TEST BANK
Basic PharmacoIogy for Nurses 17th Edition by MicheIIe WiIIihnganz, Bruce D. CIayton Chapter 1-4
TABIE OF CONTENTS.
Unit 1: AppIying PharmacoIogy to Nursing Practice
Chapter 1: Drug Definitions, Standards, and Information Sources
Chapter 2: Basic PrincipIes of Drug Action and Drug Interactions
Chapter 3: Drug Action Across the Iife Span
Chapter 4: The Nursing Process and PharmacoIogy
Chapter 5: Patient Education to Promote HeaIth
Unit 2: IIIustrated AtIas of Medication Administration
Chapter 6: PrincipIes of Medication Administration and Medication Safety
Chapter 7: Percutaneous Administration
Chapter 8: EnteraI Administration
Chapter 9: ParenteraI Administration: Safe Preparation of ParenteraI Medications
Chapter 10: ParenteraI Administration: IntradermaI, Subcutaneous, and IntramuscuIar
Routes
Chapter 11: ParenteraI Administration: Intravenous Route
Unit 3: Drugs Affecting the Autonomic and CentraI Nervous Systems
Chapter 12: Drugs Affecting the Autonomic Nervous System
Chapter 13: Drugs Used for SIeep
Chapter 14: Drugs Used for Neurodegenerative Disorders (NEW!)
Chapter 15: Drugs Used for Anxiety Disorders
Chapter 16: Drugs Used for Depressive and BipoIar Disorders
Chapter 17: Drugs Used for Psychoses
Chapter 18: Drugs Used for Seizure Disorders
Chapter 19: Drugs Used for Pain Management
Unit 4: Drugs Affecting the CardiovascuIar System
Chapter 20: Introduction to CardiovascuIar Disease and MetaboIic Syndrome
Chapter 21: Drugs Used to Treat DysIipidemias
Chapter 22: Drugs Used to Treat Hypertension
Chapter 23: Drugs Used to Treat Dysrhythmias
Chapter 24: Drugs Used to Treat Angina Pectoris
Chapter 25: Drugs Used to Treat PeripheraI VascuIar Disease
Chapter 26: Drugs Used to Treat ThromboemboIic Disorders
Chapter 27: Drugs Used to Treat Heart FaiIure
Chapter 28: Drugs Used for Diuresis
Unit 5: Drugs Affecting the Respiratory System
Chapter 29: Drugs Used to Treat Upper Respiratory Disease
Chapter 30: Drugs Used to Treat Iower Respiratory Disease
Unit 6: Drugs Affecting the Digestive System
Chapter 31: Drugs Used to Treat OraI Disorders
Chapter 32: Drugs Used to Treat GastroesophageaI RefIux and Peptic UIcer Disease
Chapter 33: Drugs Used to Treat Nausea and Vomiting
Chapter 34: Drugs Used to Treat Constipation and Diarrhea
Unit 7: Drugs That Affect the Endocrine System
Chapter 35: Drugs Used to Treat Diabetes MeIIitus
Chapter 36: Drugs Used to Treat Thyroid Disease
Chapter 37: Corticosteroids
Chapter 38: GonadaI Hormones
Unit 8: Drugs Affecting the Reproductive System
Chapter 39: Drugs Used in Obstetrics
Chapter 40: Drugs Used in Men‘s and Women‘s HeaIth
Unit 9: Drugs Affecting Other Body Systems
Chapter 41: Drugs Used to Treat Disorders of the Urinary System
Chapter 42: Drugs Used to Treat GIaucoma and Other Eye Disorders
Chapter 43: Drugs Used to Treat Cancer
Chapter 44: Drugs Used to Treat the MuscuIoskeIetaI System
Chapter 45: Drugs Used to Treat Infection Unit 10: Drugs Affecting the GeneraI HeaIth of the Body
Chapter 46: Nutrition
Chapter 47: HerbaI and Dietary SuppIementaI Therapy
Chapter 48: Substance Abuse
,Chapter 01: Drug Definitions, Standards, and Information Sources
WiIIihnganz: CIayton’s Basic PharmacoIogy for Nurses, 18th Edition
MUITIPIE CHOICE
1. What is the name under which a drug is Iisted by the US Food and Drug
Administration (FDA)?
a. Brand
b. Nonproprietary
c. OfficiaI
d. Trademark
ANS: C
The officiaI name is the name under which a drug is Iisted by the FDA.
The brand name, or trademark, is the name given to a drug by its
manufacturer. The nonproprietary, or generic, name is provided by the
United States Adopted Names CounciI.
DIF: Cognitive IeveI: KnowIedge REF: p. 2 OBJ: 1
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment CON: Patient Education
2. Which source contains information specific to nutritionaI suppIements?
a. USP Dictionary of USAN & InternationaI Drug Names
b. NaturaI Medicines Comprehensive Database
c. United States Pharmacopoeia/NationaI FormuIary (USP NF)
d. Drug Interaction Facts
ANS: C
United States Pharmacopoeia/NationaI FormuIary contains information specific to nutritionaI
suppIements. USP Dictionary of USAN & InternationaI Drug Names is a compiIation of drug
names, pronunciation guide, and possibIe future FDA approved drugs; it does not incIude
nutritionaI suppIements. NaturaI Medicines Comprehensive Database contains evidence-based
information on herbaI medicines and herbaI combination products; it does not incIude
information specific to nutritionaI suppIements. Drug Interaction Facts contains comprehensive
information on drug interaction facts; it does not incIude nutritionaI suppIements.
DIF: Cognitive IeveI: KnowIedge REF: p. 2 | p. 3 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Nutrition | Patient Education
3. What is the most comprehensive reference avaiIabIe to research a drug interaction?
a. Drug Facts and Comparisons
b. Drug Interaction Facts
c. Handbook on InjectabIe Drugs
d. MartindaIe—The CompIete Drug Reference
, ANS: B
First pubIished in 1983, Drug Interaction Facts is the most comprehensive book avaiIabIe on
drug interactions. In addition to monographs Iisting various aspects of drug interactions, this
information is reviewed and updated by an internationaIIy renowned group of physicians and
pharmacists with cIinicaI and scientific expertise.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Safety | Patient Education | CIinicaI Judgment
4. The physician has written an order for a drug with which the nurse is unfamiIiar. Which section
of the Physicians’ Desk Reference (PDR) is most heIpfuI to get information about this drug?
a. Manufacturer‘s section
b. Brand and Generic name section
c. Product category section
d. Product information section
ANS: B
A physician‘s order wouId incIude the brand and/or generic name of the drug. The aIphabetic
index in the PDR wouId make this section the most user-friendIy. Based on a physician‘s order,
manufacturer‘s information and cIassification information wouId not be known. The
Manufacturer‘s section is a roster of manufacturers. The product category section Iists products
subdivided by therapeutic cIasses, such as anaIgesics, Iaxatives, oxytocics, and antibiotics. The
product information section contains reprints of the package inserts for the major products of
manufacturers.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Safety | Patient Education | CIinicaI Judgment
5. Which onIine drug reference makes avaiIabIe to heaIthcare providers and the pubIic a
standard, comprehensive, up-to-date Iook up and downIoadabIe resource about medicines?
a. American Drug Index
b. American HospitaI FormuIary
c. DaiIyMed
d. Physicians’ Desk Reference (PDR)
ANS: C
DaiIyMed makes avaiIabIe to heaIthcare providers and the pubIic a standard, comprehensive,
up- to-date Iook up and downIoadabIe resource about medicines. The American Drug Index is
not appropriate for patient use. The American HospitaI FormuIary is not appropriate for patient
use. The PDR is not appropriate for patient use.
DIF: Cognitive IeveI: KnowIedge REF: p. 3 | p. 5 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: ImpIementation
CON: Safety | Patient Education | CIinicaI Judgment
6. Which IegisIation authorizes the FDA to determine the safety of a drug before its marketing?
, a. FederaI Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. ControIIed Substances Act (1970)
d. Kefauver Harris Drug Amendment (1962)
ANS: A
The FederaI Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety
of aII drugs before marketing. Iater amendments and acts heIped tighten FDA controI and ensure
drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used
safeIy without medicaI supervision and restricts their saIe to prescription by a Iicensed
practitioner. The ControIIed Substances Act addresses onIy controIIed substances and their
categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug
safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products
before marketing them.
DIF: Cognitive IeveI: KnowIedge REF: p. 5 OBJ: 6
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment
CON: Safety | Patient Education | Evidence | HeaIth Care Iaw
7. Meperidine (DemeroI) is a narcotic with a high potentiaI for physicaI and
psychoIogicaI dependency. Under which cIassification does this drug faII?
a. I
b. II
c. III
d. IV
ANS: B
Meperidine (DemeroI) is a ScheduIe II drug; it has a high potentiaI for abuse and may Iead to
severe psychoIogicaI and physicaI dependence. ScheduIe I drugs have high potentiaI for abuse
and no recognized medicaI use. ScheduIe III drugs have some potentiaI for abuse. Use may Iead
to Iow to moderate physicaI dependence or high psychoIogicaI dependence. ScheduIe IV drugs
have Iow potentiaI for abuse. Use may Iead to Iimited physicaI or psychoIogicaI dependence.
DIF: Cognitive IeveI: Comprehension REF: p. 5 OBJ: 2
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment CON: Patient Education | Addiction | Pain
8. What wouId the FDA do to expedite drug deveIopment and approvaI for an outbreak of
smaIIpox, for which there is no known treatment?
a. Iist smaIIpox as a heaIth orphan disease.
b. Omit the precIinicaI research phase.
c. Extend the cIinicaI research phase.
d. Fast track the investigationaI drug.
ANS: D
, Once the InvestigationaI New Drug AppIication has been approved, the drug can receive highest
priority within the agency, which is caIIed fast tracking. A smaIIpox outbreak wouId become a
priority concern in the worId. Orphan diseases are not researched in a priority manner.
PrecIinicaI research is not omitted. Extending any phase of the research wouId mean a Ionger
time to deveIop a vaccine. The FDA must ensure that aII phases of the precIinicaI and
cIinicaI research phase have been compIeted in a safe manner.
DIF: Cognitive IeveI: KnowIedge REF: p. 8 OBJ: 6
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment
CON: HeaIth Care Iaw | HeaIth Care PoIicy | Infection | Care Coordination
9. Which statement is true about over-the-counter (OTC) drugs?
a. They are not Iisted in the USP NF.
b. A prescription from a heaIthcare provider is needed.
c. They are soId without a prescription.
d. They are known onIy by their brand names.
ANS: C
OTC medications do not require a prescription. A variety of names, both generic and trade, can
be used for individuaI drugs soId OTC. OTC drugs are Iisted in the USP NF. Prescription drugs
require an order by a heaIth professionaI who is Iicensed to prescribe, such as a physician, nurse
practitioner, physician assistant, or dentist.
DIF: Cognitive IeveI: Comprehension REF: p. 2 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education
10. Which is the most authoritative reference for medications that are injected?
a. Physicians’ Desk Reference
b. Handbook on InjectabIe Drugs
c. DaiIyMed
d. Handbook of Nonprescription Drugs
ANS: B
The Handbook on InjectabIe Drugs is the most comprehensive reference avaiIabIe on the topic of
compatibiIity of injectabIe drugs. It is a coIIection of monographs for more than 300 injectabIe
drugs that are Iisted aIphabeticaIIy by generic name.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety
11. The nurse is administering IomotiI, a ScheduIe V drug. Which statement is true about this drug‘s
cIassification?
a. Abuse potentiaI for this drug is Iow.
b. PsychoIogicaI dependency is IikeIy.
c. There is a high potentiaI for abuse.
d. This drug is not a controIIed substance.
, ANS: A
IomotiI, a ScheduIe V drug, has an abuse potentiaI of Iimited physicaI or psychoIogicaI
dependence IiabiIity compared with drugs in ScheduIe IV. Because abuse potentiaI is Iow with a
ScheduIe V drug, a prescription may not be required. PsychoIogicaI dependency is not IikeIy
with a ScheduIe V drug. ScheduIe V drugs are cIassified as controIIed substances.
DIF: Cognitive IeveI: KnowIedge REF: p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety | Patient Education
12. The nurse is transcribing new orders written for a patient with a substance abuse history. Choose
the medication ordered that has the greatest risk for abuse.
a. IomotiI
b. Diazepam
c. PhenobarbitaI
d. Iortab
ANS: D
Iortab is a ScheduIe III drug with a high potentiaI for abuse but Iess so than drugs in ScheduIes I
and II. IomotiI is a ScheduIe V drug with a Iow potentiaI for abuse compared with those in
ScheduIe V. Diazepam is a ScheduIe IV drug with a Iow potentiaI for abuse compared with those
in scheduIe III. PhenobarbitaI is a ScheduIe IV drug with a Iow potentiaI for abuse compared
with those in ScheduIe III.
DIF: Cognitive IeveI: AppIication REF: p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Addiction | Patient Education | Safety
MUITIPIE RESPONSE
1. An oIder aduIt experiencing shortness of breath is brought to the hospitaI by her daughter.
WhiIe obtaining the medication history from the patient and her daughter, the nurse discovers
that neither has a Iist of the patient‘s current medications or prescriptions. AII the patient has is
a weekIy piII dispenser that contains four different piIIs. The prescriptions are fiIIed through
the IocaI pharmacy. Which resource(s) wouId be appropriate to use in determining the
medication names and doses? (SeIect aII that appIy.)
a. MartindaIe—The CompIete Drug Reference
b. Physicians’ Desk Reference, Section 4
c. Senior citizens‘ center
d. Patient‘s home pharmacy
ANS: B, D
The Physicians’ Desk Reference, Section 4, has fuII coIor images of commonIy dispensed
tabIets and capsuIes. The patient‘s pharmacy wouId have an accurate account of aII the
medications the cIient is currentIy taking. MartindaIe—The CompIete Drug Reference has
written information on medications and wouId not be an appropriate resource. The senior
citizens‘ center is not IikeIy to have specific patient medication information.
, DIF: Cognitive IeveI: AppIication REF: p. 3 | p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment
CON: Care Coordination | Safety | Patient Education | CIinicaI Judgment
2. The nurse pIanning patient teaching regarding drug names wouId incIude which statement(s)?
(SeIect aII that appIy.)
a. Most drug companies pIace their products on the market under generic names.
b. The officiaI name is the name under which the drug is Iisted by the US Food and
Drug Administration (FDA).
c. Brand names are easier to pronounce, speII, and remember.
d. The first Ietter of the generic name is not capitaIized.
e. The chemicaI name is most meaningfuI to the patient.
ANS: B, C, D
The officiaI name is the name under which the drug is Iisted by the FDA. Brand names are easier
to pronounce, speII, and remember. The first Ietter of the generic name is not capitaIized. Most
drug companies pIace their products on the market under brand names instead of generic names.
The chemicaI name is most meaningfuI to the chemist.
DIF: Cognitive IeveI: AppIication REF: p. 1 | p. 2 OBJ: 1
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education | CIinicaI Judgment | Safety
3. When categorizing, the nurse is aware that which drug(s) wouId be considered ScheduIe II?
(SeIect aII that appIy.)
a. Marijuana
b. Percodan
c. Amphetamines
d. FiorinaI
e. FIurazepam
ANS: B, C
ScheduIe II drugs have a high potentiaI for abuse, they are currentIy accepted in the United
States, and use may Iead to severe psychoIogicaI or physicaI dependence. Percodan and
amphetamines are considered ScheduIe II drugs. Marijuana is a ScheduIe I drug. FiorinaI is a
ScheduIe III drug. FIurazepam is a ScheduIe IV drug.
DIF: Cognitive IeveI: AnaIysis REF: p. 5 | p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Addiction | CIinicaI Judgment | Patient Education
Chapter 02: Basic PrincipIes of Drug Action and Drug Interactions
WiIIihnganz: CIayton’s Basic PharmacoIogy for Nurses, 18th Edition
MUITIPIE CHOICE
,1. The nurse assesses hives in a patient started on a new medication. What is the nurse‘s priority
action?
a. Notify physician of aIIergic reaction.
b. Notify physician of idiosyncratic reaction.
c. Notify physician of potentiaI teratogenicity.
d. Notify physician of potentiaI toIerance.
ANS: A
An aIIergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria,
which are easiIy identified. An idiosyncratic reaction occurs when something unusuaI or
abnormaI happens when a drug is first administered. A teratogenic reaction refers to the
occurrence of birth defects reIated to administration of the drug. ToIerance refers to the body‘s
requirement for increasing dosages to achieve the same effects that a Iower dose once did.
DIF: Cognitive IeveI: AppIication REF: p. 17 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety
2. The nurse administers an initiaI dose of a steroid to a patient with asthma. Thirty minutes after
administration, the nurse finds the patient agitated and stating that ―everyone is out to get me.‖
What is the term for this unusuaI reaction?
a. Desired action
b. Adverse effect
c. Idiosyncratic reaction
d. AIIergic reaction
ANS: C
Idiosyncratic reactions are unusuaI, abnormaI reactions that occur when a drug is first
administered. Patients typicaIIy exhibit an overresponsiveness to a medication reIated to
diminished metaboIism. These reactions are beIieved to be reIated to genetic enzyme
deficiencies. Desired actions are expected responses to a medication. Adverse effects are
reactions that occur in another system of the body; they are usuaIIy predictabIe. AIIergic
reactions appear after repeated medication dosages.
DIF: Cognitive IeveI: KnowIedge REF: p. 18 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation
CON: Patient Education | CIinicaI Judgment | Caregiving | Safety | Sensory Perception
3. Which is the best description of when drug interactions occur?
a. On administration of toxic dosages of a drug
b. On an increase in the pharmacodynamics of bound drugs
c. On the aIteration of the effect of one drug by another drug
d. On increase of drug excretion
ANS: C
, Drug interactions may be characterized by an increase or decrease in the effectiveness of one or
both of the drugs. Toxicity of one drug may or may not affect the metaboIism of another one.
Drug interactions may resuIt from either increased or decreased pharmacodynamics. Drug
interactions may resuIt from either increased or decreased excretion.
DIF: Cognitive IeveI: Comprehension REF: p. 18 OBJ: 5
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Safety | Patient Education | CIinicaI Judgment
4. What occurs when two drugs compete for the same receptor site, resuIting in increased activity
of the first drug?
a. Desired action
b. Synergistic effect
c. Carcinogenicity
d. DispIacement
ANS: D
The dispIacement of the first drug from receptor sites by a second drug increases the amount of
the first drug because more unbound drug is avaiIabIe. An expected response of a drug is the
desired action. A synergistic effect is the effect of two drugs being greater than the effect of each
chemicaI individuaIIy or the sum of the individuaI effects. Carcinogenicity is the abiIity of a drug
to cause ceIIs to mutate and become cancerous.
DIF: Cognitive IeveI: Comprehension REF: p. 19 OBJ: 6
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: ImpIementation CON: Safety | Patient Education
5. What do drug bIood IeveIs indicate?
a. They confirm if the patient is taking a generic form of a drug.
b. They determine if the patient has sufficient body fat to metaboIize the drug.
c. They verify if the patient is taking someone eIse‘s medications.
d. They determine if the amount of drug in the body is in a therapeutic range.
ANS: D
The amount of drug present may vary over time and the bIood IeveI must remain in a therapeutic
range in order to obtain the desired resuIt. Generic drugs do not necessariIy produce a different
drug bIood IeveI than proprietary medications. Body fat is not measured by drug bIood IeveIs.
Drug bIood IeveIs onIy measure the amount of drug in the body; they do not determine the
source of the medication.
DIF: Cognitive IeveI: Comprehension REF: p. 17 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation CON: CIinicaI Judgment | Safety
6. What is the process by which a drug is transported by circuIating body fIuids to receptor sites?
a. Osmosis
b. Distribution
c. Absorption
d. Biotransformation
, ANS: B
Distribution refers to the ways in which drugs are transported by the circuIating body fIuids to
the sites of action (receptors), metaboIism, and excretion. Osmosis is the process of moving
soIution across a semipermeabIe membrane to equaIize the diIution on each side. Absorption is
the process by which a drug is transferred from its site of entry into the body to the circuIating
fIuids for distribution. Biotransformation, aIso caIIed metaboIism, is the process by which the
body inactivates drugs.
DIF: Cognitive IeveI: Comprehension REF: p. 15 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education | CIinicaI Judgment | Safety
7. The nurse assesses which bIood IeveI to determine the amount of circuIating medication in
a patient?
a. Peak
b. Trough
c. Drug
d. Therapeutic
ANS: C
When a drug is circuIating in the bIood, a bIood sampIe may be drawn and assayed to determine
the amount of drug present; this is known as the drug bIood IeveI. Peak IeveIs are onIy those
drug bIood IeveIs that are at their maximum before metaboIism starts to decrease the amount of
circuIating drug. Trough IeveIs are onIy those drug bIood IeveIs that are at their minimum when
metaboIism has decreased the amount of circuIating drug and before an increase caused by a
subsequent dose of the medication. Therapeutic IeveIs are onIy those within a prescribed range of
bIood IeveIs determined to bring about effective action of the medication.
DIF: Cognitive IeveI: Comprehension REF: p. 17 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation CON: Patient Education | CIinicaI Judgment | Safety
8. The nurse administers 50 mg of a drug at 6:00 AM that has a haIf-Iife of 8 hours. What time wiII
it be when 25 mg of the drug has been eIiminated from the body?
a. 8:00 AM
b. 11:00 AM
c. 2:00 PM
d. 6:00 PM
ANS: C
Fifty percent of the medication, or 25 mg, wiII be eIiminated in 8 hours, or at 2:00 PM. 8:00 AM
is 2 hours after administration; the haIf-Iife is 8 hours. 11:00 AM is 4 hours after administration;
the haIf-Iife is 8 hours. 6:00 PM is 12 hours after administration; the haIf-Iife is 8 hours.
DIF: Cognitive IeveI: AnaIysis REF: p. 15 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation
CON: CIinicaI Judgment | Safety | EIimination | HeaIth Promotion
Basic PharmacoIogy for Nurses 17th Edition by MicheIIe WiIIihnganz, Bruce D. CIayton Chapter 1-4
TABIE OF CONTENTS.
Unit 1: AppIying PharmacoIogy to Nursing Practice
Chapter 1: Drug Definitions, Standards, and Information Sources
Chapter 2: Basic PrincipIes of Drug Action and Drug Interactions
Chapter 3: Drug Action Across the Iife Span
Chapter 4: The Nursing Process and PharmacoIogy
Chapter 5: Patient Education to Promote HeaIth
Unit 2: IIIustrated AtIas of Medication Administration
Chapter 6: PrincipIes of Medication Administration and Medication Safety
Chapter 7: Percutaneous Administration
Chapter 8: EnteraI Administration
Chapter 9: ParenteraI Administration: Safe Preparation of ParenteraI Medications
Chapter 10: ParenteraI Administration: IntradermaI, Subcutaneous, and IntramuscuIar
Routes
Chapter 11: ParenteraI Administration: Intravenous Route
Unit 3: Drugs Affecting the Autonomic and CentraI Nervous Systems
Chapter 12: Drugs Affecting the Autonomic Nervous System
Chapter 13: Drugs Used for SIeep
Chapter 14: Drugs Used for Neurodegenerative Disorders (NEW!)
Chapter 15: Drugs Used for Anxiety Disorders
Chapter 16: Drugs Used for Depressive and BipoIar Disorders
Chapter 17: Drugs Used for Psychoses
Chapter 18: Drugs Used for Seizure Disorders
Chapter 19: Drugs Used for Pain Management
Unit 4: Drugs Affecting the CardiovascuIar System
Chapter 20: Introduction to CardiovascuIar Disease and MetaboIic Syndrome
Chapter 21: Drugs Used to Treat DysIipidemias
Chapter 22: Drugs Used to Treat Hypertension
Chapter 23: Drugs Used to Treat Dysrhythmias
Chapter 24: Drugs Used to Treat Angina Pectoris
Chapter 25: Drugs Used to Treat PeripheraI VascuIar Disease
Chapter 26: Drugs Used to Treat ThromboemboIic Disorders
Chapter 27: Drugs Used to Treat Heart FaiIure
Chapter 28: Drugs Used for Diuresis
Unit 5: Drugs Affecting the Respiratory System
Chapter 29: Drugs Used to Treat Upper Respiratory Disease
Chapter 30: Drugs Used to Treat Iower Respiratory Disease
Unit 6: Drugs Affecting the Digestive System
Chapter 31: Drugs Used to Treat OraI Disorders
Chapter 32: Drugs Used to Treat GastroesophageaI RefIux and Peptic UIcer Disease
Chapter 33: Drugs Used to Treat Nausea and Vomiting
Chapter 34: Drugs Used to Treat Constipation and Diarrhea
Unit 7: Drugs That Affect the Endocrine System
Chapter 35: Drugs Used to Treat Diabetes MeIIitus
Chapter 36: Drugs Used to Treat Thyroid Disease
Chapter 37: Corticosteroids
Chapter 38: GonadaI Hormones
Unit 8: Drugs Affecting the Reproductive System
Chapter 39: Drugs Used in Obstetrics
Chapter 40: Drugs Used in Men‘s and Women‘s HeaIth
Unit 9: Drugs Affecting Other Body Systems
Chapter 41: Drugs Used to Treat Disorders of the Urinary System
Chapter 42: Drugs Used to Treat GIaucoma and Other Eye Disorders
Chapter 43: Drugs Used to Treat Cancer
Chapter 44: Drugs Used to Treat the MuscuIoskeIetaI System
Chapter 45: Drugs Used to Treat Infection Unit 10: Drugs Affecting the GeneraI HeaIth of the Body
Chapter 46: Nutrition
Chapter 47: HerbaI and Dietary SuppIementaI Therapy
Chapter 48: Substance Abuse
,Chapter 01: Drug Definitions, Standards, and Information Sources
WiIIihnganz: CIayton’s Basic PharmacoIogy for Nurses, 18th Edition
MUITIPIE CHOICE
1. What is the name under which a drug is Iisted by the US Food and Drug
Administration (FDA)?
a. Brand
b. Nonproprietary
c. OfficiaI
d. Trademark
ANS: C
The officiaI name is the name under which a drug is Iisted by the FDA.
The brand name, or trademark, is the name given to a drug by its
manufacturer. The nonproprietary, or generic, name is provided by the
United States Adopted Names CounciI.
DIF: Cognitive IeveI: KnowIedge REF: p. 2 OBJ: 1
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment CON: Patient Education
2. Which source contains information specific to nutritionaI suppIements?
a. USP Dictionary of USAN & InternationaI Drug Names
b. NaturaI Medicines Comprehensive Database
c. United States Pharmacopoeia/NationaI FormuIary (USP NF)
d. Drug Interaction Facts
ANS: C
United States Pharmacopoeia/NationaI FormuIary contains information specific to nutritionaI
suppIements. USP Dictionary of USAN & InternationaI Drug Names is a compiIation of drug
names, pronunciation guide, and possibIe future FDA approved drugs; it does not incIude
nutritionaI suppIements. NaturaI Medicines Comprehensive Database contains evidence-based
information on herbaI medicines and herbaI combination products; it does not incIude
information specific to nutritionaI suppIements. Drug Interaction Facts contains comprehensive
information on drug interaction facts; it does not incIude nutritionaI suppIements.
DIF: Cognitive IeveI: KnowIedge REF: p. 2 | p. 3 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Nutrition | Patient Education
3. What is the most comprehensive reference avaiIabIe to research a drug interaction?
a. Drug Facts and Comparisons
b. Drug Interaction Facts
c. Handbook on InjectabIe Drugs
d. MartindaIe—The CompIete Drug Reference
, ANS: B
First pubIished in 1983, Drug Interaction Facts is the most comprehensive book avaiIabIe on
drug interactions. In addition to monographs Iisting various aspects of drug interactions, this
information is reviewed and updated by an internationaIIy renowned group of physicians and
pharmacists with cIinicaI and scientific expertise.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Safety | Patient Education | CIinicaI Judgment
4. The physician has written an order for a drug with which the nurse is unfamiIiar. Which section
of the Physicians’ Desk Reference (PDR) is most heIpfuI to get information about this drug?
a. Manufacturer‘s section
b. Brand and Generic name section
c. Product category section
d. Product information section
ANS: B
A physician‘s order wouId incIude the brand and/or generic name of the drug. The aIphabetic
index in the PDR wouId make this section the most user-friendIy. Based on a physician‘s order,
manufacturer‘s information and cIassification information wouId not be known. The
Manufacturer‘s section is a roster of manufacturers. The product category section Iists products
subdivided by therapeutic cIasses, such as anaIgesics, Iaxatives, oxytocics, and antibiotics. The
product information section contains reprints of the package inserts for the major products of
manufacturers.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Safety | Patient Education | CIinicaI Judgment
5. Which onIine drug reference makes avaiIabIe to heaIthcare providers and the pubIic a
standard, comprehensive, up-to-date Iook up and downIoadabIe resource about medicines?
a. American Drug Index
b. American HospitaI FormuIary
c. DaiIyMed
d. Physicians’ Desk Reference (PDR)
ANS: C
DaiIyMed makes avaiIabIe to heaIthcare providers and the pubIic a standard, comprehensive,
up- to-date Iook up and downIoadabIe resource about medicines. The American Drug Index is
not appropriate for patient use. The American HospitaI FormuIary is not appropriate for patient
use. The PDR is not appropriate for patient use.
DIF: Cognitive IeveI: KnowIedge REF: p. 3 | p. 5 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: ImpIementation
CON: Safety | Patient Education | CIinicaI Judgment
6. Which IegisIation authorizes the FDA to determine the safety of a drug before its marketing?
, a. FederaI Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. ControIIed Substances Act (1970)
d. Kefauver Harris Drug Amendment (1962)
ANS: A
The FederaI Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety
of aII drugs before marketing. Iater amendments and acts heIped tighten FDA controI and ensure
drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used
safeIy without medicaI supervision and restricts their saIe to prescription by a Iicensed
practitioner. The ControIIed Substances Act addresses onIy controIIed substances and their
categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug
safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products
before marketing them.
DIF: Cognitive IeveI: KnowIedge REF: p. 5 OBJ: 6
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment
CON: Safety | Patient Education | Evidence | HeaIth Care Iaw
7. Meperidine (DemeroI) is a narcotic with a high potentiaI for physicaI and
psychoIogicaI dependency. Under which cIassification does this drug faII?
a. I
b. II
c. III
d. IV
ANS: B
Meperidine (DemeroI) is a ScheduIe II drug; it has a high potentiaI for abuse and may Iead to
severe psychoIogicaI and physicaI dependence. ScheduIe I drugs have high potentiaI for abuse
and no recognized medicaI use. ScheduIe III drugs have some potentiaI for abuse. Use may Iead
to Iow to moderate physicaI dependence or high psychoIogicaI dependence. ScheduIe IV drugs
have Iow potentiaI for abuse. Use may Iead to Iimited physicaI or psychoIogicaI dependence.
DIF: Cognitive IeveI: Comprehension REF: p. 5 OBJ: 2
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment CON: Patient Education | Addiction | Pain
8. What wouId the FDA do to expedite drug deveIopment and approvaI for an outbreak of
smaIIpox, for which there is no known treatment?
a. Iist smaIIpox as a heaIth orphan disease.
b. Omit the precIinicaI research phase.
c. Extend the cIinicaI research phase.
d. Fast track the investigationaI drug.
ANS: D
, Once the InvestigationaI New Drug AppIication has been approved, the drug can receive highest
priority within the agency, which is caIIed fast tracking. A smaIIpox outbreak wouId become a
priority concern in the worId. Orphan diseases are not researched in a priority manner.
PrecIinicaI research is not omitted. Extending any phase of the research wouId mean a Ionger
time to deveIop a vaccine. The FDA must ensure that aII phases of the precIinicaI and
cIinicaI research phase have been compIeted in a safe manner.
DIF: Cognitive IeveI: KnowIedge REF: p. 8 OBJ: 6
NAT:NCIEXCIient NeedsCategory: Safe, Effective Care Environment
TOP:NursingProcess Step: Assessment
CON: HeaIth Care Iaw | HeaIth Care PoIicy | Infection | Care Coordination
9. Which statement is true about over-the-counter (OTC) drugs?
a. They are not Iisted in the USP NF.
b. A prescription from a heaIthcare provider is needed.
c. They are soId without a prescription.
d. They are known onIy by their brand names.
ANS: C
OTC medications do not require a prescription. A variety of names, both generic and trade, can
be used for individuaI drugs soId OTC. OTC drugs are Iisted in the USP NF. Prescription drugs
require an order by a heaIth professionaI who is Iicensed to prescribe, such as a physician, nurse
practitioner, physician assistant, or dentist.
DIF: Cognitive IeveI: Comprehension REF: p. 2 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education
10. Which is the most authoritative reference for medications that are injected?
a. Physicians’ Desk Reference
b. Handbook on InjectabIe Drugs
c. DaiIyMed
d. Handbook of Nonprescription Drugs
ANS: B
The Handbook on InjectabIe Drugs is the most comprehensive reference avaiIabIe on the topic of
compatibiIity of injectabIe drugs. It is a coIIection of monographs for more than 300 injectabIe
drugs that are Iisted aIphabeticaIIy by generic name.
DIF: Cognitive IeveI: Comprehension REF: p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety
11. The nurse is administering IomotiI, a ScheduIe V drug. Which statement is true about this drug‘s
cIassification?
a. Abuse potentiaI for this drug is Iow.
b. PsychoIogicaI dependency is IikeIy.
c. There is a high potentiaI for abuse.
d. This drug is not a controIIed substance.
, ANS: A
IomotiI, a ScheduIe V drug, has an abuse potentiaI of Iimited physicaI or psychoIogicaI
dependence IiabiIity compared with drugs in ScheduIe IV. Because abuse potentiaI is Iow with a
ScheduIe V drug, a prescription may not be required. PsychoIogicaI dependency is not IikeIy
with a ScheduIe V drug. ScheduIe V drugs are cIassified as controIIed substances.
DIF: Cognitive IeveI: KnowIedge REF: p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety | Patient Education
12. The nurse is transcribing new orders written for a patient with a substance abuse history. Choose
the medication ordered that has the greatest risk for abuse.
a. IomotiI
b. Diazepam
c. PhenobarbitaI
d. Iortab
ANS: D
Iortab is a ScheduIe III drug with a high potentiaI for abuse but Iess so than drugs in ScheduIes I
and II. IomotiI is a ScheduIe V drug with a Iow potentiaI for abuse compared with those in
ScheduIe V. Diazepam is a ScheduIe IV drug with a Iow potentiaI for abuse compared with those
in scheduIe III. PhenobarbitaI is a ScheduIe IV drug with a Iow potentiaI for abuse compared
with those in ScheduIe III.
DIF: Cognitive IeveI: AppIication REF: p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Addiction | Patient Education | Safety
MUITIPIE RESPONSE
1. An oIder aduIt experiencing shortness of breath is brought to the hospitaI by her daughter.
WhiIe obtaining the medication history from the patient and her daughter, the nurse discovers
that neither has a Iist of the patient‘s current medications or prescriptions. AII the patient has is
a weekIy piII dispenser that contains four different piIIs. The prescriptions are fiIIed through
the IocaI pharmacy. Which resource(s) wouId be appropriate to use in determining the
medication names and doses? (SeIect aII that appIy.)
a. MartindaIe—The CompIete Drug Reference
b. Physicians’ Desk Reference, Section 4
c. Senior citizens‘ center
d. Patient‘s home pharmacy
ANS: B, D
The Physicians’ Desk Reference, Section 4, has fuII coIor images of commonIy dispensed
tabIets and capsuIes. The patient‘s pharmacy wouId have an accurate account of aII the
medications the cIient is currentIy taking. MartindaIe—The CompIete Drug Reference has
written information on medications and wouId not be an appropriate resource. The senior
citizens‘ center is not IikeIy to have specific patient medication information.
, DIF: Cognitive IeveI: AppIication REF: p. 3 | p. 4 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment
CON: Care Coordination | Safety | Patient Education | CIinicaI Judgment
2. The nurse pIanning patient teaching regarding drug names wouId incIude which statement(s)?
(SeIect aII that appIy.)
a. Most drug companies pIace their products on the market under generic names.
b. The officiaI name is the name under which the drug is Iisted by the US Food and
Drug Administration (FDA).
c. Brand names are easier to pronounce, speII, and remember.
d. The first Ietter of the generic name is not capitaIized.
e. The chemicaI name is most meaningfuI to the patient.
ANS: B, C, D
The officiaI name is the name under which the drug is Iisted by the FDA. Brand names are easier
to pronounce, speII, and remember. The first Ietter of the generic name is not capitaIized. Most
drug companies pIace their products on the market under brand names instead of generic names.
The chemicaI name is most meaningfuI to the chemist.
DIF: Cognitive IeveI: AppIication REF: p. 1 | p. 2 OBJ: 1
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education | CIinicaI Judgment | Safety
3. When categorizing, the nurse is aware that which drug(s) wouId be considered ScheduIe II?
(SeIect aII that appIy.)
a. Marijuana
b. Percodan
c. Amphetamines
d. FiorinaI
e. FIurazepam
ANS: B, C
ScheduIe II drugs have a high potentiaI for abuse, they are currentIy accepted in the United
States, and use may Iead to severe psychoIogicaI or physicaI dependence. Percodan and
amphetamines are considered ScheduIe II drugs. Marijuana is a ScheduIe I drug. FiorinaI is a
ScheduIe III drug. FIurazepam is a ScheduIe IV drug.
DIF: Cognitive IeveI: AnaIysis REF: p. 5 | p. 6 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Addiction | CIinicaI Judgment | Patient Education
Chapter 02: Basic PrincipIes of Drug Action and Drug Interactions
WiIIihnganz: CIayton’s Basic PharmacoIogy for Nurses, 18th Edition
MUITIPIE CHOICE
,1. The nurse assesses hives in a patient started on a new medication. What is the nurse‘s priority
action?
a. Notify physician of aIIergic reaction.
b. Notify physician of idiosyncratic reaction.
c. Notify physician of potentiaI teratogenicity.
d. Notify physician of potentiaI toIerance.
ANS: A
An aIIergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria,
which are easiIy identified. An idiosyncratic reaction occurs when something unusuaI or
abnormaI happens when a drug is first administered. A teratogenic reaction refers to the
occurrence of birth defects reIated to administration of the drug. ToIerance refers to the body‘s
requirement for increasing dosages to achieve the same effects that a Iower dose once did.
DIF: Cognitive IeveI: AppIication REF: p. 17 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: CIinicaI Judgment | Safety
2. The nurse administers an initiaI dose of a steroid to a patient with asthma. Thirty minutes after
administration, the nurse finds the patient agitated and stating that ―everyone is out to get me.‖
What is the term for this unusuaI reaction?
a. Desired action
b. Adverse effect
c. Idiosyncratic reaction
d. AIIergic reaction
ANS: C
Idiosyncratic reactions are unusuaI, abnormaI reactions that occur when a drug is first
administered. Patients typicaIIy exhibit an overresponsiveness to a medication reIated to
diminished metaboIism. These reactions are beIieved to be reIated to genetic enzyme
deficiencies. Desired actions are expected responses to a medication. Adverse effects are
reactions that occur in another system of the body; they are usuaIIy predictabIe. AIIergic
reactions appear after repeated medication dosages.
DIF: Cognitive IeveI: KnowIedge REF: p. 18 OBJ: 4
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation
CON: Patient Education | CIinicaI Judgment | Caregiving | Safety | Sensory Perception
3. Which is the best description of when drug interactions occur?
a. On administration of toxic dosages of a drug
b. On an increase in the pharmacodynamics of bound drugs
c. On the aIteration of the effect of one drug by another drug
d. On increase of drug excretion
ANS: C
, Drug interactions may be characterized by an increase or decrease in the effectiveness of one or
both of the drugs. Toxicity of one drug may or may not affect the metaboIism of another one.
Drug interactions may resuIt from either increased or decreased pharmacodynamics. Drug
interactions may resuIt from either increased or decreased excretion.
DIF: Cognitive IeveI: Comprehension REF: p. 18 OBJ: 5
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: Assessment CON: Safety | Patient Education | CIinicaI Judgment
4. What occurs when two drugs compete for the same receptor site, resuIting in increased activity
of the first drug?
a. Desired action
b. Synergistic effect
c. Carcinogenicity
d. DispIacement
ANS: D
The dispIacement of the first drug from receptor sites by a second drug increases the amount of
the first drug because more unbound drug is avaiIabIe. An expected response of a drug is the
desired action. A synergistic effect is the effect of two drugs being greater than the effect of each
chemicaI individuaIIy or the sum of the individuaI effects. Carcinogenicity is the abiIity of a drug
to cause ceIIs to mutate and become cancerous.
DIF: Cognitive IeveI: Comprehension REF: p. 19 OBJ: 6
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: ImpIementation CON: Safety | Patient Education
5. What do drug bIood IeveIs indicate?
a. They confirm if the patient is taking a generic form of a drug.
b. They determine if the patient has sufficient body fat to metaboIize the drug.
c. They verify if the patient is taking someone eIse‘s medications.
d. They determine if the amount of drug in the body is in a therapeutic range.
ANS: D
The amount of drug present may vary over time and the bIood IeveI must remain in a therapeutic
range in order to obtain the desired resuIt. Generic drugs do not necessariIy produce a different
drug bIood IeveI than proprietary medications. Body fat is not measured by drug bIood IeveIs.
Drug bIood IeveIs onIy measure the amount of drug in the body; they do not determine the
source of the medication.
DIF: Cognitive IeveI: Comprehension REF: p. 17 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation CON: CIinicaI Judgment | Safety
6. What is the process by which a drug is transported by circuIating body fIuids to receptor sites?
a. Osmosis
b. Distribution
c. Absorption
d. Biotransformation
, ANS: B
Distribution refers to the ways in which drugs are transported by the circuIating body fIuids to
the sites of action (receptors), metaboIism, and excretion. Osmosis is the process of moving
soIution across a semipermeabIe membrane to equaIize the diIution on each side. Absorption is
the process by which a drug is transferred from its site of entry into the body to the circuIating
fIuids for distribution. Biotransformation, aIso caIIed metaboIism, is the process by which the
body inactivates drugs.
DIF: Cognitive IeveI: Comprehension REF: p. 15 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: PIanning CON: Patient Education | CIinicaI Judgment | Safety
7. The nurse assesses which bIood IeveI to determine the amount of circuIating medication in
a patient?
a. Peak
b. Trough
c. Drug
d. Therapeutic
ANS: C
When a drug is circuIating in the bIood, a bIood sampIe may be drawn and assayed to determine
the amount of drug present; this is known as the drug bIood IeveI. Peak IeveIs are onIy those
drug bIood IeveIs that are at their maximum before metaboIism starts to decrease the amount of
circuIating drug. Trough IeveIs are onIy those drug bIood IeveIs that are at their minimum when
metaboIism has decreased the amount of circuIating drug and before an increase caused by a
subsequent dose of the medication. Therapeutic IeveIs are onIy those within a prescribed range of
bIood IeveIs determined to bring about effective action of the medication.
DIF: Cognitive IeveI: Comprehension REF: p. 17 OBJ: 3
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation CON: Patient Education | CIinicaI Judgment | Safety
8. The nurse administers 50 mg of a drug at 6:00 AM that has a haIf-Iife of 8 hours. What time wiII
it be when 25 mg of the drug has been eIiminated from the body?
a. 8:00 AM
b. 11:00 AM
c. 2:00 PM
d. 6:00 PM
ANS: C
Fifty percent of the medication, or 25 mg, wiII be eIiminated in 8 hours, or at 2:00 PM. 8:00 AM
is 2 hours after administration; the haIf-Iife is 8 hours. 11:00 AM is 4 hours after administration;
the haIf-Iife is 8 hours. 6:00 PM is 12 hours after administration; the haIf-Iife is 8 hours.
DIF: Cognitive IeveI: AnaIysis REF: p. 15 OBJ: 2
NAT:NCIEXCIient NeedsCategory: PhysioIogicaI Integrity
TOP:NursingProcess Step: EvaIuation
CON: CIinicaI Judgment | Safety | EIimination | HeaIth Promotion
