TEST BANK FOR LEHNE’S PHARMACOTHERAPEUTICS
FOR ADVANCED PRACTICE NURSES AND PHYSICIAN
ASSISTANTS 2ND EDITION ROSENTHAL Questions and
Answers 2025
Test Bank
Multiple Choice
Chapter 1: Pharmacokinetics, Pharmacodynamics, and Drug Interactions
Test Bank
Multiple Choice
1. 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?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical alterations
ANS: C
Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist would
increase the effects of morphine. Naloxone does not affect serum pH or excretion of opioids.
Naloxone does not alter the sensitivity of opioid receptors.DIF: Cognitive Level: AnalysisREF: p.
31TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
2. 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 .
a. lower; X
b. lower; Y
c. higher; X
d. higher; Y
ANS: C
,An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the
metabolism of other drugs as much as two- to threefold, thereby lowering the level of those drugs
in the body and requiring higher doses to maintain drug effectiveness.DIF: Cognitive Level:
ApplicationREF: p. 36TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. 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?
a. “This drug causes severe gastric upset if given orally.”
b. “This drug has a narrow therapeutic range, and the dose must be tightly controlled.”
c. “This drug is absorbed much too quickly in an oral form.”
d. “This drug would be inactivated by enzymes in the stomach.”
ANS: D
Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given orally. It does
not have a narrow therapeutic range.DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
4. 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.
ANS: D
Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading to toxic
effects of drugs affected by these isoenzymes. Foods can alter all pharmacokinetic and
pharmacodynamic processes. Not all medications are absorbed better on an empty stomach; some
require certain foods to enhance absorption. Patient comfort is a concern, but it is not as important
as more severe and possibly life-threatening food and drug interactions.DIF: Cognitive Level:
AnalysisREF: p. 39TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
5. 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?
a. Decreased absorption in the intestines
b. Decreased elimination through the kidneys
, c. Increased brain exposure
d. Increased fetal absorption
ANS: B
Drugs that induce PGP can increase drug export from cells of the intestinal epithelium into the
intestinal lumen, thus decreasing absorption of the drug. PGP inducers also increase drug
elimination and decrease brain and fetal drug exposure.DIF: Cognitive Level: AnalysisREF: p.
36TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
6. 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?
a. Advertising by pharmaceutical companies can enhance patient expectations ofone brand
over another, leading to a placebo effect.
b. Because the drug preparations are chemically equivalent, the effects of the two brands must
be identical.
c. Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug’s effects in the body.
d. The bioavailability of a drug is determined by the amount of the drug in eachdose.
ANS: C
Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts of the
same chemical compound), they can have different effects in the body if they differ in
bioavailability. Tablets made by different manufacturers contain different binders and fillers,
which disintegrate and dissolve at different rates and affect the bioavailability of the drug. Two
brands may be chemically equivalent and still differ in bioavailability, which is not determined by
the amount of drug in the dose.DIF: Cognitive Level: ApplicationREF: p. 19TOP: Nursing
Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
7. Two nurses are discussing theories of drug-receptor interaction. Which statements are true
regarding the affinity of a drug and its receptor?
Select all that apply.
a. Affinity and intrinsic activity are dependent properties.
b. Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
d. Drugs with low affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency.
, ANS: B , C , E
Affinity refers to the strength of the attraction between a drug and its receptor. Drugs with high
affinity are strongly attracted to their receptors, and the affinity of a drug and its receptors is
reflected in its potency. Affinity and intrinsic activity are independent properties. Drugs with low
affinity are weakly attracted to their receptors.DIF: Cognitive Level: ComprehensionREF: pp. 30-
31TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
8. A patient receives a drug that has a narrow therapeutic range. The nurse administering this
medication will expect to do what?
a. Administer the drug at intervals longer than the drug half-life.
b. Administer this medication intravenously.
c. Monitor plasma drug levels.
d. Teach the patient that maximum drug effects will occur within a short period.
ANS: C
A drug with a narrow therapeutic range is more difficult to administer safely, because the
difference between the minimum effective concentration and the toxic concentration is small.
Patients taking these medications must have their plasma drug levels monitored closely to ensure
that they are getting an effective dose that is not toxic. Administering medications at longer
intervals only increases the time required to reach effective plasma drug levels. Drugs that have a
narrow therapeutic range may be given by any route and do not differ from other medications in
the amount of time it takes for them to take effect, which is a function of a drug’s half-life and
dosing frequency.DIF: Cognitive Level: ApplicationREF: p. 25TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
9. What occurs when a drug binds to a receptor in the body?
a. It alters the receptor to become nonresponsive to its usual endogenous molecules.
b. It increases or decreases the activity of that receptor.
c. It gives the receptor a new function.
d. It prevents the action of the receptor by altering its response to chemical mediators.
ANS: B
When a drug binds to a receptor, it mimics or blocks the actions of the usual endogenous regulatory
molecules, either increasing or decreasing the rate of the physiologic activity normally controlled
by that receptor. It does not alter the activity of the receptor and does not give the receptor a new
function.DIF: Cognitive Level: AnalysisREF: p. 29TOP: Nursing Process: Assessment MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
FOR ADVANCED PRACTICE NURSES AND PHYSICIAN
ASSISTANTS 2ND EDITION ROSENTHAL Questions and
Answers 2025
Test Bank
Multiple Choice
Chapter 1: Pharmacokinetics, Pharmacodynamics, and Drug Interactions
Test Bank
Multiple Choice
1. 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?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical alterations
ANS: C
Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist would
increase the effects of morphine. Naloxone does not affect serum pH or excretion of opioids.
Naloxone does not alter the sensitivity of opioid receptors.DIF: Cognitive Level: AnalysisREF: p.
31TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
2. 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 .
a. lower; X
b. lower; Y
c. higher; X
d. higher; Y
ANS: C
,An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the
metabolism of other drugs as much as two- to threefold, thereby lowering the level of those drugs
in the body and requiring higher doses to maintain drug effectiveness.DIF: Cognitive Level:
ApplicationREF: p. 36TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. 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?
a. “This drug causes severe gastric upset if given orally.”
b. “This drug has a narrow therapeutic range, and the dose must be tightly controlled.”
c. “This drug is absorbed much too quickly in an oral form.”
d. “This drug would be inactivated by enzymes in the stomach.”
ANS: D
Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given orally. It does
not have a narrow therapeutic range.DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
4. 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.
ANS: D
Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading to toxic
effects of drugs affected by these isoenzymes. Foods can alter all pharmacokinetic and
pharmacodynamic processes. Not all medications are absorbed better on an empty stomach; some
require certain foods to enhance absorption. Patient comfort is a concern, but it is not as important
as more severe and possibly life-threatening food and drug interactions.DIF: Cognitive Level:
AnalysisREF: p. 39TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
5. 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?
a. Decreased absorption in the intestines
b. Decreased elimination through the kidneys
, c. Increased brain exposure
d. Increased fetal absorption
ANS: B
Drugs that induce PGP can increase drug export from cells of the intestinal epithelium into the
intestinal lumen, thus decreasing absorption of the drug. PGP inducers also increase drug
elimination and decrease brain and fetal drug exposure.DIF: Cognitive Level: AnalysisREF: p.
36TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
6. 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?
a. Advertising by pharmaceutical companies can enhance patient expectations ofone brand
over another, leading to a placebo effect.
b. Because the drug preparations are chemically equivalent, the effects of the two brands must
be identical.
c. Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug’s effects in the body.
d. The bioavailability of a drug is determined by the amount of the drug in eachdose.
ANS: C
Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts of the
same chemical compound), they can have different effects in the body if they differ in
bioavailability. Tablets made by different manufacturers contain different binders and fillers,
which disintegrate and dissolve at different rates and affect the bioavailability of the drug. Two
brands may be chemically equivalent and still differ in bioavailability, which is not determined by
the amount of drug in the dose.DIF: Cognitive Level: ApplicationREF: p. 19TOP: Nursing
Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
7. Two nurses are discussing theories of drug-receptor interaction. Which statements are true
regarding the affinity of a drug and its receptor?
Select all that apply.
a. Affinity and intrinsic activity are dependent properties.
b. Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
d. Drugs with low affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency.
, ANS: B , C , E
Affinity refers to the strength of the attraction between a drug and its receptor. Drugs with high
affinity are strongly attracted to their receptors, and the affinity of a drug and its receptors is
reflected in its potency. Affinity and intrinsic activity are independent properties. Drugs with low
affinity are weakly attracted to their receptors.DIF: Cognitive Level: ComprehensionREF: pp. 30-
31TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
8. A patient receives a drug that has a narrow therapeutic range. The nurse administering this
medication will expect to do what?
a. Administer the drug at intervals longer than the drug half-life.
b. Administer this medication intravenously.
c. Monitor plasma drug levels.
d. Teach the patient that maximum drug effects will occur within a short period.
ANS: C
A drug with a narrow therapeutic range is more difficult to administer safely, because the
difference between the minimum effective concentration and the toxic concentration is small.
Patients taking these medications must have their plasma drug levels monitored closely to ensure
that they are getting an effective dose that is not toxic. Administering medications at longer
intervals only increases the time required to reach effective plasma drug levels. Drugs that have a
narrow therapeutic range may be given by any route and do not differ from other medications in
the amount of time it takes for them to take effect, which is a function of a drug’s half-life and
dosing frequency.DIF: Cognitive Level: ApplicationREF: p. 25TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
9. What occurs when a drug binds to a receptor in the body?
a. It alters the receptor to become nonresponsive to its usual endogenous molecules.
b. It increases or decreases the activity of that receptor.
c. It gives the receptor a new function.
d. It prevents the action of the receptor by altering its response to chemical mediators.
ANS: B
When a drug binds to a receptor, it mimics or blocks the actions of the usual endogenous regulatory
molecules, either increasing or decreasing the rate of the physiologic activity normally controlled
by that receptor. It does not alter the activity of the receptor and does not give the receptor a new
function.DIF: Cognitive Level: AnalysisREF: p. 29TOP: Nursing Process: Assessment MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
