Question 1

The client comes to the emergency department following an overdose of aspirin, an acidic drug. What will the best plan of the nurse include?

Accepted Answer

Aspirin is an acidic drug that can cause metabolic acidosis. Sodium bicarbonate is an alkaline substance that can help to neutralize the acid in the bloodstream, restoring a more normal pH level. This can help to reverse the effects of the aspirin overdose and prevent further damage to the body. Administration of intravenous fluids may be helpful to flush the kidneys but is not the best choice for treatment of an aspirin overdose. Ammonium chloride is an acidic substance that would not be helpful in this case. Intravenous proteins are not typically used to bind aspirin in cases of overdose.

Question 2

The client is malnourished and has a low serum albumin. The physician has ordered aspirin, a highly protein -bound drug, for the client. Which evaluation by the nurse best describes the effect this will have on the client?

Accepted Answer

Since aspirin is a highly protein-bound drug, and the client has low serum albumin, there will be more free drug in circulation because there are not enough albumin molecules for the drug to bind to. This increases the risk of toxic effects because the concentration of the active form of the drug is higher than intended.

Question 3

The client is admitted to the hospital in chronic renal failure, and is on several medications. What best describes the nurse's assessment of this client?

Accepted Answer

Clients with chronic renal failure have decreased kidney function and may not be able to excrete drugs as well as someone with normal kidney function. This can lead to drug toxicity, as the drugs may accumulate in the body. Therefore, the nurse should assess the client for signs and symptoms of drug toxicity, which may include confusion, lethargy, nausea, vomiting, and changes in vital signs. The nurse should also be aware of the potential for drug interactions and adjust medication dosages as needed to prevent further harm to the client.

Question 4

The client receives a drug that is excreted in the bile. What will the best nursing assessment of the effect of this drug on the client include?

Accepted Answer

Drugs excreted in the bile are eliminated through the feces, meaning that they bypass the kidneys and avoid metabolism by the liver. Because of this, the drug may have a prolonged action, as it is not metabolized or excreted as quickly as other drugs.

Question 5

The nursing mother asks the nurse if it is all right to take St. John's Wort for mild depression. What is the best response by the nurse?

Accepted Answer

St. John's Wort can be excreted in breastmilk and may affect the baby. It is not recommended for nursing mothers to take St. John's Wort without consulting with their healthcare provider.

Question 6

The client has meningitis. The physician initially prescribed a water -soluble drug. Another physician changed the order to a lipid -soluble drug. The client is confused about this. Which plan best resolves the client's concern?

Accepted Answer

The client's confusion is centered around the change in medication from a water-soluble drug to a lipid-soluble drug. Therefore, the best plan is to address this specific concern. Option C addresses this concern by explaining that lipid-soluble drugs are more effective in treating the illness. This is the most relevant and accurate information for the client. Options A and D are not entirely accurate, as the choice of drug solubility does not necessarily relate to fewer side effects or slower excretion. Option B is also not entirely accurate, as although lipid-soluble drugs may bind to proteins, this does not necessarily make them better for the client's specific illness.

Question 7

The nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics? Select all that apply.

Accepted Answer

The four major components of pharmacokinetics include absorption (how drugs move from the site of administration to circulating fluids), distribution (how drugs are transported throughout the body), metabolism (how drugs are converted to a form that is easily removed from the body), and elimination (how drugs are removed from the body). Option B is not a component of pharmacokinetics, but rather refers to pharmacodynamics (how drugs change body illnesses and pathogens).

Question 8

The client is scheduled to receive a medication that is an enzyme inducer of the P450 system. What best describes the effect of this medication on the client?

Accepted Answer

Enzyme inducers of the P450 system increase the metabolism of drugs, leading to a reduced effect of the medication over time as the body becomes more efficient at breaking it down.

Question 9

The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?

Accepted Answer

The oral route requires higher dosages of drugs to achieve a therapeutic effect due to the first-pass effect, where the drug is metabolized in the liver before it reaches the systemic circulation, reducing the amount of active drug available.

Question 10

The physician ordered a loading dose of medication for the client; it is to be followed by a lower dose. When the client receives the lower dose, she says to the nurse "I think my doctor made a mistake; my medication dose is too low." What is the best response by the nurse?

Accepted Answer

The nurse should explain to the client that the initial larger dose was given to achieve a therapeutic level of the medication more quickly, and that the lower dose will maintain that level. This is the purpose of a loading dose. Option B is incorrect because reducing the chance of side effects is not the purpose of a loading dose. Option C is incorrect because it does not provide the client with a rationale for the dosage regimen. Option D is incorrect because it does not provide a clear explanation of the purpose of the loading dose.

Question 11

The client tells the nurse that he is on many medications, and questions how they all get to the right places. What is the best response by the nurse? Select all that apply.

Accepted Answer

The answer of The client tells the nurse that he...

Question 12

The nurse is conducting medication education for clients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the clients make which statement?

Accepted Answer

Certain foods can interfere with the absorption of medications, so it is important for clients to be aware of potential food-drug interactions to enhance medication absorption.

Question 13

The client has been receiving quetiapine (Seroquel). The physician changes the order to aripiprazole (Abilify), a more potent drug. How will the nurse expect the physician's new order to read?

Accepted Answer

Aripiprazole (Abilify) is more potent than quetiapine (Seroquel), meaning it requires a lower dose to achieve a similar therapeutic effect.

Question 14

The client is complaining of a severe headache. The physician orders aspirin. Which action by the nurse will result in the fastest relief of the client's headache?

Accepted Answer

Administering the aspirin on an empty stomach will result in the fastest relief of the client's headache because it allows for quicker absorption of the medication into the bloodstream. Administering the aspirin with an alkaline food or a high-fat food may slow down the absorption of the medication, while administering it in an enteric-coated formulation may also result in a slower onset of action.

Question 15

The client is receiving lithium (Eskalith) and asks the nurse why he has to have blood drawn so often. What is the best response by the nurse?

Accepted Answer

Lithium levels in the blood must be monitored closely because the therapeutic range is very narrow; too little and it's ineffective, too much and it can be toxic. Regular blood tests ensure the correct dosage is maintained.

Quiz 4: Pharmacokinetics