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WorksheetsNSG100 Pharm Principles
Total questions: 60
Worksheet time: 2hrs 4mins
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
“Right time” problem
“Right dose” problem
“Right route” problem
“Right medication” problem
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
The patient’s ability to swallow
The patient’s height
The patient’s last meal
The patient’s allergies
When given an intravenous medication, the patient says to the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best answer?
“The medication will cause fewer adverse effects when given intravenously.”
“The intravenous medication will have delayed absorption into the body’s tissues.”
“The action of the medication will begin sooner when given intravenously.”
“There is a lower chance of allergic reactions when drugs are given intravenously.”
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect.
Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
Absorption of parenteral drugs is faster when the stomach is empty.
Parenteral drugs exert their effects while circulating in the bloodstream.
When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that a drug’s half-life is the time it takes for
the drug to cause half of its therapeutic response.
one half of the original amount of a drug to reach the target cells.
one half of the original amount of a drug to be removed from the body.
one half of the original amount of a drug to be absorbed into the circulation.
The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Under the tongue
On top of the tongue
At the back of the throat
In the space between the cheek and the gum
Which patient response indicates a drug’s therapeutic response?
Ankle swelling
Bone strengthening
Constipation
Dizziness
Which type of drug name is used mainly by drug developers and manufacturers, and not by prescribers?
Generic name
Brand or trade name
Chemical name
Proprietary name
In the United States, which group is responsible for enforcing established standards for drug manufacturing?
United States Pharmacopeia
National Institutes of Health
Food and Drug Administration
Association of Pharmaceutical Manufacturers
How are the effects of naturally occurring testosterone changed when a patient is taking a drug that is a testosterone agonist?
Effects are increased
Effects are decreased
Effects are eliminated
Effects are unchanged
The nurse is teaching a patient about adverse drug reactions (ADRs). Which precaution is most important for the nurse to include?
“Take your medications right before you go to bed so that you can sleep through an ADR.”
“Keep a written record of the date and time an ADR occurs.”
“Stop taking the drug and flush it down the toilet.”
“Immediately seek medical help.”
Which drug administration route is most likely to result in reduced drug bioavailability?
Enteral
Intravenous
Transdermal
Subcutaneous
Which factor is a major disadvantage of the transdermal drug delivery route?
Only a prescriber can administer drugs by the transdermal route.
Transdermal drugs must be sterile rather than clean.
First pass drug loss by this route is the most extensive.
Drug absorption is dependent on adequate circulation.
A patient has a deficiency of an enzyme that prepares a specific drug for elimination. When planning care for this patient, the nurse remains alert for which response or issue?
Toxic blood levels of the drug are more likely to occur.
Higher drug dosages will be needed for the intended action to occur.
The drug will be eliminated more rapidly in the feces rather than in the urine.
Delivery of this drug by the parenteral route is more effective than by the enteral route.
A patient has all of the following health problems. Which problem causes the nurse to be alert for an increased risk for drug side effects?
Asthma
Kidney disease
GI ulcers
Chronic high blood pressure
The nurse administers orally 400 mg of a drug with a half-life of 2 hours at noon. At which time will the patient’s blood drug level first be less than 40 mg?
2:00 PM
6:00 PM
8:00 PM
Midnight
A patient is prescribed a drug that has an extremely short half-life for chest pain (angina). Which modification in drug dosage or scheduling does the nurse expect?
Once-daily dosing
More frequent dosing
Larger first dose and smaller repeat doses
Parenteral doses greater than enteral doses
Which body tissues or fluids are routes of drug elimination? (Select all that apply.)
Bone marrow
Heart
Liver
Lungs
Tears
What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented?
Ask the patient to state his or her name.
Check the patient’s wrist band.
Look at the patient’s chart.
Have the patient state his or her name and birth date.
A patient is prescribed omeprazole (Prilosec) 60 mg once a day orally. The patient is having difficulty with swallowing and has a feeding tube in place. What is the nurse’s best action?
Open the capsule and mix the contents with water, then give the drug through the feeding tube.
Raise the head of the bed 90 degrees and mix the capsule in applesauce for easier swallowing.
Contact the prescriber and pharmacist about using another drug or another form of the drug.
Hold the tube feeding for at least 30 minutes before giving the drug.
A patient with severe postoperative pain is ordered to receive morphine 2 mg intravenously. The patient asks the nurse if the drug could be taken by mouth instead. What is the nurse’s best response?
“Giving the drug intravenously will give you faster pain relief.”
“I will call your prescriber and ask if the order can be changed.”
“Your surgeon wants you to receive the drug intravenously.”
“We can substitute the intravenous drug with an oral drug.”
A patient is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must the nurse do before giving this drug?
Shave the hair off the patient’s chest.
Place the patient on a heart monitor.
Put on a pair of disposable gloves.
Measure the dose directly on the patient’s skin.
A sublingual drug is administered by placing the drug in what part of the body?
Between the cheek and the upper jaw
Under the tongue
In the nose
In the eyes
What administration technique does the nurse use to give a 2-year-old child ear drops?
Pull the earlobe down and back.
Pull the earlobe up and out.
Keep the earlobe straight.
Hang the patient’s head over the side of the bed.
The prescriber orders a new drug over the telephone for a nursing home patient who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse to obtain from the prescriber?
“How many refills are needed?”
“Do you want the drug given orally or intravenously?”
“Which brand of drug should be given, or is this a generic drug?”
“Does this drug need to be given with a meal or on an empty stomach?”
The physician orders all of the following drugs for a patient who had surgery 2 days ago. Which drug order does the nurse administer first?
Alphamine (cyanocobalamin) 100 mcg intramuscularly once
Benadryl (diphenhydramine) 25 mg orally every 8 hours
Compazine (prochlorperazine) 10 mg orally STAT
Dalmane (flurazepam) 30 mg orally at night PRN
The nurse asks the patient to state his name and birth date, and the patient responds correctly. The nurse then gives the patient the prescribed drug tablet. The patient says “I haven’t ever taken a green pill before.” What is the nurse’s best response?
“Go ahead and take the drug. The same medications from different drug companies may have a different color.”
“Go ahead and take the drug. It is likely that your health care provider has prescribed a new drug for you.”
“Don’t take this drug right now. It is probably not the one prescribed for you.”
“Don’t take this drug right now. Let me recheck everything to be sure.”
Which question is most important for the nurse to ask a patient before administering a new drug?
“Are you allergic to any drugs?”
“Do you know what this drug is for?”
“When was the last time you ate or drank?”
“What other drugs have you taken in the last 24 hours?”
When the nurse brings in the next dose of a drug that a patient first received 6 hours ago, the patient reports a “pounding” heart rate ever since taking the last dose. What is the nurse’s best first action?
Document the report as the only action.
Check the patient’s vital signs for changes.
Hold the dose and notify the prescriber immediately.
Reassure the patient that this is an expected response to the drug.
Which action is most important when the nurse prepares to administer an oral drug to a patient of any age?
Asking the patient whether he or she prefers a tablet or a capsule
Determining when the patient last ate or drank
Assessing whether the patient has nausea
Checking the patient’s ability to swallow
Which technique is used with intramuscular drug injections but not with intradermal drug injections?
Ensuring the site selected is appropriate for injection
Cleansing the selected site before inserting the needle
Aspirating the syringe before injecting the drug solution
Checking for allergic or sensitivity reactions to the injection
When compared with the subcutaneous route, what are the advantages of giving drugs intramuscularly (IM)? (Select all that apply.)
IM injections require a smaller, shorter needle.
IM drugs are absorbed faster than subcutaneous drugs.
IM injections can be much larger that subcutaneous injections.
IM injections do not require the rotation of injection sites.
IM injections are less painful than subcutaneous injections.
A patient is treated with an antibiotic for an infection of the leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of:
Pharmacotherapeutics
Pharmacokinetics
Pharmacodynamics
Pharmacogenetics
A nurse has been assigned the task of preparing educational materials for patients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or health care provider. Which of the following information is essential to include in the educational materials?
Drug administration method
Core drug knowledge
Vital signs of the patient
Diagnosis and outcome identification mechanism
Which of the following activities would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?
Compare the outcome expected with the actual patient outcome.
Reconsider core drug knowledge and core patient variables.
Ask questions to prepare an effective patient education program.
Establish a baseline for the patient’s treatment and care.
When administering heparin subcutaneously, the nurse should
Aspirate after injection
Aspirate before the injection
Vigorously massage the site
Never aspirate
Children’s medication dosages are most often calculated using the child’s body surface area and
Age
Diagnosis
Height
Weight
When the patient demonstrates a rash 30 minutes after she has taken a dose of penicillin, the nurse recognizes that the patient is likely demonstrating which type of drug reaction?
Allergy
Anaphylaxis
Antagonistic
Idiosyncratic
Which of the following patients is likely to have altered metabolism of medications?
School-age children
Adolescents
Middle adults
Elderly
What is involved in the absorption, distribution, metabolism, and excretion of medication?
Pharmacology
Pharmacotherapeutics
Pharmacokinetics
Pharmacodynamics
In terms of categories of controlled substance, which of the following descriptions reflects schedule IV drugs?
May lead to severe psychological dependence
Has the highest potential for abuse
May lead to limited physical dependence
deemed safe for use in pregnancy
A medication order has a.c. written after the medication dosage. What does a.c. stand for?
Before meals
After meals
Before
After
A nurse knows that patient education has been effective when the patient states
“I must take my parenteral medication with food.”
“If I am 30 minutes late taking my medication, I should skip that dose.”
“I will rotate the location where I give myself injections.”
“Once I start feeling better, I will stop taking my medication.”
The nurse knows that the purpose of aspiration on IM injections is to
Ensure proper placement of the needle.
Increase the force of the injection.
Reduce the discomfort of the injection.
Prolong the absorption time of the medication.
The nurse is planning to administer a tuberculin test with a 27-gauge, 3/8-inch needle. The nurse should insert the needle at an angle of _____ degrees.
15
45
90
180
The nurse knows to assess for signs of medication toxicity within older adults because of which physiological change?
Reduced glomerular filtration
Delayed esophageal clearance
Decreased gastric peristalsis
Decreased cognitive function
A patient is in need of immediate pain relief for a severe headache. The nurse knows that which medication will be absorbed the quickest?
Tylenol 650 mg PO
Morphine 4 mg SQ
Ketorolac (Toradol) 8 mg IM
Hydromorphone (Dilaudid) 4 mg IV
The nurse knows that an idiosyncratic event with the stimulant pseudoephedrine (Sudafed) is occurring when the patient
Experiences blurred vision while driving.
Falls asleep during daily activities.
Presents with a pruritus rash.
Develops xerostomia.
A patient needs assistance excreting a gaseous medication. What is the correct nursing action?
Encourage the patient to cough and deep-breathe.
Suction the patient’s respiratory secretions.
Administer the antidote via inhalation.
Administer 100% FiO2 via simple face mask.
What is the nurse’s priority action to protect a patient from medication error?
Requesting that the prescriber write out an order, rather than giving a verbal order
Asking anxious family members to leave the room before giving a medication
Checking the patient’s room number against the medication administration record
Administering as many of the medications as possible at one time
The nurse knows that a subcutaneous injection takes longer to absorb because
Fewer blood vessels are found under the subcutaneous level.
Adipose tissue takes longer to metabolize medication.
Connective tissue holds medication in place longer.
Some medication leaks out after instillation.
The nurse realizes which patient is at greatest risk for an unintended synergistic effect?
72-year-old who is seeing four different specialists
4-year-old who has mistakenly taken the entire packet of his mother’s birth control pills
50-year-old who was prescribed a second blood pressure medication
35-year-old drug addict who has ingested meth mixed with several household chemicals
Which nursing action is the number one priority for ensuring that medication stays in the target therapeutic range?
Drawing the peak and trough levels at the same time each day
Administering a double dose after a dose was missed
Delivering the same amount of the drug at the same time each day
Increasing absorption by holding all other medications 1 hour before administration
Which term refers to the movement of a drug from the site of administration to the bloodstream?
absorption
distribution
metabolism
excretion
After receiving diphenhydramine, a patient complains that his mouth is very dry. This is not uncommon for patients taking this medication. Which drug effect is this patient experiencing?
Side effect
Adverse reaction
Toxic reaction
Supportive effect
While receiving an intravenous dose of an antibiotic, levofloxacin, a patient develops severe shortness of breath, wheezing, and severe hypotension. Which action should the nurse take first?
Administer epinephrine IM.
Give bolus dose of intravenous fluids.
Stop the infusion of medication.
Prepare for endotracheal intubation.
Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended time. The nurse suspects an interaction with herbal medications. What type of interaction does she suspect?
Antagonistic drug interaction
Synergistic drug interaction
Idiosyncratic reaction
Drug incompatibility
The nurse explains that a drug may have several names. The trade name is the only name that can be:
used in an order.
trademarked.
recognized as its chemical makeup.
used by retailers to sell the drug.
When categorizing medications, drug classifications may be defined by the effects of the drug and:
the symptoms the drug relieves.
patient tolerance.
the nursing implications.
the dosage amounts.
A patient complains about the taste of the sublingual nitroglycerin and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:
can be inserted rectally without loss of absorption potential.
should not be swallowed because it alters the absorption potential.
can be held against the roof of the mouth with the tongue to reduce taste.
can be taken between the cheek and tongue to diminish taste.
