FULL TEST BANK FOR
LEHNE'S PHARMACOLOGY FOR NURSING CARE 11TH EDITION
BY JACQUELINE ROSENJACK BURCHUM DNSC FNP-BC CNE
(AUTHOR), LAURA D. ROSENTHAL DNP RN ACNP- BC FAANP
(AUTHOR)
===
,TABLE OF CONTENTS
CHAPTER 01: ORIENTATION TO PHARMACOLOGY ...................................................................... 6
CHAPTER 02: APPLICATION OF PHARMACOLOGY IN NURSING PRACTICE ........................... 8
CHAPTER 03: DRUG REGULATION, DEVELOPMENT, NAMES, AND INFORMATION ........... 14
CHAPTER 04: PHARMACOKINETICS ............................................................................................... 17
CHAPTER 05: PHARMACODYNAMICS ............................................................................................ 23
CHAPTER 06: DRUG INTERACTIONS .............................................................................................. 27
CHAPTER 07: ADVERSE DRUG REACTIONS AND MEDICATION ERRORS.............................. 33
CHAPTER 08: INDIVIDUAL VARIATION TO DRUG RESPONSES ............................................... 39
CHAPTER 09: GENETIC AND GENOMIC CONSIDERATIONS ...................................................... 44
CHAPTER 10: INTRODUCTION TO IMMUNOMODULATORS ...................................................... 48
CHAPTER 11: DRUG THERAPY DURING PREGNANCY AND BREAST-FEEDING ................... 52
CHAPTER 12: DRUG THERAPY IN PEDIATRIC PATIENTS .......................................................... 56
CHAPTER 13: DRUG THERAPY IN OLDER ADULTS ..................................................................... 62
CHAPTER 14: BASIC PRINCIPLES OF NEUROPHARMACOLOGY............................................... 68
CHAPTER 15: PHYSIOLOGY OF THE PERIPHERAL NERVOUS SYSTEM .................................. 71
CHAPTER 16: MUSCARINIC AGONISTS .......................................................................................... 75
CHAPTER 17: MUSCARINIC ANTAGONISTS .................................................................................. 78
CHAPTER 18: CHOLINESTERASE INHIBITORS AND THEIR USE IN MYASTHENIA GRAVIS82
CHAPTER 19: DRUGS THAT BLOCK NICOTINIC CHOLINERGIC TRANSMISSION ................. 86
CHAPTER 20: ADRENERGIC AGONISTS ......................................................................................... 91
CHAPTER 21: ADRENERGIC ANTAGONISTS ................................................................................. 96
CHAPTER 22: INDIRECT-ACTING ANTIADRENERGIC AGENTS .............................................. 103
CHAPTER 23: INTRODUCTION TO CENTRAL NERVOUS SYSTEM PHARMACOLOGY ....... 109
CHAPTER 24: DRUGS FOR PARKINSON DISEASE .................................................................. 112
CHAPTER 25: DRUGS FOR ALZHEIMER DISEASE ...................................................................... 119
CHAPTER 26: DRUGS FOR MULTIPLE SCLEROSIS ..................................................................... 124
CHAPTER 27: DRUGS FOR SEIZURE DISORDERS ....................................................................... 130
CHAPTER 28: DRUGS FOR MUSCLE SPASM AND SPASTICITY ............................................... 138
CHAPTER 29: LOCAL ANESTHETICS............................................................................................. 143
CHAPTER 30: GENERAL ANESTHETICS ....................................................................................... 148
CHAPTER 31: OPIOID ANALGESICS, OPIOID ANTAGONISTS, AND NONOPIOID CENTRALLY
ACTING ANALGESICS ...................................................................................................................... 154
,CHAPTER 32: PAIN MANAGEMENT IN PATIENTS WITH CANCER ......................................... 161
CHAPTER 33: DRUGS FOR HEADACHE......................................................................................... 169
CHAPTER 34: ANTIPSYCHOTIC AGENTS AND THEIR USE IN SCHIZOPHRENIA ................. 175
CHAPTER 35: ANTIDEPRESSANTS ................................................................................................. 182
CHAPTER 36: DRUGS FOR BIPOLAR DISORDER......................................................................... 190
CHAPTER 37: SEDATIVE-HYPNOTIC DRUGS .............................................................................. 196
CHAPTER 38: MANAGEMENT OF ANXIETY DISORDERS ......................................................... 203
CHAPTER 39: CENTRAL NERVOUS SYSTEM STIMULANTS AND ATTENTION-
DEFICIT/HYPERACTIVITY DISORDER.......................................................................................... 208
CHAPTER 40: SUBSTANCE USE DISORDERS I: BASIC CONSIDERATIONS............................ 213
CHAPTER 41: SUBSTANCE USE DISORDERS II: ALCOHOL ...................................................... 217
CHAPTER 42: SUBSTANCE USE DISORDERS III: NICOTINE ..................................................... 225
CHAPTER 43: SUBSTANCE USE DISORDERS IV: MAJOR DRUGS OF ABUSE OTHER THAN
ALCOHOL AND NICOTINE 229 CHAPTER 44: DIURETICS......................................................... 237
CHAPTER 45: AGENTS AFFECTING THE VOLUME AND ION CONTENT OF BODY FLUIDS
.............................................................................................................................................................. 242
CHAPTER 46: REVIEW OF HEMODYNAMICS .............................................................................. 248
CHAPTER 47: DRUGS ACTING ON THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM 251
CHAPTER 48: CALCIUM CHANNEL BLOCKERS ......................................................................... 257
CHAPTER 49: VASODILATORS ....................................................................................................... 260
CHAPTER 50: DRUGS FOR HYPERTENSION ................................................................................ 265
CHAPTER 51: DRUGS FOR HEART FAILURE ............................................................................... 273
CHAPTER 52: ANTIDYSRHYTHMIC DRUGS ................................................................................ 282
CHAPTER 53: DRUGS THAT HELP NORMALIZE CHOLESTEROL AND TRIGLYCERIDE LEVELS
.............................................................................................................................................................. 291
CHAPTER 54: DRUGS FOR ANGINA PECTORIS ........................................................................... 299
CHAPTER 55: ANTICOAGULANT, ANTIPLATELET, AND THROMBOLYTIC DRUGS ........... 307
CHAPTER 56: MANAGEMENT OF ST-ELEVATION MYOCARDIAL INFARCTION ................ 314
CHAPTER 57: DRUGS FOR HEMOPHILIA ...................................................................................... 320
CHAPTER 58: DRUGS FOR DEFICIENCY ANEMIAS .................................................................... 325
CHAPTER 59: HEMATOPOIETIC AGENTS..................................................................................... 332
CHAPTER 60: DRUGS FOR DIABETES MELLITUS....................................................................... 337
CHAPTER 61: DRUGS FOR THYROID DISORDERS ..................................................................... 345
CHAPTER 62: DRUGS RELATED TO HYPOTHALAMIC AND PITUITARY FUNCTION ......... 351
CHAPTER 63: DRUGS FOR DISORDERS OF THE ADRENAL CORTEX..................................... 356
,CHAPTER 64: ESTROGENS AND PROGESTINS: BASIC PHARMACOLOGY AND
NONCONTRACEPTIVE APPLICATIONS ........................................................................................ 361
CHAPTER 65: BIRTH CONTROL ...................................................................................................... 366
CHAPTER 66: DRUG THERAPY FOR INFERTILITY ..................................................................... 373
CHAPTER 67: DRUGS THAT AFFECT UTERINE FUNCTION ...................................................... 378
CHAPTER 68: ANDROGENS ............................................................................................................. 383
CHAPTER 69: DRUGS FOR ERECTILE DYSFUNCTION AND BENIGN PROSTATIC HYPERPLASIA
.............................................................................................................................................................. 389
CHAPTER 70: REVIEW OF THE IMMUNE SYSTEM ..................................................................... 394
CHAPTER 71: CHILDHOOD IMMUNIZATION ............................................................................... 398
CHAPTER 72: IMMUNOSUPPRESSANTS ....................................................................................... 405
CHAPTER 73: ANTIHISTAMINES .................................................................................................... 410
CHAPTER 74: CYCLOOXYGENASE INHIBITORS, NONSTEROIDAL ANTI-INFLAMMATORY
DRUGS AND ACETAMINOPHEN
.............................................................................................................................................................. 416
CHAPTER 75: GLUCOCORTICOIDS IN NONENDOCRINE DISORDERS ................................... 423
CHAPTER 76: DRUG THERAPY FOR RHEUMATOID ARTHRITIS ............................................. 430
CHAPTER 77: DRUG THERAPY FOR GOUT .................................................................................. 433
CHAPTER 78: DRUGS AFFECTING CALCIUM LEVELS AND BONE MINERALIZATION ...... 437
CHAPTER 79: DRUGS FOR ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE445
CHAPTER 80: DRUGS FOR ALLERGIC RHINITIS, COUGH, AND COLDS ................................ 454
CHAPTER 81: DRUGS FOR PEPTIC ULCER DISEASE .................................................................. 461
CHAPTER 82: LAXATIVES ............................................................................................................... 467
CHAPTER 83: OTHER GASTROINTESTINAL DRUGS .................................................................. 473
CHAPTER 84: VITAMINS .................................................................................................................. 482
CHAPTER 85: DRUGS FOR WEIGHT LOSS .................................................................................... 489
CHAPTER 86: COMPLEMENTARY AND ALTERNATIVE THERAPY ........................................ 495
CHAPTER 87: BASIC PRINCIPLES OF ANTIMICROBIAL THERAPY ........................................ 500
CHAPTER 88: DRUGS THAT WEAKEN THE BACTERIAL CELL WALL I: PENICILLINS ....... 506
CHAPTER 89: DRUGS THAT WEAKEN THE BACTERIAL CELL WALL II: OTHER DRUGS.. 513
CHAPTER 90: BACTERIOSTATIC INHIBITORS OF PROTEIN SYNTHESIS: TETRACYCLINES,
MACROLIDES, AND OTHERS .......................................................................................................... 518
CHAPTER 91: AMINOGLYCOSIDES: BACTERICIDAL INHIBITORS OF PROTEIN SYNTHESIS527
CHAPTER 92: SULFONAMIDES AND TRIMETHOPRIM .............................................................. 535
CHAPTER 93: DRUG THERAPY FOR URINARY TRACT INFECTIONS ..................................... 540
CHAPTER 94: ANTIMYCOBACTERIAL AGENTS ......................................................................... 547
,CHAPTER 95: MISCELLANEOUS ANTIBACTERIAL DRUGS ..................................................... 556
CHAPTER 96: ANTIFUNGAL AGENTS ........................................................................................... 561
CHAPTER 97: ANTIVIRAL AGENTS I: DRUGS FOR NON-HIV VIRAL INFECTIONS.............. 570
CHAPTER 98: ANTIVIRAL AGENTS II: DRUGS FOR HIV INFECTION AND RELATED
OPPORTUNISTIC INFECTIONS........................................................................................................ 577
CHAPTER 99: DRUG THERAPY FOR SEXUALLY TRANSMITTED DISEASES ........................ 583
CHAPTER 100: ANTISEPTICS AND DISINFECTANTS.................................................................. 588
CHAPTER 101: ANTHELMINTICS ................................................................................................... 592
CHAPTER 102: ANTIPROTOZOAL DRUGS I: ANTIMALARIAL AGENTS................................. 596
CHAPTER 103: ANTIPROTOZOAL DRUGS II: MISCELLANEOUS AGENTS............................. 602
CHAPTER 104: ECTOPARASITICIDES ............................................................................................ 604
CHAPTER 105: BASIC PRINCIPLES OF CANCER CHEMOTHERAPY ........................................ 609
CHAPTER 106: ANTICANCER DRUGS I: CYTOTOXIC AGENTS ............................................... 616
CHAPTER 107: ANTICANCER DRUGS II: NONCYTOTOXIC AGENTS...................................... 624
CHAPTER 108: DRUGS FOR THE EYE ............................................................................................ 629
CHAPTER 109: DRUGS FOR THE SKIN .......................................................................................... 635
CHAPTER 110: DRUGS FOR THE EAR............................................................................................ 644
CHAPTER 111: MANAGEMENT OF POISONING .......................................................................... 649
CHAPTER 112: POTENTIAL WEAPONS OF BIOLOGIC, RADIOLOGIC, AND CHEMICAL
TERRORISM ........................................................................................................................................ 654
,CHAPTER 01: ORIENTATION TO PHARMACOLOGY
BURCHUM: LEHNE’S PHARMACOLOGY FOR NURSING CARE, 11TH EDITION
MULTIPLE CHOICE
1. THE NURSE IS TEACHING A PATIENT HOW A MEDICATION WORKS TO TREAT AN
ILLNESS. TO DO THIS, THE NURSE WILL RELY ON KNOWLEDGE OF WHICH TOPIC?
A. CLINICAL PHARMACOLOGY
B. DRUG EFFICACY
C. PHARMACOKINETICS
D. PHARMACOTHER
APEUTICS ANSWER D
PHARMACOTHERAPEUTICS IS THE STUDY OF THE USE OF DRUGS TO DIAGNOSE, TREAT,
AND PREVENT CONDITIONS. CLINICAL PHARMACOLOGY IS CONCERNED WITH ALL
ASPECTS OF DRUG-HUMAN INTERACTIONS. DRUG EFFICACY MEASURES THE EXTENT
TO WHICH A GIVEN DRUG CAUSES AN INTENDED EFFECT. PHARMACOKINETICS IS THE
STUDY OF THE IMPACT OF THE BODY ON A DRUG.
PTS: 1
2. WHAT IS A DESIRED OUTCOME WHEN A DRUG IS DESCRIBED AS EASY TO
ADMINISTER?
A. IT CAN BE STORED INDEFINITELY WITHOUT NEED FOR REFRIGERATION.
B. IT DOES NOT INTERACT SIGNIFICANTLY WITH OTHER MEDICATIONS.
C. IT ENHANCES PATIENT ADHERENCE TO THE DRUG REGIMEN.
D. IT IS USUALLY RELATIVELY
INEXPENSIVE TO PRODUCE. ANSWER C
A MAJOR BENEFIT OF DRUGS THAT ARE EASY TO ADMINISTER IS THAT PATIENTS
TAKING THEM ARE MORE LIKELY TO COMPLY WITH THE DRUG REGIMEN. DRUGS THAT
ARE EASY TO GIVE MAY HAVE THE OTHER ATTRIBUTES LISTED, BUT THOSE
PROPERTIES ARE INDEPENDENT OF EASE OF ADMINISTRATION.
PTS: 1
3. A PATIENT TELLS THE NURSE THAT AN ANALGESIC HE WILL BEGIN TAKING MAY
CAUSE DROWSINESS AND WILL DECREASE PAIN UP TO 4 HOURS AT A TIME. BASED ON
THIS UNDERSTANDING OF THE DRUG’S EFFECTS BY THE PATIENT, THE NURSE WILL
ANTICIPATE WHICH OUTCOME?
A. DECREASED CHANCE OF HAVING A PLACEBO EFFECT
B. DECREASED MOTIVATION TO TAKE THE DRUG
,C. IMPROVED COMPLIANCE WITH THE DRUG REGIMEN
D. INCREASED LIKELIHOOD OF
DRUG OVERDOSE ANSWER C
A DRUG IS EFFECTIVE IF IT PRODUCES THE INTENDED EFFECTS, EVEN IF IT ALSO
PRODUCES SIDE EFFECTS. PATIENTS WHO UNDERSTAND BOTH THE RISKS AND
BENEFITS OF TAKING A MEDICATION ARE MORE LIKELY TO COMPLY WITH THE DRUG
REGIMEN.
PTS: 1
MULTIPLE RESPONSE
1. WHAT ARE CONSIDERED THE ‘BIG THREE’ PROPERTIES OF AN IDEAL DRUG? (SELECT
ALL THAT APPLY.)
A. IRREVERSIBLE ACTION
B. EFFECTIVENESS
C. SAFETY
D. SELECTIVITY
E. A RECOGNIZABLE
TRADE NAME ANSWER B, C, D
THE ‘BIG THREE’ PROPERTIES OF THE IDEAL DRUG ARE EFFECTIVENESS, SAFETY, AND
SELECTIVITY. PTS: 1
2. BEFORE ADMINISTERING A MEDICATION, WHAT DOES THE NURSE NEED TO
KNOW TO EVALUATE HOW INDIVIDUAL PATIENT VARIABILITY MIGHT AFFECT THE
PATIENT’S RESPONSE TO THE MEDICATION? (SELECT ALL THAT APPLY.)
A. CHEMICAL STABILITY OF THE MEDICATION
B. EASE OF ADMINISTRATION
C. FAMILY MEDICAL HISTORY
D. PATIENT’S AGE
E. PATIENT’S
DIAGNOSIS ANSWER C,
D, E
THE FAMILY MEDICAL HISTORY CAN INDICATE GENETIC FACTORS THAT MAY AFFECT A
PATIENT’S RESPONSE TO A MEDICATION. PATIENTS OF DIFFERENT AGES CAN RESPOND
DIFFERENTLY TO MEDICATIONS. THE PATIENT’S ILLNESS
,CAN AFFECT HOW DRUGS ARE METABOLIZED. THE CHEMICAL STABILITY OF THE
MEDICATION AND THE EASE OF ADMINISTRATION ARE PROPERTIES OF DRUGS.
PTS: 1
CHAPTER 02: APPLICATION OF PHARMACOLOGY IN NURSING PRACTICE
BURCHUM: LEHNE’S PHARMACOLOGY FOR NURSING CARE, 11TH EDITION
MULTIPLE CHOICE
1. A PATIENT IS USING A METERED-DOSE INHALER CONTAINING ALBUTEROL FOR
ASTHMA. THE MEDICATION LABEL INSTRUCTS THE PATIENT TO ADMINISTER “2
PUFFS EVERY 4 HOURS AS NEEDED FOR COUGHING OR
WHEEZING.” THE PATIENT REPORTS FEELING JITTERY SOMETIMES WHEN TAKING THE
MEDICATION, AND DOESN’T FEEL THAT THE MEDICATION IS ALWAYS EFFECTIVE.
WHICH ACTION IS OUTSIDE THE NURSE’S SCOPE OF PRACTICE?
A. ASKING THE PATIENT TO DEMONSTRATE THE USE OF THE INHALER
B. ASSESSING THE PATIENT’S EXPOSURE TO TOBACCO SMOKE
C. AUSCULTATING LUNG SOUNDS AND OBTAINING VITAL SIGNS
D. SUGGESTING THAT THE PATIENT USE 1 PUFF TO
REDUCE SIDE EFFECTS ANSWER D
IT IS NOT WITHIN THE NURSE’S SCOPE OF PRACTICE TO CHANGE THE DOSE OF A
MEDICATION WITHOUT AN ORDER FROM A PRESCRIBER. ASKING THE PATIENT TO
DEMONSTRATE INHALER USE HELPS THE NURSE TO EVALUATE THE
PATIENT’S ABILITY TO ADMINISTER THE MEDICATION PROPERLY AND IS PART OF THE
NURSE’S EVALUATION.
ASSESSING TOBACCO SMOKE EXPOSURE HELPS THE NURSE DETERMINE WHETHER
NONDRUG THERAPIES, SUCH A SMOKE AVOIDANCE, CAN BE USED AS AN ADJUNCT TO
DRUG THERAPY. PERFORMING A PHYSICAL ASSESSMENT HELPS THE NURSE
EVALUATE THE PATIENT’S RESPONSE TO THE MEDICATION.
PTS: 1
2. A POSTOPERATIVE PATIENT IS BEING DISCHARGED HOME WITH
ACETAMINOPHEN/HYDROCODONE [NORCO] FOR PAIN. THE PATIENT ASKS THE NURSE
ABOUT USING TYLENOL FOR FEVER. WHICH STATEMENT BY THE NURSE IS CORRECT?
A. “IT IS NOT SAFE TO TAKE OVER-THE-COUNTER DRUGS WITH PRESCRIPTION
MEDICATIONS.”
B. “TAKING THE TWO MEDICATIONS TOGETHER POSES A RISK OF DRUG TOXICITY.”
,C. “THERE ARE NO KNOWN DRUG INTERACTIONS, SO THIS WILL BE SAFE.”
, D. “TYLENOL AND NORCO ARE DIFFERENT DRUGS, SO THERE IS NO
RISK OF OVERDOSE.” ANSWER B
TYLENOL IS THE TRADE NAME AND ACETAMINOPHEN IS THE GENERIC NAME FOR THE
SAME MEDICATION. IT IS IMPORTANT TO TEACH PATIENTS TO BE AWARE OF THE
DIFFERENT NAMES FOR THE SAME DRUG TO MINIMIZE THE RISK OF OVERDOSE. OVER-
THE-COUNTER (OTC) MEDICATIONS AND PRESCRIPTION MEDICATIONS MAY BE TAKEN
TOGETHER UNLESS SIGNIFICANT HARMFUL DRUG INTERACTIONS ARE POSSIBLE. EVEN
THOUGH NO DRUG INTERACTIONS ARE AT PLAY IN THIS CASE, BOTH DRUGS CONTAIN
ACETAMINOPHEN, WHICH COULD LEAD TO TOXICITY.
PTS: 1
3. THE NURSE IS PREPARING TO CARE FOR A PATIENT WHO WILL BE TAKING
AN ANTIHYPERTENSIVE MEDICATION. WHICH ACTION BY THE NURSE IS PART OF
THE ASSESSMENT STEP OF THE NURSING PROCESS?
A. ASKING THE PRESCRIBER FOR AN ORDER TO MONITOR SERUM DRUG LEVELS
B. MONITORING THE PATIENT FOR DRUG INTERACTIONS AFTER GIVING THE
MEDICATION
C. QUESTIONING THE PATIENT ABOUT OVER-THE-COUNTER MEDICATIONS
D. TAKING THE PATIENT’S BLOOD PRESSURE THROUGHOUT THE
COURSE OF TREATMENT ANSWER C
THE ASSESSMENT PART OF THE NURSING PROCESS INVOLVES GATHERING
INFORMATION BEFORE BEGINNING TREATMENT, AND THIS INCLUDES ASKING ABOUT
OTHER MEDICATIONS THE PATIENT MAY BE TAKING.
MONITORING SERUM DRUG LEVELS, WATCHING FOR DRUG INTERACTIONS, AND
CHECKING VITAL SIGNS AFTER GIVING THE MEDICATION ARE ALL PART OF THE
EVALUATION PHASE.
PTS: 1
4. A POSTOPERATIVE PATIENT REPORTS PAIN, WHICH THE PATIENT RATES AS AN 8
ON A SCALE FROM 1 TO 10 (10 BEING THE MOST EXTREME PAIN). THE PRESCRIBER HAS
ORDERED ACETAMINOPHEN [TYLENOL] 650 MG PO EVERY 6 HOURS PRN PAIN. WHAT
WILL THE NURSE DO?
A. ASK THE PATIENT WHAT MEDICATIONS HAVE HELPED WITH PAIN IN THE PAST.
B. CONTACT THE PROVIDER TO REQUEST A DIFFERENT ANALGESIC MEDICATION.
C. GIVE THE PAIN MEDICATION AND REPOSITION THE PATIENT TO PROMOTE COMFORT.
D. REQUEST AN ORDER TO ADMINISTER THE
MEDICATION EVERY 4 HOURS. ANSWER B
LEHNE'S PHARMACOLOGY FOR NURSING CARE 11TH EDITION
BY JACQUELINE ROSENJACK BURCHUM DNSC FNP-BC CNE
(AUTHOR), LAURA D. ROSENTHAL DNP RN ACNP- BC FAANP
(AUTHOR)
===
,TABLE OF CONTENTS
CHAPTER 01: ORIENTATION TO PHARMACOLOGY ...................................................................... 6
CHAPTER 02: APPLICATION OF PHARMACOLOGY IN NURSING PRACTICE ........................... 8
CHAPTER 03: DRUG REGULATION, DEVELOPMENT, NAMES, AND INFORMATION ........... 14
CHAPTER 04: PHARMACOKINETICS ............................................................................................... 17
CHAPTER 05: PHARMACODYNAMICS ............................................................................................ 23
CHAPTER 06: DRUG INTERACTIONS .............................................................................................. 27
CHAPTER 07: ADVERSE DRUG REACTIONS AND MEDICATION ERRORS.............................. 33
CHAPTER 08: INDIVIDUAL VARIATION TO DRUG RESPONSES ............................................... 39
CHAPTER 09: GENETIC AND GENOMIC CONSIDERATIONS ...................................................... 44
CHAPTER 10: INTRODUCTION TO IMMUNOMODULATORS ...................................................... 48
CHAPTER 11: DRUG THERAPY DURING PREGNANCY AND BREAST-FEEDING ................... 52
CHAPTER 12: DRUG THERAPY IN PEDIATRIC PATIENTS .......................................................... 56
CHAPTER 13: DRUG THERAPY IN OLDER ADULTS ..................................................................... 62
CHAPTER 14: BASIC PRINCIPLES OF NEUROPHARMACOLOGY............................................... 68
CHAPTER 15: PHYSIOLOGY OF THE PERIPHERAL NERVOUS SYSTEM .................................. 71
CHAPTER 16: MUSCARINIC AGONISTS .......................................................................................... 75
CHAPTER 17: MUSCARINIC ANTAGONISTS .................................................................................. 78
CHAPTER 18: CHOLINESTERASE INHIBITORS AND THEIR USE IN MYASTHENIA GRAVIS82
CHAPTER 19: DRUGS THAT BLOCK NICOTINIC CHOLINERGIC TRANSMISSION ................. 86
CHAPTER 20: ADRENERGIC AGONISTS ......................................................................................... 91
CHAPTER 21: ADRENERGIC ANTAGONISTS ................................................................................. 96
CHAPTER 22: INDIRECT-ACTING ANTIADRENERGIC AGENTS .............................................. 103
CHAPTER 23: INTRODUCTION TO CENTRAL NERVOUS SYSTEM PHARMACOLOGY ....... 109
CHAPTER 24: DRUGS FOR PARKINSON DISEASE .................................................................. 112
CHAPTER 25: DRUGS FOR ALZHEIMER DISEASE ...................................................................... 119
CHAPTER 26: DRUGS FOR MULTIPLE SCLEROSIS ..................................................................... 124
CHAPTER 27: DRUGS FOR SEIZURE DISORDERS ....................................................................... 130
CHAPTER 28: DRUGS FOR MUSCLE SPASM AND SPASTICITY ............................................... 138
CHAPTER 29: LOCAL ANESTHETICS............................................................................................. 143
CHAPTER 30: GENERAL ANESTHETICS ....................................................................................... 148
CHAPTER 31: OPIOID ANALGESICS, OPIOID ANTAGONISTS, AND NONOPIOID CENTRALLY
ACTING ANALGESICS ...................................................................................................................... 154
,CHAPTER 32: PAIN MANAGEMENT IN PATIENTS WITH CANCER ......................................... 161
CHAPTER 33: DRUGS FOR HEADACHE......................................................................................... 169
CHAPTER 34: ANTIPSYCHOTIC AGENTS AND THEIR USE IN SCHIZOPHRENIA ................. 175
CHAPTER 35: ANTIDEPRESSANTS ................................................................................................. 182
CHAPTER 36: DRUGS FOR BIPOLAR DISORDER......................................................................... 190
CHAPTER 37: SEDATIVE-HYPNOTIC DRUGS .............................................................................. 196
CHAPTER 38: MANAGEMENT OF ANXIETY DISORDERS ......................................................... 203
CHAPTER 39: CENTRAL NERVOUS SYSTEM STIMULANTS AND ATTENTION-
DEFICIT/HYPERACTIVITY DISORDER.......................................................................................... 208
CHAPTER 40: SUBSTANCE USE DISORDERS I: BASIC CONSIDERATIONS............................ 213
CHAPTER 41: SUBSTANCE USE DISORDERS II: ALCOHOL ...................................................... 217
CHAPTER 42: SUBSTANCE USE DISORDERS III: NICOTINE ..................................................... 225
CHAPTER 43: SUBSTANCE USE DISORDERS IV: MAJOR DRUGS OF ABUSE OTHER THAN
ALCOHOL AND NICOTINE 229 CHAPTER 44: DIURETICS......................................................... 237
CHAPTER 45: AGENTS AFFECTING THE VOLUME AND ION CONTENT OF BODY FLUIDS
.............................................................................................................................................................. 242
CHAPTER 46: REVIEW OF HEMODYNAMICS .............................................................................. 248
CHAPTER 47: DRUGS ACTING ON THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM 251
CHAPTER 48: CALCIUM CHANNEL BLOCKERS ......................................................................... 257
CHAPTER 49: VASODILATORS ....................................................................................................... 260
CHAPTER 50: DRUGS FOR HYPERTENSION ................................................................................ 265
CHAPTER 51: DRUGS FOR HEART FAILURE ............................................................................... 273
CHAPTER 52: ANTIDYSRHYTHMIC DRUGS ................................................................................ 282
CHAPTER 53: DRUGS THAT HELP NORMALIZE CHOLESTEROL AND TRIGLYCERIDE LEVELS
.............................................................................................................................................................. 291
CHAPTER 54: DRUGS FOR ANGINA PECTORIS ........................................................................... 299
CHAPTER 55: ANTICOAGULANT, ANTIPLATELET, AND THROMBOLYTIC DRUGS ........... 307
CHAPTER 56: MANAGEMENT OF ST-ELEVATION MYOCARDIAL INFARCTION ................ 314
CHAPTER 57: DRUGS FOR HEMOPHILIA ...................................................................................... 320
CHAPTER 58: DRUGS FOR DEFICIENCY ANEMIAS .................................................................... 325
CHAPTER 59: HEMATOPOIETIC AGENTS..................................................................................... 332
CHAPTER 60: DRUGS FOR DIABETES MELLITUS....................................................................... 337
CHAPTER 61: DRUGS FOR THYROID DISORDERS ..................................................................... 345
CHAPTER 62: DRUGS RELATED TO HYPOTHALAMIC AND PITUITARY FUNCTION ......... 351
CHAPTER 63: DRUGS FOR DISORDERS OF THE ADRENAL CORTEX..................................... 356
,CHAPTER 64: ESTROGENS AND PROGESTINS: BASIC PHARMACOLOGY AND
NONCONTRACEPTIVE APPLICATIONS ........................................................................................ 361
CHAPTER 65: BIRTH CONTROL ...................................................................................................... 366
CHAPTER 66: DRUG THERAPY FOR INFERTILITY ..................................................................... 373
CHAPTER 67: DRUGS THAT AFFECT UTERINE FUNCTION ...................................................... 378
CHAPTER 68: ANDROGENS ............................................................................................................. 383
CHAPTER 69: DRUGS FOR ERECTILE DYSFUNCTION AND BENIGN PROSTATIC HYPERPLASIA
.............................................................................................................................................................. 389
CHAPTER 70: REVIEW OF THE IMMUNE SYSTEM ..................................................................... 394
CHAPTER 71: CHILDHOOD IMMUNIZATION ............................................................................... 398
CHAPTER 72: IMMUNOSUPPRESSANTS ....................................................................................... 405
CHAPTER 73: ANTIHISTAMINES .................................................................................................... 410
CHAPTER 74: CYCLOOXYGENASE INHIBITORS, NONSTEROIDAL ANTI-INFLAMMATORY
DRUGS AND ACETAMINOPHEN
.............................................................................................................................................................. 416
CHAPTER 75: GLUCOCORTICOIDS IN NONENDOCRINE DISORDERS ................................... 423
CHAPTER 76: DRUG THERAPY FOR RHEUMATOID ARTHRITIS ............................................. 430
CHAPTER 77: DRUG THERAPY FOR GOUT .................................................................................. 433
CHAPTER 78: DRUGS AFFECTING CALCIUM LEVELS AND BONE MINERALIZATION ...... 437
CHAPTER 79: DRUGS FOR ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE445
CHAPTER 80: DRUGS FOR ALLERGIC RHINITIS, COUGH, AND COLDS ................................ 454
CHAPTER 81: DRUGS FOR PEPTIC ULCER DISEASE .................................................................. 461
CHAPTER 82: LAXATIVES ............................................................................................................... 467
CHAPTER 83: OTHER GASTROINTESTINAL DRUGS .................................................................. 473
CHAPTER 84: VITAMINS .................................................................................................................. 482
CHAPTER 85: DRUGS FOR WEIGHT LOSS .................................................................................... 489
CHAPTER 86: COMPLEMENTARY AND ALTERNATIVE THERAPY ........................................ 495
CHAPTER 87: BASIC PRINCIPLES OF ANTIMICROBIAL THERAPY ........................................ 500
CHAPTER 88: DRUGS THAT WEAKEN THE BACTERIAL CELL WALL I: PENICILLINS ....... 506
CHAPTER 89: DRUGS THAT WEAKEN THE BACTERIAL CELL WALL II: OTHER DRUGS.. 513
CHAPTER 90: BACTERIOSTATIC INHIBITORS OF PROTEIN SYNTHESIS: TETRACYCLINES,
MACROLIDES, AND OTHERS .......................................................................................................... 518
CHAPTER 91: AMINOGLYCOSIDES: BACTERICIDAL INHIBITORS OF PROTEIN SYNTHESIS527
CHAPTER 92: SULFONAMIDES AND TRIMETHOPRIM .............................................................. 535
CHAPTER 93: DRUG THERAPY FOR URINARY TRACT INFECTIONS ..................................... 540
CHAPTER 94: ANTIMYCOBACTERIAL AGENTS ......................................................................... 547
,CHAPTER 95: MISCELLANEOUS ANTIBACTERIAL DRUGS ..................................................... 556
CHAPTER 96: ANTIFUNGAL AGENTS ........................................................................................... 561
CHAPTER 97: ANTIVIRAL AGENTS I: DRUGS FOR NON-HIV VIRAL INFECTIONS.............. 570
CHAPTER 98: ANTIVIRAL AGENTS II: DRUGS FOR HIV INFECTION AND RELATED
OPPORTUNISTIC INFECTIONS........................................................................................................ 577
CHAPTER 99: DRUG THERAPY FOR SEXUALLY TRANSMITTED DISEASES ........................ 583
CHAPTER 100: ANTISEPTICS AND DISINFECTANTS.................................................................. 588
CHAPTER 101: ANTHELMINTICS ................................................................................................... 592
CHAPTER 102: ANTIPROTOZOAL DRUGS I: ANTIMALARIAL AGENTS................................. 596
CHAPTER 103: ANTIPROTOZOAL DRUGS II: MISCELLANEOUS AGENTS............................. 602
CHAPTER 104: ECTOPARASITICIDES ............................................................................................ 604
CHAPTER 105: BASIC PRINCIPLES OF CANCER CHEMOTHERAPY ........................................ 609
CHAPTER 106: ANTICANCER DRUGS I: CYTOTOXIC AGENTS ............................................... 616
CHAPTER 107: ANTICANCER DRUGS II: NONCYTOTOXIC AGENTS...................................... 624
CHAPTER 108: DRUGS FOR THE EYE ............................................................................................ 629
CHAPTER 109: DRUGS FOR THE SKIN .......................................................................................... 635
CHAPTER 110: DRUGS FOR THE EAR............................................................................................ 644
CHAPTER 111: MANAGEMENT OF POISONING .......................................................................... 649
CHAPTER 112: POTENTIAL WEAPONS OF BIOLOGIC, RADIOLOGIC, AND CHEMICAL
TERRORISM ........................................................................................................................................ 654
,CHAPTER 01: ORIENTATION TO PHARMACOLOGY
BURCHUM: LEHNE’S PHARMACOLOGY FOR NURSING CARE, 11TH EDITION
MULTIPLE CHOICE
1. THE NURSE IS TEACHING A PATIENT HOW A MEDICATION WORKS TO TREAT AN
ILLNESS. TO DO THIS, THE NURSE WILL RELY ON KNOWLEDGE OF WHICH TOPIC?
A. CLINICAL PHARMACOLOGY
B. DRUG EFFICACY
C. PHARMACOKINETICS
D. PHARMACOTHER
APEUTICS ANSWER D
PHARMACOTHERAPEUTICS IS THE STUDY OF THE USE OF DRUGS TO DIAGNOSE, TREAT,
AND PREVENT CONDITIONS. CLINICAL PHARMACOLOGY IS CONCERNED WITH ALL
ASPECTS OF DRUG-HUMAN INTERACTIONS. DRUG EFFICACY MEASURES THE EXTENT
TO WHICH A GIVEN DRUG CAUSES AN INTENDED EFFECT. PHARMACOKINETICS IS THE
STUDY OF THE IMPACT OF THE BODY ON A DRUG.
PTS: 1
2. WHAT IS A DESIRED OUTCOME WHEN A DRUG IS DESCRIBED AS EASY TO
ADMINISTER?
A. IT CAN BE STORED INDEFINITELY WITHOUT NEED FOR REFRIGERATION.
B. IT DOES NOT INTERACT SIGNIFICANTLY WITH OTHER MEDICATIONS.
C. IT ENHANCES PATIENT ADHERENCE TO THE DRUG REGIMEN.
D. IT IS USUALLY RELATIVELY
INEXPENSIVE TO PRODUCE. ANSWER C
A MAJOR BENEFIT OF DRUGS THAT ARE EASY TO ADMINISTER IS THAT PATIENTS
TAKING THEM ARE MORE LIKELY TO COMPLY WITH THE DRUG REGIMEN. DRUGS THAT
ARE EASY TO GIVE MAY HAVE THE OTHER ATTRIBUTES LISTED, BUT THOSE
PROPERTIES ARE INDEPENDENT OF EASE OF ADMINISTRATION.
PTS: 1
3. A PATIENT TELLS THE NURSE THAT AN ANALGESIC HE WILL BEGIN TAKING MAY
CAUSE DROWSINESS AND WILL DECREASE PAIN UP TO 4 HOURS AT A TIME. BASED ON
THIS UNDERSTANDING OF THE DRUG’S EFFECTS BY THE PATIENT, THE NURSE WILL
ANTICIPATE WHICH OUTCOME?
A. DECREASED CHANCE OF HAVING A PLACEBO EFFECT
B. DECREASED MOTIVATION TO TAKE THE DRUG
,C. IMPROVED COMPLIANCE WITH THE DRUG REGIMEN
D. INCREASED LIKELIHOOD OF
DRUG OVERDOSE ANSWER C
A DRUG IS EFFECTIVE IF IT PRODUCES THE INTENDED EFFECTS, EVEN IF IT ALSO
PRODUCES SIDE EFFECTS. PATIENTS WHO UNDERSTAND BOTH THE RISKS AND
BENEFITS OF TAKING A MEDICATION ARE MORE LIKELY TO COMPLY WITH THE DRUG
REGIMEN.
PTS: 1
MULTIPLE RESPONSE
1. WHAT ARE CONSIDERED THE ‘BIG THREE’ PROPERTIES OF AN IDEAL DRUG? (SELECT
ALL THAT APPLY.)
A. IRREVERSIBLE ACTION
B. EFFECTIVENESS
C. SAFETY
D. SELECTIVITY
E. A RECOGNIZABLE
TRADE NAME ANSWER B, C, D
THE ‘BIG THREE’ PROPERTIES OF THE IDEAL DRUG ARE EFFECTIVENESS, SAFETY, AND
SELECTIVITY. PTS: 1
2. BEFORE ADMINISTERING A MEDICATION, WHAT DOES THE NURSE NEED TO
KNOW TO EVALUATE HOW INDIVIDUAL PATIENT VARIABILITY MIGHT AFFECT THE
PATIENT’S RESPONSE TO THE MEDICATION? (SELECT ALL THAT APPLY.)
A. CHEMICAL STABILITY OF THE MEDICATION
B. EASE OF ADMINISTRATION
C. FAMILY MEDICAL HISTORY
D. PATIENT’S AGE
E. PATIENT’S
DIAGNOSIS ANSWER C,
D, E
THE FAMILY MEDICAL HISTORY CAN INDICATE GENETIC FACTORS THAT MAY AFFECT A
PATIENT’S RESPONSE TO A MEDICATION. PATIENTS OF DIFFERENT AGES CAN RESPOND
DIFFERENTLY TO MEDICATIONS. THE PATIENT’S ILLNESS
,CAN AFFECT HOW DRUGS ARE METABOLIZED. THE CHEMICAL STABILITY OF THE
MEDICATION AND THE EASE OF ADMINISTRATION ARE PROPERTIES OF DRUGS.
PTS: 1
CHAPTER 02: APPLICATION OF PHARMACOLOGY IN NURSING PRACTICE
BURCHUM: LEHNE’S PHARMACOLOGY FOR NURSING CARE, 11TH EDITION
MULTIPLE CHOICE
1. A PATIENT IS USING A METERED-DOSE INHALER CONTAINING ALBUTEROL FOR
ASTHMA. THE MEDICATION LABEL INSTRUCTS THE PATIENT TO ADMINISTER “2
PUFFS EVERY 4 HOURS AS NEEDED FOR COUGHING OR
WHEEZING.” THE PATIENT REPORTS FEELING JITTERY SOMETIMES WHEN TAKING THE
MEDICATION, AND DOESN’T FEEL THAT THE MEDICATION IS ALWAYS EFFECTIVE.
WHICH ACTION IS OUTSIDE THE NURSE’S SCOPE OF PRACTICE?
A. ASKING THE PATIENT TO DEMONSTRATE THE USE OF THE INHALER
B. ASSESSING THE PATIENT’S EXPOSURE TO TOBACCO SMOKE
C. AUSCULTATING LUNG SOUNDS AND OBTAINING VITAL SIGNS
D. SUGGESTING THAT THE PATIENT USE 1 PUFF TO
REDUCE SIDE EFFECTS ANSWER D
IT IS NOT WITHIN THE NURSE’S SCOPE OF PRACTICE TO CHANGE THE DOSE OF A
MEDICATION WITHOUT AN ORDER FROM A PRESCRIBER. ASKING THE PATIENT TO
DEMONSTRATE INHALER USE HELPS THE NURSE TO EVALUATE THE
PATIENT’S ABILITY TO ADMINISTER THE MEDICATION PROPERLY AND IS PART OF THE
NURSE’S EVALUATION.
ASSESSING TOBACCO SMOKE EXPOSURE HELPS THE NURSE DETERMINE WHETHER
NONDRUG THERAPIES, SUCH A SMOKE AVOIDANCE, CAN BE USED AS AN ADJUNCT TO
DRUG THERAPY. PERFORMING A PHYSICAL ASSESSMENT HELPS THE NURSE
EVALUATE THE PATIENT’S RESPONSE TO THE MEDICATION.
PTS: 1
2. A POSTOPERATIVE PATIENT IS BEING DISCHARGED HOME WITH
ACETAMINOPHEN/HYDROCODONE [NORCO] FOR PAIN. THE PATIENT ASKS THE NURSE
ABOUT USING TYLENOL FOR FEVER. WHICH STATEMENT BY THE NURSE IS CORRECT?
A. “IT IS NOT SAFE TO TAKE OVER-THE-COUNTER DRUGS WITH PRESCRIPTION
MEDICATIONS.”
B. “TAKING THE TWO MEDICATIONS TOGETHER POSES A RISK OF DRUG TOXICITY.”
,C. “THERE ARE NO KNOWN DRUG INTERACTIONS, SO THIS WILL BE SAFE.”
, D. “TYLENOL AND NORCO ARE DIFFERENT DRUGS, SO THERE IS NO
RISK OF OVERDOSE.” ANSWER B
TYLENOL IS THE TRADE NAME AND ACETAMINOPHEN IS THE GENERIC NAME FOR THE
SAME MEDICATION. IT IS IMPORTANT TO TEACH PATIENTS TO BE AWARE OF THE
DIFFERENT NAMES FOR THE SAME DRUG TO MINIMIZE THE RISK OF OVERDOSE. OVER-
THE-COUNTER (OTC) MEDICATIONS AND PRESCRIPTION MEDICATIONS MAY BE TAKEN
TOGETHER UNLESS SIGNIFICANT HARMFUL DRUG INTERACTIONS ARE POSSIBLE. EVEN
THOUGH NO DRUG INTERACTIONS ARE AT PLAY IN THIS CASE, BOTH DRUGS CONTAIN
ACETAMINOPHEN, WHICH COULD LEAD TO TOXICITY.
PTS: 1
3. THE NURSE IS PREPARING TO CARE FOR A PATIENT WHO WILL BE TAKING
AN ANTIHYPERTENSIVE MEDICATION. WHICH ACTION BY THE NURSE IS PART OF
THE ASSESSMENT STEP OF THE NURSING PROCESS?
A. ASKING THE PRESCRIBER FOR AN ORDER TO MONITOR SERUM DRUG LEVELS
B. MONITORING THE PATIENT FOR DRUG INTERACTIONS AFTER GIVING THE
MEDICATION
C. QUESTIONING THE PATIENT ABOUT OVER-THE-COUNTER MEDICATIONS
D. TAKING THE PATIENT’S BLOOD PRESSURE THROUGHOUT THE
COURSE OF TREATMENT ANSWER C
THE ASSESSMENT PART OF THE NURSING PROCESS INVOLVES GATHERING
INFORMATION BEFORE BEGINNING TREATMENT, AND THIS INCLUDES ASKING ABOUT
OTHER MEDICATIONS THE PATIENT MAY BE TAKING.
MONITORING SERUM DRUG LEVELS, WATCHING FOR DRUG INTERACTIONS, AND
CHECKING VITAL SIGNS AFTER GIVING THE MEDICATION ARE ALL PART OF THE
EVALUATION PHASE.
PTS: 1
4. A POSTOPERATIVE PATIENT REPORTS PAIN, WHICH THE PATIENT RATES AS AN 8
ON A SCALE FROM 1 TO 10 (10 BEING THE MOST EXTREME PAIN). THE PRESCRIBER HAS
ORDERED ACETAMINOPHEN [TYLENOL] 650 MG PO EVERY 6 HOURS PRN PAIN. WHAT
WILL THE NURSE DO?
A. ASK THE PATIENT WHAT MEDICATIONS HAVE HELPED WITH PAIN IN THE PAST.
B. CONTACT THE PROVIDER TO REQUEST A DIFFERENT ANALGESIC MEDICATION.
C. GIVE THE PAIN MEDICATION AND REPOSITION THE PATIENT TO PROMOTE COMFORT.
D. REQUEST AN ORDER TO ADMINISTER THE
MEDICATION EVERY 4 HOURS. ANSWER B
