Test Bank For Basic Pharmacology For Nurses, 16e, 16th Edition

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Test Bank For Basic Pharmacology For Nurses, 16e, 16th Edition helps you familiarize yourself with exam formats and key concepts.

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Chapter 1: Drug Definitions, Standards, and
Information Sources
Chapter 1: Drug Definitions, Standards, and Information Sources
Test Bank
MULTIPLE CHOICE
1. What is the name under which a drug is listed by the U.S. Food and Drug
Administration (FDA)?
a. Brand
b. Nonproprietary
c. Official
d. Trademark
ANS: C
The official name is the name under which a drug is listed by the FDA. The brand
name, or trademark, is the name given to a drug by its manufacturer. The
nonproprietary, or generic, name is provided by the U.S. Adopted Names Council.
DIF: Cognitive Level: Knowledge REF: p. 1 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
2. Which source contains information specific to nutritional supplements?
a. USP Dictionary of USAN & International Drug Names
b. Natural Medicines Comprehensive Database
c. United States Pharmacopoeia/National Formulary (USP NF)
d. Drug Interaction Facts
ANS: C
United States Pharmacopoeia/National Formulary contains information specific to
nutritional supplements. USP Dictionary of USAN & International Drug Names is a
compilation of drug names, pronunciation guide, and possible future FDA approved
drugs; it does not include nutritional supplements. Natural Medicines Comprehensive
Database contains evidence based information on herbal medicines and herbal
combination products; it does not include information specific to nutritional
supplements. Drug Interaction Facts contains comprehensive information on drug
interaction facts; it does not include nutritional supplements.

DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
3. What is the most comprehensive reference available to research a drug interaction?
a. Drug Facts and Comparisons
b. Drug Interaction Facts
c. Handbook on Injectable Drugs
d. Martindale—The Complete Drug Reference
ANS: B
First published in 1983, Drug Interaction Facts is the most comprehensive book
available on drug interactions. In addition to monographs listing various aspects of
drug interactions, this information is reviewed and updated by an internationally
renowned group of physicians and pharmacists with clinical and scientific expertise.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
4. The physician has written an order for a drug with which the nurse is unfamiliar.
Which section of the Physicians’ Desk Reference (PDR) is most helpful to get
information about this drug?
a. Manufacturer’s section
b. Brand and Generic Name section
c. Product Category section
d. Product Information section
ANS: B
A physician’s order would include the brand and/or generic name of the drug. The
alphabetic index in the PDR would make this section the most user friendly. Based on
a physician’s order, manufacturer’s information and classification information would
not be known. The Manufacturer’s section is a roster of manufacturers. The Product
Category section lists products subdivided by therapeutic classes, such as analgesics,
laxatives, oxytocics, and antibiotics. The Product Information section contains reprints
of the package inserts for the major products of manufacturers.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 4

TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
5. Which online drug reference makes available to health care providers and the public
a standard, comprehensive, up to date look up and downloadable resource about
medicines?
a. American Drug Index
b. American Hospital Formulary
c. DailyMed
d. Physicians’ Desk Reference (PDR)
ANS: C
DailyMed makes available to health care providers and the public a standard,
comprehensive, up to date look up and downloadable resource about medicines.
The American Drug Index is not appropriate for patient use. The American Hospital
Formulary is not appropriate for patient use. The PDR is not appropriate for patient
use.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
6. Which legislation authorizes the FDA to determine the safety of a drug before its
marketing?
a. Federal Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. Controlled Substances Act (1970)
d. Kefauver Harris Drug Amendment (1962)
ANS: A
The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine
the safety of all drugs before marketing. Later amendments and acts helped tighten
FDA control and ensure drug safety. The Durham Humphrey Amendment defines the
kinds of drugs that cannot be used safely without medical supervision and restricts
their sale to prescription by a licensed practitioner. The Controlled Substances Act
addresses only controlled substances and their categorization. The Kefauver Harris
Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers

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are required to prove to the FDA the effectiveness of their products before marketing
them.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 8
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
7. Meperidine (Demerol) is a narcotic with a high potential for physical and
psychological dependency. Under which classification does this drug fall?
a. I
b. II
c. III
d. IV
ANS: B
Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may
lead to severe psychological and physical dependence. Schedule I drugs have high
potential for abuse and no recognized medical use. Schedule III drugs have some
potential for abuse. Use may lead to low to moderate physical dependence or high
psychological dependence. Schedule IV drugs have low potential for abuse. Use may
lead to limited physical or psychological dependence.
DIF: Cognitive Level: Comprehension REF: p. 4 | p. 5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
8. What would the FDA do to expedite drug development and approval for an
outbreak of smallpox, for which there is no known treatment?
a. List smallpox as a health orphan disease.
b. Omit the preclinical research phase.
c. Extend the clinical research phase.
d. Fast track the investigational drug.
ANS: D
Once the Investigational New Drug Application has been approved, the drug can
receive highest priority within the agency, which is called fast tracking. A smallpox
outbreak would become a priority concern in the world. Orphan diseases are not
researched in a priority manner. Preclinical research is not omitted. Extending any

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phase of the research would mean a longer time to develop a vaccine. The FDA must
ensure that all phases of the preclinical and clinical research phase have been
completed in a safe manner.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: 8
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
9. Which statement is true about over the counter (OTC) drugs?
a. They are not listed in the USP NF.
b. A prescription from a health care provider is needed.
c. They are sold without a prescription.
d. They are known only by their brand names.
ANS: C
OTC medications do not require a prescription. A variety of names, both generic and
trade, can be used for individual drugs sold OTC. OTC drugs are listed in the USP
NF. Prescription drugs require an order by a health professional who is licensed to
prescribe, such as a physician, nurse practitioner, physician assistant, or dentist.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: 2
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
10. Which is the most authoritative reference for medications that are injected?
a. Physician’s Desk Reference
b. Handbook on Injectable Drugs
c. DailyMed
d. Handbook of Nonprescription Drugs
ANS: B
The Handbook on Injectable Drugs is the most comprehensive reference available on
the topic of compatibility of injectable drugs. It is a collection of monographs for
more than 300 injectable drugs that are listed alphabetically by generic name.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

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11. The nurse is administering Lomotil, a Schedule V drug. Which statement is true
about this drug’s classification?
a. Abuse potential for this drug is low.
b. Psychological dependency is likely.
c. There is a high potential for abuse.
d. This drug is not a controlled substance.
ANS: A
Lomotil, a Schedule V drug, has an abuse potential of limited physical or
psychological dependence liability compared with drugs in Schedule IV. Because
abuse potential is low with a Schedule V drug, a prescription may not be required.
Psychological dependency is not likely with a Schedule V drug. Schedule V drugs are
classified as controlled substances.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
12. The nurse is transcribing new orders written for a patient with a substance abuse
history. Choose the medication ordered that has the greatest risk for abuse.
a. Lomotil
b. Diazepam
c. Phenobarbital
d. Lortab
ANS: D
Lortab is a Schedule III drug with a high potential for abuse but less so than drugs in
Schedules I and II. Lomotil is a Schedule V drug with a low potential for abuse
compared with those in Schedule V. Diazepam is a Schedule IV drug with a low
potential for abuse compared with those in schedule III. Phenobarbital is a Schedule
IV drug with a low potential for abuse compared with those in Schedule III.
DIF: Cognitive Level: Application REF: pp. 4-5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE

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13. The nurse is caring for a patient newly diagnosed with type 1 diabetes mellitus.
Which approach(es) to therapeutic methods would be considered in this patient’s
treatment? (Select all that apply.)
a. Therapeutic drugs
b. Concentrated carbohydrate diet
c. Family centered care
d. Regular daily exercise and activity
e. Daily baths
ANS: A, B, D
Therapeutic methods include drug therapy, diet therapy, physiotherapy, and
psychological therapy. Therapeutic methods do not include family centered care or
daily baths.
DIF: Cognitive Level: Application REF: p. 1 OBJ: 1
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
14. An older adult experiencing shortness of breath is brought to the hospital by her
daughter. While obtaining the medication history from the patient and her daughter,
the nurse discovers that neither has a list of the patient’s current medications or
prescriptions. All the patient has is a weekly pill dispenser that contains four different
pills. The prescriptions are filled through the local pharmacy. Which resource(s)
would be appropriate to use in determining the medication names and doses?(Select
all that apply.)
a. Martindale—The Complete Drug Reference
b. Physicians’ Desk Reference, Section 4
c. Senior citizens’ center
d. Patient’s home pharmacy
ANS: B, D
The Physicians’ Desk Reference, Section 4, has full color images of commonly
dispensed tablets and capsules. The patient’s pharmacy would have an accurate
account of all the medications the client is currently taking.Martindale—The
Complete Drug Reference has written information on medications and would not be

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an appropriate resource. The senior citizens’ center is not likely to have specific
patient medication information.
DIF: Cognitive Level: Application REF: p. 3 OBJ: 3 | 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
15. The nurse planning patient teaching regarding drug names would include which
statement(s)? (Select all that apply.)
a. Most drug companies place their products on the market under generic names.
b.
The official name is the name under which the drug is listed by the U.S. Food and Drug
Administration (FDA).
c. Brand names are easier to pronounce, spell, and remember.
d. The first letter of the generic name is not capitalized.
e. The chemical name is most meaningful to the patient.
ANS: B, C, D
The official name is the name under which the drug is listed by the FDA. Brand
names are easier to pronounce, spell, and remember. The first letter of the generic
name is not capitalized. Most drug companies place their products on the market
under brand names instead of generic names. The chemical name is most meaningful
to the chemist.
DIF: Cognitive Level: Application REF: p. 1 OBJ: 2
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
16. When categorizing, the nurse is aware that which drug(s) would be considered
Schedule II? (Select all that apply.)
a. Marijuana
b. Percodan
c. Amphetamines
d. Fiorinal
e. Flurazepam
ANS: B, C
Schedule II drugs have a high potential for abuse, they are currently accepted in the
United States, and use may lead to severe psychological or physical dependence.

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Percodan and amphetamines are considered Schedule II drugs. Marijuana is a
Schedule I drug. Fiorinal is a Schedule III drug. Flurazepam is a Schedule IV drug.
DIF: Cognitive Level: Analysis REF: pp. 4-5 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
Chapter 2: Basic Principles of Drug Action and
Drug Interactions
Chapter 2: Basic Principles of Drug Action and Drug Interactions
Test Bank
MULTIPLE CHOICE
1. The nurse assesses hives in a patient started on a new medication. What is the
nurse’s priority action?
a. Notify physician of allergic reaction.
b. Notify physician of idiosyncratic reaction.
c. Notify physician of potential teratogenicity.
d. Notify physician of potential tolerance.
ANS: A
An allergic reaction is indicative of hypersensitivity and manifests with hives and/or
urticaria, which are easily identified. An idiosyncratic reaction occurs when
something unusual or abnormal happens when a drug is first administered. A
teratogenic reaction refers to the occurrence of birth defects related to administration
of the drug. Tolerance refers to the body’s requirement for increasing dosages to
achieve the same effects that a lower dose once did.
DIF: Cognitive Level: Application REF: p. 17 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty
minutes after administration, the nurse finds the patient agitated and stating that
“everyone is out to get me.” What is the term for this unusual reaction?
a. Desired action
b. Adverse effect
c. Idiosyncratic reaction

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d. Allergic reaction
ANS: C
Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first
administered. Patients typically exhibit an overresponsiveness to a medication related
to diminished metabolism. These reactions are believed to be related to genetic
enzyme deficiencies. Desired actions are expected responses to a medication. Adverse
effects are reactions that occur in another system of the body; they are usually
predictable. Allergic reactions appear after repeated medication dosages.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
3. Which is the best description of when drug interactions occur?
a. On administration of toxic dosages of a drug
b. On an increase in the pharmacodynamics of bound drugs
c. On the alteration of the effect of one drug by another drug
d. On increase of drug excretion
ANS: C
Drug interactions may be characterized by an increase or decrease in the effectiveness
of one or both of the drugs. Toxicity of one drug may or may not affect the
metabolism of another one. Drug interactions may result from either increased or
decreased pharmacodynamics. Drug interactions may result from either increased or
decreased excretion.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 8
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
4. What occurs when two drugs compete for the same receptor site, resulting in
increased activity of the first drug?
a. Desired action
b. Synergistic effect
c. Carcinogenicity
d. Displacement
ANS: D

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The displacement of the first drug from receptor sites by a second drug increases the
amount of the first drug because more unbound drug is available. An expected
response of a drug is the desired action. A synergistic effect is the effect of two drugs
being greater than the effect of each chemical individually, or the sum of the
individual effects. Carcinogenicity is the ability of a drug to cause cells to mutate and
become cancerous.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 9
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
5. What do drug blood levels indicate?
a. They confirm if the patient is taking a generic form of a drug.
b. They determine if the patient has sufficient body fat to metabolize the drug.
c. They verify if the patient is taking someone else’s medications.
d. They determine if the amount of drug in the body is in a therapeutic range.
ANS: D
The amount of drug present may vary over time and the blood level must remain in a
therapeutic range in order to obtain the desired result. Generic drugs do not
necessarily produce a different drug blood level than proprietary medications. Body
fat is not measured by drug blood levels. Drug blood levels only measure the amount
of drug in the body; they do not determine the source of the medication.
DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
6. What is the process by which a drug is transported by circulating body fluids to
receptor sites?
a. Osmosis
b. Distribution
c. Absorption
d. Biotransformation
ANS: B
Distribution refers to the ways in which drugs are transported by the circulating body
fluids to the sites of action (receptors), metabolism, and excretion. Osmosis is the

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process of moving solution across a semipermeable membrane to equalize the dilution
on each side. Absorption is the process by which a drug is transferred from its site of
entry into the body to the circulating fluids for distribution. Biotransformation, also
called metabolism, is the process by which the body inactivates drugs.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 4
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
7. The nurse assesses which blood level to determine the amount of circulating
medication in a patient?
a. Peak
b. Trough
c. Drug
d. Therapeutic
ANS: C
When a drug is circulating in the blood, a blood sample may be drawn and assayed to
determine the amount of drug present; this is known as the drug blood level. Peak
levels are only those drug blood levels that are at their maximum before metabolism
starts to decrease the amount of circulating drug. Trough levels are only those drug
blood levels that are at their minimum when metabolism has decreased the amount of
circulating drug and before an increase caused by a subsequent dose of the
medication. Therapeutic levels are only those within a prescribed range of blood
levels determined to bring about effective action of the medication.
DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
8. The nurse administers 50 mg of a drug at 6:00 AM that has a half life of 8 hours.
What time will it be when 25 mg of the drug has been eliminated from the body?
a. 8:00 AM
b. 11:00 AM
c. 2:00 PM
d. 6:00 PM
ANS: C

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Fifty percent of the medication, or 25 mg, will be eliminated in 8 hours, or at 2:00 PM.
8:00 AM is 2 hours after administration; the half life is 8 hours. 11:00 AM is 4 hours
after administration; the half life is 8 hours. 6:00PM is 12 hours after administration;
the half life is 8 hours.
DIF: Cognitive Level: Analysis REF: p. 14 OBJ: 6
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
9. What will the nurse need to determine first in order to mix two drugs in the same
syringe?
a. Absorption rate of the drugs
b. Compatibility of the drugs
c. Drug blood level of each drug
d. Medication adverse effects
ANS: B
Knowledge of absorption is important but not in order to mix drugs. In order to mix
two drugs, compatibility is determined so there is no deterioration when the drugs are
mixed in the same syringe. Drug level does not indicate if it is acceptable to mix
medications in the same syringe. Adverse effects are important for the nurse to know,
but not in order to mix drugs.
DIF: Cognitive Level: Application REF: p. 18 OBJ: 9
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
10. A patient developed hives and itching after receiving a drug for the first time.
Which instruction by the nurse is accurate?
a.
Stop the medication and encourage the patient to wear a medical alert bracelet that explains
allergy.
b. Explain to the patient that these are signs and symptoms of an anaphylactic reaction.
c.
Emphasize to the patient the importance to inform medical personnel that in the future a low
dosage of this drug is necessary.
d.
Instruct the patient that it would be safe to take the drug again because this instance was a m
reaction.
ANS: A

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This initial allergic reaction is mild, and the patient is more likely to have an
anaphylactic reaction at the next exposure; a medical alert bracelet is necessary to
explain the reaction. Signs and symptoms of an anaphylactic reaction are respiratory
distress and cardiovascular collapse. A more severe reaction will occur at the next
exposure, and the patient should not receive the drug again.
DIF: Cognitive Level: Application REF: p. 17 OBJ: 7
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
11. When obtaining a patient’s health history, which assessment data would the nurse
identify as having the most effect on drug metabolism?
a. History of liver disease
b. Intake of a vegetarian diet
c. Sedentary lifestyle
d. Teacher as an occupation
ANS: A
Liver enzyme systems are the primary site for metabolism of drugs. Intake of a
vegetarian diet may affect absorption but not metabolism. Sedentary lifestyle and
occupations could affect metabolism (exposure to environmental pollutants), but these
do not have the most significant effect on metabolism.
DIF: Cognitive Level: Application REF: p. 14 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
12. A physician’s order indicates to administer a medication to the patient via the
percutaneous route. The nurse can anticipate that the patient will receive this
medication:
a. intramuscularly.
b. subcutaneously.
c. topically.
d. rectally.
ANS: C
The percutaneous route refers to drugs that are absorbed through the skin and mucous
membranes. Methods of the percutaneous route include inhalation, sublingual (under

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the tongue), or topical (on the skin) administration. The parenteral route bypasses the
gastrointestinal (GI) tract by using subcutaneous (subcut), intramuscular (IM), or
intravenous (IV) injection. The parenteral route bypasses the GI tract by using subcut,
IM, or IV injection. In the enteral route, the drug is administered directly into the GI
tract by the oral, rectal, or nasogastric route.
DIF: Cognitive Level: Application REF: p. 12 OBJ: 1
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
13. A nurse is preparing to administer tetracycline to a patient diagnosed with an
infection. Which medication should not be administered with tetracycline?
a. Ativan
b. Tylenol
c. Colace
d. Mylanta
ANS: D
Administering tetracycline with Mylanta can provide an antagonistic effect that will
result in decreased absorption of the tetracycline. Ativan, Tylenol, and Colace are not
contraindicated to administer with tetracycline.
DIF: Cognitive Level: Application REF: p. 18 OBJ: 9
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
14. Which statement(s) about liberation of drugs is/are true? (Select all that apply.)
a.
A drug must be dissolved in body fluids before it can be absorbed into body
tissues.
b.
A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption
the bloodstream for transport to the site of action.
c.
The process of converting the drug into a soluble form can be controlled to a certain degree
dosage form.
d.
Converting the drug to a soluble form can be influenced by administering the drug with or w
food in the patient’s stomach.
e. Elixirs take longer to be liberated from the dosage form.
ANS: A, B, C, D

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Regardless of the route of administration, a drug must be dissolved in body fluids
before it can be absorbed into body tissues. Before a solid drug taken orally can be
absorbed into the bloodstream for transport to the site of action, it must disintegrate
and dissolve in the GI fluids and be transported across the stomach or intestinal lining
into the blood. The process of converting a drug into a soluble form can be partially
controlled by the pharmaceutical dosage form used (e.g., solution, suspension,
capsules, and tablets with various coatings). The conversion process can also be
influenced by administering the drug with or without food in the patient’s stomach.
Elixirs are already drugs dissolved in a liquid and do not need to be liberated from the
dosage form.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
15. Which are routes of drug excretion? (Select all that apply.)
a. GI tract; feces
b. Genitourinary (GU) tract; urine
c. Lymphatic system
d. Circulatory system; blood/plasma
e. Respiratory system; exhalation
ANS: A, B, E
The GI system is a primary route for drug excretion. The GU and the respiratory
systems do function in the excretion of drugs. The lymphatic and circulatory systems
are involved with drug distribution, not drug excretion.
DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
16. Which route(s) enable(s) drug absorption more rapidly than the subcut
route? (Select all that apply.)
a. IV route
b. IM route
c. Inhalation/sublingual
d. Intradermal route

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e. Enteral route
ANS: A, B, C
IV route of administration enables drug absorption more rapidly than the subcut route.
IM route of administration enables drug absorption more rapidly because of greater
blood flow per unit weight of muscle. Inhalation/sublingual route of administration
enables drug absorption more rapidly than the subcut route. Intradermally
administered drugs are absorbed more slowly because of the limited available blood
supply in the dermis. Enterally administered drugs are absorbed more slowly because
of the biotransformation process.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 1
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
17. The nurse recognizes that which factor(s) would contribute to digoxin toxicity in a
92-year-old patient? (Select all that apply.)
a. Taking the medication with meals
b. Prolonged half life of the drug digoxin
c. Impaired renal function
d. Diminished mental capacity
ANS: B, C
Impaired renal and hepatic function in older adults impairs metabolism and excretion
of drugs, thus prolonging the half life of a medication. Food would decrease the
absorption of the drug. Diminished mental capacity does not contribute to drug
toxicity unless it is due to administration errors.
DIF: Cognitive Level: Application REF: p. 14 OBJ: 5 | 6
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
18. Which statement(s) about variables that influence drug action is/are true? (Select
all that apply.)
a.
An older adult will require increased dosage of a drug to achieve the same therapeutic effec
seen in a younger person.
b. Body weight can affect the therapeutic response of a medication.
c. Chronic smokers may metabolize drugs more rapidly than nonsmokers.
d. A patient’s attitude and expectations affect the response to medication.

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e. Reduced circulation causes drugs to absorb more rapidly.
ANS: B, C, D
Body weight can affect response to medications; typically, obese patients require an
increase in dosage and underweight patients a decrease in dosage. Chronic smoking
enhances metabolism of drugs. Attitudes and expectations play a major role in an
individual’s response to drugs. Older adults require decreased dosages of drugs to
achieve a therapeutic effect. Decreased circulation causes drugs to absorb more
slowly.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: N/A
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
19. Which factor(s) affect(s) drug actions? (Select all that apply.)
a. Teratogenicity
b. Age
c. Body weight
d. Metabolic rate
e. Illness
ANS: B, C, D, E
Age, body weight, metabolic rate, and illness may contribute to a variable response to
a medication. Teratogenicity does not contribute to a variable response to a
medication.
DIF: Cognitive Level: Comprehension REF: p. 14 OBJ: N/A
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
OTHER
20. A patient receives 200 mg of a medication that has a half life of 12 hours. How
many mg of the drug would remain in the patient’s after 24 hours?
ANS:
50
The half life is defined as the amount of time required for 50% of the drug to be
eliminated from the body. If a patient is given 200 mg of a drug that has a half life of
12 hours, then 50 mg of the drug would remain in the body after 24 hours.
DIF: Cognitive Level: Analysis REF: p. 14 OBJ: 6

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TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
Chapter 3: Drug Action Across the Life Span
Chapter 3: Drug Action Across the Life Span
Test Bank
MULTIPLE CHOICE
1. 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
Trough blood levels measure the lowest blood level of medicine and are obtained just
before the dose is administered. In this case, 6:30 AM is too early to obtain the blood
level. The other two times occur after the medication is administered.
DIF: Cognitive Level: Application REF: p. 26 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
2. What will the nurse expect the health care 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
To prevent toxicity, dosages for new medications in older adults should be one third
to one half the amount of a standard adult dosage. Loading doses of drugs could cause
severe toxicity. Tapering off is characteristic of discontinuation of medications and is
not appropriate for this situation. Older adults generally need a lower medication
dosage than younger patients.
DIF: Cognitive Level: Application REF: p. 29 OBJ: 3

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TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
3. Which drugs cause birth defects?
a. Teratogens
b. Carcinogens
c. Metabolites
d. Placebos
ANS: A
Teratogens are drugs that cause birth defects. Carcinogens cause cancer. Metabolites
are the end product of metabolism. Placebos are drugs that have no pharmacologic
activity.
DIF: Cognitive Level: Knowledge REF: p. 30 OBJ: 6
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
4. 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
Children are susceptible to Reye’s syndrome if they ingest aspirin at the time of or
shortly after a viral infection of chickenpox or influenza. Anaphylactic shock is
caused by a hypersensitivity reaction. Chickenpox is the result of being infected with
a virus. Influenza A is caused by a pathogen.
DIF: Cognitive Level: Knowledge REF: pp. 27-28 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
5. Which classification of medications commonly causes allergic reactions in
children?
a. Antacids
b. Analgesics

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c. Antibiotics
d. Anticonvulsants
ANS: C
Antibiotics, especially penicillins, commonly cause allergic reactions in children.
Intravenous antibiotics can cause rapid reactions; therefore, the pediatric patient’s
response to a medication should be assessed and monitored closely. Antacids rarely
cause allergic reactions. Children are not particularly allergic to analgesics or
anticonvulsants.
DIF: Cognitive Level: Knowledge REF: p. 28 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
6. After giving instructions to an expectant mother about taking medications during
pregnancy, which patient statement indicates the need for further teaching?
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 physic
d. “I will limit my alcohol intake to only one glass of wine weekly.”
ANS: D
Alcohol needs to be eliminated during pregnancy and for 2 to 3 months prior to
conception. Limited studies are available regarding the use of herbal medications in
general, and thus they should be avoided during pregnancy. Alternative
nonpharmacologic treatments are appropriate to use during morning sickness. The
pregnant woman should also avoid using nonprescription drugs because few data are
available about safe use in pregnancy. Because few medicines can be considered
completely safe for use in pregnancy, the physician needs to approve and recommend
the use of nonprescription drugs.
DIF: Cognitive Level: Application REF: p. 30 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
7. 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

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c. Right before the mother goes to sleep at night
d. As soon as the infant finishes breastfeeding
ANS: D
Taking medications after breastfeeding reduces the amount of the medication that will
reach the baby. Medications taken directly before breastfeeding may have a high
concentration in the milk and possibly pass on to the baby. The mother must take into
consideration when her medications are ordered to be taken, and schedule them
around breastfeeding.
DIF: Cognitive Level: Comprehension REF: p. 31 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
8. 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
The decreased circulation that occurs with aging will affect transdermal drug
absorption. Difficulty swallowing would not affect transdermal drugs being absorbed.
Kidney function affects drug excretion. Changes in pigmentation would not affect
transdermal drug absorption.
DIF: Cognitive Level: Application REF: p. 22 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
9. 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

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Dosages must be reduced to prevent accumulation. Decreasing the time interval
between dosages would increase the accumulation of the drug. The intravenous route
has the fastest absorption and with liver dysfunction would increase the accumulation
of the drug. A similar drug with a longer half life would stay in the system longer;
with impaired liver function, the result would be increased accumulation.
DIF: Cognitive Level: Comprehension REF: p. 24 OBJ: 3
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
10. The nurse is teaching an elderly patient with difficulty swallowing about his
medications. Which explanation by the nurse is most helpful?
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
It is acceptable to break scored tablets in half to facilitate swallowing of the
medication. Enteric coated tables should never be crushed because of the effect on the
absorption rate and potential for toxicity. Medications labeled “SR” indicate
“sustained release” and should not be crushed because of the effect on the absorption
rate. Medication in liquid form may be easier to swallow.
DIF: Cognitive Level: Application REF: p. 29 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
11. The nurse is administering an antibiotic intravenously. Which blood level
determines the lowest amount of medication present in the patient?
a. Peak
b. Serum
c. Therapeutic
d. Trough
ANS: D

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The lowest amount of a medication in the blood is the trough. The peak is the highest
amount of medication in the blood. Serum level identifies the amount of medication
present. Therapeutic levels identify the range in which a medication is effective.
DIF: Cognitive Level: Knowledge REF: p. 26 OBJ: none
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
12. 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
Males’ stomachs empty more rapidly; children have increased motility, resulting in
decreased absorption time. As one gets older, gastrointestinal (GI) motility is
decreased, allowing for increased absorption time; women have slower gastric
emptying, resulting in more time for absorption. Males’ stomachs empty more
rapidly; however, as one gets older, GI motility is decreased, resulting in an increase
in absorption time. As one gets older, GI motility is decreased, allowing for increased
absorption time; women have slower gastric emptying, resulting in more time for
absorption.
DIF: Cognitive Level: Application REF: pp. 20-21 OBJ: 3 | 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
13. 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
Cumulative effects are related to diminished metabolism or excretion of a drug that
causes it to accumulate. Cumulative effects can lead to drug toxicity. Toxicity occurs

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when adverse effects are severe. Inability to control the ingestion of drugs is drug
dependence. The need for higher dosage to produce the same effect as previous lower
dosages is the definition of tolerance.
DIF: Cognitive Level: Knowledge REF: p. 22 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
14. 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
An obese individual would require a larger dose of a drug to attain a therapeutic
response. An individual with kidney failure would require less medication because of
decreased excretory ability. Individuals with decreased metabolic rate would
metabolize drugs more slowly and require smaller doses or less frequent
administration. Individuals with decreased circulation would require less medication.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
15. A resident in a long term care facility reports difficulty swallowing enteric coated
aspirin and asks the nurse to crush it prior to administration. The most appropriate
action for the nurse to take is to:
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
The medication should be held and the physician notified. The physician has the
authority to determine how to proceed in this situation. Enteric coated tablets should
not be crushed because this will increase the absorption rate and the potential for

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toxicity. Geriatric patients may have difficulty swallowing and are at risk for choking
and aspiration. They should not be encouraged to swallow medications if they report
difficulty swallowing. The physician must determine if a substitution can be ordered.
Prescribing is not in the nurse’s scope of practice.
DIF: Cognitive Level: Analysis REF: p. 22 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
16. 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. What 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 premature infant’s outer layer of skin is not fully developed, although it is more
hydrated, which will enhance the absorption of the topical water soluble medication.
Neonates often wear diapers, which will act as an occlusive dressing, thereby
increasing absorption. The client’s inflammatory condition will increase the
absorption of medication. The intestinal transit rate increases as the newborn matures.
This is irrelevant when a medication is applied topically. Gastric pH would not factor
into metabolism of a medication that is applied topically.
DIF: Cognitive Level: Application REF: p. 20 | p. 22 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
17. 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.

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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 chil
ANS: A, B
The PDR lists the recommended dosages for all age groups. Because dilution may
vary among age groups, the water concentration should be verified prior to
administration. As we age, lean body mass and total body water decrease while total
fat content increases; however, this drug is not fat soluble. The nurse is responsible for
administering the medication as ordered after verifying that it is correct; the mother is
asking for verification, not refusal of administration. Drugs that are relatively
insoluble are transported in the circulation by being bound to plasma proteins;
however, this drug is water soluble.
DIF: Cognitive Level: Application REF: p. 27 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
18. For which reason(s) is/are elderly patients at increased risk for drug interactions
and toxicity? (Select all that apply.)
a. They have a higher incidence of malnourishment.
b. Their renal function is enhanced.
c. They have increased use of multiple medications.
d. Hepatic function is reduced.
e. There are often issues with swallowing.
ANS: A, C, D
Older adult patients have an increased incidence of malnourishment, are often on
multiple medications, and have reduced hepatic function, all of which puts them at
increased risk for drug interactions and toxicity. Renal function diminishes in the
elderly as a result of decreased renal blood flow, reduced cardiac output, loss of
glomeruli, and diminished tubular function and concentrating ability. Older adults
have swallowing difficulties, leading to compliance issues, but taking drugs less often
would not result in toxicity.
DIF: Cognitive Level: Comprehension REF: p. 28 OBJ: 3

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TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
19. 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
Drug therapy during pregnancy should be avoided. Recommendations by the provider
are necessary during any stage of pregnancy. Pediatric and elderly patients are
affected by differences in muscle mass and blood flow to muscles, as well as other
physiological systems. Teenagers and adult patients do not typically require special
considerations for medication administration.
DIF: Cognitive Level: Application REF: pp. 20-21 OBJ: 3 | 4 | 5 | 6
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
20. 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
Absorption by passive diffusion across the membranes depends on the pH of the
environment. Increased blood flow to gastric mucosa increases absorption of
medication and decreases time of absorption. Drug absorption does not depend on the
mental status of the patient. Fever does not affect drug absorption. The patient’s
absolute weight and body surface area do not affect drug absorption, although

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problems associated with weight greater than or less than normal may be a factor in
the process.
DIF: Cognitive Level: Application REF: p. 22 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
21. When receiving a report on a new admission from the emergency room, the nurse
learns that the patient is newly diagnosed with renal failure. Which medication(s) in
the patient’s medication history will require dosage adjustment by the
physician?(Select all that apply.)
a. Lithium
b. Tobramycin
c. Atenolol
d. Quinidine
e. Ampicillin
ANS: A, B, C, D, E
Lithium, tobramycin, atenolol, quinidine, and ampicillin are all select medications that
require dosage adjustment in renal failure.
DIF: Cognitive Level: Application REF: p. 26 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
22. Prenatal education is being provided by the nurse at a maternal family child clinic.
What information should be relayed?(Select all that apply.)
a. Herbal medicines are considered safe.
b. Limit tobacco consumption to less than two cigarettes per day.
c. Encourage a folic acid supplement.
d. One alcoholic beverage per day is acceptable in the last trimester.
e. Encourage nonpharmacologic treatments for symptoms such as nausea.
ANS: C, E
Good nutrition with appropriate ingestion of vitamins (especially folic acid) is
particularly important during pregnancy to prevent birth defects. Before using
medicines, pregnant women should be encouraged to try nonpharmacologic
treatments. Herbal medicines that have not been scientifically tested in women during

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pregnancy should be avoided. Advise against the use of tobacco. Mothers who smoke
have a higher frequency of miscarriage, stillbirths, premature births, and low birth
weight infants. Consumption of alcohol should be eliminated 2 to 3 months before
planned conception, as well as during pregnancy.
DIF: Cognitive Level: Application REF: pp. 30-31 OBJ: 6
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
Chapter 4: The Nursing Process and
Pharmacology
Chapter 4: The Nursing Process and Pharmacology
Test Bank
MULTIPLE CHOICE
1. What is the primary purpose of the nursing assessment?
a. Identifying underlying pathologic conditions
b. Assisting the physician in identifying medical conditions
c. Determining the patient’s mental status
d. Exploring patient responses to health problems
ANS: D
A nursing assessment is done to identify the patient’s response to health problems.
During the nursing assessment phase, a comprehensive information base is developed
through a physical examination, nursing history, medication history, and professional
observation. Identifying underlying pathologic conditions and assisting the physician
in identifying medical conditions is not part of the nursing process. Determining the
patient’s mental status is one part of the nursing assessment, but it is not the primary
purpose.
DIF: Cognitive Level: Comprehension REF: p. 36 OBJ: 1 | 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
2. What is the basis of the NANDA I taxonomy?
a. Functional health patterns
b. Human response patterns
c. Basic human needs

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Test Bank For Basic Pharmacology For Nurses, 16e, 16th Edition

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