Pharmacology and the Nursing Process, 9th Edition – Test Bank (Original)
Section 1: Basic Principles of Pharmacology & Nursing Process
Q1: The nurse teaches a patient that the “half-life” of a drug is:
a) The time it takes for the drug to reach peak concentration
b) The time required for the plasma concentration to decrease by 50%
c) The time needed for the body to eliminate the entire drug
d) The time until the drug produces therapeutic effect
Answer: b) The time required for the plasma concentration to decrease by 50%
Rationale: Half-life reflects drug elimination rate and guides dosing schedules.
Q2: A drug with a high first-pass effect:
a) Is mostly metabolized in the liver before reaching systemic circulation
b) Has a long duration of action
c) Is excreted unchanged in urine
d) Is unaffected by oral administration
Answer: a) Is mostly metabolized in the liver before reaching systemic circulation
Rationale: First-pass metabolism decreases bioavailability; some oral drugs require higher
doses.
Q3: Which route has the fastest absorption?
a) Oral
b) Intravenous
c) Subcutaneous
d) Transdermal
Answer: b) Intravenous
Rationale: IV administration delivers drug directly into circulation for immediate effect.
Q4: A drug’s therapeutic index (TI) indicates:
a) Its duration of action
b) Its safety margin between therapeutic and toxic doses
c) Its bioavailability
d) Its solubility
Answer: b) Its safety margin between therapeutic and toxic doses
Rationale: Higher TI indicates safer drugs; low TI requires careful monitoring.
,Q5: Peak plasma concentration occurs:
a) Immediately after drug administration
b) When the drug reaches maximum therapeutic effect
c) When the drug is fully metabolized
d) At the time of drug excretion
Answer: b) When the drug reaches maximum therapeutic effect
Rationale: Peak is the highest plasma concentration; timing is important for therapeutic
monitoring.
Section 2: Autonomic Nervous System Drugs
Q6: A cholinergic drug (e.g., bethanechol) stimulates:
a) Sympathetic nervous system
b) Parasympathetic nervous system
c) Adrenergic receptors
d) Dopaminergic receptors
Answer: b) Parasympathetic nervous system
Rationale: Cholinergic drugs mimic acetylcholine, increasing “rest and digest” responses.
Q7: A patient receiving an anticholinergic (e.g., atropine) should be monitored for:
a) Diarrhea
b) Tachycardia and dry mouth
c) Bradycardia and salivation
d) Hypotension
Answer: b) Tachycardia and dry mouth
Rationale: Anticholinergics block parasympathetic activity, causing dry mouth, blurred vision,
tachycardia.
Q8: Beta-1 adrenergic agonists primarily affect:
a) Lungs
b) Heart
c) GI tract
d) Eyes
Answer: b) Heart
Rationale: Beta-1 receptors increase heart rate and contractility; important for cardiac drugs.
Q9: A patient taking an alpha-1 blocker may experience:
a) Hypertension
b) Hypotension and dizziness
, c) Tachycardia
d) Constipation
Answer: b) Hypotension and dizziness
Rationale: Alpha-1 blockade causes vasodilation and orthostatic hypotension.
Q10: Muscarinic antagonist toxicity may include:
a) Diaphoresis
b) Hyperthermia, dry mouth, confusion
c) Bradycardia
d) Hypotension
Answer: b) Hyperthermia, dry mouth, confusion
Rationale: “Hot, dry, red, blind, mad” mnemonic for anticholinergic toxicity.
Section 3: Cardiovascular Drugs
Q11: A patient on a loop diuretic should be monitored for:
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia only
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Loop diuretics increase potassium excretion; risk of arrhythmias if low.
Q12: ACE inhibitors lower blood pressure by:
a) Vasoconstriction
b) Blocking conversion of angiotensin I to II
c) Increasing heart rate
d) Blocking beta receptors
Answer: b) Blocking conversion of angiotensin I to II
Rationale: Prevents vasoconstriction and aldosterone-mediated fluid retention.
Q13: The main adverse effect of ACE inhibitors is:
a) Persistent dry cough
b) Bradycardia
c) Tachycardia
d) Hyperkalemia
Answer: a) Persistent dry cough
Rationale: Bradykinin accumulation leads to cough; monitor and consider alternatives if
severe.
Section 1: Basic Principles of Pharmacology & Nursing Process
Q1: The nurse teaches a patient that the “half-life” of a drug is:
a) The time it takes for the drug to reach peak concentration
b) The time required for the plasma concentration to decrease by 50%
c) The time needed for the body to eliminate the entire drug
d) The time until the drug produces therapeutic effect
Answer: b) The time required for the plasma concentration to decrease by 50%
Rationale: Half-life reflects drug elimination rate and guides dosing schedules.
Q2: A drug with a high first-pass effect:
a) Is mostly metabolized in the liver before reaching systemic circulation
b) Has a long duration of action
c) Is excreted unchanged in urine
d) Is unaffected by oral administration
Answer: a) Is mostly metabolized in the liver before reaching systemic circulation
Rationale: First-pass metabolism decreases bioavailability; some oral drugs require higher
doses.
Q3: Which route has the fastest absorption?
a) Oral
b) Intravenous
c) Subcutaneous
d) Transdermal
Answer: b) Intravenous
Rationale: IV administration delivers drug directly into circulation for immediate effect.
Q4: A drug’s therapeutic index (TI) indicates:
a) Its duration of action
b) Its safety margin between therapeutic and toxic doses
c) Its bioavailability
d) Its solubility
Answer: b) Its safety margin between therapeutic and toxic doses
Rationale: Higher TI indicates safer drugs; low TI requires careful monitoring.
,Q5: Peak plasma concentration occurs:
a) Immediately after drug administration
b) When the drug reaches maximum therapeutic effect
c) When the drug is fully metabolized
d) At the time of drug excretion
Answer: b) When the drug reaches maximum therapeutic effect
Rationale: Peak is the highest plasma concentration; timing is important for therapeutic
monitoring.
Section 2: Autonomic Nervous System Drugs
Q6: A cholinergic drug (e.g., bethanechol) stimulates:
a) Sympathetic nervous system
b) Parasympathetic nervous system
c) Adrenergic receptors
d) Dopaminergic receptors
Answer: b) Parasympathetic nervous system
Rationale: Cholinergic drugs mimic acetylcholine, increasing “rest and digest” responses.
Q7: A patient receiving an anticholinergic (e.g., atropine) should be monitored for:
a) Diarrhea
b) Tachycardia and dry mouth
c) Bradycardia and salivation
d) Hypotension
Answer: b) Tachycardia and dry mouth
Rationale: Anticholinergics block parasympathetic activity, causing dry mouth, blurred vision,
tachycardia.
Q8: Beta-1 adrenergic agonists primarily affect:
a) Lungs
b) Heart
c) GI tract
d) Eyes
Answer: b) Heart
Rationale: Beta-1 receptors increase heart rate and contractility; important for cardiac drugs.
Q9: A patient taking an alpha-1 blocker may experience:
a) Hypertension
b) Hypotension and dizziness
, c) Tachycardia
d) Constipation
Answer: b) Hypotension and dizziness
Rationale: Alpha-1 blockade causes vasodilation and orthostatic hypotension.
Q10: Muscarinic antagonist toxicity may include:
a) Diaphoresis
b) Hyperthermia, dry mouth, confusion
c) Bradycardia
d) Hypotension
Answer: b) Hyperthermia, dry mouth, confusion
Rationale: “Hot, dry, red, blind, mad” mnemonic for anticholinergic toxicity.
Section 3: Cardiovascular Drugs
Q11: A patient on a loop diuretic should be monitored for:
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia only
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Loop diuretics increase potassium excretion; risk of arrhythmias if low.
Q12: ACE inhibitors lower blood pressure by:
a) Vasoconstriction
b) Blocking conversion of angiotensin I to II
c) Increasing heart rate
d) Blocking beta receptors
Answer: b) Blocking conversion of angiotensin I to II
Rationale: Prevents vasoconstriction and aldosterone-mediated fluid retention.
Q13: The main adverse effect of ACE inhibitors is:
a) Persistent dry cough
b) Bradycardia
c) Tachycardia
d) Hyperkalemia
Answer: a) Persistent dry cough
Rationale: Bradykinin accumulation leads to cough; monitor and consider alternatives if
severe.
