FULL TEST BANK
TEST BANK FOR LIPPINCOTT
ILLUSTRATED REVIEWS:
PHARMACOLOGY 8TH
EDITION BY KAREN WHALEN
, Pharmacology illustrated reviews 8th edition whalen test bank table of
content
Chapter 1: pharmacokinetics
Chapter 2: drug–receptor interactions and pharmacodynamics
Chapter 3: the autonomic nervous system
Chapter 4: cholinergic agonists
Chapter 5: cholinergic antagonists
Chapter 6: adrenergic agonists
Chapter 7: adrenergic antagonists
Chapter 8: drugs for neurodegenerative diseases
Chapter 9: anxiolytic and hypnotic drugs
Chapter 10: antidepressants
Chapter 11: antipsychotic drugs
Chapter 12: drugs for epilepsy
Chapter 13: anesthetics
Chapter 14: opioids
Chapter 15: drugs of abuse
Chapter 16: cns stimulants
Chapter 17: antihypertensives
Chapter 18: diuretics
Chapter 19: heart failure
Chapter 20: antiarrhythmics
Chapter 21: antianginal drugs
Chapter 22: anticoagulants and antiplatelet agents
Chapter 23: drugs for hyperlipidemia
Chapter 24: pituitary and thyroid
Chapter 25: drugs for diabetes
Chapter 26: estrogens and androgens
Chapter 27: adrenal hormones
Chapter 28: drugs for obesity
Chapter 29: drugs for disorders of the respiratory system
Chapter 30: antihistamines
Chapter 31: gastrointestinal and antiemetic drugs
Chapter 32: drugs for urologic disorders
Chapter 33: drugs for anemia
Chapter 34: drugs for dermatologic disorders
Chapter 35: drugs for bone disorders
Chapter 36: anti-inflammatory, antipyretic, and analgesic agents
Chapter 37: principles of antimicrobial therapy
Chapter 38: cell wall inhibitors
Chapter 39: protein synthesis inhibitors
Chapter 40: quinolones, folic acid antagonists, and urinary tract antiseptics
Chapter 41: antimycobacterial drugs
Chapter 42: antifungal drugs
Chapter 43: antiprotozoal drugs
Chapter 44: anthelmintic drugs
Chapter 45: antiviral drugs
Chapter 46: anticancer drugs
Chapter 47: immunosuppressants
Chapter 48: clinical toxicology
, Page 1 of 507
Pharmacology illustrated reviews 8th edition whalen
test bank
Chapter 1: pharmacokinetics
multiple choice
1. Which drugs will go through a pharmaceutic phase after it is administered?
a. Intramuscular cephalosporins
b. Intravenous vasopressors
c. Oral analgesics
d. Subcutaneous
antiglycemics
Answer: c
When drugs are administered parenterally, there is no pharmaceutic phase, which occurs
when a drug becomes a solution that can cross the biologic membrane.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: assessment
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
2. The nurse is preparing to administer an oral medication and wants to ensure a rapid
drug action. Which form of the medication will the nurse administer?
a. Capsule
b. Enteric-coated pill
c. Liquid suspension
d. Tablet
answe r:
c
Liquid drugs are already in solution, which is the form necessary for absorption in the gi
tract. The other forms must disintegrate into small particles and then dissolve before being
absorbed.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
Page 1 of 507
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3. The nurse is teaching a patient who will be discharged home with a prescription for an
enteric- coated tablet. Which statement by the patient indicates understanding of the teaching?
a. I may crush the tablet and put it in applesauce to improve absorption.
b. I should consume acidic foods to enhance absorption of this medication.
c. I should expect a delay in onset of the drugs effects after taking the tablet.
d. I should take this medication with high-fat foods to improve its
action. Answer: c
Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of actions
after taking these medications. Enteric-coated tablets should not be crushed or chewed, which
would alter the time and location of absorption. Acidic foods will not enhance the absorption of
the medication. The patient should not to eat high-fat food before ingesting an enteric-coated
tablet, because high-fat foods decrease the absorption rate.
Dif: cognitive level: applying (application) ref: dm 3 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be
given by subcutaneous injection instead of by mouth. The nurse will explain that this is
because
a. Absorption is diminished by the first-pass effects in the liver.
b. Absorption is faster when insulin is given subcutaneously.
c. Digestive enzymes in the gastrointestinal tract prevent absorption.
d. The oral form is less predictable with more adverse
effects. Answer: c
Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine by
digestive enzymes and must be given parenterally. Because insulin is destroyed by digestive
enzymes, it would not make it to the liver for metabolism with a first-pass effect. Subcutaneous
tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin is given
subcutaneously because it is desirable to have it absorb slowly.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: nursing intervention: patient teaching
Page 2 of 507
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Msc: nclex: physiological integrity: pharmacological and parenteral therapies
5. The nurse is preparing to administer an oral medication that is water-soluble. The nurse
understands that this drug
a. Must be taken on an empty stomach.
b. Requires active transport for absorption.
c. Should be taken with fatty foods.
d. Will readily diffuse into the gastrointestinal
tract. Answer: b
Water-soluble drugs require a carrier enzyme or protein to pass through the gi membrane.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
6. A nurse is preparing to administer an oral drug that is best absorbed in an acidic
environment. How will the nurse give the drug?
a. On an empty stomach
b. With a full glass of water
c. With food
d. With high-fat
food answer: c
Food can stimulate the production of gastric acid so medications requiring an acidic
environment should be given with a meal. High-fat foods are useful for drugs that are lipid
soluble.
Dif: cognitive level: applying (application) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
7. The nurse is preparing an injectable drug and wants to administer it for rapid
absorption. How will the nurse give this medication?
a. Im into the deltoid muscle
b. Im into the gluteal muscle
c. Subq into abdominal tissue
d. Subq into the upper
arm answer: a
Page 3 of 507
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Drugs given im are absorbed faster in muscles that have more blood vessels, such as the deltoid,
rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routes are used
when absorption needs to be slower and more sustained.
Dif: cognitive level: applying (application) ref: dm 4 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
8. The nurse is reviewing medication information with a nursing student prior to
administering an oral drug and notes that the drug has extensive first-pass effects. Which
statement by the student indicates a need for further teaching about this medication?
a. The first-pass effect means the drug may be absorbed into systemic circulation from
the intestinal lumen.
b. The first-pass effect means the drug may be changed to an inactive form and excreted.
c. The first-pass effect means the drug may be changed to a metabolite, which may be
more active than the original.
d. The first-pass effect means the drug may be unchanged as it passes through the
liver. Answer: a
Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal
lumen and go through the liver where they are either unchanged or are metabolized to an inactive
or a more active form.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
9. The nurse prepares to change a patients medication from an intravenous to an oral form
and notes that the oral form is ordered in a higher dose. The nurse understands that this is
due to differences in
a. Bioavailability.
b. Pinocytosis.
c. Protein binding.
d. Tachyphylaxis
.
Answer: a
Page 4 of 507
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Oral drugs may have less bioavailability because a lower percentage of the drug reaches the
systemic circulation. Pinocytosis refers to the process by which cells carry a solute across a
membrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapid decrease in
response to drugs that occurs when tolerance develops quickly.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: assessment
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
10. The nurse is preparing to administer a drug and learns that it binds to protein at a rate of 90%.
The patients serum albumin level is low. The nurse will observe the patient for
a. Decreased drug absorption.
b. Decreased drug interactions.
c. Decreased drug toxicity.
d. Increased drug
effects. Answer: d
Drugs that are highly protein-bound bind with albumin and other proteins, leaving less free drug
in circulation. If a patient has a low albumin, the drug is not bound, and there is more free drug
to cause drug effects. There would be increased absorption, increased interactions with other
drugs, and increased toxicity.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
11. The nurse is administering two drugs to a patient and learns that both drugs are
highly protein-bound. The nurse may expect
a. Decreased bioavailability of both drugs.
b. Decreased drug effects.
c. Decreased drug interactions.
d. Increased risk of adverse
effects. Answer: d
Two drugs that are highly protein-bound will compete for protein-binding sites, leaving more
Page 5 of 507
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Free drug in circulation and an increased risk of adverse effects as well as increased bioavailability,
increased drug effects, and increased drug interactions.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
12. A patient has been taking a drug that has a protein-binding effect of 75%. The provider
adds a new medication that has a protein-binding effect of 90%. The nurse will expect
a. Decreased drug effects of the first drug.
b. Decreased therapeutic range of the first drug.
c. Increased drug effects of the first drug.
d. Increased therapeutic range of the first
drug. Answer: c
Adding another highly protein-bound drug will displace the first drug from protein- binding sites
and release more free drug increasing the drugs effects. This does not alter the therapeutic range,
which is the serum level between drug effectiveness and toxicity.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: nursing intervention/evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
13. The nurse gives a medication to a patient with a history of liver disease. The nurse
will monitor this patient for
a. Decreased drug effects.
b. Increased drug effects.
c. Decreased therapeutic range.
d. Increased therapeutic
range. Answer: b
Liver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting the drug-
metabolizing enzymes in the liver. When the drug metabolism rate is decreased, excess drug
accumulation can occur and lead to toxicity.
Page 6 of 507
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Dif: cognitive level: applying (application) ref: dm 6 top: nursing
process: assessment/nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
14. The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be
left in the body in 24 hours if no additional drug is given?
a. None
b. 50 mg
c. 100 mg
d. 200
Mg
answe r:
c
Eight hours after the drug is given, there will be 400 mg left. Eight hours after that (16 hours),
there will be 200 mg left. At 24 hours, there will be 100 mg left.
Dif: cognitive level: applying (application) ref: dm 6 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
15. If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a monday,
when will a steady state be achieved?
a. 0800 on tuesday
b. 0800 on wednesday
c. 0800 on thursday
d. 0800 on
Friday answer:
b
Steady-state levels occur at 3 to 5 half-lives. Wednesday at 0800 is 4 half-lives from the original dose.
Dif: cognitive level: applying (application) ref: pages 6-7 top:
nursing process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
16. The nurse is preparing to administer a drug that is ordered to be given twice daily. The nurse
reviews the medication information and learns that the drug has a half-life of
Page 7 of 507
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24 hours. What will the nurse do next?
a. Administer the medication as ordered.
b. Contact the provider to discuss daily dosing.
c. Discuss every-other-day dosing with the provider.
d. Hold the medication and notify the
provider. Answer: b
A drug with a longer half-life should be given at longer intervals to avoid drug toxicity.
Dif: cognitive level: applying (application) ref: dm 12 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
17. The nurse is caring for a patient who has taken an overdose of aspirin several hours
prior. The provider orders sodium bicarbonate to be given. The nurse understands that this
drug is given for which purpose?
a. To counter the toxic effects of the aspirin
b. To decrease the half-life of the aspirin
c. To increase the excretion of the aspirin
d. To neutralize the acid of the
aspirin answer: c
Aspirin is a weak acid and is more readily excreted in alkaline urine. Sodium bicarbonate alkalizes
the urine. It does not act as an antidote to aspirin, decrease the half-life, or neutralize its ph.
Dif: cognitive level: applying (application) ref: dm 7 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
18. The nurse is preparing to administer a drug that is eliminated through the kidneys. The
nurse reviews the patients chart and notes that the patient has increased serum creatinine
and blood urea nitrogen (bun). The nurse will perform which action?
a. Administer the drug as ordered.
b. Anticipate a shorter than usual half-life of the drug.
c. Expect decreased drug effects when the drug is given.
d. Notify the provider and discuss giving a lower dose.
Page 8 of 507
TEST BANK FOR LIPPINCOTT
ILLUSTRATED REVIEWS:
PHARMACOLOGY 8TH
EDITION BY KAREN WHALEN
, Pharmacology illustrated reviews 8th edition whalen test bank table of
content
Chapter 1: pharmacokinetics
Chapter 2: drug–receptor interactions and pharmacodynamics
Chapter 3: the autonomic nervous system
Chapter 4: cholinergic agonists
Chapter 5: cholinergic antagonists
Chapter 6: adrenergic agonists
Chapter 7: adrenergic antagonists
Chapter 8: drugs for neurodegenerative diseases
Chapter 9: anxiolytic and hypnotic drugs
Chapter 10: antidepressants
Chapter 11: antipsychotic drugs
Chapter 12: drugs for epilepsy
Chapter 13: anesthetics
Chapter 14: opioids
Chapter 15: drugs of abuse
Chapter 16: cns stimulants
Chapter 17: antihypertensives
Chapter 18: diuretics
Chapter 19: heart failure
Chapter 20: antiarrhythmics
Chapter 21: antianginal drugs
Chapter 22: anticoagulants and antiplatelet agents
Chapter 23: drugs for hyperlipidemia
Chapter 24: pituitary and thyroid
Chapter 25: drugs for diabetes
Chapter 26: estrogens and androgens
Chapter 27: adrenal hormones
Chapter 28: drugs for obesity
Chapter 29: drugs for disorders of the respiratory system
Chapter 30: antihistamines
Chapter 31: gastrointestinal and antiemetic drugs
Chapter 32: drugs for urologic disorders
Chapter 33: drugs for anemia
Chapter 34: drugs for dermatologic disorders
Chapter 35: drugs for bone disorders
Chapter 36: anti-inflammatory, antipyretic, and analgesic agents
Chapter 37: principles of antimicrobial therapy
Chapter 38: cell wall inhibitors
Chapter 39: protein synthesis inhibitors
Chapter 40: quinolones, folic acid antagonists, and urinary tract antiseptics
Chapter 41: antimycobacterial drugs
Chapter 42: antifungal drugs
Chapter 43: antiprotozoal drugs
Chapter 44: anthelmintic drugs
Chapter 45: antiviral drugs
Chapter 46: anticancer drugs
Chapter 47: immunosuppressants
Chapter 48: clinical toxicology
, Page 1 of 507
Pharmacology illustrated reviews 8th edition whalen
test bank
Chapter 1: pharmacokinetics
multiple choice
1. Which drugs will go through a pharmaceutic phase after it is administered?
a. Intramuscular cephalosporins
b. Intravenous vasopressors
c. Oral analgesics
d. Subcutaneous
antiglycemics
Answer: c
When drugs are administered parenterally, there is no pharmaceutic phase, which occurs
when a drug becomes a solution that can cross the biologic membrane.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: assessment
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
2. The nurse is preparing to administer an oral medication and wants to ensure a rapid
drug action. Which form of the medication will the nurse administer?
a. Capsule
b. Enteric-coated pill
c. Liquid suspension
d. Tablet
answe r:
c
Liquid drugs are already in solution, which is the form necessary for absorption in the gi
tract. The other forms must disintegrate into small particles and then dissolve before being
absorbed.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
Page 1 of 507
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3. The nurse is teaching a patient who will be discharged home with a prescription for an
enteric- coated tablet. Which statement by the patient indicates understanding of the teaching?
a. I may crush the tablet and put it in applesauce to improve absorption.
b. I should consume acidic foods to enhance absorption of this medication.
c. I should expect a delay in onset of the drugs effects after taking the tablet.
d. I should take this medication with high-fat foods to improve its
action. Answer: c
Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of actions
after taking these medications. Enteric-coated tablets should not be crushed or chewed, which
would alter the time and location of absorption. Acidic foods will not enhance the absorption of
the medication. The patient should not to eat high-fat food before ingesting an enteric-coated
tablet, because high-fat foods decrease the absorption rate.
Dif: cognitive level: applying (application) ref: dm 3 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be
given by subcutaneous injection instead of by mouth. The nurse will explain that this is
because
a. Absorption is diminished by the first-pass effects in the liver.
b. Absorption is faster when insulin is given subcutaneously.
c. Digestive enzymes in the gastrointestinal tract prevent absorption.
d. The oral form is less predictable with more adverse
effects. Answer: c
Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine by
digestive enzymes and must be given parenterally. Because insulin is destroyed by digestive
enzymes, it would not make it to the liver for metabolism with a first-pass effect. Subcutaneous
tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin is given
subcutaneously because it is desirable to have it absorb slowly.
Dif: cognitive level: understanding (comprehension) ref: dm 3 top: nursing
process: nursing intervention: patient teaching
Page 2 of 507
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Msc: nclex: physiological integrity: pharmacological and parenteral therapies
5. The nurse is preparing to administer an oral medication that is water-soluble. The nurse
understands that this drug
a. Must be taken on an empty stomach.
b. Requires active transport for absorption.
c. Should be taken with fatty foods.
d. Will readily diffuse into the gastrointestinal
tract. Answer: b
Water-soluble drugs require a carrier enzyme or protein to pass through the gi membrane.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
6. A nurse is preparing to administer an oral drug that is best absorbed in an acidic
environment. How will the nurse give the drug?
a. On an empty stomach
b. With a full glass of water
c. With food
d. With high-fat
food answer: c
Food can stimulate the production of gastric acid so medications requiring an acidic
environment should be given with a meal. High-fat foods are useful for drugs that are lipid
soluble.
Dif: cognitive level: applying (application) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
7. The nurse is preparing an injectable drug and wants to administer it for rapid
absorption. How will the nurse give this medication?
a. Im into the deltoid muscle
b. Im into the gluteal muscle
c. Subq into abdominal tissue
d. Subq into the upper
arm answer: a
Page 3 of 507
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Drugs given im are absorbed faster in muscles that have more blood vessels, such as the deltoid,
rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routes are used
when absorption needs to be slower and more sustained.
Dif: cognitive level: applying (application) ref: dm 4 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
8. The nurse is reviewing medication information with a nursing student prior to
administering an oral drug and notes that the drug has extensive first-pass effects. Which
statement by the student indicates a need for further teaching about this medication?
a. The first-pass effect means the drug may be absorbed into systemic circulation from
the intestinal lumen.
b. The first-pass effect means the drug may be changed to an inactive form and excreted.
c. The first-pass effect means the drug may be changed to a metabolite, which may be
more active than the original.
d. The first-pass effect means the drug may be unchanged as it passes through the
liver. Answer: a
Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal
lumen and go through the liver where they are either unchanged or are metabolized to an inactive
or a more active form.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
9. The nurse prepares to change a patients medication from an intravenous to an oral form
and notes that the oral form is ordered in a higher dose. The nurse understands that this is
due to differences in
a. Bioavailability.
b. Pinocytosis.
c. Protein binding.
d. Tachyphylaxis
.
Answer: a
Page 4 of 507
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Oral drugs may have less bioavailability because a lower percentage of the drug reaches the
systemic circulation. Pinocytosis refers to the process by which cells carry a solute across a
membrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapid decrease in
response to drugs that occurs when tolerance develops quickly.
Dif: cognitive level: understanding (comprehension) ref: dm 4 top: nursing
process: assessment
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
10. The nurse is preparing to administer a drug and learns that it binds to protein at a rate of 90%.
The patients serum albumin level is low. The nurse will observe the patient for
a. Decreased drug absorption.
b. Decreased drug interactions.
c. Decreased drug toxicity.
d. Increased drug
effects. Answer: d
Drugs that are highly protein-bound bind with albumin and other proteins, leaving less free drug
in circulation. If a patient has a low albumin, the drug is not bound, and there is more free drug
to cause drug effects. There would be increased absorption, increased interactions with other
drugs, and increased toxicity.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
11. The nurse is administering two drugs to a patient and learns that both drugs are
highly protein-bound. The nurse may expect
a. Decreased bioavailability of both drugs.
b. Decreased drug effects.
c. Decreased drug interactions.
d. Increased risk of adverse
effects. Answer: d
Two drugs that are highly protein-bound will compete for protein-binding sites, leaving more
Page 5 of 507
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Free drug in circulation and an increased risk of adverse effects as well as increased bioavailability,
increased drug effects, and increased drug interactions.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
12. A patient has been taking a drug that has a protein-binding effect of 75%. The provider
adds a new medication that has a protein-binding effect of 90%. The nurse will expect
a. Decreased drug effects of the first drug.
b. Decreased therapeutic range of the first drug.
c. Increased drug effects of the first drug.
d. Increased therapeutic range of the first
drug. Answer: c
Adding another highly protein-bound drug will displace the first drug from protein- binding sites
and release more free drug increasing the drugs effects. This does not alter the therapeutic range,
which is the serum level between drug effectiveness and toxicity.
Dif: cognitive level: applying (application) ref: dm 5 top: nursing
process: nursing intervention/evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
13. The nurse gives a medication to a patient with a history of liver disease. The nurse
will monitor this patient for
a. Decreased drug effects.
b. Increased drug effects.
c. Decreased therapeutic range.
d. Increased therapeutic
range. Answer: b
Liver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting the drug-
metabolizing enzymes in the liver. When the drug metabolism rate is decreased, excess drug
accumulation can occur and lead to toxicity.
Page 6 of 507
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Dif: cognitive level: applying (application) ref: dm 6 top: nursing
process: assessment/nursing intervention
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
14. The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be
left in the body in 24 hours if no additional drug is given?
a. None
b. 50 mg
c. 100 mg
d. 200
Mg
answe r:
c
Eight hours after the drug is given, there will be 400 mg left. Eight hours after that (16 hours),
there will be 200 mg left. At 24 hours, there will be 100 mg left.
Dif: cognitive level: applying (application) ref: dm 6 top: nursing
process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
15. If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a monday,
when will a steady state be achieved?
a. 0800 on tuesday
b. 0800 on wednesday
c. 0800 on thursday
d. 0800 on
Friday answer:
b
Steady-state levels occur at 3 to 5 half-lives. Wednesday at 0800 is 4 half-lives from the original dose.
Dif: cognitive level: applying (application) ref: pages 6-7 top:
nursing process: evaluation
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
16. The nurse is preparing to administer a drug that is ordered to be given twice daily. The nurse
reviews the medication information and learns that the drug has a half-life of
Page 7 of 507
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24 hours. What will the nurse do next?
a. Administer the medication as ordered.
b. Contact the provider to discuss daily dosing.
c. Discuss every-other-day dosing with the provider.
d. Hold the medication and notify the
provider. Answer: b
A drug with a longer half-life should be given at longer intervals to avoid drug toxicity.
Dif: cognitive level: applying (application) ref: dm 12 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
17. The nurse is caring for a patient who has taken an overdose of aspirin several hours
prior. The provider orders sodium bicarbonate to be given. The nurse understands that this
drug is given for which purpose?
a. To counter the toxic effects of the aspirin
b. To decrease the half-life of the aspirin
c. To increase the excretion of the aspirin
d. To neutralize the acid of the
aspirin answer: c
Aspirin is a weak acid and is more readily excreted in alkaline urine. Sodium bicarbonate alkalizes
the urine. It does not act as an antidote to aspirin, decrease the half-life, or neutralize its ph.
Dif: cognitive level: applying (application) ref: dm 7 top: nursing
process: planning
Msc: nclex: physiological integrity: pharmacological and parenteral therapies
18. The nurse is preparing to administer a drug that is eliminated through the kidneys. The
nurse reviews the patients chart and notes that the patient has increased serum creatinine
and blood urea nitrogen (bun). The nurse will perform which action?
a. Administer the drug as ordered.
b. Anticipate a shorter than usual half-life of the drug.
c. Expect decreased drug effects when the drug is given.
d. Notify the provider and discuss giving a lower dose.
Page 8 of 507
