Chapter 03: Drug Action Across the Life Span Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition

What time will the trough blood level need to be drawn if the nurse administers the

intravenous medication dose at 9:00 AM?

a. 6:30 AM

b. 8:30 AM

c. 9:30 AM

d. 11:30 AM

ANS: B

What will the nurse expect the healthcare provider‘s order to be when starting an older adult

patient on thyroid hormone replacement therapy?

a. Administering a loading dose of the drug

b. Directions on how to taper the drug

c. A dosage that is one-third to one-half of the regular dosage

d. A dosage that is double the regular dosage

ANS: C

Which drugs cause birth defects?

a. Teratogens

b. Carcinogens

c. Metabolites

d. Placebos

ANS: A

Which life-threatening illness may occur as a result of aspirin (salicylate) administration

during viral illness to patients younger than 20 years of age?

a. Anaphylactic shock

b. Reye‘s syndrome

c. Chickenpox

d. Influenza A

ANS: B

Which classification of medications commonly causes allergic reactions in children?

a. Antacids

b. Analgesics

c. Antibiotics

d. Anticonvulsants

ANS: C

Which patient statement indicates the need for further teaching after giving instructions to an

expectant mother about taking medications during pregnancy?

a. ―I will not take herbal medicines during pregnancy.‖

b. ―For morning sickness, I will try crackers instead of taking a drug.‖

c. ―If I get a cold, I will avoid taking nonprescription medications until I check with

my physician.‖

d. ―I will limit my alcohol intake to only one glass of wine weekly.‖

ANS: D

When is the ideal time for a nursing mother to take her own medications?

a. Before the infant latches on to begin to breastfeed.

b. As soon as the mother wakes up in the morning.

c. Right before the mother goes to sleep at night.

d. As soon as the infant finishes breastfeeding.

ANS: D

Which age-related change would affect transdermal drug absorption in geriatric patients the

most?

a. Difficulty swallowing

b. Diminished kidney function

c. Changes in pigmentation

d. Altered circulatory status

ANS: D

Which intervention would be considered to reduce accumulation of a drug in a patient who

has decreased liver function?

a. Decreasing the time interval between dosages

b. Reducing the dosage

c. Administering the medication intravenously

d. Changing the drug to one that has a longer half-life

ANS: B

Which explanation by the nurse is most helpful when teaching an elderly patient with

difficulty swallowing about medications?

a. ―Enteric coated tablets can be crushed and taken with applesauce.‖

b. ―Tablets that are scored can be broken in half.‖

c. ―Medications labeled ̳SR‘ can be crushed.‖

d. ―Avoid taking medications in liquid form.‖

ANS: B

Which blood level determines the lowest amount of medication present in the patient?

a. Peak

b. Serum

c. Therapeutic

d. Trough

ANS: D

Which patient would the nurse identify as having the lowest rate of absorption of enteral

medications?

a. A 5-year-old boy

b. An 18-year-old woman

c. A 55-year-old man

d. An 85-year-old woman

ANS: A

What is the definition of cumulative effect of a drug?

a. Drug toxicity related to overmedication

b. Drug buildup related to decreased metabolism

c. The inability to control the ingestion of drugs

d. The need for higher dosage to produce the same effect as previous lower dosages

ANS: B

Which patient, when compared with the general population, would require a larger dose or

more frequent administration of a drug to attain a therapeutic response?

a. A 29 year old who has been diagnosed with kidney failure

b. A 35-year-old obese male who is being evaluated for an exercise program

c. A 52 year old diagnosed with hypothyroidism and decreased metabolic rate

d. A 72 year old with decreased circulatory status

ANS: B

Which action should the nurse implement when a resident in a long-term care facility reports

difficulty swallowing enteric coated aspirin and asks the nurse to crush it prior to

administration?

a. Crush the tablet and mix with applesauce.

b. Encourage the resident to swallow the tablet with a full glass of water.

c. Hold the medication and notify the physician.

d. Substitute a regular aspirin for the enteric coated tablet.

ANS: C

One of the prescribed medications for a 36-week gestational age baby girl is a topical

water-soluble medication to be applied to the perineum daily to treat an inflammatory rash.

Which considerations is the nurse aware of before medication administration? (Select all that

apply.)

a. Age of the client

b. Location of topical application

c. Increased intestinal transit rate

d. Condition of the skin

e. Gastric pH of 8

ANS: A, B, D

The nurse is caring for a 4-month-old child who is on a water-soluble medication for seizures.

The child‘s mother voices concern that the dosage seems ―too much‖ for the child‘s age and

would like the dosage verified. What actions will the nurse take? (Select all that apply.)

a. Verify dosage requirements in the Physicians’ Desk Reference (PDR) in mg/kg.

b. Compare the water composition requirements of adults and children.

c. Evaluate lean body mass and total fat content in adults and infants.

d. Chart ―refused per mother‖ on the MAR and do not administer.

e. Compare transportation in the circulation of plasma bound proteins between adults

and children.

ANS: A, B

Which reason(s) explains why elderly patients are at increased risk for drug interactions and

toxicity? (Select all that apply.)

a. Higher incidence of malnourishment

b. Renal function is enhanced

c. Increased use of multiple medications

d. Hepatic function is reduced

e. Issues with swallowing

ANS: A, C, D

Which patient(s) require(s) special considerations for medication administration? (Select all

that apply.)

a. A 29-year-old pregnant woman

b. A 2-month-old baby

c. An 18-year-old college student

d. A 45-year-old farmer

e. An 82-year-old retired nurse

ANS: A, B, E

Which factor(s) in a patient would influence GI absorption of medications? (Select all that

apply.)

a. Stomach pH

b. Level of consciousness

c. Fever

d. Blood flow to gastric mucosa

e. Weight

f. Body surface area

ANS: A, D