Nsg304 Pharmacology Midterm SG (Wk1) EXAM WITH 100% QUESTIONS & ANSWERS CORRECTLY/VERIFIED, Exams of Nursing

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Chapter 1 Introduction to Pharmacology: Concepts and Connections

2. Although all areas of medicine, including pharmacology, have made great advances in the past century, the early roots of pharmacology still apply for the nurse and other health professionals. What were the early roots of pharmacology? 1.Applying products to relieve human suffering

2. Creating new drugs as quickly as possible
3. Finding medicinal alternatives to plants
4. Understanding how drugs cause their effects

3. Although many substances can be considered drugs, which drug definition is the most appropriate? 1.Any substance that is found in nature or that normally occurs in the body 2.Any substance that is synthesized and tested in the laboratory setting 3.Any substance that is taken to prevent, cure, or reduce symptoms of a medical condition 4.Any substance that can be isolated from substances found in nature
4. Pharmacotherapy is a critical intervention for many conditions, and a key part of nursing intervention. Which statement best describes pharmacotherapy? 1.The study of medicine and drug therapy 2.The application of natural substances to cure diseases

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3.The application of drugs for the prevention and treatment of disease and human suffering

4. Understanding the difference between trade and generic medications

5. Which principle best describes what the nurse is expected to understand when administering medication to a client? 1.The pharmacotherapeutics for all of the medications 2.The most common side effects of the drug's prototype 3.The trade and generic names for all of the medications 4.The cost of the drug therapy from different drug manufacturers
6. The Food and Drug Administration classifies drugs by category, and these categories and drugs are found in the "Orange Book." To find out which drugs treat hypertension, the nurse would look under which classification?

1. Cardiac
2. Pharmacologic
3. Disease 4.Therapeutic

7. The nurse is creating a teaching plan for a client on the cardiac unit and is researching the medications the client is currently taking to understand how each drug produces its effects in the body. To find this information, the nurse looks up which classification for each medication?

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1.Therapeutic

2. Respiratory
3. Disease

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4. Pharmacologic

10. The trade name for a drug is usually selected to be short and easy to remember. What is the reason the nurse does not use the trade name for a drug? 1.There are no trade names for combination drugs. 2.A drug can have more than one trade name. 3.The trade name will expire and no longer be used. 4.A company might change the trade name for a drug.
11. Nursing students must memorize the generic names of drugs. What is the primary reason that generic names are used by healthcare providers over chemical and trade names? 1.A drug can have more than one chemical and trade name. 2.There is only one generic name for each drug. 3.The trade names do not reflect the action of the drug as the generic name does.

4. Nursing students should learn both the generic and trade names to avoid confusion with clients.

12. Which is one of the main reasons a pharmaceutical company might be granted an exclusive period to market and distribute a new drug?

1. It allows the company to recoup the cost of research and development.

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2. It allows consumers to learn the trade name of the drug.
3. It allows all the adverse effects to be discovered. 4.Without competition, consumer savings are significant.

13. Bioavailability of a drug can be affected by many factors. Which factor does not affect the bioavailability of a drug?

1. Inert ingredients
2. Rate of absorption
3. Safety margin 4.Tablet compression

14. Bioavailability can be different between the generic and trade versions of a drug. When is it not appropriate for a generic drug to be substituted for a trade version? 1.The trade version costs the same as the generic. 2.The time for onset of action is different between the generic and trade versions. 3.The inert ingredients are different in the generic and trade versions. 4.The drug is a critical care drug, or one with a narrow safety margin.
15. Before administering a drug, what pertinent information must the nurse obtain from the client?

1. Physical assessment, medical history, previous medications, and learning

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capabilities

2. Medical history, growth and development level of client, and ability to pay for the medication
3. Medical history, client's growth and development level, and potential adverse effects of the medication
4. Medical history, physical assessment, disease process, and learning needs

16. When a drug is ordered for a client, what is the nurse responsible for knowing and understanding about the drug?

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1. Name, intended use, special considerations, and adverse effects
2. Drug classification, contraindications, adverse effects, gender considerations, and cost of therapy
3. Drug classification, contraindications, special considerations, and severity of adverse effects
4. Name, intended use, effects, contraindications, special considerations, and adverse effects

17. After successfully completing the pharmacology course, a student nurse tells the instructor that she is glad the course is finished. What is the best response from the nursing instructor?

1. "It might be over, but now you will start your clinical courses and apply your knowledge."
2. "If you think this course was hard, you should try the graduate level."
3. "Learning is an ongoing process in pharmacology; we must continue to stay up to date."
4. "Learning difficult material is always painful, but it is necessary."

19. A client is taking a medication for a condition whose indication is not listed and asks the nurse why the healthcare provider would prescribe this drug. Which response by the nurse is the most appropriate?

1. "Some medications may be used for conditions for which they have not been approved. This is called an 'off-label' indication."

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2. "Some medications may be used as a prototype drug for a specific condition and are not listed in the nursing drug handbook."
3. "A medication can only be used for the specific condition for which it was approved."
4. "This is a generic drug, and not all generic drugs are in the nursing drug handbook. Only trade name drugs are listed."

26. The client is receiving a new and expensive medication. The client asks the nurse why the medication is so expensive compared with other medications. What is the nurse's best response?

1. "The drug companies spend too much money on marketing, and the cost gets passed on to you."
2. "It is expensive, but your insurance company will probably pay for it."
3. "These drugs are very expensive to develop and bring to market."
4. "I agree with you. You would think they could lower the cost of the drug."

27. Which statement best describes the difference between a biologic drug and a biosimilar drug?

1. Biologic drugs are medications made by living cells.
2. Biosimilar drugs are medications made by cells lysed by other cells.
3. Biologic drugs are not approved by the FDA.
4. Biosimilar drugs are more expensive than biologics.

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Chapter 2 Drug Regulations

1. Which was the greatest problem with patent medicines in early America that led to drug legislation? 1.They were only distributed in elixir formulation. 2.They had dangerous or addictive substances. 3.They smelled like medicine. 4.They could only be made out of natural products.

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3. The student nurse taking a pharmacology class is studying the Food, Drug, and Cosmetic Act of 1938. What was important about this regulation?

1. It prevented the sale of drugs that had not been tested before marketing.
2. It gave the government the power to change the labeling content of medications.
3. It helped to standardize the quality of prepared food, drugs, and cosmetics.
4. It prohibited the sale of drugs labeled with false therapeutic claims to defraud the public.

4. A client is talking to the nurse and is expressing doubt about whether to take a drug that is advertised on television. The client does not believe that commercials for drugs tell the truth. Which rationale will the nurse use when responding to the client? 1.Advertisements are not legally binding and can be misleading. 2.All drugs must be advertised in the media to inform the public.

3. Manufacturers have some ability to change things when advertising drugs.
4. False claims of a drug's therapeutic effect are prohibited by law.

6. One of the first standards used by pharmacists for preparation and potency of drugs was a formulary. What did early formularies contain?

1. Names of patent medicines and natural drugs
2. Lists of pharmaceutical products and drug recipes
3. Lists of various drugs' strengths based on individual pharmacies

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4. Lists of various drugs' potency based on geographic region

8. A pharmaceutical representative comes to the primary care office and states that his company is marketing a new drug that does not need approval by the Food and Drug Administration (FDA). What is the best response of the nurse?

1. "Is this a drug in clinical trials? Those are the only drugs that don't have to have FDA approval."
2. "Is this an over-the-counter drug? Over-the-counter drugs do not need FDA approval."
3. "Your company must be involved in academic research if the drug doesn't need FDA approval."
4. "Any pharmaceutical company must have FDA approval before marketing a drug."

9. Nursing students are studying which drug types must have Food and Drug Administration (FDA) approval before being marketed. The students know that which drugs must have approval from the FDA before being marketed?

1. Biologics
2. Cosmetics
3. Herbal preparations
4. Dietary supplements

11. The nurse explains to the client that during the Food and Drug

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Administration (FDA) drug approval process, clinical investigators from many different medical specialties address concerns. What concerns are addressed? 1.Whether a New Drug Application (NDA) must be filed 2.The marketability of the drug 3.What the cost of the drug should be 4.Whether or not the drug is safe

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12. The client receiving a newly released medication is experiencing adverse effects. Why does the nurse report these adverse effects as part of the postmarketing surveillance stage of the drug approval process? 1.The clinical trials are continuing to collect new data.

2. Individual client response is compared with the clinical trial data. 3.The efficacy of the drug is determined for new drugs.
3. Harmful effects in the larger population continue to be monitored.

14. Clients enrolled in a clinical drug trial are told that they might receive a placebo drug as part of a control group. A client asks the nurse what a placebo is. Which response by the nurse is the most appropriate?

1. "A placebo is a substance that has no therapeutic effect."
2. "A placebo is a similar drug that is safe."
3. "A placebo is a drug that has been tested before."
4. "A placebo is an over-the-counter drug."

15. The nursing student is studying how priority drugs receive accelerated approval by the Food and Drug Administration (FDA) as part of the FDA modernization. Which conditions are the priority drugs used to treat?

1. Diseases that previously were treated with older and less popular drugs
2. Diseases that affect only a small percentage of the population
3. Diseases for which the community raises money for treatment
4. Serious and life-threatening conditions that lack effective treatments

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16. The nurse is teaching a class about over-the-counter (OTC) medications at a senior citizen center. Which statement by a participant indicates the teaching was effective?

1. "Over-the-counter medications are safe, as long as we don't take them at the same time as our prescription medications."
2. "Over-the-counter medications are safe; otherwise, they would require a prescription."
3. "We should not take any over-the-counter medications without first calling our primary healthcare provider because these medications can interact with other prescriptions or products."
4. "We must read all the label directions before taking any over-the-counter medications."

17. The client was taking a prescription medication that is now available over the counter. The client asks the nurse, "Why do some medications become available over the counter and other medications remain prescription drugs?" Which response by the nurse is the most appropriate?

1. "Drugs with the least amount of side effects can become over-the-counter drugs."
2. "Drugs that have a high safety margin may be reclassified to over-the-counter drugs."
3. "The longer the drug is on the market, the better its chance of becoming

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an over-the-counter drug."

4. "If the pharmaceutical company pays the FDA a large amount of money, it can have its drug reclassified."

19. The client says to the nurse, "I wonder if I am considered a drug addict. I went to pick up my medication from the drug store and the pharmacist told me that the drug was a controlled substance." Which response by the nurse is the most appropriate?

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1. "If you continue on this medication for a long time, you will become addicted to it."
2. "You are not an addict, but the Drug Enforcement Agency (DEA) will be watching your prescription drug habits now."
3. "Any drug that has a potential for abuse is considered a controlled substance and is restricted. This does not mean the pharmacist will think you are an addict."
4. "Do you think that you are addicted to your medication?"

20. The nurse is working in a cancer treatment center. A client diagnosed with terminal cancer has received a prescription for morphine (MS Contin), a Schedule II drug for pain control. After medication teaching, which statement by the client indicates appropriate understanding?

1. "I should call the office three days before I need a refill called in to the pharmacy."
2. "I will need to see the provider each time for my refill."
3. "This is an addictive drug, so I should try not to take it."
4. "After the first prescription, my doctor will be able to call in my prescription."

21. A nurse educator is preparing a lecture regarding prescriptive authority for advanced practice registered nurses (APRNs). Which statement is appropriate for the educator to include in the lecture regarding this topic?

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1.APRNs can only prescribe medications when under the supervision of a physician. 2.APRNs prescribe medications based on federal regulations. 3.APRNs prescribe medications based on state regulations. 4.APRNs prescribe medications based on local regulations. Chapter 3 Pharmacokinetics

1. What are the four phases of pharmacokinetics that a drug goes through? 1.Absorption, distribution, ionization, and metabolism

2. Diffusion, bioavailability, metabolism, and excretion 3.Absorption, distribution, metabolism, and excretion 4.Active transport, ionization, diffusion, and excretion

3. When administering an intravenous (IV) medication to a client, the nurse understands that the medication has a high concentration in the blood and will move into areas of lower concentration by which action?

1. Facilitated diffusion 2.Active diffusion 3.Absorption
2. Simple diffusion

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4. When the nurse administers a drug that must move from an area of low concentration to an area of high concentration, what will the drug require?

1. Simple diffusion 2.Active transport 3.An intravenous route 4.A transdermal delivery system

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6. The nurse is administering an albuterol (Ventolin) inhaler to a client with asthma. The absorption of the medication will occur in what manner? 1.Very slowly

2. Over a 2- to 3-hour period
3. Over a 1- to 2-hour period 4.Very rapidly

7. The nurse has just administered a client's morning dose of medications following a high-fat breakfast. How will the absorption of the medication be affected?

1. It will be blocked.
2. It will be slowed.
3. It will be accelerated.
4. It will not be affected.

8. The nurse recognizes that adding a vasoconstrictor to a local anesthetic agent will have which effect on absorption of the anesthetic agent?

1. It will increase blood flow to the area.
2. It will help to eliminate the drug sooner.
3. It will produce a more localized effect.
4. It will slow absorption of the agent.

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10. A client is receiving antibiotic treatment for a wound abscess. For the drug to be effective, what does the nurse recognize that drug distribution to this area requires? 1.The drug to be lipid soluble 2.Adequate blood perfusion to the area 3.The drug to be bioavailable in an acidic environment

4. Use of a topical antibiotic

11. The nurse is caring for a client with obesity who has received thiopental (Pentothal), a lipid- soluble drug, during surgery. Of which fact about the drug should the nurse be aware?

1. It will need to be given at higher than normal doses.
2. It will be stored in adipose tissue.
3. It may have difficulty being distributed to body tissues.
4. It is often ineffective.

12. The nurse recognizes that when a client is receiving a lipid-soluble medication, higher concentrations will accumulate in which tissues?

1. Cardiac muscle
2. Liver
3. Bone marrow
4. Skeletal muscle

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14. When administering a drug-protein—bound drug to a client, what can the nurse expect?

1. Duration of action will be prolonged.
2. Drug excretion will be accelerated.
3. Metabolism of the drug will be delayed.

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4. Onset of drug action will be prolonged.

15. The nurse checks a newly ordered medication and finds it to be 92% protein bound. How much of the medication will be readily available to the client once the nurse administers the medication?

1. 100%
2. 8%
3. 50%
4. 92%

16. A client who was recently started on the anticoagulant warfarin (Coumadin) asks about adverse reactions. The nurse explains that adverse effects may occur because the drug is highly bound with only % available to reach the target cells. Answer: 1 Explanation: When giving a medication that is highly bound, the nurse should carefully monitor for adverse effects. The anticoagulant warfarin (Coumadin) is highly bound; 99% of the drug in the plasma exists in drug—protein complexes and only 1% exists as a free drug available to reach target cells.
17. A client has been started on diltiazem (Cardizem), a substrate of the cytochrome CYP3A4 isoenzyme system. The client also takes phenobarbital, an inducer of the CYP3A4 isoenzyme system, for seizures.

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What does the nurse recognize about diltiazem?

1. It will not be able to cross the blood—brain barrier (BBB).
2. It will be metabolized by the kidneys.
3. It might be inactivated at a faster rate than normal.
4. It might be excreted at a slower rate.

18. A client receiving metoprolol (Lopressor), a substrate of the CYP2D6 system, is started on amiodarone (Cordarone), an inhibitor of the CYP2D6 system. What should the nurse plan to do?

1. Monitor for signs of amiodarone toxicity. 2.Administer both drugs on an empty stomach.
2. Monitor for prolonged effects of the Lopressor. 4.Administer the medications at least 2 hours apart.

19. What does the nurse anticipate about the medications ordered for a client with liver disease? 1.They will be in lower doses than normal. 2.They will be administered by the parenteral route. 3.They will need to be divided evenly throughout the day. 4.They will need to be given with an antacid.
20. The nurse has administered a dose of codeine to a client for the management of postoperative pain. The nurse monitors for respiratory

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depression because % of codeine is metabolized and converted to morphine, which can cause respiratory depression in clients. Answer: 10 Explanation: Chemical changes to drugs always result in functional changes. The products of drug metabolism, or metabolites, usually have less pharmacologic activity than the original

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molecule. On rare occasions a metabolite may have greater activity than the original drug. This is the case for codeine. Although 90% of codeine is changed to inactive metabolites by the liver, 10% is converted to morphine, which has significantly greater ability to relieve severe pain and has the potential to cause respiratory depression in clients.

21. A client is seen in the emergency department for an overdose of diazepam (Valium), a weakly basic drug. In order to enhance excretion of the drug, what does the nurse anticipate that the client will receive?

1. High volumes of intravenous normal saline solution (NSS), a weakly basic solution
2. Large doses of a proton pump inhibitor, in an acidic solution 3.An intravenous solution containing sodium bicarbonate, which promotes alkaline urine 4.An intravenous solution with ammonium chloride, which acidifies filtrate

22. The nurse determines that a client who is breastfeeding has understood teaching regarding medication use when the client makes which statement?

1. "I will be sure to take medications just before breastfeeding."
2. "I know it is safe to take over-the-counter meds, but not prescription meds."
3. "I will check with my healthcare provider before taking any medication."
4. "I will only use herbal supplements while breastfeeding."

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