NU 578 unit 1 EXAM NEW VERSION LATEST UPDATE WITH ACCURATE ANSWERS GUARANTEED PASS BEST STUDYING MATERIAL

The nursing student learns that not all drugs produce effects binding to a receptor. Which drugs do not act through receptors? A. Antihistamines B. Antacids C. Beta blockers D. Opioids Correct Answer: B. Antacids Rationale: Antacids act chemically by neutralizing stomach acid rather than binding to receptors. The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug? A. It is highly toxic B. It is relatively safe C. It requires frequent blood monitoring D. It has a narrow margin of safety Correct Answer: B. It is relatively safe Rationale: A high therapeutic index indicates a wide margin between effective and toxic doses, making the drug safer. Which response would the nurse anticipate when giving two drugs that have a potentiative effect, such as meperidine and Phenergan? A. Decreased sedation B. Increased pain relief C. Reduced nausea only D. Antagonistic effect Correct Answer: B. Increased pain relief Rationale: Potentiation occurs when one drug enhances the effects of another, leading to increased therapeutic benefit. The nurse is preparing a discharge teaching plan to a patient prescribed phenobarbital and oral contraceptives, which are known to induce CYP isoenzymes. What teaching should the nurse include? A. "Continue your oral contraceptives as usual." B. "Switch to a low-dose contraceptive pill." C. "Plan to use another form of birth control while taking phenobarbital." D. "Stop taking phenobarbital during contraceptive use." Correct Answer: C. "Plan to use another form of birth control while taking phenobarbital." Rationale: Phenobarbital induces liver enzymes that reduce the effectiveness of oral contraceptives, increasing pregnancy risk. The drug the nurse is about to give induces P-glycoprotein (PGP). Which outcome should the nurse expect when this drug is given with other drugs? A. Increased absorption of other drugs B. Reduced absorption of other drugs C. Enhanced bioavailability D. Increased drug half-life Correct Answer: B. Reduced absorption of other drugs Rationale: P-glycoprotein pumps drugs out of cells, decreasing absorption and distribution of coadministered drugs. The nurse is concerned with minimizing adverse drug-drug interactions for the patient. Which drug characteristic could result in the most serious consequences from a drug-drug interaction? A. Short half-life B. Wide therapeutic index C. Low therapeutic range D. High protein binding Correct Answer: C. Low therapeutic range Rationale: Drugs with a low therapeutic range have a narrow margin of safety, making interactions more dangerous. The nurse is teaching a patient prescribed felodipine [Plendil] for hypertension. Which statement should be included in the teaching session? A. "Take this medication with milk." B. "Avoid grapefruit juice while you are taking this medication." C. "Eat foods high in vitamin K." D. "Take this drug only at night." Correct Answer: B. "Avoid grapefruit juice while you are taking this medication." Rationale: Grapefruit juice inhibits CYP3A4 enzymes, raising drug levels and risk of toxicity. Before administering a prescribed IV medication, the nurse observes precipitation in the solution. What is the priority nursing action? A. Shake the IV bag before administration B. Administer the drug slowly C. Discard the IV solution D. Filter the solution before giving Correct Answer: C. Discard the IV solution Rationale: Precipitation indicates incompatibility or contamination, and administering it could cause embolism or toxicity. The nurse reviews a patient’s prescriptions. Which drug combination may cause a harmful potentiative interaction? A. Ibuprofen and acetaminophen B. Aspirin and warfarin C. Metformin and insulin D. Amoxicillin and probiotics Correct Answer: B. Aspirin and warfarin Rationale: Both drugs inhibit clotting, greatly increasing the risk of bleeding. The nurse is caring for a patient with jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing? A. Kidney toxicity B. Pancreatitis C. Drug toxicity of the liver D. Gastritis Correct Answer: C. Drug toxicity of the liver Rationale: These are classic signs of hepatotoxicity caused by drug-induced liver injury The nurse is caring for a patient who is experiencing a respiratory rate of 6 breaths per minute after receiving a large dose of pain medication. Which term most accurately describes this reaction? A. Allergy B. Side effect C. Toxicity D. Idiosyncratic reaction Correct Answer: C. Toxicity Rationale: Severe respiratory depression caused by an excessive dose is an example of drug toxicity. The nurse is reviewing the laboratory value for a patient prescribed atorvastatin [Lipitor]. Which laboratory value is most useful for monitoring this drug? A. Blood urea nitrogen (BUN) B. Aspartate aminotransferase (AST) C. Hemoglobin (Hb) D. Creatinine clearance Correct Answer: B. Aspartate aminotransferase (AST) Rationale: Statins can cause hepatotoxicity, so liver function tests such as AST are most important to monitor. The nurse is monitoring patients for adverse drug reactions (ADRs). Which patient is most at risk for drug toxicity? A. A 35-year-old man with asthma B. A 22-year-old woman taking oral contraceptives C. A 70-year-old woman with an elevated creatinine level D. A 55-year-old man with hypertension Correct Answer: C. A 70-year-old woman with an elevated creatinine level Rationale: Impaired renal function in older adults reduces drug excretion, increasing risk of toxicity. The nurse is preparing a staff education session on safety measures to reduce medication errors. Which measure improves safety during care transitions? A. Barcoding medication labels B. Independent double-checks C. Medication reconciliation D. Unit dose dispensing Correct Answer: C. Medication reconciliation Rationale: Medication reconciliation prevents errors by ensuring accuracy of medication lists across transitions in care. Which nursing action results in the most common cause of fatal medication errors? A. Giving the wrong dose orally B. Administering a drug intravenously (IV) instead of intramuscularly (IM) C. Documenting late D. Forgetting to give a dose Correct Answer: B. Administering a drug intravenously (IV) instead of intramuscularly (IM) Rationale: Route errors, especially giving IV instead of IM, can cause fatal outcomes due to immediate systemic exposure. The nurse is caring for a patient prescribed Isoniazid for tuberculosis. The nurse should assess for which signs of drug-induced liver toxicity? (Select all that apply.) A. Nausea B. Malaise C. Jaundice D. Vomiting E. Hypertension Correct Answers: A. Nausea; B. Malaise; C. Jaundice; D. Vomiting Rationale: These are classic symptoms of hepatotoxicity associated with isoniazid therapy. The nurse is caring for a 12-year-old boy weighing 72 pounds. The healthcare provider should make precise dosage adjustments based on which measurement? A. Age B. Height C. Body surface area D. Weight alone Correct Answer: C. Body surface area Rationale: Body surface area provides the most accurate method for pediatric dose adjustments. The provider prescribes a medication that is renally eliminated for a patient with acute renal failure. The nurse recognizes the patient is at risk for which altered drug response? A. Drug tolerance B. Reduced absorption C. Development of drug toxicity D. Increased metabolism Correct Answer: C. Development of drug toxicity Rationale: Impaired renal clearance causes drugs to accumulate, increasing the risk of toxicity. A nursing student is caring for a patient who has been taking morphine sulfate for 2 weeks. Which statement shows understanding of pharmacodynamic tolerance? A. "It is when the body metabolizes drugs faster." B. "It is a condition in which the patient requires increased doses of morphine sulfate to achieve pain relief." C. "It is a psychological craving for the drug." D. "It occurs after the first dose of medication." Correct Answer: B. "It is a condition in which the patient requires increased doses of morphine sulfate to achieve pain relief." Rationale: Pharmacodynamic tolerance occurs when receptors adapt to drug exposure, requiring higher doses for effect. The nurse is caring for a group of female patients receiving medication therapy. Which factor is of greatest concern? A. Women have faster gastric emptying than men. B. Most drug research has been carried out exclusively in male subjects. C. Women excrete drugs faster. D. Female hormones protect against drug toxicity. Correct Answer: B. Most drug research has been carried out exclusively in male subjects. Rationale: Lack of female representation in drug trials limits understanding of gender differences in drug response. The nurse is caring for a patient prescribed abacavir [Ziagen] for HIV. What should be done prior to initiating therapy to reduce risk of fatal hypersensitivity? A. Monitor AST levels B. Perform genetic screening C. Provide liver protection therapy D. Administer with food Correct Answer: B. Perform genetic screening Rationale: Screening for HLA-B5701 reduces risk of abacavir-induced hypersensitivity reactions.*