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Test Bank For Clayton’s Basic Pharmacology for Nurses
19th Edition Michelle Willihnganz
Chapter 1-48 | Complete

,Test Bank For Clayton’s Basic Pharmacology for Nurses 19th Edition Michelle Willihnganz Chapter 1-48 | Complete




Chapter 1: Drug Definitions, Standards, and Information Sources
Test Bank


MULTIPLE CHOICE

1. What is the name under which a drug is listed by the U.S. Food and Drug Administration
(FDA)?
a. Brand
b. Nonproprietary
c. Official
d. Trademark
ANS: C
The official name is the name under which a drug is listed by the FDA. The brand name, or
trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic,
name is provided by the U.S. Adopted Names Council.

DIF: Cognitive Level: Knowledge REF: p. 1 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment

2. Which source contains information specific to nutritional supplements?
a. USP Dictionary of USAN & International Drug Names
b. Natural Medicines Comprehensive Database
c. United States Pharmacopoeia/National Formulary (USP NF)
d. Drug Interaction Facts
ANS: C
United States Pharmacopoeia/National Formulary contains information specific to nutritional
supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug
names, pronunciation guide, and possible future FDA approved drugs; it does not include
nutritional supplements. Natural Medicines Comprehensive Database contains evidence based
information on herbal medicines and herbal combination products; it does not include
information specific to nutritional supplements. Drug Interaction Facts contains
comprehensive information on drug interaction facts; it does not include nutritional
supplements.

DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

3. What is the most comprehensive reference available to research a drug interaction?
a. Drug Facts and Comparisons
b. Drug Interaction Facts
c. Handbook on Injectable Drugs
d. Martindale—The Complete Drug Reference
ANS: B

, First published in 1983, Drug Interaction Facts is the most comprehensive book available on
drug interactions. In addition to monographs listing various aspects of drug interactions, this
information is reviewed and updated by an internationally renowned group of physicians and
pharmacists with clinical and scientific expertise.

DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

4. The physician has written an order for a drug with which the nurse is unfamiliar. Which
section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this
drug?
a. Manufacturer’s section
b. Brand and Generic Name section
c. Product Category section
d. Product Information section
ANS: B
A physician’s order would include the brand and/or generic name of the drug. The alphabetic
index in the PDR would make this section the most user friendly. Based on a physician’s
order, manufacturer’s information and classification information would not be known. The
Manufacturer’s section is a roster of manufacturers. The Product Category section lists
products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and
antibiotics. The Product Information section contains reprints of the package inserts for the
major products of manufacturers.

DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 4
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

5. Which online drug reference makes available to health care providers and the public a
standard, comprehensive, up to date look up and downloadable resource about medicines?
a. American Drug Index
b. American Hospital Formulary
c. DailyMed
d. Physicians’ Desk Reference (PDR)
ANS: C
DailyMed makes available to health care providers and the public a standard, comprehensive,
up to date look up and downloadable resource about medicines. The American Drug Index is
not appropriate for patient use. The American Hospital Formulary is not appropriate for
patient use. The PDR is not appropriate for patient use.

DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

6. Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
a. Federal Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. Controlled Substances Act (1970)



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, d. Kefauver Harris Drug Amendment (1962)
ANS: A
The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the
safety of all drugs before marketing. Later amendments and acts helped tighten FDA control
and ensure drug safety. The Durham Humphrey Amendment defines the kinds of drugs that
cannot be used safely without medical supervision and restricts their sale to prescription by a
licensed practitioner. The Controlled Substances Act addresses only controlled substances and
their categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater
drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their
products before marketing them.

DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 8
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

7. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological
dependency. Under which classification does this drug fall?
a. I
b. II
c. III
d. IV
ANS: B
Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to
severe psychological and physical dependence. Schedule I drugs have high potential for abuse
and no recognized medical use. Schedule III drugs have some potential for abuse. Use may
lead to low to moderate physical dependence or high psychological dependence. Schedule IV
drugs have low potential for abuse. Use may lead to limited physical or psychological
dependence.

DIF: Cognitive Level: Comprehension REF: p. 4 | p. 5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment

8. What would the FDA do to expedite drug development and approval for an outbreak of
smallpox, for which there is no known treatment?
a. List smallpox as a health orphan disease.
b. Omit the preclinical research phase.
c. Extend the clinical research phase.
d. Fast track the investigational drug.
ANS: D
Once the Investigational New Drug Application has been approved, the drug can receive
highest priority within the agency, which is called fast tracking. A smallpox outbreak would
become a priority concern in the world. Orphan diseases are not researched in a priority
manner. Preclinical research is not omitted. Extending any phase of the research would mean
a longer time to develop a vaccine. The FDA must ensure that all phases of the preclinical and
clinical research phase have been completed in a safe manner.

DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: 8
TOP: Nursing Process Step: Assessment


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, MSC: NCLEX Client Needs Category: Safe, Effective Care Environment

9. Which statement is true about over the counter (OTC) drugs?
a. They are not listed in the USP NF.
b. A prescription from a health care provider is needed.
c. They are sold without a prescription.
d. They are known only by their brand names.
ANS: C
OTC medications do not require a prescription. A variety of names, both generic and trade,
can be used for individual drugs sold OTC. OTC drugs are listed in the USP NF. Prescription
drugs require an order by a health professional who is licensed to prescribe, such as a
physician, nurse practitioner, physician assistant, or dentist.

DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: 2
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

10. Which is the most authoritative reference for medications that are injected?
a. Physician’s Desk Reference
b. Handbook on Injectable Drugs
c. DailyMed
d. Handbook of Nonprescription Drugs
ANS: B
The Handbook on Injectable Drugs is the most comprehensive reference available on the
topic of compatibility of injectable drugs. It is a collection of monographs for more than 300
injectable drugs that are listed alphabetically by generic name.

DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

11. The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this
drug’s classification?
a. Abuse potential for this drug is low.
b. Psychological dependency is likely.
c. There is a high potential for abuse.
d. This drug is not a controlled substance.
ANS: A
Lomotil, a Schedule V drug, has an abuse potential of limited physical or psychological
dependence liability compared with drugs in Schedule IV. Because abuse potential is low with
a Schedule V drug, a prescription may not be required. Psychological dependency is not likely
with a Schedule V drug. Schedule V drugs are classified as controlled substances.

DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

12. The nurse is transcribing new orders written for a patient with a substance abuse history.
Choose the medication ordered that has the greatest risk for abuse.


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, a. Lomotil
b. Diazepam
c. Phenobarbital
d. Lortab
ANS: D
Lortab is a Schedule III drug with a high potential for abuse but less so than drugs in
Schedules I and II. Lomotil is a Schedule V drug with a low potential for abuse compared
with those in Schedule V. Diazepam is a Schedule IV drug with a low potential for abuse
compared with those in schedule III. Phenobarbital is a Schedule IV drug with a low potential
for abuse compared with those in Schedule III.

DIF: Cognitive Level: Application REF: pp. 4-5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity


MULTIPLE RESPONSE

13. The nurse is caring for a patient newly diagnosed with type 1 diabetes mellitus. Which
approach(es) to therapeutic methods would be considered in this patient’s treatment? (Select
all that apply.)
a. Therapeutic drugs
b. Concentrated carbohydrate diet
c. Family centered care
d. Regular daily exercise and activity
e. Daily baths
ANS: A, B, D
Therapeutic methods include drug therapy, diet therapy, physiotherapy, and psychological
therapy. Therapeutic methods do not include family centered care or daily baths.

DIF: Cognitive Level: Application REF: p. 1 OBJ: 1
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

14. An older adult experiencing shortness of breath is brought to the hospital by her daughter.
While obtaining the medication history from the patient and her daughter, the nurse discovers
that neither has a list of the patient’s current medications or prescriptions. All the patient has
is a weekly pill dispenser that contains four different pills. The prescriptions are filled through
the local pharmacy. Which resource(s) would be appropriate to use in determining the
medication names and doses? (Select all that apply.)
a. Martindale—The Complete Drug Reference
b. Physicians’ Desk Reference, Section 4
c. Senior citizens’ center
d. Patient’s home pharmacy
ANS: B, D




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, The Physicians’ Desk Reference, Section 4, has full color images of commonly dispensed
tablets and capsules. The patient’s pharmacy would have an accurate account of all the
medications the client is currently taking. Martindale—The Complete Drug Reference has
written information on medications and would not be an appropriate resource. The senior
citizens’ center is not likely to have specific patient medication information.

DIF: Cognitive Level: Application REF: p. 3 OBJ: 3 | 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

15. The nurse planning patient teaching regarding drug names would include which statement(s)?
(Select all that apply.)
a. Most drug companies place their products on the market under generic names.
b. The official name is the name under which the drug is listed by the U.S. Food and
Drug Administration (FDA).
c. Brand names are easier to pronounce, spell, and remember.
d. The first letter of the generic name is not capitalized.
e. The chemical name is most meaningful to the patient.
ANS: B, C, D
The official name is the name under which the drug is listed by the FDA. Brand names are
easier to pronounce, spell, and remember. The first letter of the generic name is not
capitalized. Most drug companies place their products on the market under brand names
instead of generic names. The chemical name is most meaningful to the chemist.

DIF: Cognitive Level: Application REF: p. 1 OBJ: 2
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

16. When categorizing, the nurse is aware that which drug(s) would be considered Schedule II?
(Select all that apply.)
a. Marijuana
b. Percodan
c. Amphetamines
d. Fiorinal
e. Flurazepam
ANS: B, C
Schedule II drugs have a high potential for abuse, they are currently accepted in the United
States, and use may lead to severe psychological or physical dependence. Percodan and
amphetamines are considered Schedule II drugs. Marijuana is a Schedule I drug. Fiorinal is a
Schedule III drug. Flurazepam is a Schedule IV drug.

DIF: Cognitive Level: Analysis REF: pp. 4-5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity




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, Chapter 2: Basic Principles of Drug Action and Drug Interactions
Test Bank

MULTIPLE CHOICE

1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority
action?
a. Notify physician of allergic reaction.
b. Notify physician of idiosyncratic reaction.
c. Notify physician of potential teratogenicity.
d. Notify physician of potential tolerance.
ANS: A
An allergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria,
which are easily identified. An idiosyncratic reaction occurs when something unusual or
abnormal happens when a drug is first administered. A teratogenic reaction refers to the
occurrence of birth defects related to administration of the drug. Tolerance refers to the body’s
requirement for increasing dosages to achieve the same effects that a lower dose once did.

DIF: Cognitive Level: Application REF: p. 17 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after
administration, the nurse finds the patient agitated and stating that “everyone is out to get me.”
What is the term for this unusual reaction?
a. Desired action
b. Adverse effect
c. Idiosyncratic reaction
d. Allergic reaction
ANS: C
Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first
administered. Patients typically exhibit an overresponsiveness to a medication related to
diminished metabolism. These reactions are believed to be related to genetic enzyme
deficiencies. Desired actions are expected responses to a medication. Adverse effects are
reactions that occur in another system of the body; they are usually predictable. Allergic
reactions appear after repeated medication dosages.

DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

3. Which is the best description of when drug interactions occur?
a. On administration of toxic dosages of a drug
b. On an increase in the pharmacodynamics of bound drugs
c. On the alteration of the effect of one drug by another drug
d. On increase of drug excretion
ANS: C



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, Drug interactions may be characterized by an increase or decrease in the effectiveness of one
or both of the drugs. Toxicity of one drug may or may not affect the metabolism of another
one. Drug interactions may result from either increased or decreased pharmacodynamics.
Drug interactions may result from either increased or decreased excretion.

DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 8
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

4. What occurs when two drugs compete for the same receptor site, resulting in increased
activity of the first drug?
a. Desired action
b. Synergistic effect
c. Carcinogenicity
d. Displacement
ANS: D
The displacement of the first drug from receptor sites by a second drug increases the amount
of the first drug because more unbound drug is available. An expected response of a drug is
the desired action. A synergistic effect is the effect of two drugs being greater than the effect
of each chemical individually, or the sum of the individual effects. Carcinogenicity is the
ability of a drug to cause cells to mutate and become cancerous.

DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 9
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

5. What do drug blood levels indicate?
a. They confirm if the patient is taking a generic form of a drug.
b. They determine if the patient has sufficient body fat to metabolize the drug.
c. They verify if the patient is taking someone else’s medications.
d. They determine if the amount of drug in the body is in a therapeutic range.
ANS: D
The amount of drug present may vary over time and the blood level must remain in a
therapeutic range in order to obtain the desired result. Generic drugs do not necessarily
produce a different drug blood level than proprietary medications. Body fat is not measured
by drug blood levels. Drug blood levels only measure the amount of drug in the body; they do
not determine the source of the medication.

DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

6. What is the process by which a drug is transported by circulating body fluids to receptor sites?
a. Osmosis
b. Distribution
c. Absorption
d. Biotransformation
ANS: B




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, Distribution refers to the ways in which drugs are transported by the circulating body fluids to
the sites of action (receptors), metabolism, and excretion. Osmosis is the process of moving
solution across a semipermeable membrane to equalize the dilution on each side. Absorption
is the process by which a drug is transferred from its site of entry into the body to the
circulating fluids for distribution. Biotransformation, also called metabolism, is the process by
which the body inactivates drugs.

DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 4
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

7. The nurse assesses which blood level to determine the amount of circulating medication in a
patient?
a. Peak
b. Trough
c. Drug
d. Therapeutic
ANS: C
When a drug is circulating in the blood, a blood sample may be drawn and assayed to
determine the amount of drug present; this is known as the drug blood level. Peak levels are
only those drug blood levels that are at their maximum before metabolism starts to decrease
the amount of circulating drug. Trough levels are only those drug blood levels that are at their
minimum when metabolism has decreased the amount of circulating drug and before an
increase caused by a subsequent dose of the medication. Therapeutic levels are only those
within a prescribed range of blood levels determined to bring about effective action of the
medication.

DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

8. The nurse administers 50 mg of a drug at 6:00 AM that has a half life of 8 hours. What time
will it be when 25 mg of the drug has been eliminated from the body?
a. 8:00 AM
b. 11:00 AM
c. 2:00 PM
d. 6:00 PM
ANS: C
Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM. 8:00
AM is 2 hours after administration; the half life is 8 hours. 11:00 AM is 4 hours after
administration; the half life is 8 hours. 6:00 PM is 12 hours after administration; the half life is
8 hours.

DIF: Cognitive Level: Analysis REF: p. 14 OBJ: 6
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

9. What will the nurse need to determine first in order to mix two drugs in the same syringe?
a. Absorption rate of the drugs



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