Test Bank for Clayton's Basic Pharmacology for Nurses 18th Edition by Michelle J. Willihnganz ,All chapters covered, Latest edition, Graded A+

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Downloaded by: bb bbbb 02: Basic Principles of Drug Action and Drug Interactions
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bb Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th bb bb bb bb bb bb




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MULTIPLE CHOICE bb




1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority a
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bb ction?
a. Notify physician of allergic reaction. bb bb bb bb



b. Notify physician of idiosyncratic reaction. bb bb bb bb



c. Notify physician of potential teratogenicity. bb bb bb bb



d. Notify physician of potential tolerance. bb bb bb bb




ANS: b b A
An allergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria, w
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hich are easily identified. An idiosyncratic reaction occurs when something unusual or abnormal
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happens when agdrug is first administered. A teratogenic reaction refers to the
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occurrence of birth defects related to administration of the drug. Tolerance refers to the body’s re
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quirement for increasinggdosages to achieve the same effects that a lower dose oncegdid.
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DIF: Cognitive Level: Application REF: p. 17 bb bb b b bb



OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Assessment CON: Clinical Judgmentg| Safety
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2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after a
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dministration, the nurse finds the patient agitated and stating that “everyonegis out to get me.” W
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hat is the term for this unusual reaction?
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a. Desired action bb



b. Adverse effect bb



c. Idiosyncratic reaction bb



d. Allergic reaction bb




ANS: b b C
Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first administer
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ed. Patients typically exhibit an overresponsiveness to a medication related to diminished metab
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olism. These reactions are believed to be related to genetic enzyme deficiencies. Desired actions
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are expected responses to a medication. Adverse effects are reactions that occur in another syste
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m of the body; they are usually predictable. Allergic reactions appear after repeated
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medication dosages.
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DIF: Cognitive Level: Knowledge REF: p. 18 bb bb b b bb



OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: Nursing Process Step: Evaluation
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CON: PatientgEducationg| Clinical Judgment | Caregiving | Safety | Sensory Perception
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3. Whichgis the best description of when drug interactions occur?
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a. On administration of toxic dosages of a drug
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b. On an increase in the pharmacodynamics of bound drugs
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c. On the alteration of the effect of one drug by another drug
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d. On increase of drug excretion bb bb bb bb




ANS: b b C

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nWillihnganz
b

Drug interactions may be characterized by an increase or decrease in the effectiveness of one or both
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of the drugs. Toxicity of one drug may or may not affectgthe metabolism of another one. Drug
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interactions may result from either increased or decreased pharmacodynamics.
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Drug interactions may result from either increased or decreased excretion.
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DIF: Cognitive Level: Comprehension REF: p. 18 bb bb b b bb



OBJ: 5 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Assessment CON: Safety | Patient Education | Clinical Judgment
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4. Whatgoccurs when two drugs compete for the same receptor site, resulting in increased a
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ctivity of the first drug?
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a. Desired action bb



b. Synergistic effect bb



c. Carcinogenicity
d. Displacement
ANS: b b D
The displacement of the first drug from receptor sites by a second druggincreases the amount of
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the first druggbecause more unbound drug is available. An expected response of a drug is the de
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sired action. A synergistic effect is the effect of two drugs being greater than the effect of each c
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hemical individually or the sum of the individual effects. Carcinogenicity is the ability of a dru
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ggto causegcells to mutate and becomegcancerous.
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DIF: Cognitive Level: Comprehension REF: p. 19 bb bb b b bb



OBJ: 6 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Implementation bb bb bb CON: Safety | Patient Educationb b bb bb bb




5. What do druggblood levels indicate?
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a. They confirm if thegpatient is taking a generic form of a drug.
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b. They determine if the patient has sufficient body fat to metabolize the drug.
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c. They verify if the patient is taking someone else’s medications.
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d. They determine if the amount of drug ingthe body is inga therapeutic range.
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ANS: b b D
The amount of drug present may vary over time and thegblood level must remain in a therapeuti c
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range in order to obtain the desired result. Generic drugs do not necessarily produce a differe
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nt drug blood level than proprietary medications. Body fat is not measured by drug bloodglevel
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s. Drug blood levels only measure the amount of drug in the body; they do not determine the so urce
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of the medication.
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DIF: Cognitive Level: Comprehension REF: p. 17 bb bb b b bb



OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Evaluation bb bb bb CON: Clinical Judgmentg| Safety b b bb bb




6. What is the process by which a drug is transported by circulating body fluids to receptor sites?
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a. Osmosis
b. Distribution
c. Absorption
d. Biotransformation

ANS: b b B

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nWillihnganz
b


Distribution refers to the ways in which drugs are transported by the circulating body fluids to t
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he sites of action (receptors), metabolism, and excretion. Osmosis is the process of moving sol
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ution across agsemipermeable membrane to equalize the dilution on each side. Absorption is th
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e process by whichga drug is transferred from its site of entry into the body to the circulating flu
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ids for distribution. Biotransformation, also called metabolism, is the process by which the bod
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y inactivates drugs.
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DIF: b b Cognitive Level: Comprehension
b b REF: p. 15 bb bb b b b b b b b b bb



OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Planning bb bb bb CON: Patient Education | Clinical Judgment | Safety
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7. The nurse assesses which blood level to determine the amount of circulating medication in a p
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atient?
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a. Peak
b. Trough
c. Drug
d. Therapeutic
ANS: b b C
When a druggis circulating in the blood, a blood sample may be drawn and assayed to determin
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e the amountgof druggpresent; this is known as the druggblood level. Peak levels are only those d
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ruggblood levels that aregat their maximum before metabolism starts to decrease the amount
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of circulating drug. Trough levels are only those drug blood levels that are at their minimum
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when metabolism has decreased thegamount of circulating drug and before an increase
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caused by a s ubsequent dose of the medication. Therapeutic levels are only those within a
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prescribed range of blood levels determined to bring about effectivegaction of the
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medication.
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DIF: Cognitive Level: Comprehension REF: p. 17 bb bb b b bb



OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: b b Nursing Process Step: Evaluation bb bb bb CON: Patient Education | Clinical Judgment | Safety
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8. The nurse administers 50 mg of a druggatg6:00 AM that has a half-
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lifegof 8 hours. What timegwill it be when 25 mggof the drugghas been eliminated from the bod y?
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a. 8:00 AM bb



b. 11:00 AM bb



c. 2:00 PM bb



d. 6:00 PM bb




ANS: b b C
Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM. 8:00 A M
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is 2 hours after administration; the half-
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lifegis 8 hours. 11:00 AM is 4 hours after administration; the half-
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life is 8 hours. 6:00 PM is 12 hours after administration; the half-life is 8 hours.
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DIF: Cognitive Level: Analysis REF: p. 15 bb bb b b bb



OBJ: 2 NAT: NCLEX Client Needs Category: Physiological Integ
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rity
TOP: Nursing Process Step: Evaluation
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CON: Clinical Judgment | Safety | Elimination | Health Promotion
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9. Whatgwill the nurse need to determine first in order to mix two drugs in the same syringe?
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