Kee: Pharmacology, 7th Edition
Chapter 1: Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic
Phases
Test Bank
MULTIPLE CHOICE
1. A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain
relief, the nurse administers the medication so that it is most rapidly absorbed from the
gastrointestinal (GI) tract. Which mode of delivery has the fastest absorption?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension
ANS: D
Drugs must be in solution to be absorbed in the gastrointestinal tract. Because liquid drugs
are already in solution, they are absorbed faster than drugs in a solid form.
DIF: Cognitive Level: Application REF: p. 3
TOP: Nursing Process: Intervention/Implementation
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
2. A client asks why she needs to take a medication on an empty stomach. The nurse explains
that food generally has which effect on drug dissolution and absorption?
, a. Enhances
b. Increases
c. Decreases
d. Does not have an effect
ANS: C
Food in the GI tract can interfere with the dissolution and absorption of some drugs.
However, there are specific drugs that should be taken with food to enhance absorption.
DIF: Cognitive Level: Application REF: p. 4
TOP: Nursing Process: Intervention/Teaching
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
3. Biotransformation is affected by many factors. What happens to the client’s drug
metabolism when liver function is decreased?
a. The client can develop toxicity.
b. The client will have an enhanced therapeutic response.
c. The client may require a larger than normal dose of the medication.
d. The client will experience a decreased therapeutic response.
ANS: A
When the drug metabolism rate is decreased, excess drug accumulation can occur and lead
to the client’s developing toxicity. The GI membrane is made up of lipids; therefore, lipid
medications are most easily absorbed across the digestive membrane of the stomach.
Medications that are nonionized (neither positive nor negative) also pass through the GI
membrane faster than those with a charge.
DIF: Cognitive Level: Application REF: p. 6
, TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
4. A client asks why the oral dose of her pain medication is higher than the intravenous dose.
The nurse explains that with the oral dose, only 20% to 40% of the drug may actually enter
systemic circulation. This reduces the amount of active drug. What is the term for this
effect?
a. Protein binding
b. Bioavailability
c. Hepatic first pass
d. Pinocytosis
ANS: B
Bioavailability is the percentage of the administered drug dose that reaches the systemic
circulation. Oral drugs that have a high first-pass hepatic metabolism may have a
bioavailability of only 20% to 40% on entering systemic circulation. To obtain the desired
drug effect, the oral dose could be three to five times larger than the drug dose for IV use.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
5. When providing a medication, which route should the nurse select to ensure the maximum
amount of bioavailability?
a. Oral
b. Intravenous
c. Intramuscular
d. Subcutaneous
, ANS: B
The percentage of bioavailability for the oral route is always less than 100%, but for the
intravenous route it is usually 100%.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
6. A client is being given two highly protein-bound drugs concurrently. What is most likely to
be the result of this administration?
a. More free drug in circulation
b. Less free drug in circulation
c. More drug bound to protein
d. More drug excreted in the urine
ANS: A
When two highly protein-bound drugs are given concurrently, they compete for protein-
binding sites, causing more free drug to be released into the circulation. Drug accumulation
and possible drug toxicity can result.
DIF: Cognitive Level: Application REF: p. 5
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
Chapter 1: Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic
Phases
Test Bank
MULTIPLE CHOICE
1. A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain
relief, the nurse administers the medication so that it is most rapidly absorbed from the
gastrointestinal (GI) tract. Which mode of delivery has the fastest absorption?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension
ANS: D
Drugs must be in solution to be absorbed in the gastrointestinal tract. Because liquid drugs
are already in solution, they are absorbed faster than drugs in a solid form.
DIF: Cognitive Level: Application REF: p. 3
TOP: Nursing Process: Intervention/Implementation
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
2. A client asks why she needs to take a medication on an empty stomach. The nurse explains
that food generally has which effect on drug dissolution and absorption?
, a. Enhances
b. Increases
c. Decreases
d. Does not have an effect
ANS: C
Food in the GI tract can interfere with the dissolution and absorption of some drugs.
However, there are specific drugs that should be taken with food to enhance absorption.
DIF: Cognitive Level: Application REF: p. 4
TOP: Nursing Process: Intervention/Teaching
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
3. Biotransformation is affected by many factors. What happens to the client’s drug
metabolism when liver function is decreased?
a. The client can develop toxicity.
b. The client will have an enhanced therapeutic response.
c. The client may require a larger than normal dose of the medication.
d. The client will experience a decreased therapeutic response.
ANS: A
When the drug metabolism rate is decreased, excess drug accumulation can occur and lead
to the client’s developing toxicity. The GI membrane is made up of lipids; therefore, lipid
medications are most easily absorbed across the digestive membrane of the stomach.
Medications that are nonionized (neither positive nor negative) also pass through the GI
membrane faster than those with a charge.
DIF: Cognitive Level: Application REF: p. 6
, TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
4. A client asks why the oral dose of her pain medication is higher than the intravenous dose.
The nurse explains that with the oral dose, only 20% to 40% of the drug may actually enter
systemic circulation. This reduces the amount of active drug. What is the term for this
effect?
a. Protein binding
b. Bioavailability
c. Hepatic first pass
d. Pinocytosis
ANS: B
Bioavailability is the percentage of the administered drug dose that reaches the systemic
circulation. Oral drugs that have a high first-pass hepatic metabolism may have a
bioavailability of only 20% to 40% on entering systemic circulation. To obtain the desired
drug effect, the oral dose could be three to five times larger than the drug dose for IV use.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
5. When providing a medication, which route should the nurse select to ensure the maximum
amount of bioavailability?
a. Oral
b. Intravenous
c. Intramuscular
d. Subcutaneous
, ANS: B
The percentage of bioavailability for the oral route is always less than 100%, but for the
intravenous route it is usually 100%.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
6. A client is being given two highly protein-bound drugs concurrently. What is most likely to
be the result of this administration?
a. More free drug in circulation
b. Less free drug in circulation
c. More drug bound to protein
d. More drug excreted in the urine
ANS: A
When two highly protein-bound drugs are given concurrently, they compete for protein-
binding sites, causing more free drug to be released into the circulation. Drug accumulation
and possible drug toxicity can result.
DIF: Cognitive Level: Application REF: p. 5
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral
Therapies
