Final Exam

Chapter 4: pharmacokinetics, Ch 5: Pharmacodynamics, ch.12, ch.13.

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?
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."

4. "We need to be careful about taking the medication with certain foods."

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?
1. "The initial dose shortens the half-life, so the medication would work more quickly."
2. "We always give medications this way; the healthcare provider 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."

3. "You had a larger dose initially so that the medication would work more quickly."

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?
1. Lipid-soluble drugs are better because of protein binding.
2. Lipid-soluble drugs are more effective in treating the client's illness.
3. Lipid-soluble drugs are better because they have fewer side effects.
4. Lipid-soluble drugs are more effective because they are excreted at a slower rate.

2. Lipid-soluble drugs are more effective in treating the client's illness.

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?
1. The client will be at risk of experiencing a decreased effectiveness of the drug.
2. The client will be at risk of experiencing toxic effects of the drug.
3. The client's kidneys will excrete the drug at a faster rate.
4. The client's liver will metabolize the drug at a faster rate.

2. The client will be at risk of experiencing toxic effects of the drug.

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

2. The client may have drug toxicity from all the drugs.

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?
1. Intravenous fluids to flush the kidneys
2. Ammonium chloride to increase metabolism in the liver
3. Sodium bicarbonate to alter the client's serum pH
4. Intravenous proteins to bind the aspirin

3. Sodium bicarbonate to alter the client's serum pH

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?
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.

4. Administer the aspirin on an empty stomach.

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?
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."

4. "To be sure you have the correct amount of medication in your system."

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?
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."

3. "No, it could be excreted in your milk and affect the baby."

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.
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

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
4. How drugs are transported throughout the body
5. How drugs are removed from the body

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.

3. In time, the patient will experience a reduced effect from this medication.

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.
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."

1. "It depends on how much protein you have in your body."
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."

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?
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.

1. The effect of the drug will be a prolonged action.

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

2. Oral route

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?
1. Pharmacodynamics
2. Active transport
3. Pharmacokinetics
4. Diffusion

3. Pharmacokinetics

A nursing student asks a nurse what the categories of pharmacokinetics are. What is the nurse's best response?
1. Diffusion
2. Ingestion
3. Absorption
4. Movement

3. Absorption

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?
1. Active transport
2. Osmosis
3. Diffusion
4. Metabolism

3. Diffusion

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.
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.

1. Absorption is decreased.

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

3. "Medications that are lipid-soluble are more completely distributed."

A nursing student asks a nurse which organ is the most responsible for the first-pass effect. What is the nurse's best response?
1. Bladder
2. Kidneys
3. Liver
4. Stomach

3. Liver

A nurse is preparing to administer medications to a client. The nurse understands that which substance has the lowest rate of crossing renal tubular membranes and would therefore be excreted in the urine?
1. Lipid-soluble drugs
2. Volatile drugs
3. Ionized drugs
4. Non-ionized drugs

3. Ionized drugs

A nursing instructor is reviewing how medications are secreted with a nursing student. 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.

2. Some medications are excreted in the feces while others can be recirculated to the liver many times.

Which assessment finding reflects a therapeutic range for a medication?
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 mL) was administered.
4. The medication was effective, but the patient experienced a lethal dysrhythmia.

2. The indication for administration was achieved without serious side effects.

A 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?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. A medication taken by injection must cross the membranes of the gastrointestinal tract to get to the bloodstream 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.

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.

The nurse is reviewing the role of diffusion in the distribution of medications with a nursing student. The nurse understands that drugs that can be distributed by simple diffusion include those with which of the below characteristics?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Large molecules
2. Ionization
3. Water-soluble agents
4. Alcohol
5. Urea

4. Alcohol
5. Urea

A client who has received an oral medication for treatment of hives asks the nurse, "How long will it be before my skin clears and quits itching?" Which concepts should the nurse consider when formulating a response?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.


1. The amount of time between administration and the drug taking effect is known as onset of action.
2. Peak plasma levels rarely occur with oral medications.
3. Duration of action is the amount of time a drug is effective.
4. Peak plasma level is dependent on the drug's plasma half-life (t1/2).
5. Drugs with short half-lives are ineffective in treating systemic illnesses.

1. The amount of time between administration and the drug taking effect is known as onset of action.
3. Duration of action is the amount of time a drug is effective.

Prior to administering a newly prescribed antibiotic, a nurse asks a client if any other drugs have been taken today. The patient responds, "Why do you need to know?" Which of the below indicate nursing responses?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "I need to be certain you are not taking another antibiotic."
2. "Some drugs block the action of others."
3. "Some drugs increase the activity of other drugs."
4. "The antibiotic I am about to give you is a prodrug."
5. "We don't want to increase first-pass effect."

2. "Some drugs block the action of others."
3. "Some drugs increase the activity of other drugs."

A nurse is reviewing excretion of medications with a student nurse. The nurse understands that the student nurse understands the teaching when the student nurse states that medications can be excreted by which route(s)?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Fecal
2. Gastric
3. Glandular
4. Pulmonary
5. Renal

1. Fecal
3. Glandular
4. Pulmonary
5. Renal

A client asks a nurse why he experiences a metallic taste after taking certain medications. The nurse explains that some medications are secreted by glandular activity. The nurse would identify which substances as examples of this excretion?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Saliva
2. Sweat
3. Breast milk
4. Urine
5. Feces

1. Saliva
2. Sweat
3. Breast milk

A client asks a nurse why a large dose of a drug was administered first followed by a lower dose of the same drug later. What is the nurse's best response?
1. Prevent a toxic concentration of the drug
2. Achieve a therapeutic dose more quickly
3. Decrease the side effects of this drug
4. Increase the absorption rate of this drug

2. Achieve a therapeutic dose more quickly

A client looks up the drug they are taking in a drug guide. The client asks a nurse why the healthcare provider prescribed a medication that has a lethal dose measure. What is the best response by the nurse?

1\. "It just refers to what is done in research; it is not used by healthcare providers prescribing drugs."

2\. "It is a value determined during research, which helps to determine the safe dose to give."

3\. "All that means is that the drug could be lethal, but I will watch you for side effects."

4. "Don't worry about that, I'll have your healthcare provider explain it to you."

2. it is a value determined during research; it is not used by healthcare providers prescribing drugs

Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?

1\. The student is able to determine if the physician prescribed the best drug for the patient.

2\. The student is able to determine if the patients are receiving safe doses of the medications.

3\. The student is able to identify interactions among the drugs each patient is receiving.

4\. The student is able to identify the patients who will need to have serum blood levels monitored.

4\. The student is able to identify the patients who will need to have serum blood levels monitored.

The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding by the student nurses?

1\. About 50% of patients will experience severe side effects from the drug.

2\. Some patients will respond differently depending on their ethnic background.

3\. About 50% of patients will not experience any effect from the drug.

4\. Some patients will require more or less than the average dose of the drug.

4\. Some patients will require more or less than the average dose of the drug.

The patient receives antibiotics for a serious infection. The patient asks the nurse, "Why don't you just give me more of that drug to cure this infection faster?" What is the best response by the nurse? \n 1. "I will check with the physician to see if it is time to increase the medication." \n 2. "You are at a maximum dose; taking more will cause interactions with other medications." \n 3. "You must stay on this drug for 2 more weeks before it can be increased." \n 4. "You are at a maximum dose; taking more will not help."

4. you are at the maximum dose; taking more will not help

The nurse administers narcotics to a surgical patient. Which statement represents the nurse's best understanding as it relates to the potency of different narcotics? \n 1. Codeine is less potent than morphine; it will not produce an allergic reaction. \n 2. Morphine is more potent than codeine; a lesser dose will be required. \n 3. Morphine is more potent than codeine; it will produce more adverse effects. \n 4. Codeine is less potent than morphine; it will not relieve pain as well.

2\. Morphine is more potent than codeine; a lesser dose will be required.

The nurse is conducting medication education about the difference between potency and efficacy to a group of patients. The nurse correctly determines that learning has occurred when the patients make which response? \n 1. "The best drug for us is the one with the highest potency." \n 2. "The best drug for us is the one with the greatest efficacy." \n 3. "Drugs with the greatest efficacy will produce the least side effects." \n 4. "Low-potency drugs have efficacy and do not produce side effects."

2. The best drug for us is the one with the greatest efficacy.

1) A client has a long history of hypertension. The healthcare provider orders an antihypertensive drug that has just come on the market. The nurse teaches the patient that this drug works more effectively than his prior drug and has fewer side effects. The patient asks how this can be. What is the best response by the nurse? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. **Select all that apply.**

\n 1. "Newer drugs are altered to affect your cells' receptors in a different way." \n 2. "Receptors tend to 'burn-out,' so newer drugs are required." \n 3. "Research into receptors helps 'fine-tune' drugs to be more effective." \n 4. "Changing the response of the drug to protein receptor-complexes produces fewer side effects." \n 5. "It is a process of trial and error with receptors until the new drug proves effective."

* newer drugs are altered to affect your cell’s receptors in a different way
* research into receptors helps ‘fine-tine’ drugs to be more effective

1) Which factor is used to help predict the safety of the dose of drug for a client? \n 1. Potency \n 2. Efficacy \n 3. Graded dose response \n 4. Frequency distribution curve

4\. Frequency distribution curve

The client and his wife receive the same medication for hypertension. The client's wife asks the nurse why she is receiving a higher amount of the medication. What is the best response by the nurse? \n 1. "Females have a higher metabolism, so you need more medication." \n 2. "Everyone is unique and responds differently to medications." \n 3. "Your hormones are different from your husband's, so you need more medication." \n 4. "You have a greater percentage of body fat, so more medication is needed."

2. “Everyone is unique and responds differently to medications.”

The student nurse has been reading about the Human Genome Project and asks the nursing instructor how this will impact future pharmacological therapies. What is the best response by the instructor? \n 1. "We will be able to alter genes so we will not need drugs." \n 2. "We will be able to standardize drug doses to make prescribing easier." \n 3. "It will help prevent disease through gene manipulation but will not impact drugs." \n 4. "It will help to individualize drug therapy for people in a more effective way."

4. “ it will help to individualize drug therapy for people in a more effective way.”

The home health nurse notes that the elderly patient doubled up on his pain medication, even though the prescribed dose was at a therapeutic level. The patient says, "If one pill is good, two pills are better." Which statement best describes the result of the patient's action? \n 1. The patient develops tolerance and does not experience any difference. \n 2. The patient experiences more pain relief from the additional dose. \n 3. The patient develops tolerance and will need increased doses of the drug. \n 4. The patient is more likely to exhibit side effects from the additional dose.

4\. The patient is more likely to exhibit side effects from the additional dose

The patient was receiving haloperidol (Haldol), a dopamine antagonist. The psychiatrist changed the order to aripiprazole (Abilify), a partial dopamine antagonist. Which statement best describes the effect of the change of medication on the patient? \n 1. The patient is more compliant in taking his medication. \n 2. The patient experiences greater efficacy. \n 3. The patient experiences a greater reduction in symptoms. \n 4. The patient experiences fewer side effects.

4\. The patient experiences fewer side effects.

The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "It could be that all of the receptors for the drug are occupied." \n 2. "It may mean that the drug has brought 100% relief to the patient." \n 3. "It means that the patient has developed resistance and needs another drug." \n 4. "It probably means that the drug is losing efficacy." \n 5. "It means that the patient needs a higher dose of the drug."

1. it could be that all of the receptors for the drug are occupied.
2. It may mean that the drug has brought 100% relief to the patient.

When administering a standard or median effective dose to a client, the nurse explains that this amount of drug will have which effect? \n 1. It will produce an effect without the presence of adverse effects. \n 2. It will be metabolized within 24 hours. \n 3. It will be effective in half of the population. \n 4. It will be effective in the majority of clients.

3\. It will be effective in half of the population.

Drug X has a median lethal dose of 30 mg and a median effective dose of 10. Drug Y has a therapeutic index of 4, while drug Z has a therapeutic index of 3. Which statement is accurate based on this information? \n 1. Drugs X and Y are safer than drug Z. \n 2. The therapeutic index of drug X is 20. \n 3. Drug Y is the safest of the three. \n 4. Drug Z is the safest of the three.

3\. Drug Y is the safest of the three.

When reading about a drug, the nurse learns it has a median toxic dose of 50 mg. The client has been receiving 60 mg of the drug. What analysis does the nurse make? \n 1. It is likely the drug will not produce the desired effect. \n 2. The efficacy and potency of this drug have not been well defined. \n 3. The client will be at greater risk of adverse effects. \n 4. This amount of drug would have been lethal to half the population.

3\. The client will be at greater risk of adverse effects.

A nursing instructor plans to teach a group of nursing students about graded-dose response curves. The instructor understands that they are most useful to determine what? \n 1. Response intensity within an individual \n 2. Response intensity within a large group of people with different characteristics \n 3. Response intensity within a large group of people with similar characteristics \n 4. Response intensity within a small group of people with similar characteristics

1\. Response intensity within an individual

At a dose of 10 mg, drug X lowers total cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 65 mg/dL is achieved at 40 mg. At a dose of 5 mg, drug Y lowers cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 55 mg/dL is achieved at 10 mg. What can be concluded about the efficacy and potency of these two drugs? \n 1. Drug X is more potent, and drug Y has a higher efficacy. \n 2. Drug X is more potent and has higher efficacy. \n 3. Drug Y is more potent and has higher efficacy. \n 4. Drug Y is more potent, and drug X has a higher efficacy.

4\. Drug Y is more potent, and drug X has a higher efficacy.

A student nurse asks a nurse about a drug that has been prescribed to decrease the effects of an endogenous chemical. The nurse understands this drug is placed in which category? \n 1. An agonist \n 2. A partial agonist \n 3. An antagonist \n 4. An agonist-antagonist

3\. An antagonist

A nurse explains to a student nurse that pharmacogenetics is a relatively new area within pharmacology. Which statement best describes the potential of this new area? \n 1. To customize drugs and prevent idiosyncratic responses \n 2. To reduce the overall number of drugs and their associated adverse effects \n 3. To reduce medication errors and provide optimal drug choices \n 4. To provide cost-effective pharmacotherapy and higher drug efficacy

1\. To customize drugs and prevent idiosyncratic responses

From a transcription error, a client received an overdose of a prescribed medication. If the therapeutic index of the medication is 10 and the median effective dose is 2, the nurse would calculate as the median lethal dose for the medication as ________. Record your answer rounding to the nearest whole number.

20

The nurse is participating in the clinical trial of a new medication for the treatment of hypertension. To assess the effectiveness of the medication, which assessments would the nurse perform to help determine whether the average dose is effective for the patient? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Blood pressure \n 2. Heart rate \n 3. Laboratory values \n 4. Diet \n 5. Sleep habits

1\. Blood pressure \n 2. Heart rate \n 3. Laboratory values

A nurse is reviewing drug safety with a student nurse. The nurse explains that the median lethal dose of drugs is often determined in laboratory preclinical trials because of which factors? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. It would be unethical to determine these values in human subjects. \n 2. The safety of the medication must be determined prior to clinical trials. \n 3. It is difficult to obtain sufficient participants for clinical trials. \n 4. Clinical trials determine only the effective dose of a drug. \n 5. It is too costly to conduct the studies during clinical trials.

1\. It would be unethical to determine these values in human subjects. \n 2. The safety of the medication must be determined prior to clinical trials.

The nurse is preparing to administer a medication to a client on a medical-surgical unit. The median lethal dose of the drug is 40 mg, and the median effective dose is 10 mg. The nurse calculates the therapeutic index to be ________. Record your answer rounding to the nearest whole number.

4

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A client with hypertension is taking a potent antihypertensive without results. The client is concerned when the healthcare provider orders a new drug. What is the nurse's response? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "The drug you took is very potent, and a higher dose is needed." \n 2. "The new drug has greater efficacy, so it will help reduce your blood pressure." \n 3. "The prescriber must have made an error in the orders." \n 4. "Efficacy in treating your hypertension is more important than potency." \n 5. "You are correct. I think the prescriber meant to order both drugs."

2\. "The new drug has greater efficacy, so it will help reduce your blood pressure." \n 4. "Efficacy in treating your hypertension is more important than potency."

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The nurse is reviewing the medication administration record for a group of clients and recognizes that which agents have nonspecific cellular responses? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Ethyl alcohol \n 2. General anesthetics \n 3. Osmotic diuretics \n 4. Calcium channel blockers \n 5. Alpha-adrenergic antihypertensives

1\. Ethyl alcohol \n 2. General anesthetics \n 3. Osmotic diuretics

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The educator has reviewed the phases of graded dose-response with the nursing staff. Which statement made by a nurse indicates an understanding of phase 2 of the response? \n 1. "This is the measure of the safety margin of the drug." \n 2. "Very few target cells have been affected by the drug." \n 3. "The client's response is based on the amount of drug given."

4\. "Increasing the drug dose will produce no additional therapeutic response."

4. increase the drug dose will produce no additional therapeutic response

A literature review reveals that a new drug has a median lethal dose of 10 and a median effective dose of 5. The nurse determines that an error in which ________ times the correct dose is given could be lethal. Record your answer rounding to the nearest whole number.

2

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During assessment, the patient mentions that he recently "sent off to a company for pharmacogenomic testing." What nursing responses are indicated? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Have you changed your medications any?" \n 2. "Have you talked with your physician about the results?" \n 3. "Why did you do that?" \n 4. "Was that test expensive?" \n 5. "Who told you about the testing?"

1\. "Have you changed your medications any?" \n 2. "Have you talked with your physician about the results?"

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The nurse reads that a newly discovered drug is a functional antagonist for some commonly administered medications. The nurse interprets this information as indicating the new drug could have which actions? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Blocks alpha receptors \n 2. Enhances drug excretion \n 3. Blocks beta receptors \n 4. Speeds drug metabolism \n 5. Inhibits protein synthesis

2\. Enhances drug excretion \n 4. Speeds drug metabolism

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The client receives methyldopa (Aldomet). Which statement below indicates the patient is experiencing side effects? \n 1. "Will you check my pupils? I can't see very well at all." \n 2. "I am so thirsty; will you please bring me another pitcher of water?" \n 3. "I am so anxious; I really need to walk around the room." \n 4. "I feel so sleepy that I don't think I can eat my dinner."

3. I am so anxious; I really need to walk around the room

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The nurse notes that a client prescribed carteolol (Cartrol), routinely takes metaproterenol (Alupent). Which should the nurse be concerned with? \n 1. The client is at risk for a hypertensive crisis. \n 2. The effects of metaproterenol (Alupent) will be decreased. \n 3. The drugs are compatible; there will not be any adverse effects. \n 4. The effects of metaproterenol (Alupent) will be increased.

2\. The effects of metaproterenol (Alupent) will be decreased.

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The nurse has provided the education for the client prescribed atenolol (Tenormin). Which statement made by the client indicates an understanding of the information? \n 1. "I need to take my pulse every day." \n 2. "If I have any side effects, I will stop the medication." \n 3. "I cannot take this drug if I develop glaucoma." \n 4. "I cannot continue to have my morning cup of coffee."

1\. I need to take my pulse every day.

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A client is prescribed prazosin (Minipress). Which information should the nurse include in the client education? \n 1. Instruct the client to not take OTC herbal preparations containing saw palmetto. \n 2. Instruct the client to not take tub baths. \n 3. Instruct the client to decrease his intake of sodium. \n 4. Instruct the client to wear sunglasses when outdoors.

1\. Instruct the client to not take OTC herbal preparations containing saw palmetto.

A client has been prescribed an alpha1 adrenergic agonist drug. The nurse would plan to monitor for effects from which organs? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Kidneys \n 2. Eyes \n 3. Heart \n 4. Bowels \n 5. Lungs

1\. Kidneys \n 2. Eyes \n 4. Bowels \n 5. Lungs

A client is prescribed a drug that activates alpha2 receptors. Which physiological response should the nurse anticipate when planning care for the client? \n 1. Inhibition of norepinephrine release \n 2. Absence of monoamine oxidase \n 3. Increased lipolysis \n 4. Destruction of presynaptic nerve terminals

1\. Inhibition of norepinephrine release

Which client conditions should the nurse anticipate to be treated with a beta2 agonists? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Heart failure \n 2. Asthma \n 3. COPD \n 4. Overactive bladder \n 5. Nasal congestion

2\. Asthma \n 3. COPD

Which substance is used in the initial production of catecholamines? \n 1. Norepinephrine \n 2. Tyrosine \n 3. Dopamine \n 4. L-dopa

2\. Tyrosine

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A client who is in heart failure is administered a beta1 agonist. Which assessment finding indicates the prescription is effective? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Heart rate increases \n 2. Pulse becomes stronger \n 3. Pupils dilate \n 4. Dysrhythmias dissipate \n 5. Blood pressure drops

1\. Heart rate increases \n 2. Pulse becomes stronger

1) A client has been prescribed isoproterenol (Isuprel). The nurse understands that which receptors will be stimulated? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Alpha1 \n 2. Alpha2 \n 3. Beta1 \n 4. Beta2 \n 5. Beta3

3\. Beta1 \n 4. Beta2

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The nurse has provided teaching about the use of an auto injection of epinephrine. Which statement made by the client indicates further teaching is required? \n 1. "I will call 911 before I inject the epinephrine." \n 2. "I will use my auto-injector immediately if I think I am having an allergic reaction." \n 3. "I will make sure I have my auto-injector available at all times." \n 4. "I will notify my healthcare provider after I inject the epinephrine."

1. i will call 911 before i inject the epinephrine

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The nurse is preparing to provide instructions on the use of an epinephrine auto-injector. Which information should the nurse include? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. If you need to use this pen, seek medical advice as follow-up. \n 2. You can dispose of a used EpiPen in your regular trash. \n 3. Keep an extra EpiPen on hand. \n 4. Store this device in your refrigerator. \n 5. Carry an EpiPen in your car's glovebox.

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1\. If you need to use this pen, seek medical advice as follow-up. \n 3. Keep an extra EpiPen on hand.

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A client has been prescribed phenylephrine (Neo-Synephrine) spray for nasal congestion. Which information about adverse effects should the nurse provide in discharge teaching? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "This drug may cause some stinging or burning in your nose." \n 2. "You may notice that your nasal secretions take on a slightly orange tint." \n 3. "You may feel like your blood pressure is low for the first few times you use this spray." \n 4. "Rebound congestion may occur if the prescription is used more than a few days." \n 5. "Do not drink herbal teas while taking this medication."

1\. "This drug may cause some stinging or burning in your nose." \n 4. "Rebound congestion may occur if the prescription is used more than a few days."

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The nurse is preparing to administer an adrenergic drug intravenously. Which should the nurse include in the plan of care? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Give the drug as rapidly as possible by intravenous push. \n 2. Dilute the drug before administration. \n 3. Use an infusion pump to control rate of administration. \n 4. Monitor for blanching at the infusion site. \n 5. Advise the patient that a sweet taste may occur as the drug is being given.

2\. Dilute the drug before administration. \n 3. Use an infusion pump to control rate of administration. \n 4. Monitor for blanching at the infusion site.

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The nurse is reviewing routine medications for a client prescribed phenylephrine (Neo-Synephrine). Which medications are most concerning? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. MAO inhibitors \n 2. Tricyclic antidepressants \n 3. Iron supplements \n 4. Digoxin \n 5. Aspirin

1\. MAO inhibitors \n 2. Tricyclic antidepressants \n 3. Iron supplements \n 4. Digoxin

A client recently prescribed an adrenergic drug states to the nurse, "I am so nervous and I cannot sleep." Based on the client's statement, which questions should the nurse ask? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "How much coffee do you drink?" \n 2. "Have you recently increased your intake of dairy products?" \n 3. "Do you eat chocolate?" \n 4. "When was the last time you ate pickled foods or aged cheese?" \n 5. "How much wine or other alcoholic beverages do you drink?"

* how much coffee do you drink?
* do you eat chocolate?

A client who has used an adrenergic nasal spray for 2 weeks states to the nurse, "I am more stuffed up now than I was when I was sick." Which information should the nurse provide the patient? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "You are having an allergic reaction to the nasal spray. Stop using it immediately." \n 2. "You probably have developed a secondary infection." \n 3. "Try increasing the amount of fluids you are drinking." \n 4. "Switch to a saline-based nasal spray." \n 5. "Continue to use your current nasal spray until the congestion goes away."

3. try increase the amount of fluids you are drinking


4. switch to a saline-based nasal spray.

An older adult has received adrenergic eye drops prior to a retinal exam. Which information should the nurse include in the client's discharge teaching? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Do not drive until the effects of the eye drops have worn off." \n 2. "Wear sunglasses when in bright light." \n 3. "You may be more comfortable in a darkened room." \n 4. "You may experience burning in your eyes for a couple of days." \n 5. "Do not eat or drink anything for at least an hour after discharge."

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1\. "Do not drive until the effects of the eye drops have worn off." \n 2. "Wear sunglasses when in bright light." \n 3. "You may be more comfortable in a darkened room."

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A client has been prescribed an adrenergic nasal spray. Which information should the nurse include in the teaching? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Do not share this spray with anyone." \n 2. "Sit upright while using this spray." \n 3. "Only use this spray for 3-5 days." \n 4. "Do not shake the bottle before using this spray." \n 5. "Keep this spray refrigerated."

1\. "Do not share this spray with anyone." \n 2. "Sit upright while using this spray." \n 3. "Only use this spray for 3-5 days."

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Which statement is accurate concerning drugs classified as adrenergic antagonists? \n 1. They are also known as anticholinergics. \n 2. The actions will block the neurotransmitter acetylcholine. \n 3. The actions are the opposite of those of sympathomimetics. \n 4. They will stimulate the sympathetic nervous system.

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3\. The actions are the opposite of those of sympathomimetics.

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A client with preexisting conditions states to the nurse, "I took my blood pressure at home and it was high so I have been taking my husband's propranolol (Inderal) for the last week." Based on the client's statement, which preexisting conditions should the nurse be most concerned with? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Obesity \n 2. Diabetes mellitus \n 3. COPD \n 4. Asthma \n 5. Rheumatoid arthritis

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2\. Diabetes mellitus \n 3. COPD \n 4. Asthma

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A client states to the nurse, "I stopped taking that beta blocker last week because it made me so tired." Which are the priority nursing assessments? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Blood pressure \n 2. Heart rhythm \n 3. Urinary output \n 4. Presence of chest pain \n 5. Presence of respiratory crackles

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1\. Blood pressure \n 2. Heart rhythm \n 4. Presence of chest pain

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A client has been prescribed prazosin (Minipress). Which information should the nurse provide? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Stay out of the sun until you determine if you become sun-sensitive." \n 2. "Take this medication just before you go to bed." \n 3. "This medication may make you dizzy." \n 4. "This medication may slow your heart rate noticeably." \n 5. "Do not take this medication with milk."

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2\. "Take this medication just before you go to bed." \n 3. "This medication may make you dizzy."

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A client who was administered prazosin (Minipress) became unconscious 30 minutes after the first dose. Which prescriptions should the nurse prepare for resuscitation? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Normal saline \n 2. Dobutamine \n 3. Atenolol (Tenormin) \n 4. Carvedilol (Coreg) \n 5. Propranolol (Inderal)

1\. Normal saline \n 2. Dobutamine

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A client has been prescribed an adrenergic-blocker for treatment of hypertension. Which information should the nurse provide? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Rise from a sitting position slowly." \n 2. "Sit on the side of the bed a few moments before you stand." \n 3. "If you feel dizzy, add more salt to your diet." \n 4. "If you feel dizzy, sit or lie down until the dizziness passes." \n 5. "Dizziness is expected so just continue your daily activities."

1\. "Rise from a sitting position slowly." \n 2. "Sit on the side of the bed a few moments before you stand." \n 4. "If you feel dizzy, sit or lie down until the dizziness passes."

A client has returned to the clinic for follow-up after being prescribed an adrenergic-blocking medication for benign prostatic hypertrophy (BPH.) Which assessment questions should the nurse ask? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "What color is your urine?" \n 2. "Do you have any difficulty starting to urinate?" \n 3. "Do you have the feeling that your bladder is full?" \n 4. "When was your last bowel movement?" \n 5. "Have you noticed being more hungry than usual?"

2\. "Do you have any difficulty starting to urinate?" \n 3. "Do you have the feeling that your bladder is full?

The nurse should classify which sympathomimetics as binding to and activating adrenergic receptors? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Epinephrine \n 2. Dopamine \n 3. Amphetamine \n 4. Cocaine \n 5. Ephedrine

1\. Epinephrine \n 2. Dopamine \n 5. Ephedrine

A client is being assessed for the presence of pheochromocytoma. Which interventions should the nurse implement? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Monitoring blood pressure \n 2. Monitoring bowel sounds \n 3. Administration of phentolamine (Regitine) \n 4. Rapid administration of normal saline \n 5. Urinary catheterization to bypass prostatic enlargement

1\. Monitoring blood pressure \n 3. Administration of phentolamine (Regitine)

The nurse suspects a client has received too much phenylephrine (Neo-Synephrine). Which findings support the nurse's suspicion? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. The client's heart rate has increased from 72 bpm to 114 bpm. \n 2. The client reports feeling anxious. \n 3. The client's blood pressure has increased from 140/86 mmHg to 180/98 mmHg. \n 4. The client's stools are dark and tarry. \n 5. The client reports burning at the injection site.

1\. The client's heart rate has increased from 72 bpm to 114 bpm. \n 3. The client's blood pressure has increased from 140/86 mmHg to 180/98 mmHg.

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A 48-year-old male client tells the nurse he wants to stop taking his prazosin (Minipress). Which questions should the nurse ask the client? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "Are you experiencing impotence?" \n 2. "Are you experiencing nasal congestion?" \n 3. "Do you feel tired?" \n 4. "Do you feel nervousness?" \n 5. "Do you feel like you heart rate slows down?"

1\. "Are you experiencing impotence?" \n 2. "Are you experiencing nasal congestion?" \n 3. "Do you feel tired?"

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A client's heart rate is 72 beats per minute with a regular rhythm. How does the nurse interpret this data in relation to the client's peripheral nervous system? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. The sympathetic system is in control. \n 2. The parasympathetic system is dominating. \n 3. Both parasympathetic and sympathetic systems are influencing cardiac status. \n 4. The autonomic nervous system is affecting cardiac status. \n 5. The somatic nervous system is affecting cardiac status.

2\. The parasympathetic system is dominating. \n 3. Both parasympathetic and sympathetic systems are influencing cardiac status. \n 4. The autonomic nervous system is affecting cardiac status.

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A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system. The nurse would look for articles about which drug classes? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. Anticholinergics \n 2. Parasympathomimetics \n 3. Parasympatholytics \n 4. Cholinergics \n 5. Muscarinic blockers

1\. Anticholinergics \n 3. Parasympatholytics \n 5. Muscarinic blockers

Which is an adrenergic receptor associated with the sympathetic nervous system? \n 1. Beta \n 2. Dopamine \n 3. Muscarinic \n 4. Norepinephrine

1\. Beta

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A client has been prescribed an oral drug containing atropine. The nurse would hold the drug and contact the prescriber if the client states which of the following? \n Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. \n 1. "I would like to wait a few minutes to take this as I just drank some aloe juice." \n 2. "Can I take this at the same time as my procainamide?" \n 3. "I have had a headache this morning." \n 4. "I am allergic to penicillin." \n 5. "My gallbladder surgery is scheduled for next week."

1\. "I would like to wait a few minutes to take this as I just drank some aloe juice." \n 2. "Can I take this at the same time as my procainamide?"

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The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for a client with myasthenia gravis. The nurse determines that learning has occurred when the client makes which statement? \n 1. "My heart may beat slower while I am on this drug." \n 2. "I will need to increase my fluid intake with this medication." \n 3. "I must take this medication immediately before eating a full meal." \n 4. "It is really important to take my medication on time."

4. It is really important to take my medication on time

The healthcare provider has ordered bethanechol (Urecholine), a cholinergic drug, for the client with urinary retention. The client also has an enlarged prostate gland. What is the priority action by the nurse? \n 1. Hold the drug and prepare to catheterize the client. \n 2. Administer the drug and measure urinary output. \n 3. Administer the drug and push fluids. \n 4. Hold the drug and contact the healthcare provider.

4\. Hold the drug and contact the healthcare provider.

A preoperative client will be receiving glycopyrrolate (Robinul), which is an anticholinergic drug. The client asks the nurse, "Why do I need to take that medication?" What is the best response by the nurse? \n 1. "It will decrease your respiratory secretions during surgery." \n 2. "It will increase your urinary output during surgery." \n 3. "It will help you breathe better during surgery." \n 4. "It will help maintain your blood pressure during surgery."

1\. "It will decrease your respiratory secretions during surgery."

The nurse is preparing to administer benztropine (Cogentin), which is an anticholinergic drug. The nurse understands this drug is contraindicated in which client? \n 1. The client with a fractured femur \n 2. The client with tachycardia \n 3. The client with an irritable colon \n 4. The client with diarrhea

2\. The client with tachycardia

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The nurse is preparing to administer medications to a group of clients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which client? \n 1. The client with glaucoma \n 2. The client with hyperthyroidism \n 3. The client with a hiatal hernia \n 4. The client with lung cancer

1\. The client with glaucoma

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The healthcare provider orders dicyclomine (Bentyl), an anticholinergic drug, for a client. What is the nurse's priority assessment prior to administering this drug? \n 1. Does the client have light sensitivity? \n 2. Is the client able to urinate? \n 3. Does the client have a history of alcoholism? \n 4. Is the client dizzy upon standing?

2\. Is the client able to urinate?