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Complete Test Bank Lilleys Pharm
for Canadian Health Care Prac
Edition Sealock Questions & Answ
rationales (Chapter 1-58)
Chapter 01: Nursing Practice in Canada and Drug Therapy
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. Which is a judgement about a particular patient’s potential need or problem?
a. A goal
b. An assessment
c. Subjective data
d. A nursing diagnosis
ANS: D
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about
heath conditions and life processes or vulnerability for that response.
DIF: Cognitive Level: Knowledge
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to s
medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
a. A “right time” problem
b. A “right dose” problem
c. A “right route” problem
d. A “right medication” problem
ANS: C
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the p
time” problem because the ordered frequency has not changed. This is not a “right dose” problem beca
an inability to swallow. This is not a “right medication” problem because the medication ordered will n
DIF: Cognitive Level: Application
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and
of possible adverse effects. What nursing process phase is the nurse practising?
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis
ANS: B
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursin
illustrated by this example.
DIF: Cognitive Level: Application
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which st
outcome criterion for this patient?
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DIF: Cognitive Level: Analysis
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6. The nurse is working during a very busy night shift, and the health care provider has just given the nurs
the telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medic
a. Recopy the order neatly on the order sheet, with the most common route indicated
b. Consult with the pharmacist for clarification about the most common route
c. Call the health care provider to clarify the route of administration
d. Withhold the drug until the health care provider visits the patient
ANS: C
If a medication order does not include the route, the nurse must ask the health care provider to clarify i
administration.
DIF: Cognitive Level: Application | Cognitive Level: Analysis
7. Which constitutes the traditional Five Rights of medication administration?
a. Right drug, right route, right dose, right time, and right patient
b. Right drug, the right effect, the right route, the right time, and the right patient
c. Right patient, right strength, right diagnosis, right drug, and right route
d. Right patient, right diagnosis, right drug, right route, and right time
ANS: A
The traditional Five Rights of medication administration were considered to be Right drug, Right route
Right patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights
DIF: Cognitive Level: Comprehension
8. What correctly describes the nursing process?
a. Diagnosing, planning, assessing, implementing, and finally evaluating
b. Assessing, then diagnosing, implementing, and ending with evaluating
c. A linear direction that begins with assessing and continues through diagnosing,
planning, and finally implementing
d. An ongoing process that begins with assessing and continues with diagnosing,
planning, implementing, and evaluating
ANS: D
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that begins with
through diagnosing, planning, implementing, and finally evaluating, which may then lead back to any o
DIF: Cognitive Level: Application
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
a. The patient’s identification
b. The patient’s weight
c. The patient’s last meal
d. Any drug or food allergies
ANS: C
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to a
compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by
DIF: Cognitive Level: Application
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nurs
a. Anxiety
b. Anxiety related to new drug therapy
c. Anxiety related to anxious feelings about drug therapy, as evidenced by
statements such as “I’m upset about having to give myself shots”
d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m
upset about having to give myself shots”
ANS: D
Formulation of nursing diagnoses is usually a three-step process. The only complete answer is “Anxiet
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Chapter 02: Pharmacological Principles
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both abso
identical amounts. Which term best denotes that the drugs have the same absorption rates?
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same b
bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent
“Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is
effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to
do not have a chemical reaction when mixed (or given, in the case of drugs) together.
DIF: Cognitive Level: Comprehension
2. A patient is receiving medication via intravenous injection. Which information should the nurse provid
a. The medication will cause fewer adverse effects when given intravenously.
b. The medication will be absorbed slowly into the tissues over time.
c. The medication’s action will begin faster when given intravenously.
d. Most of the drug is inactivated by the liver before it reaches the target area.
ANS: C
Intravenous injections are the fastest route of absorption. The intravenous route does not affect the num
intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivatio
before it reaches the target area.
DIF: Cognitive Level: Comprehension
3. Which is true regarding parenteral drugs?
a. They bypass the first-pass effect.
b. They decrease blood flow to the stomach.
c. They are altered by the presence of food in the stomach.
d. They exert their effects while circulating in the bloodstream.
ANS: A
Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed into cel
exert their effects. Enteral drugs (drugs taken orally), not parenteral drugs, decrease blood flow to the s
the presence of food in the stomach. Parenteral drugs must be absorbed into cells and tissues from the c
exert their effects; they do not exert their effects while circulating in the bloodstream.
DIF: Cognitive Level: Analysis
4. A drug’s half-life is best defined as
a. The time it takes for the drug to elicit half its therapeutic response.
b. The time it takes one-half of the original amount of a drug to reach the target
cells.
c. The time it takes one-half of the original amount of a drug to be removed from the
body.
d. The time it takes one-half of the original amount of a drug to be absorbed into the
circulation.
ANS: C
A drug’s half-life is the time it takes for one-half of the original amount of a drug to be removed from t
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6. A drug interacts with enzymes by
a. altering cell membrane permeability.
b. “fooling” a receptor on the cell wall.
c. enhancing the drug’s effectiveness within the cells.
d. “fooling” the enzyme into binding with it instead of its normal target cell.
ANS: D
When drugs interact with enzymes, they inhibit the action of a specific enzyme by “fooling” the enzym
of to its normal target cell. Thus, the target cells are protected from the action of the enzymes to result
alteration of cell membrane permeability, the “fooling” of a receptor on the cell wall, and the enhancem
drugs within cells do not occur with selective enzyme interactions.
DIF: Cognitive Level: Comprehension
7. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Whic
from this protein binding?
a. Renal excretion will take longer.
b. The drug will be metabolized quickly.
c. The duration of action of the medication will be longer.
d. The duration of action of the medication will be shorter.
ANS: C
Drugs that are bound to plasma proteins are characterized by a longer duration of action. Protein bindin
excretion longer and does not increase metabolism of the drug. Protein binding of a drug means that th
longer, not shorter.
DIF: Cognitive Level: Application
8. When monitoring a patient on an insulin drip to reduce blood glucose levels, the nurse notes that the pa
extremely low, and the patient is lethargic and difficult to awaken. Which adverse drug reaction is the n
a. An adverse effect
b. An allergic reaction
c. An idiosyncratic reaction
d. A pharmacological reaction
ANS: D
A pharmacological reaction is an extension of the drug’s normal effects in the body. In this case, the in
blood glucose levels too much. An adverse effect is a predictable, well-known adverse drug reaction th
changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involv
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal re
a drug.
DIF: Cognitive Level: Comprehension
9. A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where should
place the tablet?
a. Under the tongue
b. In the space between the cheek and gum
c. At the back of the throat, for easy swallowing
d. On a non-hairy area on the chest
ANS: A
Drugs taken by the sublingual route are placed under the tongue. Placing the tablet in the space betwee
for the buccal route; placing the tablet at the back of the throat (for easy swallowing) is done in the ora
on a non-hairy area on the chest is done in the topical or transdermal route.
DIF: Cognitive Level: Comprehension
10. The nurse is administering medications to a patient who is in liver failure due to end-stage cirrhosis. Th
patients with liver failure are most likely to have problems with which pharmacokinetic phase?
a. Absorption
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Chapter 03: Legal and Ethical Considerations
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. In the development of a new drug by a pharmaceutical company, the researcher must ensure that the pa
drug studies do not have unrealistic expectations of the new drug’s usefulness. What will the researche
study to prevent bias that may occur?
a. A placebo
b. Health Canada approval
c. Informed consent
d. Efficacy information
ANS: A
To prevent bias that may occur as a result of unrealistic expectations of an investigational new drug, a p
into the study. Health Canada approval, if given, does not be obtained until after phase III of the study.
required in all drug studies. Efficacy information is not determined until the study is under way.
DIF: Cognitive Level: Comprehension
2. A member of an investigational drug study team is working with healthy volunteers whose participatio
optimal dosage range and pharmacokinetics of the drug. In what type of study is the team member part
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
ANS: A
Phase I studies involve small numbers of healthy volunteers to determine the optimal dosage range and
drug. Phases II, III, and IV involve progressively larger numbers of volunteers who have the disease or
designed to diagnose or treat.
DIF: Cognitive Level: Application
3. A patient has a prescription for a drug classified as Schedule F. What important information should the
obtaining refills for this medication?
a. No prescription refills are permitted.
b. Refills may be obtained via telephone order.
c. Refills are indicated by the prescriber.
d. The patient may have no more than six refills in a 12-month period.
ANS: C
Schedule F contains a list of drugs that can be sold and refilled only on prescription; prescriptions can b
indicated by the prescriber.
DIF: Cognitive Level: Analysis
4. A patient has been chosen to be a recipient of an investigational drug for heart failure and has given inf
indicated by the patient’s informed consent?
a. The patient has been informed of the possible benefits of the new therapy.
b. The patient will be informed of the details of the study as the research continues.
c. The patient will not be assured of receiving the actual drug during the experiment.
d. The patient has received an explanation of the study’s purpose, procedures, and
the benefits and risks involved.
ANS: D
Informed consent involves the careful explanation of the purpose of the study, procedures to be used, a
risks involved. Being informed of the possible benefits of the new therapy, being informed of the study
continues, and being assured of receiving the actual drug during the experiment do not describe inform
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6. What potential failure is identified when a patient with a documented penicillin allergy receives 1.2 g o
a. Failure to assess
b. Failure to evaluate
c. Failure to ensure safety
d. Failure to identify the patient
ANS: C
Failure to ensure safety includes lack of adequate monitoring, failure to identify patient allergies and ot
medication therapy, inappropriate drug administration technique, and failure to implement appropriate
improper assessment of the patient’s condition. Whereas failure to assess or evaluate includes failure to
the patient’s condition after taking a medication, failure to report these changes, failure to take a compl
nursing assessment/history, and failure to monitor the patient after medication administration. Failure t
identity is a medication error.
DIF: Cognitive Level: Application
7. Which statement correctly describes drugs in Part G, Part II of the Food and Drugs Act?
a. They are drugs with high potential for misuse that have an accepted medical use.
b. They are drugs with high potential for misuse that do not have an accepted
medical use.
c. They are medically accepted drugs that may cause mild physical or psychological
dependence.
d. They are medically accepted drugs with very limited potential for causing mild
physical or psychological dependence.
ANS: A
Part G, Part II drugs are those with high potential for misuse that have an accepted medical use (e.g., b
DIF: Cognitive Level: Comprehension
8. Miss Knox, a 26-year-old, has returned to the surgical unit post appendectomy. The physician has pres
morphine for pain. According to the Controlled Drugs and Substances ACT (CDSA), morphine is class
a. Schedule I
b. Schedule IV
c. Schedule V
d. Schedule III
ANS: A
The CDSA is based on eight schedules that list controlled drugs and substances based on potential for m
they are to manufacture into illicit substances. A summary of Schedule I contains the most dangerous d
(opium, heroin, morphine, cocaine), fentanyls, and methamphetamine.
DIF: Cognitive Level: Comprehension
MULTIPLE RESPONSE
1. Which are elements of ethical principles in nursing and health care according to the Canadian Nurses A
Ethics? (Select all that apply.)
a. Promoting justice
b. Maintaining anonymity
c. Demonstrating responsibility
d. Preserving dignity
e. Promoting health and well-being
ANS: A, D, E
Elements of ethical principles in nursing and health care according to the CNA Code of Ethics include
compassionate, competent, and ethical nursing care; maintaining privacy and confidentiality; promotin
preserving dignity, and promoting and respecting informed decision making; and promoting health and
DIF: Cognitive Level: Critical Thinking
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Chapter 04: Patient-Focused Considerations
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. During the last trimester of pregnancy, drug transfer to the fetus is more likely to occur. Which is a rea
a. Fetal size
b. Decreased surface area
c. Enhanced placental blood flow
d. Increased amount of bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester, as a result of enhanced placental bloo
surface area, and an increased amount of free drug in the mother’s circulation. Increased, not decreased
drug transfer to the fetus. The placenta’s surface area does not increase during this time. Drug transfer
increased amount of free drug, not protein-bound drug, in the mother’s circulation. “Fetal size” is incor
trimester of pregnancy is the period of greatest danger of drug-induced developmental defects. During
undergoes rapid cell proliferation. Gestational age is more important than fetal size.
DIF: Cognitive Level: Comprehension
2. Which type of dosage calculation is used most commonly when calculating drug dosages for children?
a. Fried’s rule
b. Clark’s rule
c. Young’s rule
d. The mg/kg formula
ANS: D
The body weight method, using the mg/kg formula, is the most common and reliable method for calcul
patients. Fried’s rule, Clark’s rule, and Young’s rule are not methods used for calculating drug dosages
DIF: Cognitive Level: Knowledge
3. While assessing an 82-year-old woman, the nurse determines that the patient is experiencing polypharm
experience most likely to indicate?
a. The patient has a lower risk of drug interactions.
b. The patient takes medications for one illness several times a day.
c. The patient risks problems only if she also takes over-the-counter medications.
d. The patient takes multiple medications for several different illnesses.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of the
prescribed by different specialists who may be unaware of the patient’s other treatments. This situation
risk of drug interactions and adverse reactions. Polypharmacy means that the patient has a higher, not l
interactions, and that the patient is taking several different medications, not just one. Polypharmacy can
over-the-counter medications, and natural health products.
DIF: Cognitive Level: Application
4. For accurate medication administration to young patients, the nurse must take into account which infor
a. Weight, height, age, and organ maturity
b. Age, glomerular filtration rate, and weight
c. Weight, height, body temperature, and age
d. Weight, height, and total body water content
ANS: A
To accurately administer medications to young patients, their weight, height, age, physical condition, m
maturity must be taken into account. Glomerular filtration rate, body temperature, and total body water
considerations when administering medications to young patients.
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6. An older adult patient will often experience a reduction in the stomach’s ability to produce hydrochlori
result in which alteration?
a. Delayed gastric emptying
b. Increased gastric acidity
c. Decreased intestinal absorption of medications
d. Altered absorption of select drugs
ANS: D
This aging-related change results in a decrease in gastric acidity and may alter the absorption of some d
emptying, increased gastric acidity, and decreased intestinal absorption of medications are not results o
production.
DIF: Cognitive Level: Application
7. Which is the reason drug toxicity is more likely to occur in the neonate?
a. The lungs are immature.
b. The kidneys are smaller.
c. The liver is not fully developed.
d. Renal excretion of the drug is faster.
ANS: C
A neonate’s liver is not fully developed and cannot detoxify many drugs; thus, drug toxicity is more lik
The lungs and kidneys do not play major roles in drug metabolism. Renal excretion of the drug is slow
immaturity.
DIF: Cognitive Level: Comprehension
8. An 83-year-old female patient has been given a thiazide diuretic to treat mild heart failure. She and her
watch for which complications?
a. Dizziness and constipation
b. Fatigue and dehydration
c. Daytime sedation and lethargy
d. Edema and blurred vision
ANS: B
Electrolyte imbalance, fatigue, and dehydration are common complications of thiazide diuretics in olde
and constipation, daytime sedation and lethargy, and edema and blurred vision are not complications th
are given to older adults.
DIF: Cognitive Level: Comprehension
9. Which complication is common with an older adult patient who is taking digoxin?
a. Hallucinations
b. Edema
c. Dry mouth
d. Constipation
ANS: A
Common complications for older adults taking digoxin include visual disorders, nausea, diarrhea, dysrh
decreased appetite, and weight loss. Nonsteroidal anti-inflammatory drugs may cause edema, anticholi
may cause dry mouth, and opioids may cause constipation.
DIF: Cognitive Level: Comprehension
10. The nurse is aware that confusion, ataxia, and increased risk for falls are older adult patients’ common
medication?
a. Laxatives
b. Anticoagulants
c. Sedatives
d. Diuretics
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11. The nurse is trying to give a liquid medication to a 2-year-old child and notes that the medication has a
for the nurse to give this medication to a child is to
a. Give the medication with spoonfuls of sherbet.
b. Add the medication to the child’s bottle.
c. Tell the child you have candy.
d. Add the medication to a cup of milk.
ANS: A
Using sherbet or another non-essential food that makes the medication taste better is the best way to gi
medication to a child. Adding the medication to the child’s bottle is not correct because the child may n
of the bottle, thus wasting the medication. Telling the child that the medication is candy is not correct b
“candy” with drugs may lead to the child’s thinking that drugs are actually candy. Adding the medicati
correct because the child may not drink the entire cup of milk, and the distasteful drug may cause the c
future.
DIF: Cognitive Level: Application
12. For which cultural group must the nurse respect the value placed on natural health products, the use of
balance of opposing forces that lead to illness or health?
a. Hispanic Canadians
b. Asian Canadians
c. Indigenous peoples
d. Black people of African descent
ANS: B
Some Asian Canadians believe in yin and yang, which are opposing forces leading to illness or health,
in balance. Other health practices for this cultural group include belief in the use of heat and in the valu
Hispanic Canadians, Indigenous peoples, and Black people of African descent do not typically engage
DIF: Cognitive Level: Comprehension
13. A nurse is assessing an older adult Indigenous woman who is being treated for hypertension. During th
important information should the nurse remember or expect in regard to culture?
a. The patient should be discouraged from using traditional remedies and rituals.
b. The nurse should expect the patient to value protective bracelets and herbal teas.
c. The nurse should remember that the balance between body, mind, and
environment is important to this patient’s health beliefs.
d. The assessment should include information about cultural practices and beliefs
regarding medication, treatment, and healing.
ANS: D
All beliefs need to be strongly considered to prevent a conflict between the goals of nursing and health
patient’s cultural background. Assessing cultural practices and beliefs is part of a thorough assessment.
a patient’s cultural practices. Protective bracelets, use of herbal teas, and balance between body, mind,
describe beliefs and practices that usually apply to this patient’s cultural group.
DIF: Cognitive Level: Application
14. Which ethnocultural group believes in harmony with nature and views ill spirits as causing disease?
a. Black people of African descent
b. South Asian Canadians
c. Filipino Canadians
d. Indigenous peoples
ANS: D
Indigenous peoples believe in harmony with nature and view ill spirits as causing disease.
DIF: Cognitive Level: Comprehension
15. Which contributes to drug polymorphism?
a. The number of drugs ordered by the physician
