Deck 4: Pharmacokinetics

Question 1

The nurse recognizes that medications can be excreted by the following routes: (Select all that apply.)
1)Pulmonary
2)Renal
3)Fecal
4)Glandular
5)Gastric

Answer 1

1, 2, 3, 4

Question 2

The nurse reads that a drug undergoes enterohepatic recirculation and explains to a colleague that this drug:
1)Will have a very low therapeutic effect.
2)Must be given several times a day.
3)Might have a prolonged activity in the body.
4)Will be concentrated in the liver.

Answer 2

3

Question 3

A client receiving metoprolol (Lopressor), a substrate of the CYP2D6 system, is started on amiodarone (Cordarone), an inhibitor of the CYP2D6 system.The nurse should plan to:
1)Administer the medications at least two hours apart.
2)Monitor for prolonged effects of the Lopressor.
3)Monitor for signs of amiodarone toxicity.
4)Administer both drugs on an empty stomach.

Answer 3

2

Question 4

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:
1)Passive diffusion.
2)Active diffusion.
3)Facilitated diffusion.
4)Absorption.

Question 5

The nurse checks a newly ordered medication and finds it to be 92% protein-bound.The nurse understands that the amount of drug which will be readily available to the client is:
1)8%.
2)50%.
3)92%.
4)100%.

Question 6

The nurse has just administered a client's a.m.dose of medications following a high-fat breakfast.The nurse recognizes that the absorption of the medications will be:
1)Accelerated.
2)Not affected.
3)Slowed.
4)Blocked.

Question 7

A client is receiving an antibiotic with the potential to become nephrotoxic.The nurse should plan to monitor the:
1)Rate of intravenous administration.
2)Route of drug administration.
3)Urinary concentration of the drug.
4)Plasma levels of the drug.

Question 8

The nurse anticipates that the medications ordered for a client with cirrhosis will:
1)Be administered by the parenteral route.
2)Need to be given with an antacid.
3)Need to be divided evenly throughout the day.
4)Be in lower doses than normal.

Question 9

When caring for an obese client who has received thiopental (Pentothal)during surgery, the nurse is aware that the drug:
1)Will be eliminated quickly.
2)Will be stored in adipose tissue.
3)Is often ineffective.
4)Will need to be given at higher-than-normal doses.

Question 10

A client has been started on diltiazem (Cardizem), a susbstrate of the cytochrome CYP3A4 isoenzyme system.Since the client also takes Phenobarbital for seizures, which is an inducer of the CYP3A4 isoenzyme system, the nurse recognizes that diltiazem:
1)Will not be able to cross the blood brain barrier (BBB).
2)Might be inactivated at a faster rate than normal.
3)Might be excreted at a slower rate.
4)Will be metabolized by the kidneys.

Question 11

The nurse determines that a client who is breastfeeding has understood teaching regarding medication use when she states:
1)"I will only use herbal supplements while breastfeeding."
2)"I will be sure to take medications just before breastfeeding."
3)"I will check with my health care provider before taking any medication."
4)"I know it is safe to take over-the-counter meds, but not prescription meds."

Question 12

The nurse is administering an albuterol (Ventolin)inhaler to a client with asthma.The absorption of the medication will occur:
1)Over a 2-3-hour period.
2)Very slowly, since the airways are constricted.
3)Very rapidly.
4)In a slow, steady fashion.

Question 13

The nurse recognizes that when a client is receiving a lipid-soluble medication, higher concentrations will accumulate in which tissues?
1)Skeletal muscle
2)Cardiac muscle
3)Bone marrow
4)Liver

Question 14

A client has been started on a medication for postoperative pain.The nurse anticipates that the client will receive optimal pain relief when the plasma concentration of the drug:
1)Reaches a therapeutic range.
2)Approaches a toxic concentration.
3)Achieves a minimal effective concentration.
4)Concentrates in the muscle tissue.

Question 15

When the nurse administers a drug that must move from an area of low concentration to an area of high concentration, it will require:
1)Active transport.
2)Simple diffusion.
3)An intravenous route.
4)A transdermal delivery system.

Question 16

A client is taken off medication therapy with digoxin (Lanoxin).Recalling that this drug undergoes enterohepatic recirculation, the nurse explains to the client:
1)"You might experience some toxic effects from the drug in the next few days."
2)"You might continue to have effects of the drug for a few weeks."
3)"Expect to experience some side effects until the drug is totally eliminated."
4)"The drug will be totally out of your system in the next 48 hours."

Question 17

The nurse recognizes that adding a vasoconstrictor to a local anesthetic agent will have which effect on absorption of the anesthetic agent?
1)It will produce a more local effect.
2)It will increase blood flow to the area.
3)It will slow absorption of the agent.
4)It will help to eliminate the drug sooner.

Question 18

When administering a highly protein-bound drug to a client, the nurse can expect:
1)Duration of action will be prolonged.
2)Onset of drug action will be prolonged.
3)Metabolism of the drug will be delayed.
4)Drug excretion will be accelerated.

Question 19

A client is seen in the Emergency Department for a diazepam (Valium)overdose.In order to enhance excretion of the drug, the nurse anticipates that the client will receive:
1)High volumes of intravenous normal saline solution (NSS).
2)An intravenous solution containing sodium bicarbonate.
3)Large doses of a proton pump inhibitor.
4)An intravenous solution with ammonium chloride.

Question 20

A client is receiving antibiotic treatment for a wound abscess.The nurse recognizes that drug distribution to this area, in order to be effective, requires:
1)The drug to be lipid-soluble.
2)The drug to be bio-available in an acidic environment.
3)Adequate blood perfusion to the abscess.
4)Use of a topical antibiotic.

Question 21

The nurse is preparing to medicate a client for a migraine headache.The nurse should choose the drug with which half-life?
1)1-3 minutes
2)2-3 hours
3)10-20 hours
4)5-10 days

Question 22

Following the administration of a loading dose of an antibiotic, the nurse anticipates that the client will receive which dosing schedule of additional antibiotic?
1)Intermittent doses of the antibiotic
2)Daily bolus injections
3)Alternating high and low doses of the antibiotic
4)A second loading dose

Question 23

A client has been ordered a loading dose of a cardiac glycoside for an exacerbation of heart failure.When the client comments, "I usually take a much lower dose," the nurse responds:
1)"Giving a large dose will reduce the incidence of side effects."
2)"The physician ordered this dose so I need to administer it."
3)"You are being given a large dose in order to increase blood levels of the drug quickly."
4)"Your usual dose is probably no longer effective for your condition, and you need to be on a higher dose now."

Question 24

The nurse is administering a drug with a half-life of 6 hours.The nurse understands the client will eliminate most of the drug in how many hours?
1)6
2)12
3)24
4)36

Question 25

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:
1)The drug to elicit a therapeutic response.
2)The drug to reach the target tissue.
3)One-half of the drug to be absorbed.
4)One-half of the drug to be eliminated by the body.