Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a medication that is known to
have a narrow therapeutic index. The nurse reviews the
patient's laboratory results and notes that the serum drug level
is at the upper limit of the therapeutic range. Which action
should the nurse take?
,A. Administer the medication as prescribed and monitor the
patient for adverse effects.
B. Hold the medication and notify the healthcare provider of
the lab result.
C. Administer a reduced dose of the medication to prevent
toxicity.
D. Document the lab result and administer the medication as
scheduled.
Correct Answer: A
Rationale: A narrow therapeutic index indicates a small margin
between therapeutic and toxic doses. A drug level at the upper
limit of the therapeutic range is still within the safe and
effective range. The nurse should administer the dose as
prescribed and continue to monitor the patient for signs of
toxicity, which is the most appropriate and safe action. Option B
is incorrect because holding the medication would result in
subtherapeutic levels and ineffective treatment. Option C is
incorrect because altering a dose is a prescribing function and
not within the nurse's scope. Option D is incorrect as it does not
include the necessary monitoring for a high-risk drug.
Why the Other Options Are Incorrect
A. This is the correct answer.
B. Holding the medication and notifying the provider is not
indicated for a drug level that is still within the therapeutic
,range; it would delay necessary treatment.
C. Administering a reduced dose is a prescribing error unless a
specific order for a reduced dose based on levels is in place.
D. While documentation is important, the most critical action is
to monitor the patient for potential toxicity, not just document
and administer without further assessment.
Learning Objective: Apply knowledge of pharmacokinetic
principles to monitor drug therapy and ensure patient safety.
Bloom's Taxonomy: Apply
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient with a new prescription for an antihypertensive
medication asks the nurse, "How will this drug know where to
go in my body to work?" Which response by the nurse best
explains the concept of drug distribution?
A. "The drug is designed to target a specific receptor on the
cells of your blood vessels."
B. "The drug is carried by your blood to various tissues, where it
can exert its effects."
C. "The drug is broken down by your liver and then distributed
, to the areas it needs to go."
D. "Your body's immune system directs the drug to the areas of
inflammation in your arteries."
Correct Answer: B
Rationale: Distribution is the process by which a drug is
transported from the bloodstream to the tissues and organs
where it will have its effect. This is a fundamental
pharmacokinetic process. Option A describes
pharmacodynamics (drug-receptor interaction). Option C
describes metabolism. Option D is incorrect as the immune
system does not direct drug distribution.
Why the Other Options Are Incorrect
A. This describes a drug's mechanism of action at the receptor
level, not the process of distribution.
B. This is the correct definition of distribution.
C. This describes the process of metabolism, not distribution.
D. The immune system does not direct drugs to specific areas;
this statement is false.
Learning Objective: Explain the pharmacokinetic process of
drug distribution.
Bloom's Taxonomy: Understand
Difficulty: Easy
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a medication that is known to
have a narrow therapeutic index. The nurse reviews the
patient's laboratory results and notes that the serum drug level
is at the upper limit of the therapeutic range. Which action
should the nurse take?
,A. Administer the medication as prescribed and monitor the
patient for adverse effects.
B. Hold the medication and notify the healthcare provider of
the lab result.
C. Administer a reduced dose of the medication to prevent
toxicity.
D. Document the lab result and administer the medication as
scheduled.
Correct Answer: A
Rationale: A narrow therapeutic index indicates a small margin
between therapeutic and toxic doses. A drug level at the upper
limit of the therapeutic range is still within the safe and
effective range. The nurse should administer the dose as
prescribed and continue to monitor the patient for signs of
toxicity, which is the most appropriate and safe action. Option B
is incorrect because holding the medication would result in
subtherapeutic levels and ineffective treatment. Option C is
incorrect because altering a dose is a prescribing function and
not within the nurse's scope. Option D is incorrect as it does not
include the necessary monitoring for a high-risk drug.
Why the Other Options Are Incorrect
A. This is the correct answer.
B. Holding the medication and notifying the provider is not
indicated for a drug level that is still within the therapeutic
,range; it would delay necessary treatment.
C. Administering a reduced dose is a prescribing error unless a
specific order for a reduced dose based on levels is in place.
D. While documentation is important, the most critical action is
to monitor the patient for potential toxicity, not just document
and administer without further assessment.
Learning Objective: Apply knowledge of pharmacokinetic
principles to monitor drug therapy and ensure patient safety.
Bloom's Taxonomy: Apply
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient with a new prescription for an antihypertensive
medication asks the nurse, "How will this drug know where to
go in my body to work?" Which response by the nurse best
explains the concept of drug distribution?
A. "The drug is designed to target a specific receptor on the
cells of your blood vessels."
B. "The drug is carried by your blood to various tissues, where it
can exert its effects."
C. "The drug is broken down by your liver and then distributed
, to the areas it needs to go."
D. "Your body's immune system directs the drug to the areas of
inflammation in your arteries."
Correct Answer: B
Rationale: Distribution is the process by which a drug is
transported from the bloodstream to the tissues and organs
where it will have its effect. This is a fundamental
pharmacokinetic process. Option A describes
pharmacodynamics (drug-receptor interaction). Option C
describes metabolism. Option D is incorrect as the immune
system does not direct drug distribution.
Why the Other Options Are Incorrect
A. This describes a drug's mechanism of action at the receptor
level, not the process of distribution.
B. This is the correct definition of distribution.
C. This describes the process of metabolism, not distribution.
D. The immune system does not direct drugs to specific areas;
this statement is false.
Learning Objective: Explain the pharmacokinetic process of
drug distribution.
Bloom's Taxonomy: Understand
Difficulty: Easy
