Deck 3: Pharmacokinetics

Question 1

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?
Select all that apply.

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

Answer 1

Large molecules
Ionization
Water-soluble agents

Question 2

The nurse is preparing an intramuscular (IM)injection for a client with strep throat.Which principles of absorption may have guided the health care provider's decision to order the medication by IM route?
Select all that apply.

A)IM drugs are rapidly absorbed.
B)IM drugs bypass the gastrointestinal tract,resulting in increased absorption.
C)IM drugs avoid drug-drug and food-drug interactions,which can decrease absorption.
D)IM drugs have the ability to accumulate in the muscle and may remain in the body for an extended amount of time.
E)IM drugs bypass the gastrointestinal tract and are delivered to the small intestine,where most medications are rapidly absorbed.

Answer 2

IM drugs are rapidly absorbed.
IM drugs bypass the gastrointestinal tract,resulting in increased absorption.
IM drugs avoid drug-drug and food-drug interactions,which can decrease absorption.

Question 3

The nurse checks a newly ordered medication and finds it to be 92% protein bound.How much of the medication will be readily available to the client once the nurse administers the medication?

A)100%.
B)8%.
C)50%.
D)92%.

Answer 3

8%.

Question 4

The nurse determines that a client who is breast-feeding has understood teaching regarding medication use when the client makes which statement?

A)"I will be sure to take medications just before breast-feeding."
B)"I know it is safe to take over-the-counter meds,but not prescription meds."
C)"I will check with my health care provider before taking any medication."
D)"I will only use herbal supplements while breast-feeding."

Question 5

When administering an intravenous (IV)medication to a client,the nurse understands that the medication has a high concentration in the blood and will move into areas of lower concentration by which action?

A)Facilitated diffusion
B)Active diffusion
C)Absorption
D)Simple diffusion

Question 6

The nurse has just administered a client's morning dose of medications following a high-fat breakfast.How will the absorption of the medication be affected?

A)It will be blocked.
B)It will be slowed.
C)It will be accelerated.
D)It will not be affected.

Question 7

The nurse recognizes that when a client is receiving a lipid-soluble medication,higher concentrations will accumulate in which tissues?

A)Cardiac muscle
B)Liver
C)Bone marrow
D)Skeletal muscle

Question 8

A client has been started on diltiazem (Cardizem),a susbstrate of the cytochrome CYP3A4 isoenzyme system.The client also takes phenobarbital,an inducer of the CYP3A4 isoenzyme system,for seizures.What does the nurse recognize about diltiazem?

A)It will not be able to cross the blood brain barrier (BBB).
B)It will be metabolized by the kidneys.
C)It might be inactivated at a faster rate than normal.
D)It might be excreted at a slower rate.

Question 9

What are the four phases of pharmacokinetics that a drug goes through?

A)Absorption,distribution,ionization,and metabolism
B)Diffusion,bioavailability,metabolism,and excretion
C)Absorption,distribution,metabolism,and excretion
D)Active transport,ionization,diffusion,and excretion

Question 10

The nurse recognizes that adding a vasoconstrictor to a local anesthetic agent will have which effect on absorption of the anesthetic agent?

A)It will increase blood flow to the area.
B)It will help to eliminate the drug sooner.
C)It will produce a more localized effect.
D)It will slow absorption of the agent.

Question 11

When administering a drug-protein-bound drug to a client,what can the nurse expect?

A)Duration of action will be prolonged.
B)Drug excretion will be accelerated.
C)Metabolism of the drug will be delayed.
D)Onset of drug action will be prolonged.

Question 12

The nurse is administering an albuterol (Ventolin)inhaler to a client with asthma.The absorption of the medication will occur in what manner?

A)Very slowly,since the airways are constricted
B)Over a 2- to 3-hour period
C)In a slow,steady fashion
D)Very rapidly

Question 13

The nurse is caring for an obese client who has received thiopental (Pentothal),a lipid-soluble drug,during surgery.Of which fact about the drug should the nurse be aware?

A)It will need to be given at higher than normal doses.
B)It will be stored in adipose tissue.
C)It may have difficulty being distributed to body tissues.
D)It is often ineffective.

Question 14

A client is receiving antibiotic treatment for a wound abscess.What does the nurse recognize that drug distribution to this area requires,in order to be effective?

A)The drug to be lipid soluble
B)Adequate blood perfusion to the area
C)The drug to be bio-available in an acidic environment
D)Use of a topical antibiotic

Question 15

A client is seen in the emergency department for an overdose of diazepam (Valium),a weakly basic drug.In order to enhance excretion of the drug,what does the nurse anticipate that the client will receive?

A)High volumes of intravenous normal saline solution (NSS),a weakly basic solution
B)Large doses of a proton pump inhibitor,in an acidic solution
C)An intravenous solution containing sodium bicarbonate,which promotes alkaline urine
D)An intravenous solution with ammonium chloride,which acidifies filtrate

Question 16

The nurse is teaching a client the importance of taking the medication as prescribed.Client teaching is guided by the nurse's knowledge of which principles of pharmacokinetics?
Select all that apply.

A)A medication taken by injection must cross the membranes of the gastrointestinal tract to get to the blood stream 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 17

A client is admitted to the burn unit with 75% body surface area burns.Which orders would be appropriate for this client to control pain?
Select all that apply.

A)Morphine 10 mg IV every 2 to 4 hours as needed for pain
B)Morphine 10 mg IM every 2 to 4 hours as needed for pain
C)Morphine 10 mg transdermal patch every 2 to 4 hours as needed for pain
D)Morphine 10 mg sublingual every 2 to 4 hours as needed for pain
E)Morphine 10 mg subcutaneous every 2 to 4 hours as need for pain

Question 18

What does the nurse anticipate about the medications ordered for a client with liver disease?

A)They will be in lower doses than normal.
B)They will be administered by the parenteral route.
C)They will need to be divided evenly throughout the day.
D)They will need to be given with an antacid.

Question 19

When the nurse administers a drug that must move from an area of low concentration to an area of high concentration,what will the drug require?

A)Simple diffusion
B)Active transport
C)An intravenous route
D)A transdermal delivery system

Question 20

A client receiving metoprolol (Lopressor),a substrate of the CYP2D6 system,is started on amiodarone (Cordarone),an inhibitor of the CYP2D6 system.What should the nurse plan to do?

A)Monitor for signs of amiodarone toxicity.
B)Administer both drugs on an empty stomach.
C)Monitor for prolonged effects of the Lopressor.
D)Administer the medications at least two hours apart.

Question 21

The nurse is caring for a client who is receiving medications from several different classifications for the treatment of multiple health problems.For which medications or classifications does the nurse anticipate prolonged activity due to enterohepatic recirculation?
Select all that apply.

A)Mebendazole (Vermox)
B)Digoxin (Lanoxin)
C)Phenothiazines
D)Topical steroids
E)Topical anti-infectives

Question 22

The nurse recognizes that medications can be excreted by which routes?
Select all that apply.

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

Question 23

The nurse is preparing to medicate a client for a migraine headache.The nurse should choose the drug with which half-life?

A)10 to 20 hours
B)5 to 10 days
C)2 to 3 hours
D)1 to 3 minutes

Question 24

The nurse is reviewing the concept of a drug's half-life for a student nurse,explaining that it is the time it takes for what to happen?

A)One-half of the drug to be absorbed
B)One-half of the drug to be eliminated by the body
C)The drug to elicit a therapeutic response
D)The drug to reach the target tissue

Question 25

A client is prescribed a loading dose of a cardiac glycoside for an exacerbation of heart failure.When the client comments,"I usually take a much lower dose," which response by the nurse is the most appropriate?

A)"Giving a large dose will reduce the incidence of side effects."
B)"You are being given a large dose in order to increase blood levels of the drug quickly."
C)"The health care provider ordered this dose,so I need to administer it."
D)"Your usual dose is probably no longer effective for your condition,and you need to be on a higher dose now."

Question 26

The nurse reads that a drug undergoes enterohepatic recirculation.How would the nurse explain this process to a colleague?

A)This drug must be given several times a day.
B)The drug will have a very low therapeutic effect.
C)The drug will be concentrated in the liver.
D)The drug might have a prolonged activity in the body.

Question 27

A client asks the nurse why he experiences a metallic taste after taking certain medications.The nurse explains that a medication may cause glandular secretions that occur by which routes?
Select all that apply.

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

Question 28

A health care provider has discontinued the client's medication,digoxin (Lanoxin).Recalling that this drug undergoes enterohepatic recirculation,which statement does the nurse make to the client?

A)"You might continue to have effects of the drug for a few weeks."
B)"You might experience some toxic effects from the drug in the next few days."
C)"Expect to experience some side effects until the drug is totally eliminated."
D)"The drug will be totally out of your system in the next 48 hours."

Question 29

Following the administration of a loading dose of an antibiotic,the nurse anticipates that the client will receive which dosing schedule of additional antibiotic?

A)A second loading dose
B)Regularly intermittent doses of the antibiotic
C)Alternating high and low doses of the antibiotic
D)Daily bolus injections

Question 30

A client is receiving an antibiotic with the potential for nephrotoxicity.Which item should the nurse should plan to monitor?

A)Urinary concentration of the drug
B)Route of drug administration
C)Plasma levels of the drug
D)Rate of intravenous administration

Question 31

The nurse is preparing to administer felodipine to a hospitalized client.The nurse assesses the client for which disorders that may cause an increased risk for adverse effects associated with this medication due to its extended half-life?
Select all that apply.

A)Renal disease
B)Liver disease
C)Gastrointestinal disease
D)Cardiac disease
E)Pulmonary disease

Question 32

A client has been started on a medication for postoperative pain.When does the nurse anticipate the client will receive optimal pain relief?

A)When the drug concentrates in the muscle tissue
B)When the drug reaches a therapeutic range
C)When the drug achieves a minimal effective concentration
D)When the drug approaches a toxic concentration