Deck 4: Pharmacokinetics

Question 1

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

A) "We can safely take the drug for at least 6 months beyond the expiration date."
B) "We don't need to worry about storage of the drug, it won't lose potency."
C) "We should not take our medications with milk or dairy products."
D) "We need to be careful about taking the medication with certain foods."

Answer 1

"We need to be careful about taking the medication with certain foods."

Question 2

The physician ordered a loading dose of medication for the patient; it is to be followed by a lower dose. When the patient 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?

A) "The initial dose shortened the half-life, so the medication would work more quickly."
B) "We always give medications this way; the doctor did not make a mistake."
C) "You had a larger dose initially so that the medication would work more quickly."
D) "Giving a larger dose initially will reduce the chance of side effects."

Answer 2

"You had a larger dose initially so that the medication would work more quickly."

Question 3

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

A) How drugs move from the site of administration to circulating fluids
B) How drugs are converted to a form that is easily removed from the body
C) How drugs change body illnesses and pathogens
D) How drugs are transported throughout the body
E) How drugs are removed from the body

Answer 3

How drugs move from the site of administration to circulating fluids
How drugs are converted to a form that is easily removed from the body
How drugs are transported throughout the body
How drugs are removed from the body

Question 4

The patient 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 patient?

A) In time, the patient will experience no effect from other medications.
B) In time, the patient will experience increased effects from other medications.
C) In time, the patient will experience a reduced effect from this medication.
D) In time, the patient will experience an increased effect from this medication.

Question 5

The patient tells the nurse that he is on many medications and questions how they all get to the right places. What are the best responses by the nurse?

A) "It depends on how much protein you have in your body."
B) "It depends on the health of your kidneys."
C) "It depends on whether they are fat based or water based."
D) "It depends on the amount of blood flow to your body tissues."
E) "It depends on the health of your liver."

Question 6

Following ingestion, a drug crosses a membrane from an area of higher concentration to an area of lower concentration. This is an example of

A) active transport.
B) osmosis.
C) diffusion.
D) metabolism.

Question 7

Which statement regarding medication distribution within the body is accurate?

A) The blood-brain barrier inhibits rapid crossing of all medications.
B) Body organs with high levels of blood flow are more difficult organs to which to deliver drugs.
C) Medications that are lipid-soluble are more completely distributed.
D) Drug-protein complexes must form prior to crossing capillary membranes.

Question 8

Enzymatic activity that changes a medication into a less active form is an example of

A) pharmacodynamics.
B) active transport.
C) pharmacokinetics.
D) diffusion.

Question 9

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

A) Administration of intravenous fluids to flush the kidneys
B) Administration of ammonium chloride to the patient
C) Administration of sodium bicarbonate to the patient
D) Administration of intravenous proteins to bind the aspirin

Question 10

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

A) Teach the patient that lipid-soluble drugs are better because of protein binding.
B) Teach the patient that lipid-soluble drugs are more effective in treating his illness.
C) Teach the patient that lipid-soluble drugs are better because they have fewer side effects.
D) Teach the patient that lipid-soluble drugs are more effective because they are excreted at a slower rate.

Question 11

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

A) The patient's liver may compensate for renal failure; the drugs may be effective.
B) The patient may have drug toxicity from all the drugs.
C) The patient may have drug toxicity only if the drugs are excreted by the kidneys.
D) The patient may have decreased effectiveness of the drugs.

Question 12

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

A) Administer the aspirin with an alkaline food, like cottage cheese.
B) Administer the aspirin in an enteric-coated formulation.
C) Administer the aspirin with a high-fat food, like peanut butter.
D) Administer the aspirin on an empty stomach.

Question 13

Aspirin is ionized as it enters the small intestine. Which statement is accurate regarding the absorption of aspirin in the small intestine?

A) Absorption is decreased.
B) Absorption is increased.
C) Ionization has nothing to do with the absorption rate.
D) Aspirin must travel past the small intestine for absorption to occur.

Question 14

Which of the following are the four categories of pharmacokinetics?

A) Diffusion, active transport, interspersing, and storage
B) Ingestion, metabolism, interspersing, and excretion
C) Absorption, distribution, metabolism, and excretion
D) Ingestion, settling, movement, and storage

Question 15

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?

A) "No, it will probably cause your baby to have more allergies."
B) "No, because it might decrease the amount of milk you produce."
C) "No, it could be excreted in your milk and affect the baby."
D) "No, it will affect the taste of your milk, and your baby might reject nursing."

Question 16

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

A) The patient will be at risk to experience a decreased effectiveness of the drug.
B) The patient will be at risk to experience toxic effects of the drug.
C) The patient's kidneys will excrete the drug at a faster rate.
D) The patient's serum globulin is more important than serum albumin.

Question 17

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?

A) Intravenous route
B) Oral route
C) Rectal route
D) Sublingual route

Question 18

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

A) The effect of the drug will be a prolonged action.
B) The effect of the drug will be increased side effects.
C) The effect of the drug will be decreased side effects.
D) The effect of the drug will be decreased.

Question 19

The patient 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?

A) "To detect side effects before they become a problem."
B) "To be sure the medication is working properly."
C) "To determine if your body is responding as it should."
D) "To be sure you have the correct amount of medication in your system."

Question 20

Which organ is the most responsible for the first-pass effect?

A) Bladder
B) Kidneys
C) Liver
D) Stomach

Question 21

The nurse recognizes that medications can be excreted by which routes?

A) Fecal
B) Gastric
C) Glandular
D) Pulmonary
E) Renal

Question 22

A patient who has received an oral medication for treatment of hives says, "How long will it be before my skin clears and quits itching?" Which concepts should the nurse consider when formulating a response?

A) The amount of time between administration and the drug taking effect is known as onset of action.
B) Peak plasma levels rarely occur with oral medications.
C) Duration of action is the amount of time a drug is effective.
D) Peak plasma level is dependent on the drug's plasma half-life (t_1/2)_.
E) Drugs with short half-lives are ineffective in treating systemic illnesses.

Question 23

Which finding would most accurately indicate that a therapeutic range for a medication had been reached?

A) No serious adverse effects are experienced following administration.
B) The indication for administration was achieved without serious side effects.
C) A pre-specified amount (in milligrams) was administered.
D) The medication was effective, but the patient experienced a lethal dysrhythmia.

Question 24

Prior to administering a newly prescribed antibiotic, the nurse asks the patient if any other drugs have been taken today. The patient responds, "Why do you need to know?" Which nursing responses are indicated?

A) "I need to be certain you are not taking another antibiotic."
B) "Some drugs block the action of others."
C) "Some drugs increase the activity of other drugs."
D) "The antibiotic I am about to give you is a prodrug."
E) "We don't want to increase first-pass effect."

Question 25

The nurse is teaching a patient the importance of taking the medication as prescribed. Patient teaching is guided by the nurse's knowledge of which principles of pharmacokinetics?

A) A medication taken by injection must cross the membranes of the gastrointestinal tract to get to the bloodstream before it can be distributed throughout the body.
B) A drug may be exposed to several physiological processes while en route to target cells.
C) Liver enzymes may chemically change the drug.
D) Excretion organs such as kidneys and intestines must be healthy enough to eliminate the drug.
E) Many processes to which drugs are exposed are destructive, thereby helping facilitate the drug's movement throughout the body.

Question 26

The nurse is reviewing the role of diffusion in the distribution of medications. Drugs that cannot be distributed by simple diffusion include those with which characteristics?

A) Large molecules
B) Ionization
C) Water-soluble agents
D) Alcohol
E) Urea

Question 27

Which values must be known in order to determine a drug's therapeutic range?

A) Toxic concentration
B) Onset of action
C) Peak plasma level
D) Absorption rate
E) Minimal effective concentration

Question 28

Which statement is accurate regarding medications that end up being secreted in bile?

A) All medications secreted in bile are excreted in the feces.
B) Some medications are excreted in the feces while others can be recirculated to the liver many times.
C) Most medications secreted in bile are metabolized in the gallbladder.
D) Generally, medications are not secreted in the bile.

Question 29

A patient asks the nurse why he experiences a metallic taste after taking certain medications. The nurse explains that some medications are secreted by glandular activity. The nurse would identify which substances as examples of this excretion?

A) Saliva
B) Sweat
C) Breast milk
D) Urine
E) Feces

Question 30

Which substance has the lowest rate of crossing renal tubular membranes and would therefore be excreted in the urine?

A) Lipid-soluble drugs
B) Volatile drugs
C) Ionized drugs
D) Non-ionized drugs