcium are not considered high alert drugs.
9. BASIC CONCEPTS Which statement about agonist and antagonist drugs is true? [Multiple Choice]
a. The target tissues for these types of drugs are invading bacteria and viruses.
, b. Both agonist and antagonist drugs must interact with receptors to produce their intended responses. ✔
c. Antagonist drugs produce only intended responses and agonist drugs produce both intended responses and
side effects.
d. These types of drugs are less likely to cause allergic responses than drugs that are neither agonists nor
antagonists.
ANS: B
Agonist drugs excite a receptor to produce their intended responses on a cell or tissue in the same way that a
naturally occurring substance does. Antagonist drugs produce their intended responses by binding to and
blocking receptors.
10. Which body tissues or fluids are routes of drug elimination? (select all that apply) [Multiple Response]
a. Bone marrow
b. Heart
c. Liver ✔
d. Lungs ✔
e. Ovary
f. Saliva ✔
g. Tears ✔
ANS: C, D, F, G
The liver and kidneys are the main sites of drug metabolism and drug elimination. The lungs are able to eliminate
drugs that are easily turned into gases (vaporized). Although only a small amount of any drug can be expected to
be in the saliva or tears, they are an excretion and elimination route. The bone marrow, heart, and ovaries are not
true excretory organs.
11. BASIC CONCEPTS How are the terms drug and medication different in the health care environment? [Multiple
Choice]
a. Medications must be prescribed, whereas drugs are available over-the-counter.
b. Medications are used to treat health problems, whereas drugs can be misused.
c. Drugs are always illegal, whereas medications are legal.
d. There is no difference between these two terms. ✔
ANS: D
