Test Bank FOR Lehne's PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE for Nursing AND PHYSICIAN ASSISTANTS 5th Edition. 100% Correct Answers LATEST 2024 UPDATE

Chapter 1: Prescriptive Authority Test Bank Multiple Choice 1. An APRN works in a urology clinic under the supervision of a physician who does not restrict the types of medications the APRN is allowed to prescribe. State law does not require the APRN to practice under physician supervision. How would the APRN’s prescriptive authority be described? a. Full authority b. Independent c. Without limitation d. Limited authority ANSWER: B The APRN has independent prescriptive authority because the regulating body does not require that the APRN work under physician supervision. Full prescriptive authority gives the provider the right to prescribe independently and without limitation. Limited authority places restrictions on the types of drugs that can be prescribed.DIF: Cognitive Level: ComprehensionREF: p. 1TOP: Nursing Process: I MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 2. Which factors increase the need for APRNs to have full prescriptive authority? a. More clients will have access to health care. b. Enrollment in medical schools is predicted to decrease. c. Physician’s assistants are being utilized less often. d. APRN education is more complex than education for physicianswer. ANSWER: A Implementation of the Affordable Care Act has increased the number of individuals with health care coverage, and thus the number who have access to health care services. The increase in the number of clients creates the need for more providers with prescriptive authority. APRNs can fill this practice gap.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 3. Which factors could be attributed to limited prescriptive authority for APRNs? Select all that apply. a. Inaccessibility of client care b. Higher health care costs c. Higher quality medical treatment d. Improved collaborative care e. Enhanced health literacy ANSWER: A , B Limiting prescriptive authority for APRNs can create barriers to quality, affordable, and accessible client care. It may also lead to poor collaboration among providers and higher health care costs. It would not directly impact client’s health literacy.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 4. Which aspects support the APRN’s provision for full prescriptive authority? Select all that apply. a. Clinical education includes prescription of medications and disease processes. b. Federal regulations support the provision of full authority for APRNs. c. National examinations provide validation of the APRN’s ability to provide safecare. d. Licensure ensures compliance with health care and safety standards. e. Limiting provision can decrease health care affordability. ANSWER: A , C , D APRNs are educated to practice and prescribe independently without supervision. National examinations validate the ability to provide safe and competent care. Licensure ensures compliance with standards to promote public health and safety. Limited prescriptive authority creates numerous barriers to quality, affordable, and accessible client care.DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 5. Which aspects support the APRN’s provision for full prescriptive authority? Select all that apply. a. Clinical education includes prescription of medications and disease processes. b. Federal regulations support the provision of full authority for APRNs. c. National examinations provide validation of the APRN’s ability to provide safecare. d. Licensure ensures compliance with health care and safety standards. ANSWER: A , C , D APRNs are educated to practice and prescribe independently without supervision. National examinations validate the ability to provide safe and competent care. Licensure ensures compliance with standards to promote public health and safety. Limited prescriptive authority creates numerous barriers to quality, affordable, and accessible client care.DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 6. A family caregiver practitioner practicing in Maine is hired at a practice across state lines in Virginia. Which aspect of practice may change for the APRN? a. The APRN will have less prescriptive authority in the new position. b. The APRN will have more prescriptive authority in the new position. c. The APRN will have equal prescriptive authority in the newposition. d. The APRN’s authority will depend on federalregulations. ANSWER: A Virginia allows limited prescriptive authority, while Maine gives full authority to certified caregiver practitioners. The federal government does not regulate prescriptive authority.DIF: Cognitive Level: ComprehensionREF: p. 3TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed. Chapter 2: Rational Drug Selection and Prescription Writing Test Bank Multiple Choice 7. How can collaboration with a pharmacist improve positive outcomes for clients? Select all that apply. a. Pharmacists can suggest foods that will help with the client’s condition. b. Pharmacists have additional information on drug interactions. c. The pharmacist can suggest adequate medication dosing. d. Pharmacists have firsthand knowledge of the facility formulary. e. Pharmacy can alter prescriptions when necessary to prevent client harm. ANSWER: B , C , D Providers should collaborate with pharmacists because they will likely have additional information on formulary, drug interactions, and suggestions for adequate medication dosing. Dietitianswer can make foods recommendations to treat the client’s condition. The pharmacist can contact the prescriber about questionable prescriptions, but cannot alter the prescription without notification of and approval by the provider.DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 8. A client presents with delirium tremens requiring Ativan administration. The provider of care is not in the facility. Which action by the caregiver is most appropriate? a. Obtain a telephone order. b. Contact the on-call hospitalist. c. Obtain an order from the charge caregiver. d. Wait for a written Ativan order. ANSWER: A In an emergency situation, such as delirium tremens with seizure activity, it is acceptable to provide a telephone order. Contacting the on-call hospitalist or waiting for a written order would take more time than available for a client with high seizure risk. Writing an order is outside the scope of practice for the charge caregiver.DIF: Cognitive Level: ApplicationREF: p. 7TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 9. A client with chronic pain calls the provider’s office to request a refill on their oxycontin. Which action is most appropriate? a. Fax an order to the pharmacy. b. Schedule an appointment with the client. c. Verify the client’s adherence to drug regimen. d. Determine the client’s current medication dosage. ANSWER: B Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is important to verify the client’s adherence to the drug regimen and determine the current dosage of medication; however, this can be accomplished by scheduling an appointment and evaluating the client in person.DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 10. A client prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat, itchy red rash on the chest and neck. Which action is most important? a. Provide a different prescription. b. Discontinue the medication. c. Prescribe an antihistamine cream. d. Assess for respiratory compromise. ANSWER: B The priority action is to discontinue the medication to prevent worsening of the client’s symptoms. A different prescription would be provided, topical antihistamine may be administered, and the client would be assessed for respiratory involvement, but these actions would not be performed first.DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 11. A client taking three medications for hypertension is diagnosed with COPD. Which action should be taken prior to prescribing medications to treat COPD? a. Obtain baseline laboratory values. b. Obtain a complete medication history. c. Assess liver enzyme levels. d. Determine if client has insurance coverage. ANSWER: B Prior to adding medications to the treatment regimen, it is essential to assess for any potential drug- drug interactions through a complete medical history. Baseline laboratory values are not necessary for COPD treatment. Liver enzyme levels may give insight into the possibility of altered metabolism but would not be the first action. The presence of insurance coverage would affect the client’s access to treatment but may not affect the type of medication prescribed.DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 12. A client with diabetes reports losing their job and an inability to purchase required medications. Which action is most appropriate? a. Provide a 7-day sample pack. b. Decrease the daily dose by half. c. Contact a different pharmacy. d. Prescribe a different medication. ANSWER: C Providing a 7-day sample will address the client’s immediate need, but will not help with the client’s long-term need for medication. Decreasing the daily dose will diminish the effectiveness of the medication. Selecting a different pharmacy could decrease the cost of the medication, as costs vary based on the location and the pharmacy dispensing the medication. Prescribing a different medication would be the last option.DIF: Cognitive Level: ApplicationREF: p. 5TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 13. A client recently prescribed hydrocodone calls to report theyare unable to fill the prescription. Which factors could contribute to the inability to fill the prescription? Select all that apply. a. DEA number missing from prescription b. Prescription sent via electronic messenger c. Dose higher than typically prescribed d. Prescriber license number not included e. Client name and date of birth were handwritten ANSWER: A , B , D In order to fill a hydrocodone prescription, the prescriber name, license number, DEA number, and contact information must be included. Schedule II medications, such as narcotics, must be prescribed using written prescriptions. Though the pharmacist may question the high dosing, that would not prevent filling the prescription. The client’s name and date of birth must be included on the prescription, but there are no regulations that the name cannot be handwritten.DIF: Cognitive Level: ComprehensionREF: pp. 6-8TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed. Chapter 3: Promoting Positive Outcomes of Drug Therapy Test Bank Multiple Choice 14. A client reports that a medication prescribed for recurrent migraine headaches is not working. Which action should be taken first? a. Ask the client about the number and frequency of tablets taken. b. Assess the client’s headache pain on a scale from 1 to 10. c. Report the client’s complaint to the prescriber. d. Suggest biofeedback as an adjunct to drug therapy. ANSWER: A When evaluating the effectiveness of a drug, it is important to determine whether the client is using the drug as ordered. Asking the client to tell the caregiver how many tablets are taken and how often helps the caregiver determine compliance. Assessing current pain does not yield information about how well the medication is working unless the client is currently taking it. The caregiver should gather as much information about compliance, symptoms, and drug effectiveness as possible before contacting the prescriber. Biofeedback may be an effective adjunct to treatment, but it should not be recommended without complete information about drug effectiveness.DIF: Cognitive Level: ApplicationREF: pp. 15-16TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 15. A client is prescribed metronidazole for bacterial vaginosis. Which client history finding would be most concerning? a. Recent yeast infection b. Family history of cervical cancer c. Drinks two glasses of wine every night d. Client is currently unemployed ANSWER: C Clients taking metronidazole should be educated not to drink alcohol to prevent adverse reactions. It would be concerning that the client drinks wine daily. History of a yeast infection may indicate increased risk for recurrence with administration of an antimicrobial. A family history of cervical cancer is not related to administration of metronidazole. Unemployment can indicate lack of insurance coverage, which may limit the client’s ability to purchase medications, but is not the most concerning client finding.DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 16. A client is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the client to administer “two puffs every 4 hours as needed for coughing or wheezing.” The client reports feeling jittery sometimes when taking the medication, and she doesn’t feel that the medication is always effective. Which action is most appropriate? a. Asking the client to demonstrate use of the inhaler b. Assessing the client’s exposure to tobacco smoke c. Auscultating lung sounds and obtaining vitalsigns d. Suggesting that the client use one puff to reduce side effects ANSWER: C Asking the client to demonstrate inhaler use helps to evaluate the client’s ability to administer the medication properly and is part of the caregiver’s evaluation, but is not a priority intervention based on the client’s current report. Assessing tobacco smoke exposure helps the caregiver determine whether nondrug therapies, such as smoke avoidance, can be used as an adjunct to drug therapy, but does not relate to the client’s current problem. Performing a physical assessment helps the caregiver evaluate the client’s response to the medication and identify the presence of other side effects.DIF: Cognitive Level: ApplicationREF: p. 13TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 17. A client newly diagnosed with diabetes is to be discharged from the hospital. Which action should be taken first during medication education? a. Asking the client to demonstrate how to measure and administer insulin b. Discussing methods of storing insulin and discarding syringes c. Giving information about how diet and exercise affect insulin requirements d. Teaching the client about the long-term consequences of poor diabetes control ANSWER: A Because insulin must be given correctly to control symptoms and because an overdose can be fatal, it is most important for the client to know how to administer it. Asking for a demonstration of technique is the best way to determine whether the client has understood the teaching. When a client is receiving a lot of new information, the information presented first is the most likely to be remembered. The other teaching points are important as well, but they are not as critical and can be taught later.DIF: Cognitive Level: ApplicationREF: p. 11TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 18. The drug manual states that older adult clients are at increased risk for hepatic side effects. Which action is most important when prescribing this medication to an 80-year-old client? a. Obtain pretreatment laboratory work. b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of adverse effects. c. Discontinue the order; the drug is contraindicated for this client. d. Give the medication intravenously so that the drug does not pass through the liver. ANSWER: A The drug manual indicates that this drug should be given with caution to elderly clients. Getting information about liver function before giving the drug establishes baseline data that can be compared with post-treatment data to determine whether the drug is affecting the liver. Giving the correct dose at the correct interval helps to minimize risk, but without baseline information, the effects cannot be determined. The drug is not contraindicated.DIF: Cognitive Level: AnalysisREF: p. 12TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 19. A client recently diagnosed with HIV is prescribed several medications to treat the condition. Which factors could impact the client’s adherence to the treatment regimen? Select all that apply. a. The client is uninsured b. The client works three part-time jobs c. The medication regimen includes six different pills d. Client has an eighth-grade reading comprehension level e. Medication regimen requires medication be taken at regular 4-hour intervals. ANSWER: A , B , C , E Lack of insurance coverage can inhibit the client from purchasing the medications, limiting his access to treatment. Having three part-time jobs indicates that the client has a busy schedule, which contributes to forgetfulness and poor adherence. The more complex the medication regimen, the more difficult it is to maintain client adherence. Although a client with an eighth- grade reading comprehension level may have difficulty understanding professional medical language, medication teaching can be adjusted to meet the client’s learning needs.DIF: Cognitive Level: ComprehensionREF: pp. 13-14TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 20. A client diagnosed with bipolar disorder is prescribed daily lithium. Which action is most important to determine if the therapeutic level is maintained? a. Obtain preadministration blood work. b. Administer medication at regular intervals. c. Ensure periodic laboratory testing is completed. d. Assess the client for adverse effects. ANSWER: C Therapeutic serum levels are determined through periodic laboratory testing. Preadministration blood work may be necessary to determine the client’s physical condition but will not determine therapeutic levels. Scheduling medication administration at regular intervals will help to ensure medication is absorbed and metabolized predictably, but will not determine therapeutic blood levels. Assessing the client for physical signs of adverse effects does not determine if a therapeutic level has been obtained.DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed. Chapter 4: Pharmacokinetics, Pharmacodynamics, and Drug Interactions Test Bank Multiple Choice 21. The caregiver administers naloxone [Narcan] to a client who has received a toxic dose of morphine sulfate. The caregiver understands that the naloxone is effective because of which action? a. Countering the effects of morphine sulfate by agonist actions b. Increasing the excretion of morphine sulfate by altering serum pH c. Preventing activation of opioid receptors through antagonist actions d. Regulating the sensitivity of opioid receptors by neurochemical alterations ANSWER: C Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist would increase the effects of morphine. Naloxone does not affect serum pH or excretion of opioids. Naloxone does not alter the sensitivity of opioid receptors.DIF: Cognitive Level: AnalysisREF: p. 31TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 22. A client is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The caregiver caring for this client understands that this client may require doses of drug . a. lower; X b. lower; Y c. higher; X d. higher; Y ANSWER: C An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the metabolism of other drugs as much as two- to threefold, thereby lowering the level of those drugs in the body and requiring higher doses to maintain drug effectiveness.DIF: Cognitive Level: ApplicationREF: p. 36TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 23. The caregiver is preparing to administer penicillin G intramuscularly to a child. The child’s parents ask why the drug cannot be given in an oral liquid form. What is the caregiver’s reply? a. “This drug causes severe gastric upset if given orally.” b. “This drug has a narrow therapeutic range, and the dose must be tightly controlled.” c. “This drug is absorbed much too quickly in an oral form.” d. “This drug would be inactivated by enzymes in the stomach.” ANSWER: D Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given orally. It does not have a narrow therapeutic range.DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 24. Which statement about food and drug interactions is true? a. Foods alter drug absorption and metabolism but not drug action. b. Medications are best absorbed on an empty stomach. c. Client discomfort is the food and drug interaction of most concern. d. Some foods can inhibit CYP isoenzymes and alter drug metabolism. ANSWER: D Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading to toxic effects of drugs affected by these isoenzymes. Foods can alter all pharmacokinetic and pharmacodynamic processes. Not all medications are absorbed better on an empty stomach; some require certain foods to enhance absorption. Client comfort is a concern, but it is not as important as more severe and possibly life-threatening food and drug interactions.DIF: Cognitive Level: AnalysisREF: p. 39TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 25. A caregiver is teaching a client about a drug that induces P-glycoprotein. The caregiver will explain that this drug may cause which effect on other drugs? a. Decreased absorption in the intestines b. Decreased elimination through the kidneys c. Increased brain exposure d. Increased fetal absorption ANSWER: B Drugs that induce PGP can increase drug export from cells of the intestinal epithelium into the intestinal lumen, thus decreasing absorption of the drug. PGP inducers also increase drug elimination and decrease brain and fetal drug exposure.DIF: Cognitive Level: AnalysisREF: p. 36TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 26. A client claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the caregiver know to be most likely? a. Advertising by pharmaceutical companies can enhance client expectations ofone brand over another, leading to a placebo effect. b. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical. c. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug’s effects in the body. d. The bioavailability of a drug is determined by the amount of the drug in eachdose. ANSWER: C Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts of the same chemical compound), they can have different effects in the body if they differ in bioavailability. Tablets made by different manufacturers contain different binders and fillers, which disintegrate and dissolve at different rates and affect the bioavailability of the drug. Two brands may be chemically equivalent and still differ in bioavailability, which is not determined by the amount of drug in the dose.DIF: Cognitive Level: ApplicationREF: p. 19TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 27. Two caregivers are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? Select all that apply. a. Affinity and intrinsic activity are dependent properties. b. Affinity refers to the strength of the attraction between a drug and its receptor. c. Drugs with high affinity are strongly attracted to their receptors. d. Drugs with low affinity are strongly attracted to their receptors. e. The affinity of a drug for its receptors is reflected in its potency. ANSWER: B , C , E Affinity refers to the strength of the attraction between a drug and its receptor. Drugs with high affinity are strongly attracted to their receptors, and the affinity of a drug and its receptors is reflected in its potency. Affinity and intrinsic activity are independent properties. Drugs with low affinity are weakly attracted to their receptors.DIF: Cognitive Level: ComprehensionREF: pp. 30- 31TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 28. A client receives a drug that has a narrow therapeutic range. The caregiver administering this medication will expect to do what? a. Administer the drug at intervals longer than the drug half-life. b. Administer this medication intravenously. c. Monitor plasma drug levels. d. Teach the client that maximum drug effects will occur within a short period. ANSWER: C A drug with a narrow therapeutic range is more difficult to administer safely, because the difference between the minimum effective concentration and the toxic concentration is small. Clients taking these medications must have their plasma drug levels monitored closely to ensure that they are getting an effective dose that is not toxic. Administering medications at longer intervals only increases the time required to reach effective plasma drug levels. Drugs that have a narrow therapeutic range may be given by any route and do not differ from other medications in the amount of time it takes for them to take effect, which is a function of a drug’s half-life and dosing frequency.DIF: Cognitive Level: ApplicationREF: p. 25TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 29. What occurs when a drug binds to a receptor in the body? a. It alters the receptor to become nonresponsive to its usual endogenous molecules. b. It increases or decreases the activity of that receptor. c. It gives the receptor a new function. d. It prevents the action of the receptor by altering its response to chemical mediators. ANSWER: B When a drug binds to a receptor, it mimics or blocks the actions of the usual endogenous regulatory molecules, either increasing or decreasing the rate of the physiologic activity normally controlled by that receptor. It does not alter the activity of the receptor and does not give the receptor a new function.DIF: Cognitive Level: AnalysisREF: p. 29TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 30. A client is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated bythis client in the past. Which could be a probable cause of the test result? a. A loading dose was not given. b. The drug was not completely dissolved in the IV solution. c. The client is taking another medication that binds to serum albumin. d. The medication is being given at a frequency that is longer than its half-life. ANSWER: C Gentamicin binds to albumin, but only weakly, and in the presence of another drug that binds to albumin, it can rise to toxic levels in blood serum. A loading dose increases the initial amount ofa drug and is used to bring drug levels to the desired plateau more quickly. A drug that is not completely dissolved carries a risk of causing embolism. A drug given at a frequency longer than the drug half-life will likely be at subtherapeutic levels and not at toxic levels.DIF: Cognitive Level: AnalysisREF: p. 21TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential