FULL TEST BANK
Focus On Nursing Pharmacology 9th
Edition By Karch
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,Table of content
Chapter 1 Introduction to Drugs
Chapter 2 Drugs and the Body
Chapter 3 Toxic Effects of Drugs
Chapter 4 The Nursing Process in Drug Therapy and Patient Safety
Chapter 5 Dosage Calculations
Chapter 6 Challenges to Effective Drug Therapy
Chapter 7 Introduction to Cell Physiology
Chapter 8 Anti-infective Agents
Chapter 9 Antibiotics
Chapter 10 Antiviral Agents
Chapter 11 Antifungal Agents
Chapter 12 Antiprotozoal Agents
Chapter 13 Anthelmintic Agents
Chapter 14 Antineoplastic Agents
Chapter 15 Introduction to the Immune Response and Inflammation
Chapter 16 Antiinflammatory, Antiarthritis, and Related Agents
Chapter 17 Immune Modulators
Chapter 18 Vaccines and Sera
Chapter 19 Introduction to Nerves and the Nervous System
Chapter 20 Anxiolytic and Hypnotic Agents
Chapter 21 Antidepressant Agents
Chapter 22 Psychotherapeutic Agents
Chapter 23 Antiseizure Agents
Chapter 24 Antiparkinsonism Agents
Chapter 25 Muscle Relaxants
Chapter 26 Opioid Agonists, Opioid Antagonists, and Antimigraine Agents
Chapter 27 General and Local Anesthetic Agents
Chapter 28 Neuromuscular Junction Blocking Agents
Chapter 29 Introduction to the Autonomic Nervous System
Chapter 30 Adrenergic Agonists
Chapter 31 Adrenergic Antagonists
Chapter 32 Cholinergic Agonists
Chapter 33 Anticholinergic Agents
Chapter 34 Introduction to the Endocrine System
Chapter 35 Hypothalamic and Pituitary Agents
Chapter 36 Adrenocortical Agents
,Chapter 37 Thyroid and Parathyroid Agents
Chapter 38 Agents to Control Blood Glucose Levels
Chapter 39 Introduction to the Reproductive System
Chapter 40 Drugs Affecting the Female Reproductive System
Chapter 41 Drugs Affecting the Male Reproductive System
Chapter 42 Introduction to the Cardiovascular System
Chapter 43 Drugs Affecting Blood Pressure
Chapter 44 Agents for Treating Heart Failure
Chapter 45 Antiarrhythmic Agents
Chapter 46 Antianginal Agents
Chapter 47 Lipid-Lowering Agents
Chapter 48 Drugs Affecting Blood Coagulation
Chapter 49 Drugs Used to Treat Anemias
Chapter 50 Introduction to the Renal System
Chapter 51 Diuretic Agents
Chapter 52 Drugs Affecting the Urinary Tract and the Bladder
Chapter 53 Introduction to the Respiratory System
Chapter 54 Drugs Acting on the Upper Respiratory Tract
Chapter 55 Drugs Acting on the Lower Respiratory Tract
Chapter 56 Introduction to the Gastrointestinal System
Chapter 57 Drugs Affecting Gastrointestinal Secretions
Chapter 58 Drugs Affecting Gastrointestinal Motility
Chapter 59 Antiemetic Agents
Chapter 60 Vitamins, Minerals, and Complementary/Alternative Medications
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 3
Chapter 01 - Introduction to Drugs
A nurse working in radiology administers iodine to a patient who is having a computed tomography (CT)
scan. The nurse working on the oncology unit administers chemotherapy to patients who have
cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR)
vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best
describes the actions of all three nurses?
Pharmacoeconomics
Pharmacotherapeutics
Pharmacodynamics
Pharmacokinetics
Ans: B
Feedback:
Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical
pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of
drugs to treat, prevent, and diagnose disease. The radiology nurse is administering a drug to help
diagnose a disease. The oncology nurse is administering a drug to help treat a disease.
Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a
drug affects the body and pharmacokinetics is how the body acts on the body.
A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for
pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential.
Under what category would morphine be classified?
Schedule I
Schedule II
Schedule III
Schedule IV
Ans: B
Feedback:
Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 4
liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs
have a lesser abuse potential than II and an accepted medical use. Schedule IV drugs have low abuse
potential and limited dependence liability.
When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
Working with animals who are given experimental drugs
Choosing appropriate patients to be involved in the drug study
Monitoring and observing patients closely for adverse effects
Conducting research to determine effectiveness of the drug Ans: C
Feedback:
Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record
any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect
and analyze the information to be shared with the Food and Drug Administration (FDA) but would not
conduct research independently because nurses do not prescribe medications. Use of animals in drug
testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate
in studies where the participants have the disease the drug is intended to treat. These patients are
monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers
who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
What concept is considered when generic drugs are substituted for brand name drugs?
Bioavailability
Critical concentration
Distribution
Half-life
Ans: A
Feedback:
Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to
act on body cells. Binders used in a generic drug may not be the same as those used in the brand name
drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a
generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a
therapeutic effect and should not differ between generic and brand name medications. Distribution is
the phase of pharmacokinetics, which involves the movement of a drug to the body’s tissues and is the
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 5
same in generic and brand name drugs. A drug’s half-life is the time it takes for the amount of drug to
decrease to half the peak level, which should not change when substituting a generic medication.
A nurse is assessing the patient’s home medication use. After listening to the patient list current
medications, the nurse asks what priority question?
Do you take any generic medications?
Are any of these medications orphan drugs?
Are these medications safe to take during pregnancy?
Do you take any over-the-counter medications?
Ans: D
Feedback:
It is important for the nurse to specifically question use of over-the-counter medications because
patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs
unless they too are health care providers. Safety during pregnancy, use of a generic medication, or
classification of orphan drugs are things the patient would be unable to answer but could be found in
reference books if the nurse wishes to research them.
After completing a course on pharmacology for nurses, what will the nurse know?
Everything necessary for safe and effective medication administration
Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
General drug information; the nurse can consult a drug guide for specific drug information.
The drug actions that are associated with each classification of medication Ans: C
Feedback:
After completing a pharmacology course nurses will have general drug information needed for safe and
effective medication administration but will need to consult a drug guide for specific drug information
before administering any medication. Pharmacology is constantly changing, with new drugs entering
the market and new uses for existing drugs identified. Continuing education in pharmacology is
essential to safe practice. Nurses tend to become familiar with the medications they administer most
often, but there will always be a need to research new drugs and also those the nurse is not familiar with
because no nurse knows all medications.
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 6
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy
Category B drug. What would the nurse inform the patient?
Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant
women.
Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant
women.
There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable
despite potential risks.
Ans: B
Feedback:
Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have
not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of
pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in
pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters.
Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate
studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the
use of the drugs in pregnant women may outweigh potential risks.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-
counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC
drugs?
OTC drugs are safe and do not cause adverse effects if taken properly.
OTC drugs have been around for years and have not been tested by the Food and Drug
Administration (FDA).
OTC drugs are different from any drugs available by prescription and cost less.
OTC drugs could cause serious harm if not taken according to directions.
Ans: D
Feedback:
It is important to follow package directions because OTCs are medications that can cause serious harm
if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed;
however, all drugs can produce adverse effects even when taken properly. They may have originally
been prescription drugs that were tested by the FDA or they may have been grandfathered in when the
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 7
FDA laws changed. OTC education should always be included as a part of the hospital discharge
instructions.
What would be the best source of drug information for a nurse?
Drug Facts and Comparisons
A nurse’s drug guide
A drug package insert
The Physicians’ Drug Reference (PDR) Ans: B
Feedback:
A nurse’s drug guide provides nursing implications and patient teaching points that are most useful to
nurses in addition to need-to-know drug information in a very user friendly organizational
style.Lippincott’s Nursing Drug Guide (LNDG) has drug monographs organized alphabetically and
includes nursing implications and patient teaching points. Numerous other drug handbooks are also on
the market and readily available for nurses to use. Although other drug reference books such as Drug
Facts and Comparisons, PDR, and drug package inserts can all provide essential drug information, they
will not contain nursing implications and teaching points and can be more difficult to use than nurse’s
drug guides.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the
name of the medication is still readable. What is the nurse’s priority action?
Discard the entire bottle and contents and obtain a new bottle.
Find the drug information and create a new label for the bottle.
Ask another nurse to verify the contents of the bottle.
Administer the medication if the name of the drug can be clearly read.
Ans: A
Feedback:
When the drug label is soiled obscuring some information the safest action by the nurse is to discard the
bottle and contents because drug labels contain a great deal of important information, far more than just
the name of the drug. Concentration of the drug, expiration date, administration directions, and
precautions may be missing from the label and so put the patient at risk. Looking up drug information
in a drug handbook or consulting with another nurse will not supply the expiration date or
concentration of medication. Be safe and discard the bottle and its contents.
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 8
What aspect of pharmacology does a nurse study? (Select all that apply.)
Chemical pharmacology
Molecular pharmacology
Impact of drugs on the body
The body’s response to a drug
Adverse and anticipated drug effects Ans:
C, D, E
Feedback:
Nurses study pharmacology from a pharmacotherapeutic level, which includes the effect of drugs on
the body, the body’s response to drugs, and both expected and unexpected drug effects. Chemical and
molecular pharmacology (Options A and B) are not included in nursing pharmacology courses.
The nurse, providing patient teaching about home medication use to an older adult, explains that even when
drugs are taken properly they can produce negative or unexpected effects. What are these negative
or unexpected effects called?
Teratogenic effects
Toxic effects
Adverse effects
Therapeutic effects
Ans: C
Feedback:
Negative or unexpected effects are known as adverse or side effects. Teratogenic effects are adverse
effects on the fetus and not a likely concern for an older adult. Toxic effects occur when medication is
taken in larger than recommended dosages caused by an increase in serum drug levels. Therapeutic
effects are the desired actions for which the medication is prescribed.
After administering a medication, for what would the nurse assess the patient?
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Test Bank - Focus on Nursing Pharmacology (9th Edition by Karch) 9
Drug effects
Allergies
Pregnancy
Preexisting conditions
Ans: A
Feedback:
After the medication is administered, the nurse assesses the patient for drug affects, both therapeutic
and adverse. The nurse would assess the patient for allergies, preexisting conditions, and pregnancy
before administering a medication.
The nurse receives an order to administer an unfamiliar medication and obtains a nurse’s drug guide
published four years earlier. What is the nurse’s most prudent action?
Find a more recent reference source.
Use the guide if the drug is listed.
Ask another nurse for drug information.
Verify the information in the guide with the pharmacist.
Ans: A
Feedback:
The nurse is responsible for all medications administered and must find a recent reference source to
ensure the information learned about the medication is correct and current. Using an older drug guide
could be dangerous because it would not contain the most up-to-date information. Asking another nurse
or the pharmacist does not guarantee accurate information will be obtained and could harm the patient
if the information is wrong.
What would the nurse provide when preparing a patient for discharge and home medication self-
administration?
Personal contact information to use if the patient has questions
Thorough medication teaching about drugs and the drug regimen
Over-the-counter medications to use to treat potential adverse effects
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