TEST BANK
LEHNE'S PHARMACOLOGY FOR NURSING CARE, 12TH EDITION
Jacqueline Burchum & Laura D. Rosenthal
ALL CHAPTERS | COMPLETE GUIDE 2024–2025
MULTIPLE CHOICE & MULTIPLE RESPONSE QUESTIONS
With Accurate Answers & Detailed Reasoning Explanations
Continuing from Chapter 02, Question 3 onward — 70 Pages
For Educational Use Only
,CH 02: Application of Pharmacology in Nursing Practice (Continued)
Burchum: Lehne's Pharmacology for Nursing Care, 12TH Edition
MULTIPLE CHOICE
3. The nursing attendant is reviewing a client's plan of care after administering an antihypertensive drug. Which
action represents the evaluation step of the nursing process?
a. Ordering serum drug levels
b. Questioning the client about OTC drug use
c. Reviewing the client's blood pressure readings after drug administration
d. Teaching the client about the drug's side effects
ACCURATE ANSWER:- C
Reasoning :->>>>Evaluation assesses whether nursing interventions achieved desired outcomes. Reviewing blood
pressure after antihypertensive administration determines whether the drug is effective. Ordering labs and client teaching
are implementation or planning activities. OTC questioning is assessment.
POINTS: 1
4. A hospital client prescribed warfarin is also taking an OTC herbal supplement. The most important nursing
action is:
a. Advise the client to stop the herbal immediately
b. Inform the prescriber of all substances the client is taking
c. Document the finding only
d. Reassure the client that herbals are always safe
ACCURATE ANSWER:- B
Reasoning :->>>>The prescriber must know all substances including herbals to evaluate drug–herb interactions.
Warfarin is highly affected by herbal products that alter INR. Advising the client to stop independently is outside nursing
scope. Documentation alone is insufficient when safety is at risk.
POINTS: 1
5. A client being discharged states: 'I will stop taking this drug once I feel better.' This statement indicates:
a. The client understands the regimen
b. The client needs further teaching about medication adherence
c. The client has high health literacy
d. The client is ready for discharge
ACCURATE ANSWER:- B
Reasoning :->>>>Stopping drugs prematurely can cause relapse, resistance, or rebound effects. The nursing attendant
must reinforce completing the full course. This is one of the most common and dangerous discharge teaching gaps.
POINTS: 1
6. A client asks why the nursing attendant asks so many questions before giving a new drug. The best response
is:
a. 'It is hospital policy.'
b. 'These questions help me identify factors that may alter how this drug works for you.'
c. 'I need to fill out paperwork.'
d. 'Your prescriber requires this.'
ACCURATE ANSWER:- B
Reasoning :->>>>A thorough pre-administration assessment identifies individual factors such as allergies, organ
function, other medications, and health history that may influence drug effectiveness or safety. This response explains the
clinical rationale for assessment.
POINTS: 1
7. Which step of the nursing process involves developing the outcome: 'Client will maintain systolic BP below 130
mmHg within 4 weeks'?
a. Assessment
b. Diagnosis
, c. Planning
d. Evaluation
ACCURATE ANSWER:- C
Reasoning :->>>>Planning involves setting measurable client-centered outcomes and selecting interventions.
Formulating a specific outcome statement is a planning activity. Assessment collects data, implementation executes the
plan, and evaluation measures whether goals were achieved.
POINTS: 1
MULTIPLE RESPONSE
1. Which nursing actions are appropriate during assessment for a client taking multiple drugs? (Select all that
apply.)
a. Obtain a complete drug history including OTC and herbal products
b. Assess for known drug allergies and prior adverse reactions
c. Administer all drugs before completing assessment
d. Review relevant laboratory values
e. Assess the client's understanding of their drug regimen
ACCURATE ANSWER:- A, B, D, E
Reasoning :->>>>A thorough assessment includes all drugs (prescription, OTC, herbal), allergy history, relevant labs,
and drug knowledge. Administering drugs before completing assessment bypasses critical safety steps and is unsafe
practice.
POINTS: 1
, CH 03: Pharmacokinetics
Burchum: Lehne's Pharmacology for Nursing Care, 12TH Edition
MULTIPLE CHOICE
1. A drug has a half-life of 8 hours. Approximately how long will it take to reach steady-state plasma levels?
a. 8 hours
b. 16 hours
c. 32 to 40 hours
d. 64 hours
ACCURATE ANSWER:- C
Reasoning :->>>>Steady state is achieved after approximately 4–5 half-lives of consistent dosing. With a half-life of 8
hours: 4×8=32 hours to 5×8=40 hours. This pharmacokinetic principle guides dosing interval planning and predicts when
therapeutic levels will be consistently achieved.
POINTS: 1
2. A client with severe liver disease is prescribed a drug with extensive first-pass metabolism. The nursing
attendant anticipates this client will require:
a. A higher dose
b. A lower dose due to reduced first-pass metabolism
c. The same dose as a client with normal liver function
d. IV administration only
ACCURATE ANSWER:- B
Reasoning :->>>>First-pass metabolism occurs in the liver. In severe liver disease, hepatic metabolism is impaired, so
less drug is broken down on first pass, resulting in higher plasma drug levels. A reduced dose is required to prevent toxicity.
POINTS: 1
3. Which factor most directly affects the volume of distribution (Vd) of a drug?
a. The drug's molecular weight alone
b. The degree of drug binding to plasma proteins and tissues
c. The rate of renal excretion
d. The amount absorbed from the GI tract
ACCURATE ANSWER:- B
Reasoning :->>>>Volume of distribution reflects how widely a drug distributes throughout the body. Drugs binding
extensively to tissue proteins have large Vd; those remaining protein-bound in plasma have small Vd. Renal excretion
affects elimination; GI absorption affects bioavailability — neither directly determines Vd.
POINTS: 1
4. A client with chronic kidney disease is prescribed a renally excreted drug. What happens if the dose is not
adjusted?
a. Reduced therapeutic effect
b. Drug accumulation leading to toxicity
c. Increased first-pass metabolism compensating for decreased excretion
d. Rapid distribution into adipose tissue
ACCURATE ANSWER:- B
Reasoning :->>>>Impaired renal excretion causes drug accumulation. Without dose adjustment, plasma levels rise
above the therapeutic range increasing the risk of toxicity. Dose reductions or extended intervals are necessary in renal
impairment.
POINTS: 1
5. Which age-related pharmacokinetic change most significantly affects drug dosing in older adults?
a. Increased gastric acid production
b. Decreased hepatic blood flow and enzyme activity
c. Increased glomerular filtration rate
d. Decreased body fat percentage
LEHNE'S PHARMACOLOGY FOR NURSING CARE, 12TH EDITION
Jacqueline Burchum & Laura D. Rosenthal
ALL CHAPTERS | COMPLETE GUIDE 2024–2025
MULTIPLE CHOICE & MULTIPLE RESPONSE QUESTIONS
With Accurate Answers & Detailed Reasoning Explanations
Continuing from Chapter 02, Question 3 onward — 70 Pages
For Educational Use Only
,CH 02: Application of Pharmacology in Nursing Practice (Continued)
Burchum: Lehne's Pharmacology for Nursing Care, 12TH Edition
MULTIPLE CHOICE
3. The nursing attendant is reviewing a client's plan of care after administering an antihypertensive drug. Which
action represents the evaluation step of the nursing process?
a. Ordering serum drug levels
b. Questioning the client about OTC drug use
c. Reviewing the client's blood pressure readings after drug administration
d. Teaching the client about the drug's side effects
ACCURATE ANSWER:- C
Reasoning :->>>>Evaluation assesses whether nursing interventions achieved desired outcomes. Reviewing blood
pressure after antihypertensive administration determines whether the drug is effective. Ordering labs and client teaching
are implementation or planning activities. OTC questioning is assessment.
POINTS: 1
4. A hospital client prescribed warfarin is also taking an OTC herbal supplement. The most important nursing
action is:
a. Advise the client to stop the herbal immediately
b. Inform the prescriber of all substances the client is taking
c. Document the finding only
d. Reassure the client that herbals are always safe
ACCURATE ANSWER:- B
Reasoning :->>>>The prescriber must know all substances including herbals to evaluate drug–herb interactions.
Warfarin is highly affected by herbal products that alter INR. Advising the client to stop independently is outside nursing
scope. Documentation alone is insufficient when safety is at risk.
POINTS: 1
5. A client being discharged states: 'I will stop taking this drug once I feel better.' This statement indicates:
a. The client understands the regimen
b. The client needs further teaching about medication adherence
c. The client has high health literacy
d. The client is ready for discharge
ACCURATE ANSWER:- B
Reasoning :->>>>Stopping drugs prematurely can cause relapse, resistance, or rebound effects. The nursing attendant
must reinforce completing the full course. This is one of the most common and dangerous discharge teaching gaps.
POINTS: 1
6. A client asks why the nursing attendant asks so many questions before giving a new drug. The best response
is:
a. 'It is hospital policy.'
b. 'These questions help me identify factors that may alter how this drug works for you.'
c. 'I need to fill out paperwork.'
d. 'Your prescriber requires this.'
ACCURATE ANSWER:- B
Reasoning :->>>>A thorough pre-administration assessment identifies individual factors such as allergies, organ
function, other medications, and health history that may influence drug effectiveness or safety. This response explains the
clinical rationale for assessment.
POINTS: 1
7. Which step of the nursing process involves developing the outcome: 'Client will maintain systolic BP below 130
mmHg within 4 weeks'?
a. Assessment
b. Diagnosis
, c. Planning
d. Evaluation
ACCURATE ANSWER:- C
Reasoning :->>>>Planning involves setting measurable client-centered outcomes and selecting interventions.
Formulating a specific outcome statement is a planning activity. Assessment collects data, implementation executes the
plan, and evaluation measures whether goals were achieved.
POINTS: 1
MULTIPLE RESPONSE
1. Which nursing actions are appropriate during assessment for a client taking multiple drugs? (Select all that
apply.)
a. Obtain a complete drug history including OTC and herbal products
b. Assess for known drug allergies and prior adverse reactions
c. Administer all drugs before completing assessment
d. Review relevant laboratory values
e. Assess the client's understanding of their drug regimen
ACCURATE ANSWER:- A, B, D, E
Reasoning :->>>>A thorough assessment includes all drugs (prescription, OTC, herbal), allergy history, relevant labs,
and drug knowledge. Administering drugs before completing assessment bypasses critical safety steps and is unsafe
practice.
POINTS: 1
, CH 03: Pharmacokinetics
Burchum: Lehne's Pharmacology for Nursing Care, 12TH Edition
MULTIPLE CHOICE
1. A drug has a half-life of 8 hours. Approximately how long will it take to reach steady-state plasma levels?
a. 8 hours
b. 16 hours
c. 32 to 40 hours
d. 64 hours
ACCURATE ANSWER:- C
Reasoning :->>>>Steady state is achieved after approximately 4–5 half-lives of consistent dosing. With a half-life of 8
hours: 4×8=32 hours to 5×8=40 hours. This pharmacokinetic principle guides dosing interval planning and predicts when
therapeutic levels will be consistently achieved.
POINTS: 1
2. A client with severe liver disease is prescribed a drug with extensive first-pass metabolism. The nursing
attendant anticipates this client will require:
a. A higher dose
b. A lower dose due to reduced first-pass metabolism
c. The same dose as a client with normal liver function
d. IV administration only
ACCURATE ANSWER:- B
Reasoning :->>>>First-pass metabolism occurs in the liver. In severe liver disease, hepatic metabolism is impaired, so
less drug is broken down on first pass, resulting in higher plasma drug levels. A reduced dose is required to prevent toxicity.
POINTS: 1
3. Which factor most directly affects the volume of distribution (Vd) of a drug?
a. The drug's molecular weight alone
b. The degree of drug binding to plasma proteins and tissues
c. The rate of renal excretion
d. The amount absorbed from the GI tract
ACCURATE ANSWER:- B
Reasoning :->>>>Volume of distribution reflects how widely a drug distributes throughout the body. Drugs binding
extensively to tissue proteins have large Vd; those remaining protein-bound in plasma have small Vd. Renal excretion
affects elimination; GI absorption affects bioavailability — neither directly determines Vd.
POINTS: 1
4. A client with chronic kidney disease is prescribed a renally excreted drug. What happens if the dose is not
adjusted?
a. Reduced therapeutic effect
b. Drug accumulation leading to toxicity
c. Increased first-pass metabolism compensating for decreased excretion
d. Rapid distribution into adipose tissue
ACCURATE ANSWER:- B
Reasoning :->>>>Impaired renal excretion causes drug accumulation. Without dose adjustment, plasma levels rise
above the therapeutic range increasing the risk of toxicity. Dose reductions or extended intervals are necessary in renal
impairment.
POINTS: 1
5. Which age-related pharmacokinetic change most significantly affects drug dosing in older adults?
a. Increased gastric acid production
b. Decreased hepatic blood flow and enzyme activity
c. Increased glomerular filtration rate
d. Decreased body fat percentage
