Karch's Focus on Nursing Pharmacology 10th Edition
Test Bank | Chapters 1-60 included
PART 1: INTRODUCTION TO NURSING PHARMACOLOGY (Questions 1–20)
Chapter 1: Introduction to Drugs
1. A nurse is administering iodine to a patient undergoing a CT scan,
chemotherapy to an oncology patient, and an MMR vaccine to a 14-month-old
child. Which branch of pharmacology best describes the actions of all three
nurses?
A. Pharmacoeconomics
B. Pharmacotherapeutics
C. Pharmacodynamics
D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacotherapeutics is the branch of pharmacology that
deals with the uses of drugs to treat, prevent, and diagnose disease. The radiology
nurse is administering a drug to help diagnose disease; the oncology nurse is
administering a drug to treat disease; and the public health nurse is administering
a vaccine to prevent disease. Pharmacoeconomics includes any costs involved in
drug therapy. Pharmacodynamics involves how a drug affects the body.
Pharmacokinetics is how the body acts on the drug.
2. A physician has ordered intramuscular injections of morphine, a narcotic, every
4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware
this drug has a high abuse potential. Under what category would morphine be
classified?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV
, Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule
II drugs because of severe dependence liability. Schedule I drugs have no
accepted medical use in the United States and high abuse potential. Schedule III
drugs have less abuse potential than Schedule II drugs. Schedule IV drugs have
limited abuse potential.
3. A 68-year-old patient with newly diagnosed bacterial pneumonia is prescribed
an oral antibiotic. The nurse notes the patient has difficulty swallowing pills and
asks whether the drug can be given crushed with applesauce. What should the
nurse do first?
A. Crush the tablet and give it with applesauce to improve swallowing.
B. Check the medication label and drug information for instructions about
crushing.
C. Ask the patient to try swallowing the tablet with extra water.
D. Contact the prescriber to change the route to intravenous administration.
Correct Answer: B
Rationale: Checking the medication label and drug information first
identifies whether the formulation is extended-release, enteric-coated, or
otherwise unsuitable for crushing. This step prevents loss of extended-release
properties or mucosal irritation and aligns with safe-administration principles.
Crushing without verification risks rapid drug release or inactivation, causing
toxicity or reduced efficacy. Encouraging more water may help swallowing but
bypasses the safety check. Contacting the prescriber may be appropriate later,
but first the nurse must verify formulation and administration guidance.
4. A patient is started on a new antihypertensive. The nurse documents the time
the first dose is given and plans to measure blood pressure at specified intervals.
Which pharmacokinetic parameter is the nurse most concerned with when
planning timing for monitoring therapeutic effect and adverse hypotension?
,A. Bioavailability
B. Half-life
C. Onset of action
D. Peak plasma concentration
Correct Answer: C
Rationale: Onset of action determines when a drug begins to produce its
therapeutic (or adverse) effects; planning monitoring around the expected onset
helps detect hypotension early. Bioavailability affects the amount reaching
systemic circulation but is less useful than onset for timing immediate monitoring.
Half-life influences dosing intervals and steady state but not the immediate timing
of first therapeutic effects. Peak concentration is important for toxicity/efficacy,
but peak may occur after onset; onset is primary for initial monitoring.
5. A nurse reviews a patient's medication list and notes two drugs metabolized by
the same hepatic enzyme. The patient reports new fatigue and lightheadedness.
What nursing interpretation is most appropriate?
A. The combination will increase renal excretion of both drugs.
B. Co-administration may cause a drug-drug interaction altering drug levels.
C. The drugs will neutralize each other and cause therapeutic failure.
D. There is no concern because hepatic metabolism prevents interactions.
Correct Answer: B
Rationale: When two drugs are metabolized by the same hepatic enzyme,
competition for the enzyme can lead to altered drug levels (increased levels of
one or both drugs), potentially causing toxicity. Fatigue and lightheadedness are
concerning for drug accumulation. The combination does not necessarily increase
renal excretion. Drugs do not neutralize each other. Hepatic metabolism is
precisely the site where interactions occur—this is a common mechanism for
drug-drug interactions.
6. Which statements accurately describe pharmacokinetics? Select all that apply.
, A. Absorption is the movement of a drug from the site of administration into the
bloodstream.
B. Distribution involves the transport of drug molecules to target tissues.
C. Metabolism primarily occurs in the kidneys.
D. Excretion is the removal of drugs and their metabolites from the body.
E. Half-life refers to the time required for half of the drug dose to be eliminated.
Correct Answers: A, B, D, E
Rationale: Absorption is the movement of a drug from the site of
administration into the bloodstream. Distribution involves the transport of drug
molecules to target tissues. Excretion is the removal of drugs and their
metabolites from the body. Half-life refers to the time required for half of the
drug dose to be eliminated. Metabolism primarily occurs in the liver, not the
kidneys—the kidneys are primarily involved in excretion.
Chapter 2: Pharmacodynamics and Pharmacokinetics
7. A nurse is administering a drug that binds to a receptor and produces a
response. This drug is best described as:
A. An antagonist
B. An agonist
C. A partial agonist
D. A competitive antagonist
Correct Answer: B
Rationale: An agonist is a drug that binds to a receptor and produces a
response. An antagonist binds to a receptor but does not produce a response
(blocks the receptor). A partial agonist produces a partial response. A competitive
antagonist competes with an agonist for the receptor but does not activate it.
Test Bank | Chapters 1-60 included
PART 1: INTRODUCTION TO NURSING PHARMACOLOGY (Questions 1–20)
Chapter 1: Introduction to Drugs
1. A nurse is administering iodine to a patient undergoing a CT scan,
chemotherapy to an oncology patient, and an MMR vaccine to a 14-month-old
child. Which branch of pharmacology best describes the actions of all three
nurses?
A. Pharmacoeconomics
B. Pharmacotherapeutics
C. Pharmacodynamics
D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacotherapeutics is the branch of pharmacology that
deals with the uses of drugs to treat, prevent, and diagnose disease. The radiology
nurse is administering a drug to help diagnose disease; the oncology nurse is
administering a drug to treat disease; and the public health nurse is administering
a vaccine to prevent disease. Pharmacoeconomics includes any costs involved in
drug therapy. Pharmacodynamics involves how a drug affects the body.
Pharmacokinetics is how the body acts on the drug.
2. A physician has ordered intramuscular injections of morphine, a narcotic, every
4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware
this drug has a high abuse potential. Under what category would morphine be
classified?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV
, Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule
II drugs because of severe dependence liability. Schedule I drugs have no
accepted medical use in the United States and high abuse potential. Schedule III
drugs have less abuse potential than Schedule II drugs. Schedule IV drugs have
limited abuse potential.
3. A 68-year-old patient with newly diagnosed bacterial pneumonia is prescribed
an oral antibiotic. The nurse notes the patient has difficulty swallowing pills and
asks whether the drug can be given crushed with applesauce. What should the
nurse do first?
A. Crush the tablet and give it with applesauce to improve swallowing.
B. Check the medication label and drug information for instructions about
crushing.
C. Ask the patient to try swallowing the tablet with extra water.
D. Contact the prescriber to change the route to intravenous administration.
Correct Answer: B
Rationale: Checking the medication label and drug information first
identifies whether the formulation is extended-release, enteric-coated, or
otherwise unsuitable for crushing. This step prevents loss of extended-release
properties or mucosal irritation and aligns with safe-administration principles.
Crushing without verification risks rapid drug release or inactivation, causing
toxicity or reduced efficacy. Encouraging more water may help swallowing but
bypasses the safety check. Contacting the prescriber may be appropriate later,
but first the nurse must verify formulation and administration guidance.
4. A patient is started on a new antihypertensive. The nurse documents the time
the first dose is given and plans to measure blood pressure at specified intervals.
Which pharmacokinetic parameter is the nurse most concerned with when
planning timing for monitoring therapeutic effect and adverse hypotension?
,A. Bioavailability
B. Half-life
C. Onset of action
D. Peak plasma concentration
Correct Answer: C
Rationale: Onset of action determines when a drug begins to produce its
therapeutic (or adverse) effects; planning monitoring around the expected onset
helps detect hypotension early. Bioavailability affects the amount reaching
systemic circulation but is less useful than onset for timing immediate monitoring.
Half-life influences dosing intervals and steady state but not the immediate timing
of first therapeutic effects. Peak concentration is important for toxicity/efficacy,
but peak may occur after onset; onset is primary for initial monitoring.
5. A nurse reviews a patient's medication list and notes two drugs metabolized by
the same hepatic enzyme. The patient reports new fatigue and lightheadedness.
What nursing interpretation is most appropriate?
A. The combination will increase renal excretion of both drugs.
B. Co-administration may cause a drug-drug interaction altering drug levels.
C. The drugs will neutralize each other and cause therapeutic failure.
D. There is no concern because hepatic metabolism prevents interactions.
Correct Answer: B
Rationale: When two drugs are metabolized by the same hepatic enzyme,
competition for the enzyme can lead to altered drug levels (increased levels of
one or both drugs), potentially causing toxicity. Fatigue and lightheadedness are
concerning for drug accumulation. The combination does not necessarily increase
renal excretion. Drugs do not neutralize each other. Hepatic metabolism is
precisely the site where interactions occur—this is a common mechanism for
drug-drug interactions.
6. Which statements accurately describe pharmacokinetics? Select all that apply.
, A. Absorption is the movement of a drug from the site of administration into the
bloodstream.
B. Distribution involves the transport of drug molecules to target tissues.
C. Metabolism primarily occurs in the kidneys.
D. Excretion is the removal of drugs and their metabolites from the body.
E. Half-life refers to the time required for half of the drug dose to be eliminated.
Correct Answers: A, B, D, E
Rationale: Absorption is the movement of a drug from the site of
administration into the bloodstream. Distribution involves the transport of drug
molecules to target tissues. Excretion is the removal of drugs and their
metabolites from the body. Half-life refers to the time required for half of the
drug dose to be eliminated. Metabolism primarily occurs in the liver, not the
kidneys—the kidneys are primarily involved in excretion.
Chapter 2: Pharmacodynamics and Pharmacokinetics
7. A nurse is administering a drug that binds to a receptor and produces a
response. This drug is best described as:
A. An antagonist
B. An agonist
C. A partial agonist
D. A competitive antagonist
Correct Answer: B
Rationale: An agonist is a drug that binds to a receptor and produces a
response. An antagonist binds to a receptor but does not produce a response
(blocks the receptor). A partial agonist produces a partial response. A competitive
antagonist competes with an agonist for the receptor but does not activate it.
