Pharmacology NCLEX Review Questions Chapter 2-3

Pharmacology NCLEX Review questions Questions Chapter 2 1. What is the study of physiochemical properties of drugs and how they influence the body called? A. PharmacologyectrncorI B. Pharmacokinetics C. Pharmacodynamics D. Pharmacotherapeutics In simple terms, pharmacodynamics is the study of what drugs do to the body. Awarded 0.0 points out of 1.0 possible points. 2. Which statement best describes pharmacokinetics? A. Adverse effects and toxic reactions to medications B. Physiologic interaction between a drug and body cells C. Converts medication into its active chemical substance D. What the body does to the drug after it is administered Pharmacokinetics involves the study of how the drug moves through the body, including absorption, distribution, metabolism, and excretion. Awarded 1.0 points out of 1.0 possible points. 3. What is another term for biotransformation of a drug? A. Dilution B. Excretion C. Absorption D. Metabolism Metabolism connotes a breakdown of a product. Biotransformation is actually a more accurate term because some drugs are actually changed into an active form in the liver in contrast to being broken down for excretion. Awarded 1.0 points out of 1.0 possible points. 4. A drug given by which route is altered by the first-pass effect? A. Oral B. Sublingual C. Intravenous (IV) D. Subcutaneous (subcut) Medications absorbed in the stomach and small intestine travel through the portal system and are metabolized by the liver before they reach the general circulation. Awarded 1.0 points out of 1.0 possible points. 5. Drug half-life is defined as the amount of time required for 50% of a drug to: A. be absorbed by the body. B. exert a response. C. be eliminated by the body. ectCror D. reach a therapeutic level. In pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%, is the drug’s half-life (also called elimination half-life). Awarded 1.0 points out of 1.0 possible points. 6. Which nursing action will increase the absorption of a medication administered intramuscularly (IM)? A. Massage the site after injection. B. Apply ice packs to the injection site. C. Lower the extremity below the level of the heart.ectrncorI D. Administer the medication via the Z-track method. Massaging the site increases circulation to the area and thus increases absorption, but this should not be performed after all IM injections; it is drug specific. See the recommendations on specific drugs. Awarded 0.0 points out of 1.0 possible points. 7. When administering two medications that are highly protein bound, the nurse understands to monitor the patient carefully for which effect? A. A short duration of medication action B. Increase in the risk of drug–drug interactions C. Immediate improvement in the patient’s condition D. Hypovolemic shock caused by a low albumin level When administering two medications that are highly protein bound, the medications can compete for binding sites on plasma proteins. This competition results in either less of both or less of one of the drugs binding to the proteins, thus increasing the risk of toxicity or adverse effects. Awarded 1.0 points out of 1.0 possible points. 8. To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route? A. Intrathecally B. IV C. IM D. Subcut When a drug is administered IV, it does not need to be absorbed because it is injected directly into the circulation. Awarded 1.0 points out of 1.0 possible points. 9. Patients with renal failure would MOST likely have problems with which pharmacokinetic process? A. Excretion B. Absorption C. Metabolism D. Distribution The kidneys are responsible for the majority of drug excretion. Awarded 1.0 points out of 1.0 possible points. 10. What is the ratio between a drug’s therapeutic effects and toxic effects called? A. Affinity B. Tolerance C. Therapeutic index D. Cumulative effect The ratio of a drug’s therapeutic benefits to its toxic effects is referred to as the drug’s therapeutic index. Awarded 1.0 points out of 1.0 possible points. 11. A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse’s best response to the patient? A. “Medications given orally bypass the portal circulatory system.” B. “Medications given intravenously are not affected by the first-pass effect.” C. “Drugs administered intravenously enter the portal system before systemic distribution.” D. “A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver.” When drugs with a high first-pass effect are administered orally, a large amount of drug may be metabolized before it reaches the systemic circulation. The same drug given IV will bypass the liver. This prevents the first-pass effect from taking place, and therefore more of the drug reaches the circulation. Parenteral doses of drugs with a high first-pass effect are much smaller than oral doses, yet they produce the same pharmacologic response. Awarded 0.0 points out of 1.0 possible points. 12. The nurse understands that drugs exert their actions on the body by what process? (Select all that apply.) A. Interacting with receptors B. Altering metabolic chemical processes C. Making the cell perform a new function D. Inhibiting the action of a specific enzyme Drugs cannot make a cell perform a new function; they can only alter the way a cell performs its current function. Awarded 0.333333 points out of 1.0 possible points. 13. The nurse knows that which factors will affect the absorption of orally administered medications? (Select all that apply.) A. Time of day B. pH of the stomach C. Form of drug preparation D. Patient in high-Fowler’s positiont E. Presence of food in the stomach Various factors affecting the rate of drug absorption include the administration route of the drug, presence or absence of food or fluids administered with the drug, dosage formulation, status of the absorptive surface, blood flow to the small intestine, acidity of the stomach, and status of gastrointestinal motility. Time of day would affect the acidity of the stomach and would therefore affect the rate of drug absorption. Awarded 0.75 points out of 1.0 possible points. 1. Questions Chapter 3 1. When calculating pediatric dosages, the nurse understands which method is MOST accurate for dosing calculations? A. Use of drug reference recommendations based on mg/kg of body weight. B. Calculated doses based on body weight need to be increased by 10% because of immature renal and hepatic function C. Dosage calculation by body surface area because it takes into account the difference in size for children and neonates D. Medication dosing calculated according to body weight because it is based on maturational growth and development The body surface area takes into account not only the child’s weight but also the relationship with height and is therefore both the most accurate and most preferred method. Immature renal and hepatic function would necessitate a decrease in dose, not an increase. Awarded 0.0 points out of 1.0 possible points. 2. The nurse is teaching a pregnant patient about the effects of medication on fetal development. The nurse understands the greatest risk for medication effects on developing fetuses occurs during which time period? A. First trimester B. Second trimester C. Third trimester D. Birthing process During the first trimester of pregnancy, fetuses are at the greatest risk for drug-induced developmental defects. During this period, the fetus undergoes rapid cell proliferation, and the skeleton, muscles, limbs, and visceral organs are developing at their most rapid rate. Awarded 1.0 points out of 1.0 possible points. 3. Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates the health care provider will perform which action to minimize the risk of toxicity? A. Decrease the amount of drug given. B. Increase the amount of drug given. C. Shorten the time interval between doses. D. Administer the medication intravenously. A lower binding capacity leaves more drug available for action; thus, a lower dose would be required to prevent toxicity. Awarded 1.0 points out of 1.0 possible points. 4. The physiologic changes that normally occur in older adult patients have which implication for drug response? A. Drug elimination is faster. B. Drug metabolism is quicker. C. Drug half-life is lengthened. D. Protein binding is more efficient. Drug half-life is extended secondary to diminished liver and renal function in older adults. Awarded 1.0 points out of 1.0 possible points. 5. While conducting a health history for an older adult patient with heart failure, the patient tells the nurse, I have chronic constipation.” The nurse suspects this gastrointestinal complaint is caused by which class of drugs? A. Anticoagulants B. Calcium channel blockers C. Potassium-sparing diuretics D. Nonsteroidal antiinflammatory drugsectrncorI Calcium channel blocker drugs may worsen constipation in the older adult population and thus should be avoided. Awarded 0.0 points out of 1.0 possible points. 6. The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor? A. Fetal sex B. Drug properties C. Diet of the mother D. Maternal blood type Drug properties have a direct correlation to the safety or potential harm of drug therapy during pregnancy, and nurses working in prenatal settings need to be aware of information related to drug properties. Awarded 1.0 points out of 1.0 possible points. 7. A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the nurse’s best response to the mother’s question? A. “You should not take any medication while breastfeeding.” B. “Only certain medications pass to infants while breastfeeding.” C. “I will leave the health care provider a message to return your call.” D. “Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking.” The nurse is aware that medications can pass in breast milk, but each medication is different. Women who take medication while breastfeeding must be assessed on a caseby-case basis, including assessment of the medication the patient is taking. Awarded 1.0 points out of 1.0 possible points. 8. A nurse working with older adult patients is concerned about the number of medications prescribed for each patient. Which older adult assessment should be of highest priority related to polypharmacy? A. Drug interactions B. Cost of medications C. Schedule of medications D. Nonadherence to drug regimen The highest priority for older adult patients with multiple medications (polypharmacy) is the assessment for drug interactions. The more medications an older adult patient takes, the higher the risk for drug interactions. Awarded 1.0 points out of 1.0 possible points.