Deck 4: Pharmacokinetics

Question 1

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?
1)The patient's liver may compensate for renal failure;the drugs may be effective.
2)The patient may have drug toxicity from all the drugs.
3)The patient may have drug toxicity only if the drugs are excreted by the kidneys.
4)The patient may have decreased effectiveness of the drugs.

Answer 1

2

Question 2

The patient comes to the emergency department following an overdose of aspirin,an acidic drug.What will the best plan of the nurse include?
1)Administration of intravenous fluids to flush the kidneys
2)Administration of ammonium chloride to the patient
3)Administration of sodium bicarbonate to the patient
4)Administration of intravenous proteins to bind the aspirin

Answer 2

3

Question 3

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?
1)The patient will be at risk to experience a decreased effectiveness of the drug.
2)The patient will be at risk to experience toxic effects of the drug.
3)The patient's kidneys will excrete the drug at a faster rate.
4)The patient's serum globulin is more important than serum albumin.

Answer 3

2

Question 4

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?
1)Teach the patient that lipid-soluble drugs are better because of protein binding.
2)Teach the patient that lipid-soluble drugs are more effective in treating his illness.
3)Teach the patient that lipid-soluble drugs are better because they have fewer side effects.
4)Teach the patient that lipid-soluble drugs are more effective because they are excreted at a slower rate.

Question 5

Aspirin is ionized as it enters the small intestine.Which statement is accurate regarding the absorption of aspirin in the small intestine?
1)Absorption is decreased.
2)Absorption is increased.
3)Ionization has nothing to do with the absorption rate.
4)Aspirin must travel past the small intestine for absorption to occur.

Question 6

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?
1)"To detect side effects before they become a problem."
2)"To be sure the medication is working properly."
3)"To determine if your body is responding as it should."
4)"To be sure you have the correct amount of medication in your system."

Question 7

Enzymatic activity that changes a medication into a less active form is an example of
1)pharmacodynamics.
2)active transport.
3)pharmacokinetics.
4)diffusion.

Question 8

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

Question 9

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?
1)Administer the aspirin with an alkaline food,like cottage cheese.
2)Administer the aspirin in an enteric-coated formulation.
3)Administer the aspirin with a high-fat food,like peanut butter.
4)Administer the aspirin on an empty stomach.

Question 10

Which of the following are the four categories of pharmacokinetics?
1)Diffusion,active transport,interspersing,and storage
2)Ingestion,metabolism,interspersing,and excretion
3)Absorption,distribution,metabolism,and excretion
4)Ingestion,settling,movement,and storage

Question 11

The patient tells the nurse that he is on many medications,and s how they all get to the right places.What is the best response by the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"It depends on how much protein you have in your body."
2)"It depends on the health of your kidneys."
3)"It depends on whether they are fat based or water based."
4)"It depends on the amount of blood flow to your body tissues."
5)"It depends on the health of your liver."

Question 12

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?
1)Intravenous route
2)Oral route
3)Rectal route
4)Sublingual route

Question 13

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

Question 14

Following ingestion,a drug crosses a membrane from an area of higher concentration to an area of lower concentration.This is an example of
1)active transport.
2)osmosis.
3)diffusion.
4)metabolism.

Question 15

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?
1)In time,the patient will experience no effect from other medications.
2)In time,the patient will experience increased effects from other medications.
3)In time,the patient will experience a reduced effect from this medication.
4)In time,the patient will experience an increased effect from this medication.

Question 16

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?
1)"No,it will probably cause your baby to have more allergies."
2)"No,because it might decrease the amount of milk you produce."
3)"No,it could be excreted in your milk and affect the baby."
4)"No,it will affect the taste of your milk,and your baby might reject nursing."

Question 17

Which organ is the most responsible for the first-pass effect?
1)Bladder
2)Kidneys
3)Liver
4)Stomach

Question 18

The nursing instructor is teaching pharmacology to student nurses.What will the nursing instructor include as the four major components of pharmacokinetics? Credit will be given only if all correct choices and no incorrect choices are selected.
1)How drugs move from the site of administration to circulating fluids
2)How drugs are converted to a form that is easily removed from the body
3)How drugs change body illnesses and pathogens
4)How drugs are transported throughout the body
5)How drugs are removed from the body

Question 19

Which statement regarding medication distribution within the body is accurate?
1)The blood-brain barrier inhibits rapid crossing of all medications.
2)Body organs with high levels of blood flow are more difficult organs to which to deliver drugs.
3)Medications that are lipid-soluble are more completely distributed.
4)Drug-protein complexes must form prior to crossing capillary membranes.

Question 20

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?
1)The effect of the drug will be a prolonged action.
2)The effect of the drug will be increased side effects.
3)The effect of the drug will be decreased side effects.
4)The effect of the drug will be decreased.

Question 21

Which of the following would most accurately indicate that a therapeutic range for a medication had been reached?
1)No serious adverse effects are experienced following administration.
2)The indication for administration was achieved without serious side effects.
3)A pre-specified amount (in milligrams)was administered.
4)The medication was effective,but the patient experienced a lethal dysrhythmia.

Question 22

Which of the following substances would have the lowest rate of crossing renal tubular membranes,and would therefore be excreted in the urine?
1)Lipid-soluble drugs
2)Water
3)Ionized drugs
4)Non-ionized drugs

Question 23

A patient is admitted to the burn unit with 75% body surface area burns.Which orders would be appropriate for this patient to control pain? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Morphine 10 mg IV every 2 to 4 hours as needed for pain
2)Morphine 10 mg IM every 2 to 4 hours as needed for pain.
3)Morphine 10 mg transdermal patch every 2 to 4 hours as needed for pain.
4)Morphine 10 mg sublingual every 2 to 4 hours as needed for pain.
5)Morphine 10 mg subcutaneous every 2 to 4 hours as need for pain.

Question 24

The nurse is preparing an intramuscular (IM)injection for a patient with strep throat.What principles of absorption may have guided the health care provider's decision to order the medication by IM route? Credit will be given only if all correct choices and no incorrect choices are selected.
1)IM drugs are rapidly absorbed.
2)IM drugs bypass the gastrointestinal tract,resulting in increased absorption.
3)IM drugs avoid drugÂ?drug and foodÂ?drug interactions,which can decrease absorption.
4)IM drugs have the ability to accumulate in the muscle and may remain in the body for an extended amount of time.
5)IM drugs bypass the gastrointestinal tract and are delivered to the small intestine,where most medications are rapidly absorbed.

Question 25

The nurse recognizes that medications can be excreted by which routes? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Fecal
2)Gastric
3)Glandular
4)Pulmonary
5)Renal

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Large molecules
2)Ionization
3)Water-soluble agents
4)Alcohol
5)Urea

Question 27

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)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.
2)A drug may be exposed to several physiological processes while en route to target cells.
3)Liver enzymes may chemically change the drug.
4)Excretion organs such as kidneys and intestines must be healthy enough to eliminate the drug.
5)Many processes to which drugs are exposed are destructive,thereby helping facilitate the drug's movement throughout the body.

Question 28

A patient 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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Saliva
2)Sweat
3)Breast milk
4)Urine
5)Feces

Question 29

Which statement is accurate regarding medications that end up being secreted in bile?
1)All medications secreted in bile are excreted in the feces.
2)Some medications are excreted in the feces while others can be recirculated to the liver many times.
3)Most medications secreted in bile are metabolized in the gallbladder.
4)Generally,medications are not secreted in the bile.