Test Bank - Focus on Nursing Pharmacology
(8th Edition by Karch)
SECTION A: Foundational Pharmacology Principles (Ch 1–6)
Questions 1–20
1. A nurse working in radiology administers iodine to a patient undergoing a computed
tomography (CT) scan. The same nurse later administers a measles-mumps-rubella (MMR)
vaccine at a public health clinic. Which branch of pharmacology best describes the actions of
this nurse in both settings?
A. Pharmacoeconomics
B. Pharmacotherapeutics
C. Pharmacodynamics
D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacotherapeutics is the branch of pharmacology that deals with the uses of
drugs to treat, prevent, and diagnose disease. The radiology nurse administers a drug to help
diagnose a disease, and the public health nurse administers a vaccine to prevent disease.
Pharmacoeconomics includes costs involved in drug therapy. Pharmacodynamics involves how a
drug affects the body. Pharmacokinetics is how the body acts on the drug .
2. A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as
needed for pain. The nurse is aware that this drug has a high abuse potential. Under what
category would morphine be classified?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV
Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule II drugs because
of severe dependence liability. Schedule I drugs have high abuse potential and no accepted
,medical use. Schedule III drugs have a lesser abuse potential than Schedule II and an accepted
medical use. Schedule IV drugs have low abuse potential and limited dependence liability .
3. A patient is taking a medication that is highly protein-bound. The nurse understands that if
the patient becomes malnourished with low serum albumin levels, what is the expected
effect?
A. The amount of free drug available will increase, potentially leading to toxicity.
B. The amount of free drug available will decrease.
C. The drug will be metabolized more quickly.
D. The drug will be excreted more rapidly.
Correct Answer: A
Rationale: When a drug is highly protein-bound (e.g., warfarin, phenytoin), only the
unbound (free) fraction is pharmacologically active. If albumin levels are low due to
malnutrition or liver disease, more free drug is available, increasing the risk of toxicity. The dose
may need adjustment .
4. The first-pass effect refers to which of the following?
A. The initial metabolism of an oral drug by the liver before it reaches systemic circulation.
B. The first dose of a medication given to a patient.
C. The immediate effect of a drug after intravenous administration.
D. The binding of a drug to plasma proteins.
Correct Answer: A
Rationale: The first-pass effect (or first-pass metabolism) occurs when orally administered
drugs are absorbed from the gastrointestinal tract and transported via the portal vein to the
liver, where they are metabolized before reaching systemic circulation. This reduces
bioavailability .
5. The nurse is administering a drug that is known to be a CYP450 enzyme inducer. The nurse
should monitor the patient for which effect?
A. Decreased effectiveness of other medications metabolized by the same enzyme.
B. Increased risk of toxicity from other medications.
,C. No interaction with other medications.
D. Increased excretion of the drug.
Correct Answer: A
Rationale: CYP450 enzyme inducers increase the metabolism of other drugs metabolized by
the same enzyme, leading to decreased effectiveness of those medications. Enzyme inhibitors,
by contrast, would lead to increased drug levels and risk of toxicity .
6. A patient develops a severe rash and anaphylaxis after receiving a penicillin injection. This
reaction was not predicted by the drug's pharmacologic profile. How would the nurse classify
this reaction?
A. Type A (augmented) reaction
B. Type B (bizarre) reaction
C. Type C (chronic) reaction
D. Type D (delayed) reaction
Correct Answer: B
Rationale: Type B (bizarre) reactions are unpredictable, dose-independent, and often
immunologically mediated. Type A reactions are predictable extensions of pharmacologic
effects. Type C occurs with chronic use. Type D manifests after prolonged latency .
7. A nurse is assessing a patient's home medication use. After listening to the patient list
current medications, what priority question should the nurse ask?
A. "Do you take any generic medications?"
B. "Are any of these medications orphan drugs?"
C. "Are these medications safe to take during pregnancy?"
D. "Do you take any over-the-counter medications?"
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter
(OTC) medications because patients may not consider them important enough to report. The
patient is unlikely to know the meaning of orphan drugs unless they are health care providers .
8. After completing a course on pharmacology for nurses, what will the nurse know?
, A. Everything necessary for safe and effective medication administration.
B. Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
C. General drug information; the nurse can consult a drug guide for specific drug information.
D. The drug actions that are associated with each classification of medication.
Correct Answer: C
Rationale: After completing a pharmacology course, nurses will have general drug
information needed for safe and effective medication administration but will need to consult a
drug guide for specific drug information before administering any medication. Pharmacology is
constantly changing, and continuing education is essential .
9. A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a
Pregnancy Category B drug. What should the nurse inform the patient?
A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate
studies in pregnant women.
C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies
in pregnant women.
D. There is evidence of human fetal risk, but the potential benefits may be acceptable.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the
fetus. However, there have not been adequate studies in pregnant women. Category A indicates
no risk in pregnant women. Category C indicates animal studies show adverse effects. Category
D reveals evidence of human fetal risk .
10. Which statement by a patient indicates a good understanding of over-the-counter (OTC)
drug use?
A. "OTC drugs are safe and do not cause adverse effects if taken properly."
B. "OTC drugs have been around for years and have not been tested by the FDA."
C. "OTC drugs are different from any drugs available by prescription and cost less."
D. "OTC drugs could cause serious harm if not taken according to directions."
Correct Answer: D
(8th Edition by Karch)
SECTION A: Foundational Pharmacology Principles (Ch 1–6)
Questions 1–20
1. A nurse working in radiology administers iodine to a patient undergoing a computed
tomography (CT) scan. The same nurse later administers a measles-mumps-rubella (MMR)
vaccine at a public health clinic. Which branch of pharmacology best describes the actions of
this nurse in both settings?
A. Pharmacoeconomics
B. Pharmacotherapeutics
C. Pharmacodynamics
D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacotherapeutics is the branch of pharmacology that deals with the uses of
drugs to treat, prevent, and diagnose disease. The radiology nurse administers a drug to help
diagnose a disease, and the public health nurse administers a vaccine to prevent disease.
Pharmacoeconomics includes costs involved in drug therapy. Pharmacodynamics involves how a
drug affects the body. Pharmacokinetics is how the body acts on the drug .
2. A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as
needed for pain. The nurse is aware that this drug has a high abuse potential. Under what
category would morphine be classified?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV
Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule II drugs because
of severe dependence liability. Schedule I drugs have high abuse potential and no accepted
,medical use. Schedule III drugs have a lesser abuse potential than Schedule II and an accepted
medical use. Schedule IV drugs have low abuse potential and limited dependence liability .
3. A patient is taking a medication that is highly protein-bound. The nurse understands that if
the patient becomes malnourished with low serum albumin levels, what is the expected
effect?
A. The amount of free drug available will increase, potentially leading to toxicity.
B. The amount of free drug available will decrease.
C. The drug will be metabolized more quickly.
D. The drug will be excreted more rapidly.
Correct Answer: A
Rationale: When a drug is highly protein-bound (e.g., warfarin, phenytoin), only the
unbound (free) fraction is pharmacologically active. If albumin levels are low due to
malnutrition or liver disease, more free drug is available, increasing the risk of toxicity. The dose
may need adjustment .
4. The first-pass effect refers to which of the following?
A. The initial metabolism of an oral drug by the liver before it reaches systemic circulation.
B. The first dose of a medication given to a patient.
C. The immediate effect of a drug after intravenous administration.
D. The binding of a drug to plasma proteins.
Correct Answer: A
Rationale: The first-pass effect (or first-pass metabolism) occurs when orally administered
drugs are absorbed from the gastrointestinal tract and transported via the portal vein to the
liver, where they are metabolized before reaching systemic circulation. This reduces
bioavailability .
5. The nurse is administering a drug that is known to be a CYP450 enzyme inducer. The nurse
should monitor the patient for which effect?
A. Decreased effectiveness of other medications metabolized by the same enzyme.
B. Increased risk of toxicity from other medications.
,C. No interaction with other medications.
D. Increased excretion of the drug.
Correct Answer: A
Rationale: CYP450 enzyme inducers increase the metabolism of other drugs metabolized by
the same enzyme, leading to decreased effectiveness of those medications. Enzyme inhibitors,
by contrast, would lead to increased drug levels and risk of toxicity .
6. A patient develops a severe rash and anaphylaxis after receiving a penicillin injection. This
reaction was not predicted by the drug's pharmacologic profile. How would the nurse classify
this reaction?
A. Type A (augmented) reaction
B. Type B (bizarre) reaction
C. Type C (chronic) reaction
D. Type D (delayed) reaction
Correct Answer: B
Rationale: Type B (bizarre) reactions are unpredictable, dose-independent, and often
immunologically mediated. Type A reactions are predictable extensions of pharmacologic
effects. Type C occurs with chronic use. Type D manifests after prolonged latency .
7. A nurse is assessing a patient's home medication use. After listening to the patient list
current medications, what priority question should the nurse ask?
A. "Do you take any generic medications?"
B. "Are any of these medications orphan drugs?"
C. "Are these medications safe to take during pregnancy?"
D. "Do you take any over-the-counter medications?"
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter
(OTC) medications because patients may not consider them important enough to report. The
patient is unlikely to know the meaning of orphan drugs unless they are health care providers .
8. After completing a course on pharmacology for nurses, what will the nurse know?
, A. Everything necessary for safe and effective medication administration.
B. Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
C. General drug information; the nurse can consult a drug guide for specific drug information.
D. The drug actions that are associated with each classification of medication.
Correct Answer: C
Rationale: After completing a pharmacology course, nurses will have general drug
information needed for safe and effective medication administration but will need to consult a
drug guide for specific drug information before administering any medication. Pharmacology is
constantly changing, and continuing education is essential .
9. A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a
Pregnancy Category B drug. What should the nurse inform the patient?
A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate
studies in pregnant women.
C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies
in pregnant women.
D. There is evidence of human fetal risk, but the potential benefits may be acceptable.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the
fetus. However, there have not been adequate studies in pregnant women. Category A indicates
no risk in pregnant women. Category C indicates animal studies show adverse effects. Category
D reveals evidence of human fetal risk .
10. Which statement by a patient indicates a good understanding of over-the-counter (OTC)
drug use?
A. "OTC drugs are safe and do not cause adverse effects if taken properly."
B. "OTC drugs have been around for years and have not been tested by the FDA."
C. "OTC drugs are different from any drugs available by prescription and cost less."
D. "OTC drugs could cause serious harm if not taken according to directions."
Correct Answer: D
