Pharmacology A Nursing Process Approach Kee 7th Edition Test Bank

Pharmacology A Nursing Process Approach Kee 7th

Edition Test Bank
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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

Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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 Test Bank 1-2

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

Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

 Test Bank 1-3

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

Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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