LEHNE’S PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES AND
PHYSICIAN ASSITANTS 3RD EDITION 2025
________________________________________
Chapter I
A patient taking three medications for hypertension is diagnosed with COPD. Which action
should be taken prior to prescribing medications to treat COPD?
✓ Obtain a complete medication history.
A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate?
✓ Contact a different pharmacy.
A patient reports that a medication prescribed for recurrent migraine headaches is not working.
Which action should be taken first?
✓ Ask the patient about the number and frequency of tablets taken.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning?
✓ Drinks two glasses of wine every night
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label
instructs the patient to administer "two puffs every 4 hours as needed for coughing or
wheezing." The patient reports feeling jittery sometimes when taking the medication, and she
doesn't feel that the medication is always effective. Which action is most appropriate?
✓ Auscultating lung sounds and obtaining vital signs
A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action
should be taken first during medication education?
✓ Asking the patient to demonstrate how to measure and administer insulin
The drug manual states that older adult patients are at increased risk for hepatic side effects.
Which action is most important when prescribing this medication to an 80-year-old patient?
, ✓ Obtain pretreatment laboratory work.
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most
important to determine if the therapeutic level is maintained?
✓ Ensure periodic laboratory testing is completed.
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of which
action?
✓ Preventing activation of opioid receptors through antagonist actions
A patient is taking drug X and receives a new prescription for drug Y, which is listed as an
inducing agent. The nurse caring for this patient understands that this patient may require doses
of drug.
✓ higher; X
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents
ask why the drug cannot be given in an oral liquid form. What is the nurse's reply?
✓ "This drug would be inactivated by enzymes in the stomach."
Which statement about food and drug interactions is true?
a. Foods alter drug absorption and metabolism but not drug action.
b. Medications are best absorbed on an empty stomach.
c. Patient discomfort is the food and drug interaction of most concern.
d. Some foods can inhibit CYP isoenzymes and alter drug metabolism.
✓ Some foods can inhibit CYP isoenzymes and alter drug metabolism.
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain
that this drug may cause which effect on other drugs?
✓ Decreased elimination through the kidneys
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of
Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What
does the nurse know to be most likely?
✓ Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug's effects in the body.
, A patient receives a drug that has a narrow therapeutic range. The nurse administering this
medication will expect to do what?
✓ Monitor plasma drug levels.
What occurs when a drug binds to a receptor in the body?
✓ It increases or decreases the activity of that receptor.
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The
dosing is correct, and this medication has been tolerated by this patient in the past. Which could
be a probable cause of the test result?
✓ The patient is taking another medication that binds to serum albumin.
A patient reports becoming "immune" to a medication because it no longer works to alleviate
symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:
✓ desensitization of receptor sites by continual exposure to the drug.
A patient who is taking morphine for pain asks the nurse how a pain medication can also cause
constipation. What does the nurse know about morphine?
✓ It is selective to receptors that regulate more than one body process.
A nursing student is preparing to give a medication that has a boxed warning. The student asks
the nurse what this means. What will the nurse explain about boxed warnings?
✓ They alert prescribers to measures to mitigate potential harm from side effects.
A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes
that the drug has been linked to symptoms of Parkinson disease in some patients. What will
the nurse do?
✓ Observe the patient closely for such symptoms and prepare to treat them if needed.
A nurse provides teaching to a patient who will begin taking a drug with a known risk of
hepatotoxicity. Which statement by the patient indicates a need for further teaching?
✓ "Routine testing and early detection of problems will prevent liver failure."
A nurse is reviewing a medication administration record before administering medications.
Which order will the nurse implement?
✓ Furosemide [Lasix] 20 mg PO daily
ADVANCED PRACTICE NURSES AND
PHYSICIAN ASSITANTS 3RD EDITION 2025
________________________________________
Chapter I
A patient taking three medications for hypertension is diagnosed with COPD. Which action
should be taken prior to prescribing medications to treat COPD?
✓ Obtain a complete medication history.
A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate?
✓ Contact a different pharmacy.
A patient reports that a medication prescribed for recurrent migraine headaches is not working.
Which action should be taken first?
✓ Ask the patient about the number and frequency of tablets taken.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning?
✓ Drinks two glasses of wine every night
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label
instructs the patient to administer "two puffs every 4 hours as needed for coughing or
wheezing." The patient reports feeling jittery sometimes when taking the medication, and she
doesn't feel that the medication is always effective. Which action is most appropriate?
✓ Auscultating lung sounds and obtaining vital signs
A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action
should be taken first during medication education?
✓ Asking the patient to demonstrate how to measure and administer insulin
The drug manual states that older adult patients are at increased risk for hepatic side effects.
Which action is most important when prescribing this medication to an 80-year-old patient?
, ✓ Obtain pretreatment laboratory work.
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most
important to determine if the therapeutic level is maintained?
✓ Ensure periodic laboratory testing is completed.
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of which
action?
✓ Preventing activation of opioid receptors through antagonist actions
A patient is taking drug X and receives a new prescription for drug Y, which is listed as an
inducing agent. The nurse caring for this patient understands that this patient may require doses
of drug.
✓ higher; X
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents
ask why the drug cannot be given in an oral liquid form. What is the nurse's reply?
✓ "This drug would be inactivated by enzymes in the stomach."
Which statement about food and drug interactions is true?
a. Foods alter drug absorption and metabolism but not drug action.
b. Medications are best absorbed on an empty stomach.
c. Patient discomfort is the food and drug interaction of most concern.
d. Some foods can inhibit CYP isoenzymes and alter drug metabolism.
✓ Some foods can inhibit CYP isoenzymes and alter drug metabolism.
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain
that this drug may cause which effect on other drugs?
✓ Decreased elimination through the kidneys
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of
Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What
does the nurse know to be most likely?
✓ Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug's effects in the body.
, A patient receives a drug that has a narrow therapeutic range. The nurse administering this
medication will expect to do what?
✓ Monitor plasma drug levels.
What occurs when a drug binds to a receptor in the body?
✓ It increases or decreases the activity of that receptor.
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The
dosing is correct, and this medication has been tolerated by this patient in the past. Which could
be a probable cause of the test result?
✓ The patient is taking another medication that binds to serum albumin.
A patient reports becoming "immune" to a medication because it no longer works to alleviate
symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:
✓ desensitization of receptor sites by continual exposure to the drug.
A patient who is taking morphine for pain asks the nurse how a pain medication can also cause
constipation. What does the nurse know about morphine?
✓ It is selective to receptors that regulate more than one body process.
A nursing student is preparing to give a medication that has a boxed warning. The student asks
the nurse what this means. What will the nurse explain about boxed warnings?
✓ They alert prescribers to measures to mitigate potential harm from side effects.
A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes
that the drug has been linked to symptoms of Parkinson disease in some patients. What will
the nurse do?
✓ Observe the patient closely for such symptoms and prepare to treat them if needed.
A nurse provides teaching to a patient who will begin taking a drug with a known risk of
hepatotoxicity. Which statement by the patient indicates a need for further teaching?
✓ "Routine testing and early detection of problems will prevent liver failure."
A nurse is reviewing a medication administration record before administering medications.
Which order will the nurse implement?
✓ Furosemide [Lasix] 20 mg PO daily
