Deck 1: Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic Phases

Question 1

A client asks why the oral dose of her pain medication is higher than the intravenous dose. The nurse explains that with the oral dose, only 20% to 40% of the drug may actually enter systemic circulation. This reduces the amount of active drug. What is the term for this effect?

A) Protein binding
B) Bioavailability
C) Hepatic first pass
D) Pinocytosis

Answer 1

Bioavailability

Question 2

A nurse is determining whether a medication is ordered to be given at the appropriate intervals. This is done by assessing the half-life of the medication. The serum half-life (t 1/2 ) of a drug is the time required:

A) for half of a drug dose to be absorbed.
B) after absorption for half of the drug to be eliminated.
C) for a drug to be achieve maximum effectiveness.
D) for half of the drug dose to be completely distributed.

Answer 2

after absorption for half of the drug to be eliminated.

Question 3

The nurse teaches the client that undesired effects are frequently associated with a client stopping a medication before completion of the full course. The nurse should also instruct the client that physiologic effects not related to the desired effect, which can be predicted or associated with the use of the drug, may also occur. What should the client recognize about these physiologic effects?

A) They are severe adverse reactions.
B) They are side effects.
C) They are synergistic effects.
D) They are toxic effects.

Answer 3

They are side effects.

Question 4

The nurse sees that the client has been prescribed a loading dose of medication. What effect should the nurse expect to result from the client receiving a loading dose?

A) A rapid maximum effective concentration
B) Maintenance dose the lowest plasma concentration of the drug
C) Therapeutic dose the highest plasma concentration of the drug
D) A rapid minimum effective concentration

Question 5

The nurse notes that the client is rapidly developing a decreased response to a medication. This decreased response is known as:

A) pharmacogenetics.
B) tachyphylaxis.
C) drug accumulation.
D) drug toxicity.

Question 6

When providing a medication, which route should the nurse select to ensure the maximum amount of bioavailability?

A) Oral
B) Intravenous
C) Intramuscular
D) Subcutaneous

Question 7

A client's creatinine clearance level is 105 mL/min. Based on this information, what type of change in his medication should the nurse anticipate?

A) Increased dosage
B) Decreased dosage
C) Unchanged dosage
D) Dosage withheld

Question 8

Biotransformation is affected by many factors. What happens to the client's drug metabolism when liver function is decreased?

A) The client can develop toxicity.
B) The client will have an enhanced therapeutic response.
C) The client may require a larger than normal dose of the medication.
D) The client will experience a decreased therapeutic response.

Question 9

A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain relief, the nurse administers the medication so that it is most rapidly absorbed from the gastrointestinal (GI) tract. Which mode of delivery has the fastest absorption?

A) Tablet
B) Enteric-coated pill
C) Capsule
D) Liquid suspension

Question 10

A client is suffering from end-stage renal disease. Because of this condition, the nurse monitors drug levels to assess for which phenomenon?

A) Toxicity
B) Subtherapeutic levels
C) Drug ineffectiveness
D) Poor compliance

Question 11

The nurse is monitoring a patient prescribed an aminoglycoside antibiotic for toxicity. Which nursing intervention is indicated when administering this medication?

A) Ensure that the client voids before administration.
B) Have emergency airway equipment at the bedside.
C) Monitor blood levels of the medication.
D) Determine liver function before each dose.

Question 12

A nursing role is to teach clients to watch for adverse medication reactions. The client should be able to recognize what about adverse reactions?

A) They are mild, easily treatable side effects.
B) They are therapeutic, expected effects.
C) They are undesired effects that may be severe.
D) They are the desired therapeutic effects.

Question 13

A client is taking a drug that is moderately highly protein bound. Several days later, the client takes a second drug that is 90% protein bound. What is most likely to have occurred as a result of this administration?

A) The first drug remains protein bound.
B) The first drug becomes increasingly inactive.
C) The first drug is released from the protein and becomes more pharmacologically active.
D) The second drug becomes more active.

Question 14

Because of hereditary influence, drug action may vary from a predicted drug response. This variance is known as:

A) biotransformation.
B) tachyphylaxis.
C) pharmacogenetics.
D) transcription factors.

Question 15

A nurse is learning how to draw peak and trough levels of a medication. In order to draw them correctly, the nurse should know what the trough level is. The trough level is the __________ of a drug.

A) minimum effective concentration
B) highest plasma concentration
C) lowest plasma concentration
D) rate of absorption

Question 16

The client is receiving frequent daily drug dosing of a drug that has a long duration of action. What should the nurse expect to be the result of this administration?

A) Drug accumulation and possible drug toxicity
B) Increased drug excretion
C) Enhanced therapeutic response
D) Increased drug half-life

Question 17

A client is to receive a drug that has a half-life of 36 hours. The drug would probably be administered on which dose schedule?

A) Once a week
B) Once a day
C) Twice a day
D) Three times a day

Question 18

Isoproterenol (Isuprel) is an example of a medication that enhances the beta receptors in the body. What is the term for drugs that stimulate a response?

A) Antagonists
B) Agonists
C) Depressants
D) Therapeutic effect

Question 19

A client asks why she needs to take a medication on an empty stomach. The nurse explains that food generally has which effect on drug dissolution and absorption?

A) Enhances
B) Increases
C) Decreases
D) Does not have an effect

Question 20

A client is being given two highly protein-bound drugs concurrently. What is most likely to be the result of this administration?

A) More free drug in circulation
B) Less free drug in circulation
C) More drug bound to protein
D) More drug excreted in the urine

Question 21

The nurse receives the results of laboratory testing and sees that the level of valproic acid in the client's blood is 78 mcg/mL. What is the nurse's most appropriate response?

A) The nurse must call the physician immediately; this is a toxic level of medication.
B) He or she must do nothing; this is a therapeutic level of medication.
C) He or she must call the physician; this is a dangerously high level of medication.
D) The nurse must do nothing; this is a subnormal level of medication.

Question 22

The client has been placed on an enteric-coated medication. An appropriate action on the part of the nurse is to instruct the client to __________ the medication.

A) weigh herself at the same time every day while on
B) drink at least eight glasses of water daily while on
C) adhere to a low-sodium diet while on
D) avoid eating fatty food before taking

Question 23

The client has been prescribed digoxin. Before administering the drug on a routine basis to the client, the nurse should recognize that the client should receive a _____ dose.

A) therapeutic
B) peak
C) trough
D) loading

Question 24

The nurse is caring for a client who needs to have a peak drug level drawn. He was given the oral medication 30 minutes ago. What is the best action on the part of the nurse?

A) Call the lab to have the medication level drawn immediately.
B) Arrange for the level to be drawn tomorrow since the peak time has passed.
C) Wait for at least another 30 minutes before calling to have the level drawn.
D) Schedule the level to be drawn in 8 hours.