NSG 100 FINAL EXAM | UPDATED ACTUAL | COMPLETE
EXAM PREPARATION WITH VERIFIED SOLUTIONS
• A patient asks the nurse the difference between a generic drug and a trade or
brand-name drug. Which of the following are true regarding generic drugs?
(Select all that apply)
A.Have less potential for abuse and dependence
B.Have the same chemical composition as the brand-name drug
C.May have several brand names
D.May have several generic names
E.Are usually less expensive than a brand-name drug -✓✓ANSWER: Answer: B, C,
E
Generic and trade or brand-name drugs have the same chemical composition and
the same effects, Generic drugs are usually less expensive. Each drug has only one
generic name. The trade name is the brand of proprietary name given by the
manufacturer; various manufacturers give the drug different brand names. There
is no difference in abuse potential between a generic and brand-name drug.
• Patients with renal failure would most likely have problems with which
pharmacokinetic process?
A.Excretion
B.Absorption
C.Metabolism
D.Distribution -✓✓ANSWER: ANS: A
The kidneys are responsible for the majority of drug excretion. A patient with
renal failure would have a difficult time with drug excretion.
,• A staff educator is preparing an in-service to review factors that influence
medication metabolism. Which of the following would the educator include as a
reason to administer a lower medication dosage? (Select all that apply)
A.Increased renal excretion
B.Increased medication-metabolizing enzymes
C.Liver failure
D.Peripheral vascular disease
E.Concurrent use of medication with the same pathway of metabolism -
✓✓ANSWER: Answer: C, E
Rationale: Increased renal excretion and Increased medication-metabolizing
enzymes decrease the concentration of the medication, potentially requiring
increased strength. Liver failure decreases metabolism, thus increasing the
concentration of a medication. This requires decreasing the dosage. Peripheral
vascular disease impairs distribution, may require an increased dose. When the
same pathway metabolizes two medications, they compete for metabolism,
potentially increasing the concentration of one or both medications. Requiring
deceasing the dose of one or both medications
• A patient asks the nurse why a lower dose of IV pain medication is being given
than the previous oral dose. What is the nurse's best response to the patient?
A."Medications given orally bypass the portal circulatory system."
B."Medications given intravenously are not affected by the first-pass effect."
C."Drugs administered intravenously enter the portal system before systemic
distribution."
D."A large percentage of an intravenously administered drug is metabolized into
inactive metabolites in the liver." -✓✓ANSWER: Ans: B
Rationale: When drugs with a high first-pass effect are administered orally, a large
amount of drug may be metabolized before it reaches the systemic circulation.
The same drug given IV will bypass the liver. This prevents the first-pass effect
,from taking place, and therefore more of the drug reaches the circulation.
Parenteral doses of drugs with a high first-pass effect are much smaller than oral
doses, yet they produce the same pharmacologic response.
• A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain.
The pharmacy sends up enteric-coated tablets, but the patient refuses the
tablets, stating that she cannot swallow pills. What will the nurse do?
A.Crush the tablets and mix them with applesauce or pudding.
B.Call the pharmacy and ask for the liquid form of the medication.
C.Call the pharmacy and ask for the IV form of the medication
D.Encourage the patient to try to swallow the tablets -✓✓ANSWER: ANS: B
The liquid form is appropriate because it is also given via the oral route. Enteric-
coated tablets should not be crushed, and the patient should not be forced to
take the tablets. This medication does not have an IV form, but even if it did, the
routes cannot be changed without a health care provider's order.
• When teaching a pregnant woman about the use of drugs during pregnancy,
which statement will the nurse include?
A.Exposure of the fetus to drugs is most detrimental during the second trimester
of pregnancy.
B.Pregnant women must never take drugs to control high blood pressure.
C.Drug transfer to a fetus is most likely to occur during the last trimester of
pregnancy.
D.A fetus is at greatest risk for drug-induced developmental defects during the
second trimester of pregnancy. -✓✓ANSWER: ANS: C
Drug transfer to the fetus is most likely to occur during the last trimester of
pregnancy. Exposure of a fetus to drugs is most detrimental during the first
, trimester of pregnancy, and fetuses are at greatest risk for drug-induced
developmental defects during the first trimester of pregnancy. Pregnant women
need to take medications to control situations such as high blood pressure.
• When administering medications to pediatric patients, the nurse understands
that the dosage calculations for pediatric patients are different than for adults
because pediatric patients•
A.are more likely to develop edema.
B.have more stomach acid.
C.have skin that is less permeable.
D.have immature liver and kidney function -✓✓ANSWER: ANS: D
In pediatric patients, body temperature is less well regulated, and dehydration
occurs easily; pediatric patients lack stomach acid to kill bacteria and have skin
that is thinner and more permeable. It is true that pediatric patients have
immature liver and kidney function, resulting in impaired drug metabolism and
excretion.
• The nurse caring for a pediatric patient calculates the safe range for the
prescribed medication. Based on the nurses calculations, the dose ordered
exceeds the high limit. What is the nurse's next action?
A.Contact the prescriber immediately.
B.Administer only half the ordered dose.
C.Proceed with administration of the prescribed dose.
D.Contact pharmacy to substitute the prescribed medication with one that will
calculate in the safe range. -✓✓ANSWER: ANS: A
The nurse should contact the prescriber immediately and before administering
the medications. Giving only half the prescribed dose is making a prescribed order
EXAM PREPARATION WITH VERIFIED SOLUTIONS
• A patient asks the nurse the difference between a generic drug and a trade or
brand-name drug. Which of the following are true regarding generic drugs?
(Select all that apply)
A.Have less potential for abuse and dependence
B.Have the same chemical composition as the brand-name drug
C.May have several brand names
D.May have several generic names
E.Are usually less expensive than a brand-name drug -✓✓ANSWER: Answer: B, C,
E
Generic and trade or brand-name drugs have the same chemical composition and
the same effects, Generic drugs are usually less expensive. Each drug has only one
generic name. The trade name is the brand of proprietary name given by the
manufacturer; various manufacturers give the drug different brand names. There
is no difference in abuse potential between a generic and brand-name drug.
• Patients with renal failure would most likely have problems with which
pharmacokinetic process?
A.Excretion
B.Absorption
C.Metabolism
D.Distribution -✓✓ANSWER: ANS: A
The kidneys are responsible for the majority of drug excretion. A patient with
renal failure would have a difficult time with drug excretion.
,• A staff educator is preparing an in-service to review factors that influence
medication metabolism. Which of the following would the educator include as a
reason to administer a lower medication dosage? (Select all that apply)
A.Increased renal excretion
B.Increased medication-metabolizing enzymes
C.Liver failure
D.Peripheral vascular disease
E.Concurrent use of medication with the same pathway of metabolism -
✓✓ANSWER: Answer: C, E
Rationale: Increased renal excretion and Increased medication-metabolizing
enzymes decrease the concentration of the medication, potentially requiring
increased strength. Liver failure decreases metabolism, thus increasing the
concentration of a medication. This requires decreasing the dosage. Peripheral
vascular disease impairs distribution, may require an increased dose. When the
same pathway metabolizes two medications, they compete for metabolism,
potentially increasing the concentration of one or both medications. Requiring
deceasing the dose of one or both medications
• A patient asks the nurse why a lower dose of IV pain medication is being given
than the previous oral dose. What is the nurse's best response to the patient?
A."Medications given orally bypass the portal circulatory system."
B."Medications given intravenously are not affected by the first-pass effect."
C."Drugs administered intravenously enter the portal system before systemic
distribution."
D."A large percentage of an intravenously administered drug is metabolized into
inactive metabolites in the liver." -✓✓ANSWER: Ans: B
Rationale: When drugs with a high first-pass effect are administered orally, a large
amount of drug may be metabolized before it reaches the systemic circulation.
The same drug given IV will bypass the liver. This prevents the first-pass effect
,from taking place, and therefore more of the drug reaches the circulation.
Parenteral doses of drugs with a high first-pass effect are much smaller than oral
doses, yet they produce the same pharmacologic response.
• A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain.
The pharmacy sends up enteric-coated tablets, but the patient refuses the
tablets, stating that she cannot swallow pills. What will the nurse do?
A.Crush the tablets and mix them with applesauce or pudding.
B.Call the pharmacy and ask for the liquid form of the medication.
C.Call the pharmacy and ask for the IV form of the medication
D.Encourage the patient to try to swallow the tablets -✓✓ANSWER: ANS: B
The liquid form is appropriate because it is also given via the oral route. Enteric-
coated tablets should not be crushed, and the patient should not be forced to
take the tablets. This medication does not have an IV form, but even if it did, the
routes cannot be changed without a health care provider's order.
• When teaching a pregnant woman about the use of drugs during pregnancy,
which statement will the nurse include?
A.Exposure of the fetus to drugs is most detrimental during the second trimester
of pregnancy.
B.Pregnant women must never take drugs to control high blood pressure.
C.Drug transfer to a fetus is most likely to occur during the last trimester of
pregnancy.
D.A fetus is at greatest risk for drug-induced developmental defects during the
second trimester of pregnancy. -✓✓ANSWER: ANS: C
Drug transfer to the fetus is most likely to occur during the last trimester of
pregnancy. Exposure of a fetus to drugs is most detrimental during the first
, trimester of pregnancy, and fetuses are at greatest risk for drug-induced
developmental defects during the first trimester of pregnancy. Pregnant women
need to take medications to control situations such as high blood pressure.
• When administering medications to pediatric patients, the nurse understands
that the dosage calculations for pediatric patients are different than for adults
because pediatric patients•
A.are more likely to develop edema.
B.have more stomach acid.
C.have skin that is less permeable.
D.have immature liver and kidney function -✓✓ANSWER: ANS: D
In pediatric patients, body temperature is less well regulated, and dehydration
occurs easily; pediatric patients lack stomach acid to kill bacteria and have skin
that is thinner and more permeable. It is true that pediatric patients have
immature liver and kidney function, resulting in impaired drug metabolism and
excretion.
• The nurse caring for a pediatric patient calculates the safe range for the
prescribed medication. Based on the nurses calculations, the dose ordered
exceeds the high limit. What is the nurse's next action?
A.Contact the prescriber immediately.
B.Administer only half the ordered dose.
C.Proceed with administration of the prescribed dose.
D.Contact pharmacy to substitute the prescribed medication with one that will
calculate in the safe range. -✓✓ANSWER: ANS: A
The nurse should contact the prescriber immediately and before administering
the medications. Giving only half the prescribed dose is making a prescribed order
