Pharmacology: A Patient-Centered Nursing Process Approach, (Kee, Pharmacology) 8th Edition Test Bank

Name: Pharmacology: A Patient-Centered Nursing Process Approach, (Kee, Pharmacology) 8th Edition Test Bank
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Chapter 1: Drug Action:
Pharmaceutic,
Pharmacokinetic, and
Pharmacodynamic Phases
Kee: Pharmacology, 7th Edition
Chapter 1: Drug Action: Pharmaceutic, Pharmacokinetic, and
Pharmacodynamic Phases
Test Bank
MULTIPLE CHOICE
1. A nurse is providing an oral medication for pain relief to a client. To attain the
fastest pain relief, the nurse administers the medication so that it is most rapidly
absorbed from the gastrointestinal (GI) tract. Which mode of delivery has the fastest
absorption?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension
ANS: D
Drugs must be in solution to be absorbed in the gastrointestinal tract. Because liquid
drugs are already in solution, they are absorbed faster than drugs in a solid form.
DIF: Cognitive Level: Application REF: p. 3
TOP: Nursing Process: Intervention/Implementation
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
2. A client asks why she needs to take a medication on an empty stomach. The nurse
explains that food generally has which effect on drug dissolution and absorption?
a. Enhances
b. Increases
c. Decreases

d. Does not have an effect
ANS: C
Food in the GI tract can interfere with the dissolution and absorption of some drugs.
However, there are specific drugs that should be taken with food to enhance
absorption.
DIF: Cognitive Level: Application REF: p. 4
TOP: Nursing Process: Intervention/Teaching
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
3. Biotransformation is affected by many factors. What happens to the client’s drug
metabolism when liver function is decreased?
a. The client can develop toxicity.
b. The client will have an enhanced therapeutic response.
c. The client may require a larger than normal dose of the medication.
d. The client will experience a decreased therapeutic response.
ANS: A
When the drug metabolism rate is decreased, excess drug accumulation can occur and
lead to the client’s developing toxicity. The GI membrane is made up of lipids;
therefore, lipid medications are most easily absorbed across the digestive membrane
of the stomach. Medications that are nonionized (neither positive nor negative) also
pass through the GI membrane faster than those with a charge.
DIF: Cognitive Level: Application REF: p. 6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
4. A client asks why the oral dose of her pain medication is higher than the
intravenous dose. The nurse explains that with the oral dose, only 20% to 40% of the
drug may actually enter systemic circulation. This reduces the amount of active drug.
What is the term for this effect?
a. Protein binding
b. Bioavailability
c. Hepatic first pass

d. Pinocytosis
ANS: B
Bioavailability is the percentage of the administered drug dose that reaches the
systemic circulation. Oral drugs that have a high first-pass hepatic metabolism may
have a bioavailability of only 20% to 40% on entering systemic circulation. To obtain
the desired drug effect, the oral dose could be three to five times larger than the drug
dose for IV use.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
5. When providing a medication, which route should the nurse select to ensure the
maximum amount of bioavailability?
a. Oral
b. Intravenous
c. Intramuscular
d. Subcutaneous
ANS: B
The percentage of bioavailability for the oral route is always less than 100%, but for
the intravenous route it is usually 100%.
DIF: Cognitive Level: Comprehension REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
6. A client is being given two highly protein-bound drugs concurrently. What is most
likely to be the result of this administration?
a. More free drug in circulation
b. Less free drug in circulation
c. More drug bound to protein
d. More drug excreted in the urine
ANS: A

When two highly protein-bound drugs are given concurrently, they compete for
protein-binding sites, causing more free drug to be released into the circulation. Drug
accumulation and possible drug toxicity can result.
DIF: Cognitive Level: Application REF: p. 5
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
7. A client is taking a drug that is moderately highly protein bound. Several days later,
the client takes a second drug that is 90% protein bound. What is most likely to have
occurred as a result of this administration?
a. The first drug remains protein bound.
b. The first drug becomes increasingly inactive.
c. The first drug is released from the protein and becomes more pharmacologically active.
d. The second drug becomes more active.
ANS: C
Only drugs not bound to protein are active and can cause a pharmacologic response.
As the free drug in the circulation decreases, more bound drug is released from the
protein to maintain the balance of free drug.
DIF: Cognitive Level: Application REF: p. 5
TOP: Nursing Process: Active
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
8. A nurse is determining whether a medication is ordered to be given at the
appropriate intervals. This is done by assessing the half-life of the medication. The
serum half-life (t ) of a drug is the time required:
a. for half of a drug dose to be absorbed.
b. after absorption for half of the drug to

DIF: Cognitive Level: Comprehension REF: pp. 5-6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
9. A client is to receive a drug that has a half-life of 36 hours. The drug would
probably be administered on which dose schedule?
a. Once a week
b. Once a day
c. Twice a day
d. Three times a day
ANS: B
Since the medication requires 36 hours to be eliminated from the body, a once-daily
dosing pattern would allow therapeutic drug levels to be maintained.
DIF: Cognitive Level: Analysis REF: pp. 5-6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies

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ANS: C
The trough drug level is the lowest plasma concentration of a drug, and it measures
the rate at which the drug is eliminated.
DIF: Cognitive Level: Comprehension REF: p. 9
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and
Parenteral Therapies
16. The client is receiving frequent daily drug dosing of a drug that has a long
duration of action. What should the nurse expect to be the result of this
administration?
a. Drug accumulation and possible drug toxicity
b. Increased drug excretion
c. Enhanced therapeutic response
d. Increased drug half-life
ANS: A
When the drug level exceeds the therapeutic range, toxic effects are likely to occur

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