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(Download PDF) Pharmacology A Nursing Process Approach 7th Edition Kee Test Bank Full Chapter
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Kee: Pharmacology, 7th Edition
Chapter 8: Drug Interactions and Over-the-Counter Drugs
Test Bank
MULTIPLE CHOICE
1. A nurse is monitoring for drug interactions based on which premise about drug
interactions?
a. Drug interactions are undesirable drug effects.
b. Drug interactions are changes occurring with drug absorption.
c. Drug interactions are altered effects of a drug from interaction with other drugs.
d. Drug interactions are reactions that occur in vitro.
ANS: C
Drug interactions are an altered or modified action or effect of a drug as a result of
interaction with one or more other drugs.
2. The nurse is aware that drugs can block, decrease, or increase the actions of another drug.
Laxatives can have which effect on drug absorption?
a. Increase
b. Decrease
c. Block
d. Enhance
ANS: B
Laxatives increase gastric and intestinal emptying, decreasing the time the medication is
in contact with the gastric lining and is available for drug absorption.
4. A client is taking antacids with an antibiotic. The nurse’s instructions are based on the
fact that antacids such as aluminum hydroxide (Amphojel) can:
a. increase drug absorption.
b. slow drug metabolism.
c. increase drug metabolism.
d. slow or block drug absorption.
ANS: D
Antacids impair medication absorption by changing the pH and surface area of the gastric
lining. Many drugs are formulated to be absorbed in an acidic environment, and antacids
make the environment more alkaline.
6. The nurse has provided instructions to a client taking diazepam (Valium) for short-term
anxiety. Which statement by the client indicates that the client needs additional
instruction?
a. “I will avoid drinking alcohol while taking this drug.”
b. “I will continue to eat grapefruit while taking this drug.”
c. “I will avoid using heavy equipment when taking this drug.”
d. “I will contact the healthcare provider if I develop a rash.”
ANS: B
Flavanoids are found in grapefruit, and taking diazepam (Valium) with grapefruit may
increase drug levels. The other statements are appropriate.
7. Cimetidine (Tagamet) is an enzyme inhibitor for the medication theophylline. Drugs that
are enzyme inhibitors:
a. convert drugs to metabolites.
b. increase metabolism, promoting drug elimination.
c. decrease metabolism, promoting an increase in plasma drug concentration.
d. increase drug action.
ANS: C
An enzyme inhibitor decreases the metabolism of certain drugs.
8. A client smokes regularly. She takes theophylline (Theo-Dur and others) daily. What is
an effect of smoking while on theophylline?
a. Decrease in theophylline clearance
b. Increase in theophylline clearance
c. Increase in the distribution of theophylline
d. Decrease in the dose for theophylline
ANS: B
Smoking increases hepatic enzyme activity, increasing the clearance of theophylline
(Theo-Dur and others). Smokers may need an increased dose of medication.
9. Some drugs can affect the excretion of other drugs. The antidysrhythmic drug quinidine
decreases the excretion of digoxin (Lanoxin). How would the digoxin concentration in
the body fluids be affected?
a. No effect
b. Decreased
c. Increased
d. Unabsorbed
ANS: C
Because the excretion of digoxin (Lanoxin) is decreased, this would allow the digoxin to
accumulate in the bloodstream.
10. A client is receiving two analgesics for pain relief. Two drugs with similar action are
administered to achieve which kind of effect?
a. Additive
b. Synergistic
c. Opposing
d. Antagonistic
ANS: A
Additive drugs include those with similar actions that increase the function of one
another when given together.
11. A client is scheduled for surgery, and an antihistamine and narcotic have been prescribed
as preoperative drugs. The antihistamine increases the effect of the narcotic. This is an
example of which drug effect?
a. Additive
b. Potentiation
c. Opposing
d. Antagonistic
ANS: B
Potentiating drugs include those with different actions that when given together increase
the function of one another.
12. A client receives morphine sulfate and demonstrates signs of respiratory depression. The
physician orders naloxone (Narcan) to block the effects of the narcotic. When two drugs
given concurrently have opposite effects, what kind of pharmacodynamic interactions
occur?
a. Additive
b. Synergistic
c. Agonistic
d. Antagonistic
ANS: D
When two drugs that have opposite effects, or antagonistic effects, are administered
together, each drug cancels the effect of the other.
13. Food is known to increase, decrease, or delay drug absorption. A client has a high serum
cholesterol level, and lovastatin (Mevacor) is prescribed. The client is taking the drug at
mealtime and asks why this is necessary. What does taking lovastatin with food
accomplish?
a. Decrease in drug absorption
b. Decrease in drug absorption
c. Decrease in drug action
d. Increase in drug excretion
ANS: B
The absorption of the statin medications is increased in the presence of food.
14. A client is taking tetracycline for acne. It is a drug known to cause photosensitivity. To
avoid phototoxicity, the nurse provides client teaching. Which statement by the client
indicates a need for more teaching?
a. “I need to avoid excessive sunlight.”
b. “I need to use sunscreen when I go out during the day.”
c. “I need to wear protective clothing over exposed skin areas in sunlight.”
d. “I can stay in the sun for only about 4 hours a day.”
ANS: D
Four hours would be too long to be exposed, especially during peak sunlight times.
15. The nurse instructs a client with which condition to avoid taking over-the-counter cough
and cold remedies?
a. High blood cholesterol
b. Rheumatoid arthritis
c. Hypotension
d. Thyroid disease
ANS: D
Clients with heart disease, hypertension, and thyroid disease should avoid taking over-
the-counter cough and cold preparations as they may contain sympathomimetics, which
may increase blood pressure and cause nervousness, headache, and insomnia.
16. Some medications previously requiring a prescription are now available as over-the-
counter (OTC) drugs. Client teaching related to OTC drugs should include:
a. instructions to take only prescribed drugs.
b. instructions to report OTC drugs being taken to the healthcare provider.
c. teaching that herbal drugs can be taken with prescribed drugs.
d. teaching that all OTC drugs are considered safe.
ANS: B
OTC medications may interact with prescribed medications or may have certain effects
that should be evaluated by a healthcare provider.
17. A client with a history of deep vein thrombosis takes warfarin (Coumadin) daily. He has
been experiencing headaches and has been taking over-the-counter pain relievers. The
nurse discovers that the client is taking aspirin. Which assessment should the nurse be
most attentive to at this time?
a. The client reports that his gums are bleeding more than usual when he brushes his
teeth.
b. The client complains of constipation.
c. The client reports that he is unable to sleep at night despite feeling very fatigued.
d. The nurse notes that the client has a runny nose and some nasal congestion.
ANS: A
Aspirin and warfarin both increase the bleeding time. An early manifestation of this is
bleeding from the gums.
18. A client eats a large meal and then takes her medications. Usually food has which effect
on drug dissolution and absorption?
a. Enhances
b. Increases
c. Decreases
d. No effect
ANS: C
Food typically delays drug absorption, although it occasionally has other effects.
19. The nurse is caring for a client who is being treated with aspirin and an oral antidiabetic
agent. The nurse anticipates an increased risk of _____ from the interaction between the
drugs.
a. bleeding
b. clotting
c. hypoglycemia
d. hyperglycemia
ANS: C
Oral antidiabetic agents, when taken with aspirin, can increase the risk of hypoglycemia.
20. The nurse is caring for a client who is being treated with both isoniazid and phenytoin.
The nurse anticipates which result from the interaction between the drugs?
a. Toxic level of phenytoin
b. Subnormal level of isoniazid
c. Toxic level of isoniazid
d. Subnormal level of phenytoin
ANS: A
Administering isoniazid along with phenytoin may result in phenytoin developing toxic
levels.
21. The nurse notes that the client has been ordered to receive both aminophylline and
dobutamine by IV infusion. The client has one IV access and has been dehydrated. What
is the highest priority action on the part of the nurse?
a. Call the pharmacist for additional information on the medications.
b. Start a second intravenous access in the client’s arm.
c. Call the physician for orders regarding the medications.
d. Administer the medications using piggyback tubing.
ANS: C
The drugs are incompatible by intravenous infusion.
MULTIPLE RESPONSE
1. Which drug groups are considered to be over-the-counter (OTC) drug groups? (Select all
that apply.)
a. Herbal products
b. Laxatives
c. Antibiotics
d. Antacids
ANS: A, B, D
Antibiotics require a physician’s prescription. The other medications are available OTC.
{34}
The Duke of Cornwall and York, heir to the British crown (but
not yet created Prince of Wales), sailed, with his wife, from
England in March, to be present at the opening of the first
Parliament of the federated Commonwealth of Australia, which
is arranged to take place early in May. He makes the voyage in
royal state, on a steamer specially fitted and converted for
the occasion into a royal yacht, with an escort of two
cruisers.
----------AUSTRALIA: End--------
----------AUSTRIA-HUNGARY: Start--------
AUSTRIA-HUNGARY:
Financial relations of the two countries
forming the dual Empire.
"On all these grounds the Austrians declare that they can no
longer go on paying the old Quota of 68.6 per cent. The
Hungarians admit the great progress made by Hungary, but with
some qualifications. In spite of the growth of Budapest,
Fiume, and a few other towns, Hungary is still, on the whole,
very backward when compared with Austria. The total volume of
her manufactures is very small, in spite of the rapid increase
of recent years. Hungary is still, to all intents and
purposes, an agricultural country, and as such, has suffered
largely from the fall in prices."
L. S. Amery,
Austro-Hungarian Financial Relations
(Economic Journal, September, 1898).
AUSTRIA-HUNGARY: A. D. 1894-1895.
The Hungarian Ecclesiastical Laws.
Conflict with the Church.
Resignation of Count Kalnoky.
AUSTRIA-HUNGARY: A. D. 1895-1896.
Race-jealousies and conflicts.
The position of Bohemia in the part of the dual Empire
called Austria.
Anti-Semitic agitation in Vienna.
Austrian Ministry of Count Badeni.
Enlarged parliamentary franchise.
AUSTRIA-HUNGARY: A. D. 1896.
Celebration of the Millennium of the Kingdom of Hungary.
{37}
AUSTRIA-HUNGARY: A. D. 1897.
The forces of feudalism and clericalism in Austria.
Austrian parties in the Reichsrath.
Their aims, character and relative strength.
Count Badeni's language decrees for Bohemia.
{38}
"Of the fractions into which the Liberal party is now divided
the most important is the Deutsch Fortschrittliche, or
Progressive, which split off from the main body in November
1896. Its chief object was to direct a stronger opposition on
national and liberal lines to Count Badeni. Its 35 members are
almost exclusively recruited from Bohemia and Moravia. They
differ from the German 'Volkspartei' mainly in their refusal
to accept anti-Semitism, which would be both against their
liberal professions and their economic convictions as
representatives of the commercial and manufacturing classes.
The constitutional landowners (Verfassungstreue
Grossgrundbesitz, 30 seats) represent the most conservative
element of the old Liberal party. … The 12 members of the Free
German Union (Freie Deutsche Vereinigung) may perhaps consider
themselves the most authentic remnant of the great Liberal
party—it is their chief claim to distinction. The German
National or People's party (Deutsche Volkspartei, 43 seats)
first made its appearance at the elections of 1885. It
rejected the old idea of the Liberals that the Germans were
meant, as defenders of the State, to look to State interests
alone without regard to the fate of their own nationality, and
took up a more strictly national as well as a more democratic
attitude. It has also of late years included anti-Semitism in
its programme. Its main strength lies in the Alpine provinces,
where it heads the German national and Liberal opposition to
the Slovenes on the one side, and the German clericals on the
other. It is at present the largest of the German parties. …
"Least but not last of the German parties comes the little
group of five led by Schönerer and Wolf. Noisy, turbulent, and
reckless, this little body of extremists headed the
obstruction in the Reichsrath, the disorganised larger German
parties simply following in its wake. The object these men aim
at is the incorporation of German Austria in the German
Empire, the non-German parts being left to take care of
themselves. Both the German National party and Schönerer's
followers are anti-Semitic, but anti-Semitism only plays a
secondary part in their programme. The party that more
specially claims the title of anti-Semite is the Christian
Social (Christlich-Soziale, 27 seats). The growth of this
party in the last few years has been extraordinarily rapid. In
Dr. Lueger and Prince Alois Liechtenstein it has found leaders
who thoroughly understand the arts of exciting or humouring
the Viennese populace. … The characteristic feature of
Austrian anti-Semitism, besides the reaction against the
predominance of the ubiquitous Jew in commerce, journalism,
and the liberal professions, is that it represents the
opposition of the small tradesman or handicraftsman to the
increasing pressure of competition from the large Jewish shops
and the sweating system so frequently connected with them. The
economic theories of the party are of the crudest and most
mediæval kind; compulsory apprenticeship, restricted trade
guilds, penalties on stock exchange speculation, &c., form the
chief items of its programme. …
{39}