Test Bank - Focus on Nursing Pharmacology 8th
Edition by Karch
Chapter 02 - Drugs and the Body
1. Drugs do not metabolize the same way in all people. For what patient would
a nurse expect to assess for an alteration in drug metabolism?
A. A 35-year-old woman with cervical cancer
B. A 41-year-old man with kidney stones
C. A 50-year-old man with cirrhosis of the liver
D. A 62-year-old woman in acute renal failure
Ans: C Feedback: The liver is the most important site of drug metabolism. If
the liver is not functioning effectively, as in patients with cirrhosis, drugs will
not metabolize normally so that toxic levels could develop unless dosage is
reduced. A patient with cervical cancer or kidney stones would not be
expected to have altered ability to metabolize drugs so long as no liver damage
existed. The patient with renal failure would have altered excretion of the
drugs through the renal system but metabolism would not be impacted.
2. A patient presents to the emergency department with a drug level of 50
units/ml. The half-life of this drug is 1 hour. With this drug, concentrations
above 25 units/mL are considered toxic and no more drug is given. How long
will it take for the blood level to reach the non-toxic range?
A. 30 minutes
B. 1 hour
C. 2 hours
D. 3 hours
, Ans: B Feedback: Half-life is the time required for the serum concentration of
a drug to decrease by 50%. After 1 hour, the serum concentration would be
25 units/mL (50/2) if the body can properly metabolize and excrete the drug.
After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and
reach the nontoxic range. In 30 minutes the drug level would be 37.5 units/mL,
whereas in 3 hours the drug level would be 6.25.
3. A patient has recently moved from Vermont to Southern Florida. The patient
presents to the clinic complaining of dizzy spells and weakness. While
conducting the admission assessment, the patient tells the nurse that he have
been on the same antihypertensive drug for 6 years and had stable blood
pressures and no adverse effects. Since his move, he has been having problems
and he feels that the drug is no longer effective. The clinic nurse knows that
one possible reason for the change in the effectiveness of the drug could be
what?
A. The impact of the placebo effect on the patient’s response.
B. The accumulative effect of the drug if it has been taken for many years.
C. The impact of the warmer environment on the patient’s physical status.
D. Problems with patient compliance with the drug regimen while on
vacation.
Ans: C Feedback: Antihypertensive drugs work to decrease the blood
pressure. When a patient goes to a climate that is much warmer than usual,
blood vessels dilate and the blood pressure falls. If a patient is taking an
antihypertensive drug and moves to a warmer climate, there is a chance that
the patient’s blood pressure will drop too low, resulting in dizziness and
feelings of weakness. Even mild dehydration could exacerbate these effects.
Most antihypertensives are metabolized and excreted and do not accumulate
in the body. Patients must be very compliant with their drug regimen on
, vacation. After several years on an antihypertensive drug, the effects of that
drug are known; therefore, the placebo effect should not be an issue.
4. An important concept taught by the nurse when providing medication
teaching is the need to provide a complete list of medications taken to health
care providers to avoid what?
A. Spending large amounts of money on medications
B. Allergic reactions to medications
C. Drug drug interactions
D. Critical concentrations of medications in the body
Ans: C Feedback: It is important that all health care providers have a complete
list of the patient’s medications to avoid drug drug interactions caused by one
provider ordering a medication, unaware of another medication the patient is
taking that could interact with the new prescription. Using the same
pharmacist for all prescriptions will also help to prevent this from happening.
Informing the provider of all medications taken will not reduce costs of
medications, which is best accomplished by requesting generic medications.
Allergies should be disclosed to all health care providers as well, but this is
not why it is important to provide a complete list of medications taken. Critical
concentrations are desirable because that is the amount of drug needed to
cause a therapeutic effect, or, in other words, to have the effect the drug is
prescribed for.
5. A pharmacology student asks the instructor what an accurate description of a
drug agonist is. What is the instructor’s best response?
A. A drug that reacts with a receptor site on a cell preventing a reaction with
another chemical on a different receptor site
B. A drug that interferes with the enzyme systems that act as catalyst for
different chemical reactions
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