Pharmacology: A Patient-Centered Nursing Process Approach 9th Edition Test Bank

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Pharmacology: A Patient-Centered Nursing Process Approach 9th Edition Test Bank provides a structured approach to mastering key exam concepts with step-by-step explanations and practice questions.

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Chapter 01: Drug Development and Ethical Considerations
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition
MULTIPLE CHOICE
1. The nurse is obtaining consent from a subject newly recruited for a clinical drug trial that
will last for 6 months. All subjects will be given gift certificates for participating. One
subject says, “Well, I guess if the drug doesn’t work, I’ll just have to put up with the
symptoms for 6 months.” What will the nurse tell the subject?
a. “Participation for the duration of the study is required.”
b. “Participation may end at any time without penalty.”
c. “Withdrawal from the study may end at any time, but the gift certificate will not be
given.”
d. “You can request placement in the treatment group.”
ANS: B
All participants have the right to autonomy, which is the right to self-determination. Patients
have the right to refuse to participate or to withdraw from a study at any time without
penalty. Patients generally are not allowed to choose participation in either the treatment or
the control group.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
2. The nurse is assisting with a clinical drug trial in which the side effects of two effective
drugs are being compared. A patient who would benefit from either drug has elected to
withdraw from the study, and the nurse assists with the paperwork to facilitate this. This is
an example of
a. autonomy.
b. beneficence.
c. justice.
d. veracity.
ANS: A
All participants have the right to autonomy, which is the right to self-determination. Patients
have the right to refuse to participate or to withdraw from a study at any time without
penalty even if the health care provider disagrees with that choice.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
3. During a clinical drug trial for a new medication, researchers note a previously unknown
serious adverse effect occurring in more than 50% of subjects. The study is discontinued.
Which ethical principle is being exercised?
a. Beneficence
b. Justice
c. Respect for persons
d. Veracity

ANS: A
Beneficence is the duty to do good and to not harm others. Once a serious adverse effect is
noted in a majority of subjects, researchers have an ethical obligation to stop the study.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
4. In a 5-year experimental clinical trial to investigate a new cancer treatment, researchers in
the second year note overwhelming improvement in almost all of the subjects in the
treatment group. The lead researcher elects to continue the study. Which ethical principle is
being violated?
a. Beneficence
b. Justice
c. Respect for persons
d. Veracity
ANS: B
The principle of justice requires that all people be treated fairly, including equal access to
health care for all. Once a benefit is demonstrated, it should be available to all participants.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
5. The nurse is enrolling subjects for a double-blind experimental study. One patient asks the
nurse to explain the role of the experimental group. The nurse will explain that subjects in
the experimental group in this type of study
a. are selected for participation in that group.
b. have unique baseline characteristics.
c. receive a placebo.
d. receive the treatment being evaluated.
ANS: D
In a double-blind experimental study, subjects in the experimental group receive the
treatment or drug under study. They are randomly assigned and not selected. They should
have similar baseline characteristics to those in the control group. They do not receive a
placebo.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 6
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Management of Client Care
6. The nurse is obtaining signatures on consent forms for participation in a clinical drug trial.
One patient says, “I’m not sure I want to do this, but I need the cash.” The nurse will take
which action?
a. Ask the patient to clarify concerns.
b. Reinforce that cash is given to all subjects equally.
c. Report this statement to the party named on the consent.
d. Review the elements of the study and obtain consent.
ANS: C

If a nurse suspects that a patient is being coerced to participate in the study, the nurse should
report this to the party named on the informed consent. When a patient verbalizes
participation based on a financial reward, there is an element of coercion.
DIF: Cognitive Level: Applying (Application) REF: p. 3
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
7. Which is the characteristic of preclinical in vivo testing?
a. A comparison of experimental and control data in animals
b. A study conducted in a test tube in a laboratory
c. A study that determines the effects of the placebo in human participants
d. A study to assess the seriousness of the disease to be treated
ANS: A
Preclinical in vivo testing is performed in animals or other living organisms. In vitro studies
occur in test tubes. Safe therapeutic dose studies are part of clinical research. Prior to
clinical trials, an assessment is made of the disease and its seriousness.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
8. Many drugs marketed in the 1980s may not be effective in a majority of the population. The
nurse understands that this is because these drugs
a. did not pass through the appropriate phases of clinical trials.
b. did not require human subject protections and are invalid.
c. were not tested on women, minorities, or children.
d. were tested on healthy subjects only.
ANS: C
Drug research was historically done only with Caucasian males, causing uncertainty as to
the validity of the research results.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
9. The nurse is assisting with data collection in a study of drug effects in healthy subjects. The
nurse assists with blood and urine collection to determine serum drug levels and the
presence of metabolites in the urine. Which phase of a drug study does this represent?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
ANS: A
Phase I drug trials are performed to assess safety and to identify the pharmacokinetics, such
as metabolism and elimination, of drugs in healthy subjects.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care

10. The nurse is enrolling subjects for a clinical drug trial in which subjects will be randomly
assigned to either a treatment or a placebo group. The pills in both groups will be in
identical packaging with identical appearance. The group that receives the intervention is the
a. control group.
b. experimental group.
c. dependent group.
d. independent group.
ANS: B
The experimental group in a drug trial is the group that receives the drug being tested. The
control group may receive no drug, a different drug, a placebo, or the same drug with a
different dose, route, or frequency of administration. Dependent and independent are not
terms to describe groups in a study; they denote the variables.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 6
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
11. The nurse is assisting with a clinical drug trial to test the safe dose of an analgesic
medication and learns that subjects have been told that the study is about measuring the
analgesic effects. Which ethical principle has been violated?
a. Beneficence
b. Justice
c. Respect for persons
d. Veracity
ANS: D
Veracity requires health care professionals to tell the truth.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
12. A clinical drug trial is concluding a study of pharmacokinetics and safety of a drug in
healthy individuals. The nurse will assist enrollment of participants into the next phase of
the study and will include which subjects?
a. Healthy subjects
b. Healthy and ill subjects
c. Subjects with the disease the drug will treat
d. Subjects with other diseases
ANS: C
After Phase I studies demonstrating drug safety and pharmacokinetics have been completed,
the drug is tested on subjects who have the disease the drug will treat.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 6
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care

13. Before marketing a new drug that has been approved for use based on clinical effectiveness
and safety, the manufacturer wishes to study the potential new uses for the drug. This is an
example of which phase of study?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
ANS: D
Phase IV studies are performed to examine potential new indications for approved drugs.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
14. Which statement about the safety and efficacy of medications in children is accurate?
a. Children cannot give consent, so clinical drug trials are not performed on children.
b. Children can only be subjects in quasi-experimental clinical studies.
c. Data from adult clinical drug trials can be extrapolated to children.
d. Federal law requires that drugs for children be tested on children.
ANS: D
The U.S. Food and Drug Administration (FDA) Modernization Act of 1997 requires that
drugs intended for use in children be tested on children.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 8
TOP: Nursing Process: N/A MSC: NCLEX: Management of Client Care
15. The nurse is preparing to administer a schedule II injectable drug and is drawing up half of
the contents of a single-use vial. Which nursing action is correct?
a. Ask another nurse to observe and cosign wasting the remaining drug from the vial.
b. Keep the remaining amount in the patient’s drawer to give at the next dose.
c. Record the amount unused in the patient’s medication record.
d. Dispose of the vial with the remaining drug into a locked collection box.
ANS: A
Schedule II drugs are controlled substances, and all must be accounted for. When wasting a
portion of a drug, another nurse should observe and cosign that a drug was wasted.
DIF: Cognitive Level: Applying (Application) REF: p. 8
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
16. A patient is prescribed a medication and asks the nurse if the drug is available in a generic
form. The nurse understands that a generic medication will have a name that
a. is a registered trademark.
b. is always capitalized.
c. is related to the drug’s chemical structure.
d. is nonproprietary.
ANS: D

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The generic name is the official, nonproprietary name for a drug. The brand name is the
trademark name and is always capitalized. The chemical name describes the chemical
structure of the drug.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 11
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
17. A patient receives a prescription on which the provider has noted that a generic medication
may be given. The patient asks the nurse what this means. What will the nurse tell the
patient about generic drugs?
a. They contain the same inert ingredients as brand-name drugs.
b. They have chemical structures that are identical to proprietary drugs.
c. They tend to be less expensive than brand-name drugs.
d. They undergo extensive testing before they are marketed.
ANS: C
Generic drugs are approved by the FDA if they are proved to be bioequivalent to the
brand-name drug. They tend to be less expensive because manufacturers of these drugs do
not have to do the extensive testing required of brand-name drugs before marketing. They
are not identical to brand-name drugs and often have different inert ingredients.
DIF: Cognitive Level: Applying (Application) REF: p. 11
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Management of Client Care
18. The nurse reviews information about a drug and notes the initials “United States
Pharmacopeia (USP)” after the drug’s official name. The nurse understands that this
designation indicates the drug
a. is a controlled substance.
b. is approved by the FDA.
c. is available in generic form.
d. meets quality and safety standards.
ANS: D
The “USP” designation is given to drugs that have met high standards for therapeutic use,
patient safety, quality, purity, strength, packaging safety, and dosage form by the United
States Pharmacopoeia National Formulary. The FDA classifies controlled substances with
Roman numerals from I to V. The USP designation does not indicate FDA approval. The
USP designation does not indicate generic availability.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 7
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
19. The nurse is preparing to give a medication to a child. The child’s parent asks whether the
drug is safe for children. How will the nurse respond to the parent?
a. “Drugs are tested on adults and safe doses for children are based on weights
compared to adult weights.”
b. “Drugs are deemed safe for children over time when repeated use proves

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effectiveness and safety.”
c. “Drugs are tested for both efficacy and safety in children in order to be marketed
for pediatric use.”
d. “Drugs are tested on children in postmarketing studies and on a limited basis.”
ANS: C
The Pediatric Research Equity Act requires drug manufacturers to test drugs on children.
DIF: Cognitive Level: Applying (Application) REF: p. 9
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
20. Which law(s) govern all drug administration by nurses?
a. Drug Regulation and Reform Act
b. FDA Amendments Act
c. Nurse Practice Acts
d. The Controlled Substances Act
ANS: C
Each state’s Nurse Practice Act identifies how nurses administer medications. The other acts
govern how drugs are marketed and tested.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 9
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
21. A patient is taking methadone as part of a heroin withdrawal program. The nurse
understands that, in this instance, methadone is classified as which drug schedule?
a. C-I
b. C-II
c. C-III

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DIF: Cognitive Level: Understanding (Comprehension) REF: p. 9
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
1. Which are responsibilities of the FDA? (Select all that apply.)
a. To ensure a drug has accurate labeling.
b. To ensure a drug is affordable.
c. To ensure a drug is effective.
d. To ensure a drug is free from adverse reactions.
e. To ensure a drug is tested for harmful effects.
ANS: A, C, E
The FDA ensures that drugs are labeled correctly, that they are tested and proven effective
for the conditions they are marketed to treat, and that they are tested for harmful effects. The
FDA does not ensure affordability or freedom from adverse reactions, although these must
be noted in drug information materials.
DIF: Cognitive Level: Understanding (Comprehension) REF: pp. 8-9
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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Chapter 02: Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition
MULTIPLE CHOICE
1. Which drug will go through a disintegration process after it is administered?
a. Intramuscular (IM) cephalosporins
b. Intravenous (IV) vasopressors
c. Oral analgesics
d. Subcutaneous antiglycemics
ANS: C
When drugs are administered parenterally, there is no disintegration process, which occurs
when a drug becomes a solution that can cross the biologic membrane.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 16
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is preparing to administer an oral medication and wants to ensure a rapid drug
action. Which form of the medication will the nurse administer?
a. Capsule
b. Enteric-coated pill
c. Liquid suspension
d. Tablet
ANS: C
Liquid drugs are already in solution, which is the form necessary for absorption in the
gastrointestinal (GI) tract. The other forms must disintegrate into small particles and then
dissolve before being absorbed.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 16
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of
actions after taking these medications. Enteric-coated tablets should not be crushed or
chewed, which would alter the time and location of absorption. Acidic foods will not
enhance the absorption of the medication. The patient should not eat high-fat food before
ingesting an enteric-coated tablet because high-fat foods decrease the absorption rate.
DIF: Cognitive Level: Applying (Application) REF: p. 16
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be
given by subcutaneous injection instead of by mouth. The nurse will explain that this is
because
a. absorption is diminished by the first-pass effects in the liver.
b. absorption is faster when insulin is given subcutaneously.
c. digestive enzymes in the GI tract prevent absorption.
d. the oral form is less predictable with more adverse effects.
ANS: C
Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine
by digestive enzymes and must be given parenterally. Because insulin is destroyed by
digestive enzymes, it would not make it to the liver for metabolism with a first-pass effect.
Subcutaneous tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin
is given subcutaneously because it is desirable to have it absorb slowly.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 17
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer an oral medication that is water soluble. The nurse
understands that this drug
a. must be taken on an empty stomach.
b. requires active transport for absorption.
c. should be taken with fatty foods.
d. will readily diffuse into the GI tract.

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ANS: C
Food can stimulate the production of gastric acid, so medications requiring an acidic
environment should be given with a meal. High-fat foods are useful for drugs that are lipid
soluble.
DIF: Cognitive Level: Applying (Application) REF: p. 17
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. The nurse is preparing an injectable drug and wants to administer it for rapid absorption.
How will the nurse give this medication?
a. IM into the deltoid muscle
b. IM into the gluteal muscle
c. Subcut into abdominal tissue
d. Subcut into the upper arm
ANS: A
Drugs given IM are absorbed faster in muscles that have more blood vessels, such as the
deltoid, rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routes
are used when absorption needs to be slower and more sustained.
DIF: Cognitive Level: Applying (Application) REF: p. 17
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. The nurse is reviewing medication information with a nursing student prior to administering
an oral drug and notes that the drug has extensive first-pass effects. Which statement by the
student indicates a need for further teaching about this medication?
a. “The first-pass effect means the drug may be absorbed into systemic circulation
from the intestinal lumen.”
b. “The first-pass effect means the drug may be changed to an inactive form and
excreted.”
c. “The first-pass effect means the drug may be changed to a metabolite, which may
be more active than the original.”
d. “The first-pass effect means the drug may be unchanged as it passes through the
liver.”

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a. bioavailability.
b. pinocytosis.
c. protein binding.
d. tachyphylaxis.
ANS: A
Oral drugs may have less bioavailability because a lower percentage of the drug reaches the
systemic circulation. Pinocytosis refers to the process by which cells carry a solute across a
membrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapid
decrease in response to drugs that occurs when tolerance develops quickly.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 17
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
10. The nurse is preparing to administer a drug and learns that it binds to protein at a rate of
90%. The patient’s serum albumin level is low. The nurse will observe the patient for
a. decreased drug absorption.
b. decreased drug interactions.
c. decreased drug toxicity.
d. increased drug effects.
ANS: D
Drugs that are highly protein-bound bind with albumin and other proteins, leaving less free
drug in circulation. If a patient has a low albumin, the drug is not bound, and there is more
free drug to cause drug effects. There would be increased absorption, increased interactions
with other drugs, and increased toxicity.
DIF: Cognitive Level: Applying (Application) REF: p. 18
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. The nurse is administering two drugs to a patient and learns that both drugs are highly
protein-bound. The nurse may expect
a. decreased bioavailability of both drugs.

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a. decreased drug effects of the first drug.
b. decreased therapeutic range of the first drug.
c. increased drug effects of the first drug.
d. increased therapeutic range of the first drug.
ANS: C
Adding another highly protein-bound drug will displace the first drug from protein-binding
sites and release more free drug, increasing the drug’s effects. This does not alter the
therapeutic range, which is the serum level between drug effectiveness and toxicity.
DIF: Cognitive Level: Applying (Application) REF: p. 18
TOP: Nursing Process: Nursing Intervention/Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
13. The nurse gives a medication to a patient with a history of liver disease. The nurse will
monitor this patient for
a. decreased drug effects.
b. increased drug effects.
c. decreased therapeutic range.
d. increased therapeutic range.
ANS: B
Liver diseases such as cirrhosis and hepatitis alter drug metabolism by inhibiting the
drug-metabolizing enzymes in the liver. When the drug metabolism rate is decreased, excess
drug accumulation can occur and lead to toxicity.
DIF: Cognitive Level: Applying (Application) REF: p. 19
TOP: Nursing Process: Assessment/Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
14. The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be left
in the body in 24 hours if no additional drug is given?
a. None

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d. 0800 on Friday
ANS: B
Steady-state levels occur at 3 to 5 half-lives. Wednesday at 0800 is 4 half-lives from the
original dose.
DIF: Cognitive Level: Applying (Application) REF: p. 19
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
16. The nurse is preparing to administer a drug that is ordered to be given twice daily. The nurse
reviews the medication information and learns that the drug has a half-life of 24 hours. What
will the nurse do next?
a. Administer the medication as ordered
b. Contact the provider to discuss daily dosing
c. Discuss every-other-day dosing with the provider
d. Hold the medication
ANS: B
A drug with a longer half-life should be given at longer intervals to avoid drug toxicity.
DIF: Cognitive Level: Applying (Application) REF: p. 19
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
17. The nurse is caring for a patient who has taken an overdose of aspirin several hours prior.
The provider orders sodium bicarbonate to be given. The nurse understands that this drug is
given for which purpose?
a. To counter the toxic effects of the aspirin
b. To decrease the half-life of the aspirin
c. To increase the excretion of the aspirin
d.

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Increased creatinine and BUN indicate decreased renal function, so a drug that is eliminated
through the kidneys can become toxic. The nurse should discuss a lower dose with the
provider. The drug will have a longer half-life and will exhibit increased effects with
decreased renal function.
DIF: Cognitive Level: Applying (Application) REF: p. 19
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
19. The nurse understands that the length of time needed for a drug to reach the minimum
effective concentration (MEC) is the
a. duration of action.
b. onset of action.
c. peak action time.
d. time response curve.
ANS: B
The onset of action is the time it takes to reach the MEC. Duration of action is the length of

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