TEST BANK for Lehnes Pharmacology For

Nursing Care 11th Edition Burchum Test Bank

Chapter 1 - 112 | Updated Guide A+
 Chapter 1: Orientation to Pharmacology Test Bank

MULTIPLE CHOICE

1. The nurse is teaching a patient how a medication works to treat an illness. To

do this, the nurse will rely on knowledge of:

a. clinical pharmacology.

b. drug efficacy.

c. pharmacokinetics.

d. pharmacotherapeutics.

ANS: D

Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent conditions.
Clinical pharmacology is concerned with all aspects of drug–human interactions. Drug efficacy
measures the extent to which a given drug causes an intended effect.

Pharmacokinetics is the study of the impact of the body on a drug.

DIF: Cognitive Level: Comprehension REF: Four Basic Terms TOP: Nursing
Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

2. What does it mean when a drug is described as easy to administer?

a. It can be stored indefinitely without need for refrigeration.

b. It does not interact significantly with other medications.

c. It enhances patient adherence to the drug regimen.

d. It is usually relatively inexpensive to produce.

ANS: C

A major benefit of drugs that are easy to administer is that patients taking them are more likely to
comply with the drug regimen. Drugs that are easy to give may have the other attributes listed,
but those properties are independent of ease of administration.

DIF: Cognitive Level: Comprehension

REF: Additional Properties of an Ideal Drug: Ease of Administration TOP: Nursing Process:
Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

3. A patient tells the nurse that he was told by the prescriber that the analgesic he
is taking is very effective. Which statement by the patient demonstrates an understanding of the
drug’s effectiveness?

a. ―I don’t have to worry about toxicity, since it takes a large amount of this drug
to cause an overdose.‖

b. ―It has no side effects and doesn’t interact with other drugs.‖

c. ―I only have to take it every 12 hours.‖

d. ―It might make me sleepy, and it lessens pain for several hours at a time.‖

ANS: D

A drug is effective if it produces the intended effects, even if it also produces side effects.
Because no drug is completely safe, the level of toxicity does not determine effectiveness. All
drugs have side effects and many react with other substances; these do not affect the drug’s
effectiveness. Ease of administration is independent of a drug’s effectiveness.
DIF: Cognitive Level: Comprehension REF: Properties of an Ideal Drug TOP:
Nursing Process: Evaluation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

MULTIPLE RESPONSE

1. What are the properties of an ideal drug? (Select all that apply.)

a. Irreversible action

b. Predictability

c. Ease of administration

d. Chemical stability

e. A simple trade name

ANS: B, C, D

In addition to predictability, ease of administration, and chemical stability, other properties

include a reversible action so that any harm the drug may cause can be undone and a simple
generic name, because generic names are usually complex and difficult to remember and
pronounce.

DIF: Cognitive Level: Comprehension

REF: Properties of an Ideal Drug | Additional Properties of an Ideal Drug TOP: Nursing Process:
Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

2. Before administering a medication, what does the nurse need to know to

evaluate how
individual patient variability might affect the patient’s response to the medication? (Select all
that apply.)

a. Chemical stability of the medication

b. Ease of administration

c. Family medical history

d. Patient’s age

e. Patient’s diagnosis

ANS: C, D, E

The family medical history can indicate genetic factors that may affect a patient’s response to a
medication. Patients of different ages can respond differently to medications. The patient’s
illness can affect how drugs are metabolized. The chemical stability of the medication and the
ease of administration are properties of drugs.

DIF: Cognitive Level: Analysis REF: Sources of Individual Variation TOP: Nursing
Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
Chapter 2: Application of Pharmacology in Nursing Practice Test Bank

MULTIPLE CHOICE

1. A patient is using a metered-dose inhaler containing albuterol for asthma. The

medication label instructs the patient to administer ―2 puffs every 4 hours as needed for coughing
or

wheezing.‖ The patient reports feeling jittery sometimes when taking the medication, and she
doesn’t feel that the medication is always effective. Which is not an appropriate nursing
intervention for this patient?

a. Asking the patient to demonstrate use of the inhaler

b. Assessing the patient’s exposure to tobacco smoke

c. Auscultating lung sounds and obtaining vital signs

d. Suggesting that the patient use one puff to reduce side effects

ANS: D

It is not within the nurse’s scope of practice to change the dose of a medication without an order
from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to

evaluate the patient’s ability to administer the medication properly and is part of the nurse’s
evaluation. Assessing tobacco smoke exposure helps the nurse determine whether nondrug
therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a
physical assessment helps the nurse evaluate the patient’s response to the medication.

DIF: Cognitive Level: Application

REF: Applying the Nursing Process in Drug Therapy: Preadministration Assessment [and all
subsections under this heading] TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

2. A postoperative patient is being discharged home with

acetaminophen/hydrocodone (Lortab) for pain. The patient asks the nurse about using Tylenol
for fever. Which statement by the nurse is correct?

a. ―It is not safe to take over-the-counter drugs with prescription medications.‖

b. ―Taking the two medications together poses a risk of drug toxicity.‖

c. ―There are no known drug interactions, so this will be safe.‖

d. ―Tylenol and Lortab are different drugs, so there is no risk of overdose.‖

ANS: B

Tylenol is the trade name and acetaminophen is the generic name for the same medication. It is
important to teach patients to be aware of the different names for the same drug to minimize the
risk of overdose. Over-the-counter (OTC) medications and prescription medications may be
taken together unless significant harmful drug interactions are possible. Even though no drug
interactions are at play in this case, both drugs contain acetaminophen, which could lead to
toxicity.

DIF: Cognitive Level: Application

REF: Application of Pharmacology in Patient Education: Dosage and Administration TOP:

Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

3. The nurse is preparing to care for a patient who will be taking an

antihypertensive medication. Which action by the nurse is part of the assessment step of the
nursing process?
a. Asking the prescriber for an order to monitor serum drug levels

b. Monitoring the patient for drug interactions after giving the medication

c. Questioning the patient about over-the-counter medications

d. Taking the patient’s blood pressure throughout the course of treatment

ANS: C

The assessment part of the nursing process involves gathering information before beginning
treatment, and this includes asking about other medications the patient may be taking.

Monitoring serum drug levels, watching for drug interactions, and checking vital signs after
giving the medication are all part of the evaluation phase.

DIF: Cognitive Level: Application REF: Preadministration Assessment TOP:

Nursing Process: Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

4. A postoperative patient reports pain, which the patient rates as an 8 on a scale

from 1 to 10 (10 being the most extreme pain). The prescriber has ordered acetaminophen
(Tylenol) 650 mg PO every 6 hours PRN pain. What will the nurse do?

a. Ask the patient what medications have helped with pain in the past.

b. Contact the provider to request a different analgesic medication.

c. Give the pain medication and reposition the patient to promote comfort.

d. Request an order to administer the medication every 4 hours.

ANS: B

The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to
moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication.
Asking the patient to tell the nurse what has helped in the past is a part of an initial assessment
and should be done preoperatively and not when the patient is having severe pain. Because the
patient is having severe pain, acetaminophen combined with nondrug therapies will not be
sufficient. Increasing the frequency of the dose of a medication for mild pain will not be
effective.

DIF: Cognitive Level: Analysis REF: Analysis and Nursing Diagnosis TOP:
Nursing Process: Diagnosis

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

5. A patient newly diagnosed with diabetes is to be discharged from the hospital.

The nurse teaching this patient about home management should begin by doing what?

a. Asking the patient to demonstrate how to measure and administer insulin

b. Discussing methods of storing insulin and discarding syringes

c. Giving information about how diet and exercise affect insulin requirements

d. Teaching the patient about the long-term consequences of poor diabetes

control

ANS: A

Because insulin must be given correctly to control symptoms and because an overdose can be
fatal, it is most important for the patient to know how to administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood the
teaching. When a patient is receiving a lot of new information, the information presented first is
the most likely to be remembered. The other teaching points are important as well, but they are
not as critical and can be taught later.

DIF: Cognitive Level: Application REF: Planning TOP: Nursing Process:

Planning MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
6. The nurse receives an order to give morphine 5 mg IV every 2 hours PRN
pain. Which action is not part of the six rights of drug administration?

a. Assessing the patient’s pain level 15 to 30 minutes after giving the medication

b. Checking the medication administration record to see when the last dose was
administered

c. Consulting a drug manual to determine whether the amount the prescriber

ordered is appropriate

d. Documenting the reason the medication was given in the patient’s electronic
medical record

ANS: A

Assessing the patient’s pain after administering the medication is an important part of the nursing
process when giving medications, but it is not part of the six rights of drug administration.
Checking to see when the last dose was given helps ensure that the medication is given at the
right time. Consulting a drug manual helps ensure that the medication is given in the right dose.
Documenting the reason for a pain medication is an important part of the right documentation—
the sixth right.

DIF: Cognitive Level: Application

REF: Evolution of Nursing Responsibilities Regarding Drugs | Implementation TOP: Nursing

Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

7. A patient tells a nurse that a medication prescribed for recurrent migraine

headaches is not working. What will the nurse do?

a. Ask the patient about the number and frequency of tablets taken.

b. Assess the patient’s headache pain on a scale from 1 to 10.

c. Report the patient’s complaint to the prescriber.

d. Suggest biofeedback as an adjunct to drug therapy.

ANS: A

When evaluating the effectiveness of a drug, it is important to determine whether the patient is
using the drug as ordered. Asking the patient to tell the nurse how many tablets are taken and
how often helps the nurse determine compliance. Assessing current pain does not yield
information about how well the medication is working unless the patient is currently taking it.
The nurse should gather as much information about compliance, symptoms, and drug
effectiveness as possible before contacting the prescriber. Biofeedback may be an effective
adjunct to treatment, but it should not be recommended without complete information about drug
effectiveness.

DIF: Cognitive Level: Application REF: Evaluation TOP: Nursing

Process: Evaluation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

8. A nurse is preparing to administer medications. Which patient would the nurse

consider to have the greatest predisposition to an adverse reaction?

a. A 30-year-old man with kidney disease

b. A 75-year-old woman with cystitis

c. A 50-year-old man with an upper respiratory tract infection

d. A 9-year-old boy with an ear infection

ANS: A

The individual with impaired kidney function would be at risk of having the drug accumulate to
a toxic level because of potential excretion difficulties. Cystitis is an infection of the bladder and
not usually the cause of excretion problems that might lead to an adverse reaction from a
medication. A respiratory tract infection would not predispose a patient to an adverse reaction,
because drugs are not metabolized or excreted by the lungs. A 9-year-old boy would not have the
greatest predisposition to an adverse reaction simply because he is a child; nor does an ear
infection put him at greater risk.

DIF: Cognitive Level: Analysis REF: Minimizing Adverse Reactions TOP: Nursing
Process: Planning

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

9. A nurse consults a drug manual before giving a medication to an 80-year-old

patient. The manual states that elderly patients are at increased risk for hepatic side effects.
Which action by the nurse is correct?

a. Contact the provider to discuss an order for pretreatment laboratory work.

b. Ensure that the drug is given in the correct dose at the correct time to minimize
the risk of adverse effects.

c. Notify the provider that this drug is contraindicated for this patient.

d. Request an order to give the medication intravenously so that the drug does not
pass through the liver.

ANS: A

The drug manual indicates that this drug should be given with caution to elderly patients. Getting
information about liver function before giving the drug establishes baseline data that can be
compared with post-treatment data to determine whether the drug is affecting the liver. Giving
the correct dose at the correct interval helps to minimize risk, but without baseline information,
the effects cannot be determined. The drug is not contraindicated.

DIF: Cognitive Level: Analysis REF: Minimizing Adverse Effects TOP: Nursing
Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
10. A patient has been receiving intravenous penicillin for pneumonia for several
days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and
notes a temperature of 38.5° C (101° F). Which is the correct action by the nurse?

a. Administer the next dose and continue to evaluate the patient’s symptoms.

b. Ask the prescriber if an antihistamine can be given to relieve the itching.

c. Contact the prescriber to request an order for a chest radiograph.

d. Hold the next dose and notify the prescriber of the symptoms.

ANS: D

Pruritus and wheezing are signs of a possible allergic reaction, which can be fatal; therefore, the
medication should not be given and the prescriber should be notified. When patients are having a
potentially serious reaction to a medication, the nurse should not continue giving the medication.
Antihistamines may help the symptoms of an allergic reaction, but the first priority is to stop the
medication. Obtaining a chest radiograph is not helpful.

DIF: Cognitive Level: Application

REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in

Patient Care: Identifying High-Risk Patients TOP: Nursing Process: Evaluation MSC: NCLEX
Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

MULTIPLE RESPONSE

1. A nurse is reviewing a patient’s medical record before administering a

medication. Which factor(s) can alter the patient’s physiologic response to the drug? (Select all
that apply.)

a. Ability to swallow pills

b. Age

c. Genetic factors

d. Gender

e. Height

ANS: B, C, D

Age, genetic factors, and gender all influence an individual patient’s ability to absorb,
metabolize, and excrete drugs; therefore, these factors must be assessed before a medication is
administered. A patient’s ability to swallow pills, although it may determine the way a drug is
administered, does not affect the physiologic response. Height does not affect response; weight
and the distribution of adipose tissue can affect the distribution of drugs.

DIF: Cognitive Level: Analysis

REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in

Patient Care: Preadministration Assessment

TOP: Nursing Process: Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
Chapter 3: Drug Regulation, Development, Names, and Information Test Bank

MULTIPLE CHOICE

1. A nurse educator is conducting a continuing education class on pharmacology.

To evaluate

the learning of the nurses in the class, the nurse educator asks, ―Which drug name is a generic
drug name?‖ Which is the correct response?

a. Acetaminophen

b. Tylenol

c. Cipro

d. Motrin

ANS: A

Acetaminophen is the generic name. Tylenol, Cipro, and Motrin are all trade names.

DIF: Cognitive Level: Comprehension REF: Table 3-3: The Three Types of Drug
Names TOP: Nursing Process: Diagnosis

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

2. The FDA Amendments Act (FDAAA) was passed in 2007 to address which
aspect of drug safety?

a. Allowing pharmaceutical companies to identify off-label uses of medications

approved for other uses

b. Evaluating drug safety information that emerges after a drug has been
approved and is in use
c. Expediting the approval process of the U.S. Food and Drug Administration
(FDA) so that needed drugs can get to market more quickly

d. Requiring manufacturers to notify patients before removing a drug from the

market

ANS: B

The FDAAA was passed to enable the Food and Drug Administration to continue oversight of a
drug after granting it approval so that changes in labeling could be made as necessary and
postmarketing risks could be tracked and identified. A provision of the FDA Modernization Act
(FDAMA), passed in 1997, allows drug companies to promote their products for off-label uses as
long as they promise to conduct studies to support their claims. Regulations to permit accelerated
approval of drugs for life-threatening diseases were adopted in 1992 by the FDA. The
requirement that drug companies notify patients 6 months before removing a drug from the
market is a provision of the FDAMA.

DIF: Cognitive Level: Comprehension REF: Landmark Drug Legislation TOP:

Nursing Process: Evaluation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

3. A nursing student asks a nurse about pharmaceutical research and wants to

know the purpose of randomization in drug trials. The nurse explains that randomization is used
to:

a. ensure that differences in outcomes are the result of treatment and not
differences in subjects.

b. compare the outcome caused by the treatment to the outcome caused by no

treatment.

c. make sure that researchers are unaware of which subjects are in which group.
d. prevent subjects from knowing which group they are in and prevent
preconception bias.

ANS: A

Randomization helps prevent allocation bias, which can occur when researchers place subjects
with desired characteristics in the study group and other subjects in the control group so that
differences in outcome are actually the result of differences in subjects and not treatment.

Comparing treatment outcome to no treatment outcome is the definition of a controlled study.

The last two options describe the use of blinding in studies; blinding ensures that researchers or
subjects (or both) are unaware of which subjects are in which group so that preconceptions about
benefits and risks cannot bias the results.

DIF: Cognitive Level: Comprehension REF: The Randomized Drug Trial TOP:
Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

4. Someone asks a nurse about a new drug that is in preclinical testing and wants
to know why it cannot be used to treat a friend’s illness. Which statement by the nurse is correct?

a. ―A drug at this stage of development can be used only in patients with serious
disease.‖

b. ―At this stage of drug development, the safety and usefulness of the
medication is unknown.‖

c. ―Clinical trials must be completed to make sure the drug is safe to use in
humans.‖

d. ―Until postmarketing surveillance data are available, the drug cannot be used.‖

ANS: B
Preclinical testing must be completed before drugs can be tested in humans. In this stage, drugs
are evaluated for toxicities, pharmacokinetic properties, and potentially useful effects. Some
drugs can be used in patients before completion of Phase III studies, but this is after preclinical
testing is complete. Clinical trials proceed in stages, and each stage has guidelines defining how
a new drug may be used and which patients may receive it. Postmarketing surveillance takes
place after a drug is in general use.

DIF: Cognitive Level: Comprehension

REF: Landmark Drug Legislation | Stages of Drug Development TOP: Nursing Process:
Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

5. A patient asks a nurse why drugs that have been approved by the FDA still
have unknown side effects. The nurse tell the patient that:

a. testing for all side effects of a medication would be prohibitively expensive.

b. patients in drug trials often are biased by their preconceptions of a drug’s

benefits.

c. researchers tend to conduct studies that will prove the benefits of their new
drugs.

d. subjects in drug trials do not always represent the full spectrum of possible
patients.

ANS: D

All drug trials are limited by a relatively small group of subjects who may not have all the
characteristics of people who will be using the drug; therefore, some side effects go undetected
until the drug is in use. Although drug trials are very expensive, this is only an indirect reason
they do not detect all side effects before approval. In theory, well-designed drug trials, using
blinded studies, minimize or eliminate subject bias. Designing studies to prove desired results is
unethical.

DIF: Cognitive Level: Analysis REF: Failure to Detect All Adverse Effects TOP:
Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

6. A nurse is teaching nursing students about the use of nonproprietary names for
drugs. The nurse tells them which fact about nonproprietary names?

a. They are approved by the FDA and are easy to remember.

b. They are assigned by the U.S. Adopted Names Council.

c. They clearly identify the drug’s pharmacological classification.

d. They imply the efficacy of the drug and are less complex.

ANS: B

Nonproprietary, or generic, names are assigned by the U.S. Adopted Names Council, which
ensures that each drug has only one name. Trade names, or brand names, are approved by the
FDA and are easier to remember. Some nonproprietary names contain syllables that identify the
classification, although not all do. Drug names are not supposed to identify the use for the drug,
although some brand names do so.

DIF: Cognitive Level: Comprehension REF: Drug Names: The Three Types of
Drug Names TOP: Nursing Process: Diagnosis

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

Chapter 4: Pharmacokinetics Test Bank

MULTIPLE CHOICE

1. A patient tells the nurse that the oral drug that has been prescribed has caused
a lot of stomach discomfort in the past. What will the nurse ask the prescriber?

a. Whether a sublingual form of the medication can be given

b. Whether the medication can be given by a parenteral route instead

c. To order an enteric-coated form of the drug

d. Whether the patient can receive a sustained-release preparation of the drug

ANS: C

Enteric-coated drugs are preparations that have been coated with a material that dissolves in the
intestines, not the stomach. This coating is used either to protect the drug from stomach acid and
pepsin or to protect the stomach from a drug that can cause gastric upset. Sublingual forms often
are used for drugs that undergo rapid inactivation during the first pass through the hepatic
circulation so that the drug can be absorbed directly into the systemic circulation.

Parenteral routes are more costly and less safe than oral administration and should not be used
unless necessary. A sustained-release preparation is used to release the drug into the body over a
specific period to reduce the number of daily doses required to sustain therapeutic drug levels.

DIF: Cognitive Level: Application

REF: Comparing Oral Administration with Parenteral Administration TOP: Nursing Process:
Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

2. A patient claims to get better effects with a tablet of Brand X of a drug than
with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active
ingredient. What does the nurse know to be most likely?
a. Advertising by pharmaceutical companies can enhance patient expectations of
one brand over another, leading to a placebo effect.

b. Because the drug preparations are chemically equivalent, the effects of the two
brands must be identical.

c. Tablets can differ in composition and can have differing rates of disintegration
and dissolution, which can alter the drug’s effects in the body.

d. The bioavailability of a drug is determined by the amount of the drug in each

dose.

ANS: C

Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts of the
same chemical compound), they can have different effects in the body if they differ in
bioavailability. Tablets made by different manufacturers contain different binders and fillers,
which disintegrate and dissolve at different rates and affect the bioavailability of the drug.

Two brands may be chemically equivalent and still differ in bioavailability, which is not
determined by the amount of drug in the dose.

DIF: Cognitive Level: Application

REF: Pharmaceutical Preparations for Oral Administration TOP: Nursing Process: Diagnosis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies

3. A patient receives a drug that has a narrow therapeutic range. The nurse
administering this medication will expect to do what?

a. Administer the drug at intervals longer than the drug half-life.

b. Administer this medication intravenously.

c. Monitor plasma drug levels.

d. Teach the patient that maximum drug effects will occur within a short period.

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To Download complete file please copy and paste the below link into
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