Question 1

A nursing mother asks a nurse if it is all right to take St. John's wort for mild depression. What is the best response by the nurse?

Accepted Answer

St. John's wort can be excreted in breast milk and may cause unwanted effects on a nursing infant. It is important to advise nursing mothers to avoid taking any herbal or medication without consulting their healthcare provider to ensure the safety of their baby.

Question 2

A client prescribed a loading dose to be followed by a lower maintenance dose asks the nurse why the maintenance dose is lower. Which response should the nurse provide the client?

Accepted Answer

The initial dose, or loading dose, is normally larger so that the medication can reach therapeutic levels in the body more quickly. The maintenance dose is then lower as it is intended to maintain the levels that the loading dose achieved. The nurse should explain this to the client to ensure understanding and promote adherence to the medication regimen.

Question 3

The patient is malnourished and has a low serum albumin. A nurse is caring for a client with a low serum albumin level. The healthcare provider has ordered aspirin, which is a highly protein-bound drug. Which evaluation by the nurse best describes the effect this will have on the client?

Accepted Answer

Aspirin is a highly protein-bound drug, which means that it binds to albumin in the bloodstream. In a client with low serum albumin, there is less albumin available to bind to the aspirin. This can lead to an increased amount of free (unbound) aspirin in the bloodstream, which can cause toxic effects such as bleeding or ulceration of the stomach lining. Therefore, the nurse should monitor the client closely for signs of aspirin toxicity.

Question 4

A nurse is administering aspirin to a client. Aspirin is ionized as it enters the small intestine. The nurse understands which of the following is correct regarding absorption of aspirin in the small intestine.

Accepted Answer

Aspirin is a weak acid, and in the basic (or less acidic) environment of the small intestine, it becomes ionized. Ionized molecules do not easily cross cell membranes, which decreases their absorption. Therefore, the absorption of aspirin is decreased in the small intestine compared to more acidic environments where it remains non-ionized and more readily absorbed.

Question 5

A nurse administers medications by various routes of delivery. The nurse recognizes which route of administration requires higher dosages of drugs to achieve a therapeutic effect?

Accepted Answer

The oral route requires higher dosages of drugs to achieve a therapeutic effect due to the first-pass effect, where the drug is metabolized in the liver before reaching systemic circulation, reducing the amount of active drug available.

Question 6

A 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?

Accepted Answer

Option D is the correct answer because it shows understanding that certain foods can impact medication absorption, and therefore it is important to be cautious about what they eat when taking their medication. Option A is incorrect because it suggests unsafe practices regarding medication expiration. Option B is incorrect because it suggests that storage conditions do not affect medication potency, which is not true. Option C is incorrect because it is not specific to medication absorption and instead relates to potential interactions between the medication and dairy products.

Question 7

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

Accepted Answer

Drugs that are excreted in the bile will have a prolonged action because they will be reabsorbed through enterohepatic circulation.

Question 8

A client tells a nurse that he is on many medications and asks how they all get to the right places. What are the best responses by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The answer of A client tells a nurse that he...

Question 9

A nurse is caring for a client with meningitis who is receiving a water-soluble drug. The client asks the nurse why the healthcare provider changed the prescription to a lipid-soluble drug. What is the best response by the nurse?

Accepted Answer

Lipid-soluble drugs are favored for meningitis because they can easily cross the blood-brain barrier and reach the central nervous system, where the infection is located. Water-soluble drugs do not pass the blood-brain barrier effectively, making them less effective in treating meningitis.

Question 10

A healthcare provider prescribes aspirin to a client complaining of a severe headache. Which action by the nurse will result in the fastest relief of the client's headache?

Accepted Answer

Administering aspirin on an empty stomach will result in the fastest relief of the client's headache as it allows for faster absorption and distribution of the medication into the bloodstream. Administering the aspirin with an alkaline or high-fat food may delay absorption, while enteric-coated formulations are designed to dissolve in the intestines, resulting in slower onset of action.

Question 11

A client is admitted to the hospital in chronic renal failure and several drugs are prescribed. What best describes the nurse's assessment of this client?

Accepted Answer

In chronic renal failure, the kidneys are unable to effectively excrete drugs, increasing the risk of drug toxicity. Therefore, the nurse should closely monitor the client for any signs of toxicity from the prescribed medications.

Question 12

A client asks a nurse how medications are distributed within the body. What among the below would be the nurse's response?

Accepted Answer

Medications that are lipid-soluble are more completely distributed within the body because they can easily pass through cell membranes. This allows them to be distributed to different tissues and organs effectively.

Question 13

A client is receiving lithium (Eskalith) and asks the nurse why their blood has to be drawn so often. What is the best response by the nurse?

Accepted Answer

Lithium has a narrow therapeutic range, so frequent blood tests are necessary to ensure that the drug concentration remains within the safe and effective range, preventing toxicity or subtherapeutic levels.

Question 14

A nurse is reviewing enzymatic activity that changes a medication to a less active form with a nursing student. The nurse knows the teaching is effective if the nursing student responds that which of the following is an example of this concept?

Accepted Answer

This concept is known as pharmacokinetics, specifically metabolism. Enzymatic activity in the liver can convert a medication to a less active form, which may affect the drug's effectiveness. Pharmacodynamics refers to how drugs interact with the body and their biological effects. Active transport and diffusion are mechanisms of drug transport across cell membranes, but are not related to enzymatic activity changing a medication's form.

Question 15

A nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The four major components of pharmacokinetics include absorption (how drugs move from the site of administration to circulating fluids), metabolism (how drugs are converted to a form that is easily removed from the body), distribution (how drugs are transported throughout the body), and excretion (how drugs are removed from the body). Choice C, how drugs change body illnesses and pathogens, refers to pharmacodynamics, not pharmacokinetics.

Question 16

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?

Accepted Answer

Enzyme inducers of the P450 system increase the metabolism of drugs, leading to a reduced effect of the medication over time as the body becomes more efficient at breaking it down.

Question 17

A nurse administers a drug to a client. Following ingestion, the drug crosses a membrane from an area of higher concentration to an area of lower concentration. The nurse understands that this is an example of which of the following?

Accepted Answer

Diffusion is the movement of a substance from an area of higher concentration to an area of lower concentration. This process does not require energy, unlike active transport where substances move against a concentration gradient and use energy, or metabolism where substances undergo chemical reactions within the body. Osmosis is the movement of water across a semi-permeable membrane from an area of higher concentration to lower concentration of solutes, and is a specific type of diffusion.

Question 18

A nursing student asks a nurse what the categories of pharmacokinetics are. What is the nurse's best response?

Accepted Answer

The categories of pharmacokinetics are absorption, distribution, metabolism, and excretion (ADME). Diffusion and movement are not categories of pharmacokinetics, and while ingestion may play a role in absorption, it is not a category in and of itself.

Question 19

A nursing student asks a nurse which organ is the most responsible for the first-pass effect. What is the nurse's best response?

Accepted Answer

The liver is the most responsible organ for the first-pass effect, where it metabolizes drugs before they can reach systemic circulation. This process reduces the bioavailability of drugs, meaning that less of the drug reaches its target site in the body. The other organs listed (bladder, kidneys, stomach) do not play a significant role in the first-pass effect.

Question 20

A client comes to the emergency department following an overdose of aspirin, which is an acidic drug. The nurse should anticipate administering which of the following?

Accepted Answer

Aspirin is an acidic drug and can cause metabolic acidosis in high doses. Administration of sodium bicarbonate can help to alkalize the serum pH and decrease the toxic effects of the aspirin. Intravenous fluids may also be administered to flush the kidneys, but this alone will not effectively treat the acidosis. Ammonium chloride can actually worsen the acidosis by increasing acid production in the liver. Intravenous proteins would not be effective in binding the aspirin.

Quiz 4: Pharmacokinetics