Pharmacology for the Primary Care Provider 4th Edition By Edmunds-Test Bank

Chapter 1: Pharmacological Concepts: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic Aspects

Test Bank Questions

1. When aiming for rapid pain relief, a nurse administers oral pain medication in a form that is swiftly absorbed from the gastrointestinal (GI) tract. Which delivery method offers the fastest absorption?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension

ANS: D
For fast absorption in the GI tract, drugs need to be in a solution. Liquid medications, being already in solution, are absorbed more quickly than solid forms.

DIF: Application Level: Applied REF: p. 3
TOP: Nursing Process: Intervention/Implementation
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A client inquires why she must take a medication on an empty stomach. The nurse clarifies that food generally has what impact on drug dissolution and absorption?
a. Enhances
b. Increases
c. Decreases
d. No effect

ANS: C
Food in the GI tract can hinder the dissolution and absorption of certain drugs. However, some drugs need to be taken with food to boost absorption.

DIF: Application Level: Applied REF: p. 4
TOP: Nursing Process: Intervention/Teaching
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. Liver function decrease affects biotransformation. What occurs with drug metabolism when liver function diminishes?
a. Client may develop toxicity.
b. Client will experience enhanced therapeutic response.
c. Client might require higher-than-normal medication dosage.
d. Client will encounter reduced therapeutic response.

ANS: A
Reduced drug metabolism rate can lead to drug accumulation and toxicity. Since the GI membrane comprises lipids, lipid medications are absorbed most easily through the stomach’s digestive membrane. Medications that are nonionized (neither positively nor negatively charged) cross the GI membrane faster than charged ones.

DIF: Application Level: Applied REF: p. 6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A client questions why the oral dose of her pain medication exceeds the intravenous dose. The nurse explains that with oral doses, only 20% to 40% of the drug may reach systemic circulation, reducing active drug levels. What describes 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 enters systemic circulation. Oral drugs with high first-pass hepatic metabolism may have a bioavailability of 20% to 40%. To achieve the desired drug effect, the oral dose may need to be three to five times greater than the IV dose.

DIF: Comprehension Level: Understanding REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. Which administration route ensures maximum bioavailability when giving medications?
a. Oral
b. Intravenous
c. Intramuscular
d. Subcutaneous

ANS: B
Oral bioavailability is always less than 100%, while it is generally 100% for intravenous administration.

DIF: Comprehension Level: Understanding REF: p. 4
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. When two highly protein-bound drugs are administered simultaneously, what is the likely outcome?
a. Increased free drug circulation
b. Reduced free drug circulation
c. Higher drug protein binding
d. Elevated drug excretion through urine

ANS: A
Concurrently administering highly protein-bound drugs causes them to compete for protein-binding sites, leading to an increase in free drug circulation. This may result in drug accumulation and potential toxicity.

DIF: Application Level: Applied REF: p. 5
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. If a client is taking a moderately highly protein-bound drug and later takes a drug that is 90% protein-bound, what is likely to happen?
a. The first drug remains protein-bound.
b. The first drug becomes less active.
c. The first drug is released from protein and becomes more active.
d. The second drug becomes more potent.

ANS: C
Only unbound drugs are active and cause a pharmacologic response. As circulation free drug levels drop, bound drug is released from protein to maintain the free drug balance.

DIF: Application Level: Applied REF: p. 5
TOP: Nursing Process: Active
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A nurse assesses the medication’s appropriate dosing intervals by evaluating its half-life. The drug’s half-life (t) signifies the duration required for:
a. half of a drug dose to be absorbed.
b. half of the drug to be eliminated post-absorption.
c. drug to achieve maximum efficacy.
d. half of the drug dose to be fully distributed.

ANS: B
A drug’s half-life (t) is the time taken for half of the drug concentration to be eliminated.

DIF: Comprehension Level: Understanding REF: pp. 5-6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. If a drug has a half-life of 36 hours, what dosing schedule is likely?
a. Weekly
b. Daily
c. Twice daily
d. Thrice daily

ANS: B
Given a 36-hour elimination timeframe, a once-daily dosing regimen would maintain therapeutic drug levels.

DIF: Analysis Level: Analyzed REF: pp. 5-6
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. In end-stage renal disease, what does monitoring drug levels help assess?
a. Toxicity
b. Sub-therapeutic levels
c. Ineffective drug action
d. Poor adherence

ANS: A
Renal function impairment can lead to drug toxicity due to the kidneys being the primary elimination route.

DIF: Comprehension Level: Understanding REF: pp. 6-7
TOP: Nursing Process: Analysis
MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies