Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario
A nurse is preparing to administer an oral medication to a
patient and notes that the drug undergoes extensive first-pass
metabolism in the liver.
,Question
Which route of administration would best bypass first-pass
metabolism?
Options
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Correct Answer
B. Sublingual
Rationale
Sublingual administration allows the drug to be absorbed
directly into systemic circulation, bypassing hepatic first-pass
metabolism.
Why the Other Options Are Incorrect
A. Oral – Subject to first-pass metabolism.
B. Sublingual – Correct; bypasses liver metabolism.
C. Rectal – Partially bypasses, but not as reliably as sublingual.
D. Intramuscular – Not typically used to bypass first-pass
metabolism intentionally.
Learning Objective
Explain routes of drug administration and their impact on
metabolism.
,Bloom's Taxonomy
Understand
Difficulty
Easy
NCLEX Client Needs Category
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill
Recognize Cues
Question 2
Clinical Scenario
A patient receiving a new medication reports dizziness and
fatigue after the first dose.
Question
What type of drug response is the patient most likely
experiencing?
Options
A. Therapeutic effect
B. Side effect
C. Allergic reaction
D. Idiosyncratic reaction
Correct Answer
B. Side effect
, Rationale
Side effects are predictable, secondary effects of a drug that are
not the primary intended outcome.
Why the Other Options Are Incorrect
A. Therapeutic effect – Intended beneficial outcome.
B. Side effect – Correct; predictable and secondary.
C. Allergic reaction – Involves immune response such as rash or
anaphylaxis.
D. Idiosyncratic reaction – Unpredictable and unusual response.
Learning Objective
Differentiate types of drug responses.
Bloom's Taxonomy
Understand
Difficulty
Easy
NCLEX Client Needs Category
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill
Recognize Cues
Question 3
Clinical Scenario
A nurse is reviewing a patient's medication list and identifies a
narrow therapeutic index drug.
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario
A nurse is preparing to administer an oral medication to a
patient and notes that the drug undergoes extensive first-pass
metabolism in the liver.
,Question
Which route of administration would best bypass first-pass
metabolism?
Options
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Correct Answer
B. Sublingual
Rationale
Sublingual administration allows the drug to be absorbed
directly into systemic circulation, bypassing hepatic first-pass
metabolism.
Why the Other Options Are Incorrect
A. Oral – Subject to first-pass metabolism.
B. Sublingual – Correct; bypasses liver metabolism.
C. Rectal – Partially bypasses, but not as reliably as sublingual.
D. Intramuscular – Not typically used to bypass first-pass
metabolism intentionally.
Learning Objective
Explain routes of drug administration and their impact on
metabolism.
,Bloom's Taxonomy
Understand
Difficulty
Easy
NCLEX Client Needs Category
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill
Recognize Cues
Question 2
Clinical Scenario
A patient receiving a new medication reports dizziness and
fatigue after the first dose.
Question
What type of drug response is the patient most likely
experiencing?
Options
A. Therapeutic effect
B. Side effect
C. Allergic reaction
D. Idiosyncratic reaction
Correct Answer
B. Side effect
, Rationale
Side effects are predictable, secondary effects of a drug that are
not the primary intended outcome.
Why the Other Options Are Incorrect
A. Therapeutic effect – Intended beneficial outcome.
B. Side effect – Correct; predictable and secondary.
C. Allergic reaction – Involves immune response such as rash or
anaphylaxis.
D. Idiosyncratic reaction – Unpredictable and unusual response.
Learning Objective
Differentiate types of drug responses.
Bloom's Taxonomy
Understand
Difficulty
Easy
NCLEX Client Needs Category
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill
Recognize Cues
Question 3
Clinical Scenario
A nurse is reviewing a patient's medication list and identifies a
narrow therapeutic index drug.
