Question 1

The nurse gives a medication to a patient with a history of liver disease.The nurse will monitor this patient for

Accepted Answer

Liver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting the drug-metabolizing enzymes in the liver.When the drug metabolism rate is decreased,excess drug accumulation can occur and lead to toxicity.

Question 2

The nurse gives 800 mg of a drug that has a half-life of 8 hours.How much drug will be left in the body in 24 hours if no additional drug is given?

Accepted Answer

Eight hours after the drug is given,there will be 400 mg left.Eight hours after that (16 hours),there will be 200 mg left.At 24 hours,there will be 100 mg left.

Question 3

The nurse is preparing to administer a drug and learns that it binds to protein at a rate of 90%.The patient's serum albumin level is low.The nurse will observe the patient for

Accepted Answer

Drugs that are highly protein-bound bind with albumin and other proteins,leaving less free drug in circulation.If a patient has a low albumin,the drug is not bound,and there is more free drug to cause drug effects.There would be increased absorption,increased interactions with other drugs,and increased toxicity.

Question 4

A nurse is preparing to administer an oral drug that is best absorbed in an acidic environment.How will the nurse give the drug?

Accepted Answer

Food can stimulate the production of gastric acid,so medications requiring an acidic environment should be given with a meal.High-fat foods are useful for drugs that are lipid soluble.

Question 5

The nurse is administering two drugs to a patient and learns that both drugs are highly protein-bound.The nurse may expect

Accepted Answer

Two drugs that are highly protein-bound will compete for protein-binding sites,leaving more free drug in circulation and an increased risk of adverse effects as well as increased bioavailability,increased drug effects,and increased drug interactions.

Question 6

The nurse administers albuterol to a patient who has asthma.The albuterol acts by stimulating beta?-adrenergic receptors to cause bronchodilation.The nurse understands that albuterol is a beta-adrenergic

Accepted Answer

An agonist medication is one that stimulates a certain type of cell to produce a response.

Question 7

The nurse is caring for a patient who has taken an overdose of aspirin several hours prior.The provider orders sodium bicarbonate to be given.The nurse understands that this drug is given for which purpose?

Accepted Answer

Aspirin is a weak acid and is more readily excreted in alkaline urine.Sodium bicarbonate alkalizes the urine.It does not act as an antidote to aspirin,decrease the half-life,or neutralize its pH.

Question 8

The nurse is reviewing medication information with a nursing student prior to administering an oral drug and notes that the drug has extensive first-pass effects.Which statement by the student indicates a need for further teaching about this medication?

Accepted Answer

Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal lumen and go through the liver,where they are either unchanged or are metabolized to an inactive or a more active form.

Question 9

The nurse prepares to change a patient's medication from an IV to an oral form and notes that the oral form is ordered in a higher dose.The nurse understands that this is due to differences in

Accepted Answer

Oral drugs may have less bioavailability because a lower percentage of the drug reaches the systemic circulation.Pinocytosis refers to the process by which cells carry a solute across a membrane.Protein binding can occur with both routes.Tachyphylaxis describes a rapid decrease in response to drugs that occurs when tolerance develops quickly.

Question 10

The nurse is preparing to administer a drug that is ordered to be given twice daily.The nurse reviews the medication information and learns that the drug has a half-life of 24 hours.What will the nurse do next?

Accepted Answer

A drug with a longer half-life should be given at longer intervals to avoid drug toxicity.

Question 11

Which drug will go through a disintegration process after it is administered?

Accepted Answer

When drugs are administered parenterally,there is no disintegration process,which occurs when a drug becomes a solution that can cross the biologic membrane.

Question 12

If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a Monday,when will a steady state be achieved?

Accepted Answer

Steady-state levels occur at 3 to 5 half-lives.Wednesday at 0800 is 4 half-lives from the original dose.

Question 13

The nurse is preparing to administer an oral medication and wants to ensure a rapid drug action.Which form of the medication will the nurse administer?

Accepted Answer

Liquid drugs are already in solution,which is the form necessary for absorption in the gastrointestinal (GI)tract.The other forms must disintegrate into small particles and then dissolve before being absorbed.

Question 14

The nurse is preparing to administer a drug that is eliminated through the kidneys.The nurse reviews the patient's chart and notes that the patient has increased serum creatinine and blood urea nitrogen (BUN).The nurse will perform which action?

Accepted Answer

Increased creatinine and BUN indicate decreased renal function,so a drug that is eliminated through the kidneys can become toxic.The nurse should discuss a lower dose with the provider.The drug will have a longer half-life and will exhibit increased effects with decreased renal function.

Question 15

A patient has been taking a drug that has a protein-binding effect of 75%.The provider adds a new medication that has a protein-binding effect of 90%.The nurse will expect

Accepted Answer

Adding another highly protein-bound drug will displace the first drug from protein-binding sites and release more free drug,increasing the drug's effects.This does not alter the therapeutic range,which is the serum level between drug effectiveness and toxicity.

Question 16

The nurse is preparing an injectable drug and wants to administer it for rapid absorption.How will the nurse give this medication?

Accepted Answer

Drugs given IM are absorbed faster in muscles that have more blood vessels,such as the deltoid,rather than those with fewer blood vessels,such as the gluteals.Subcutaneous routes are used when absorption needs to be slower and more sustained.

Question 17

The nurse is teaching a patient who will be discharged home with a prescription for an enteric-coated tablet.Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Enteric-coated tablets resist disintegration in the acidic environment of the stomach and disintegrate when they reach the small intestine.There is usually some delay in onset of actions after taking these medications.Enteric-coated tablets should not be crushed or chewed,which would alter the time and location of absorption.Acidic foods will not enhance the absorption of the medication.The patient should not eat high-fat food before ingesting an enteric-coated tablet because high-fat foods decrease the absorption rate.

Question 18

A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be given by subcutaneous injection instead of by mouth.The nurse will explain that this is because

Accepted Answer

Insulin,growth hormones,and other protein-based drugs are destroyed in the small intestine by digestive enzymes and must be given parenterally.Because insulin is destroyed by digestive enzymes,it would not make it to the liver for metabolism with a first-pass effect.Subcutaneous tissue has fewer blood vessels,so absorption is slower in such tissue.Insulin is given subcutaneously because it is desirable to have it absorb slowly.

Question 19

The nurse understands that the length of time needed for a drug to reach the minimum effective concentration (MEC)is the

Accepted Answer

The onset of action is the time it takes to reach the MEC.Duration of action is the length of time a drug has a pharmacologic effect.Peak action time occurs when the drug reaches its highest blood level.The time response curve is an evaluation of the other three measures.

Question 20

The nurse is preparing to administer an oral medication that is water soluble.The nurse understands that this drug

Accepted Answer

Water-soluble drugs require a carrier enzyme or protein to pass through the GI membrane.

Quiz 2: Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics