Chapter 1 - The Nursing Process and Drug Therapy
1. An 86-year-old patient is being discharged to home on drug therapy for hyperthyroidism and has
very little information regarding the medication. Which statement best reflects a realistic outcome of
patient teaching activities?
a. The patient and patient’s daughter will state the proper way to take the drug
b. The nurse will provide teaching about the drug’s adverse effects
c. The patient will state all the symptoms of toxicity of the drug
d. The patient will call the prescriber if adverse effects occur
2. A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy
during the first few days of therapy. Which is the best human needs statement for this situation?
a. Physical activity
b. Physical safety
c. Freedom pain
d. Interchange of gases
3. A patient’s medical record includes an order that reads as follows: “atenolol 25 mg once daily at
0900.” Which action by the nurse is correct?
a. The nurse does not give the drug
b. The nurse five the drug orally
c. The nurse gives the drug intravenously
d. The nurse contacts the prescriber to clarify the dosage route
4. The nurse is compiling a drug history for a patient. Which questions from the nurse will obtain
the most information from the patient? (select all that apply)
a. Do you use sleeping pills to get to sleep?
b. Do you have a family history of heart disease
c. When you have pain, what do you do to relieve it?
d. Did you have the mumps as a child
e. Tell me about what happened when you had an allergic reaction to penicillin
f. What herbal products or over-the-counter medications do you use?
5. A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse
that he is allergic to penicillin. Which is the most appropriate response by the nurse?
a. Many people are allergic to penicillin
b. This allergy is not of major concern because the drug is given so often
c. What type of reaction did you have when you took penicillin
d. Drug allergies don’t usually occur in older individuals due to built-up resistance to
allergic reactions
6. The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2
diabetes mellitus. Which of these reflect the correct order of the steps of nursing?
a. Assessment, planning, human needs statement, implementation, evaluation
b. Evaluation, assessment, human needs statement, planning, implementation
c. Human needs assessment, assessment, planning, implementation, evaluation
d. Assessment, human needs statement, planning, implementation, evaluation
7. The nurse is reviewing new medication orders that have been written for a newly admitted
patient. The nurse will need to clarify which order?
a. Metformin (Glucophage) 1000 mg PO twice a day
b. Sitagliptin (Januvia) 50 mg daily
c. Simvastatin (Zocor) 29 mg PO once a day
d. Irbesartan (Avapro) 300 mg PO once a day
e. Docusate (Colace) as needed for constipation
8. The nurse is reviewing data collected from a medication history. Which of these data are
considered objective data? (select all that apply)
a. White blood cell count 22,000 mm3
b. Blood pressure 150/94 mm Hg
c. Patient rates pain as an 8 on a 10 point scale
, d. Patients wife reports that the patient has been very sleepy during the day
e. Patient’s weight is 68 kg
Chapter 2-Pharmacologic Principles
1. An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all
night and did not sleep at all. The nurse recognizes that this woman has experienced which type of
reaction or effect?
a. Allergic reaction
b. Idiosyncratic reaction
c. Mutagenic effect
d. Synergistic effect
2. The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in
which phase of pharmacokinetics may occur in this patient?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
3. A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type
of therapy?
a. Palliative therapy
b. Maintenance therapy
c. Supportive therapy
d. Supplemental therapy
4. The nurse is giving mediation to a patient in heart failure. The intravenous route is chosen instead of
the intramuscular route. What physical function does the nurse recognize as the most influential
when deciding to use the intravenous route of drug administration?
a. Altered biliary function
b. Increased glomerular filtration
c. Reduced liver metabolism
d. Diminished circulation
5. A patient has just received a prescription for an enteric-coated stool softener. When teaching the
patient, the nurse should include which statements? Select all that apply
a. Take the tablet with 2 or 3 ounces of orange juice
b. Be sure to drink 6 to 8 ounces of water with tablets
c. Avoid taking all other medications with any enteric-coated tablet
d. Crush the tablet before swallowing if you have problems with swallowing
e. Be sure to swallow the tablet whole without chewing it
6. Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1
indicating the phase that occurs first and 4 indicating the phase that occurs last.
a. Enzymes in the liver transform the drug into an inactive metabolite (3)
b. Drug metabolites are secreted through passive glomerular filtration into the renal tubules (4)
c. A drug binds to the plasma protein albumin and circulates through the body (2)
d. A drug moves from the intestinal lumen into the mesenteric blood system (1)
7. The nurse is reviewing the various forms of topical medications. Which of these are considered
topical medications? Select all that apply
a. Rectal ointment for hemorrhoids
b. Eye drops for inflammation
c. Sublingual tablet for chest pain
d. Inhaled medication for asthma
e. Intradermal injection for tuberculosis testing
Chapter 3 - Lifespan Considerations
,1. The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which
factors put the neonatal patient at risk with regards to drug therapy?
a. Higher gastric pH
b. Increased peristalsis in the GI tract
c. Immature renal function
d. Reduced first-pass elimination in the liver
e. Decreased protein-binding of medications
2. The physiologic differences in the pediatric patient compared with the adult patient affect the
amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main
differences is that infants have which of these factors?
a. Increased protein in circulation
b. Fat composition lower than 0.001%
c. More muscular body composition
d. Water composition of approximately 75%
3. While teaching a 76-year-old patient about the adverse effects of his medication, the nurse encourages
him to keep a journal of the adverse effects he experiences. This intervention is important for the
older adult patient because of which alteration in pharmacokinetics?
a. Increased renal excretion of protein-bound drugs
b. More alkaline gastric pH, resulting in more adverse effects
c. Decreased blood flow to the liver, resulting in altered metabolism
d. Less adipose tissue to store fat-soluble drugs
4. When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, “I
get dizzy when I stand up.” She also states that she has nearly fainted “a time or two” in the
afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of
medication may be responsible for these effects?
a. Nonsteroidal antiinflammatory drugs (nSAIDS)
b. Cardiac glycosides
c. Anticoagulants
d. Antihypertensives
5. A pregnant patient who is at 32 weeks gestation has a cold and calls the office to ask about taking an
over-the-counter medication that is rated as pregnancy category A. What answer by the nurse is
correct?
a. This drug causes problems in the human fetus, so you should not take this medication
b. This drug may cause problems in the human fetus, but nothing has been proven in
clinical trials. It is best not to take this medication
c. This drug has not caused problems in animals, but no testing has been done in humans. It
is probably safe to take
d. Studies indicate that there is no risk to the human fetus, so it is okay to take this
medication as directed if you need it
6. The nurse is preparing to administer an injection to a preschool-age child. Which approaches
are appropriate for this age group? Select all that apply
a. Explain to the child in advance about the injection
b. Provide a brief, concrete explanation about the injection
c. Encourage participation in the procedure
d. Make use of magical thinking
e. Provide comfort measure after the injection
7. An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse
is assessing the current medications he is taking at home. Which method is the best way to assess his
home medications?
a. Ask the patient what medications he takes at home
b. Ask the patient’s wife what medications he takes at home
c. Ask the patient’s wife to bring his medications to the hospital in their original container
d. Contact the patient pharmacy for a list of the patient's current medications
, Chapter 4-cultural, legal, and ethical considerations
1. A patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the
nurse, “I would like to try to live long enough to see my granddaughter graduate in 3 months, but
after that I don’t want any extra treatments.'' This patient is demonstrating which of these?
a. Veracity
b. Beneficence
c. Maleficence
d. Autonomy
2. When caring for an older Chinese patient, the nurse recognizes which of these cultural issues that
may influence the care of this patient?
a. Chest x-ray are seen as a break in the soul’s integrity
b. Hospital diet are interpreted as being healing and healthful
c. The use of herbal products may be important practice for this patient
d. Being hospitalized is a source of peace and socialization for this culture
3. A patient is being counseled for possible participation in a clinical trial for a new medication. After the
patient meets with the physician, the nurse is asked to obtain the patient’s signature on the consent
forms. The nurse knows that this “informed consent” indicates which of these?
a. Once therapy has begun, the patient cannot withdraw from the clinical trial
b. The patient has been informed of all potential hazards and benefits of the therapy
c. The patient has received only the information that will help to make the clinical trial a success
d. No matter what happens, the patient will not be able to sue the researchers for damage
4. A new drug has been approved for use, and the drug manufacturer has made it available for sale.
During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered
during the testing and considers withdrawing the drug. This illustrates which phase of investigational
drug studies?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
5. A patient of Japanese descent says that members of her family often have “strong reactions” after
taking certain medications, but her white friends have no problem with the same dosages of the
same drug. The nurse recognizes that, because of this trait, which statement applies?
a. She may need lower doses of the medication prescribed
b. She may need higher doses of the medication prescribed
c. She should not receive these medications because of potential problems with metabolism
d. These situations vary greatly, and her account may not indicate a valid cause for concern
6. When evaluating polymorphism and medication administration the nurse considers which factors?
Select all that apply
a. Nutritional status
b. Drug route
c. Genetic factors
d. Cultural beliefs
e. Patient’s age
7. A patient shows the nurse an article in the newspaper about a new blackbox warning and states, “I take
this drug! Is it safe for me to take now?” which of these statements about black box warnings is true?
Select all that apply
a. Serious adverse effects from the drug have been reported
b. The FDA is asking for a mandatory recall of this drug
c. Serious adverse effects have been reported with this drug, and the patient will not be able
to take it again because the risks outweigh the benefits
d. It can still be prescribed as long as the prescriber and patient are aware of the potential
risk
1. An 86-year-old patient is being discharged to home on drug therapy for hyperthyroidism and has
very little information regarding the medication. Which statement best reflects a realistic outcome of
patient teaching activities?
a. The patient and patient’s daughter will state the proper way to take the drug
b. The nurse will provide teaching about the drug’s adverse effects
c. The patient will state all the symptoms of toxicity of the drug
d. The patient will call the prescriber if adverse effects occur
2. A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy
during the first few days of therapy. Which is the best human needs statement for this situation?
a. Physical activity
b. Physical safety
c. Freedom pain
d. Interchange of gases
3. A patient’s medical record includes an order that reads as follows: “atenolol 25 mg once daily at
0900.” Which action by the nurse is correct?
a. The nurse does not give the drug
b. The nurse five the drug orally
c. The nurse gives the drug intravenously
d. The nurse contacts the prescriber to clarify the dosage route
4. The nurse is compiling a drug history for a patient. Which questions from the nurse will obtain
the most information from the patient? (select all that apply)
a. Do you use sleeping pills to get to sleep?
b. Do you have a family history of heart disease
c. When you have pain, what do you do to relieve it?
d. Did you have the mumps as a child
e. Tell me about what happened when you had an allergic reaction to penicillin
f. What herbal products or over-the-counter medications do you use?
5. A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse
that he is allergic to penicillin. Which is the most appropriate response by the nurse?
a. Many people are allergic to penicillin
b. This allergy is not of major concern because the drug is given so often
c. What type of reaction did you have when you took penicillin
d. Drug allergies don’t usually occur in older individuals due to built-up resistance to
allergic reactions
6. The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2
diabetes mellitus. Which of these reflect the correct order of the steps of nursing?
a. Assessment, planning, human needs statement, implementation, evaluation
b. Evaluation, assessment, human needs statement, planning, implementation
c. Human needs assessment, assessment, planning, implementation, evaluation
d. Assessment, human needs statement, planning, implementation, evaluation
7. The nurse is reviewing new medication orders that have been written for a newly admitted
patient. The nurse will need to clarify which order?
a. Metformin (Glucophage) 1000 mg PO twice a day
b. Sitagliptin (Januvia) 50 mg daily
c. Simvastatin (Zocor) 29 mg PO once a day
d. Irbesartan (Avapro) 300 mg PO once a day
e. Docusate (Colace) as needed for constipation
8. The nurse is reviewing data collected from a medication history. Which of these data are
considered objective data? (select all that apply)
a. White blood cell count 22,000 mm3
b. Blood pressure 150/94 mm Hg
c. Patient rates pain as an 8 on a 10 point scale
, d. Patients wife reports that the patient has been very sleepy during the day
e. Patient’s weight is 68 kg
Chapter 2-Pharmacologic Principles
1. An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all
night and did not sleep at all. The nurse recognizes that this woman has experienced which type of
reaction or effect?
a. Allergic reaction
b. Idiosyncratic reaction
c. Mutagenic effect
d. Synergistic effect
2. The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in
which phase of pharmacokinetics may occur in this patient?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
3. A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type
of therapy?
a. Palliative therapy
b. Maintenance therapy
c. Supportive therapy
d. Supplemental therapy
4. The nurse is giving mediation to a patient in heart failure. The intravenous route is chosen instead of
the intramuscular route. What physical function does the nurse recognize as the most influential
when deciding to use the intravenous route of drug administration?
a. Altered biliary function
b. Increased glomerular filtration
c. Reduced liver metabolism
d. Diminished circulation
5. A patient has just received a prescription for an enteric-coated stool softener. When teaching the
patient, the nurse should include which statements? Select all that apply
a. Take the tablet with 2 or 3 ounces of orange juice
b. Be sure to drink 6 to 8 ounces of water with tablets
c. Avoid taking all other medications with any enteric-coated tablet
d. Crush the tablet before swallowing if you have problems with swallowing
e. Be sure to swallow the tablet whole without chewing it
6. Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1
indicating the phase that occurs first and 4 indicating the phase that occurs last.
a. Enzymes in the liver transform the drug into an inactive metabolite (3)
b. Drug metabolites are secreted through passive glomerular filtration into the renal tubules (4)
c. A drug binds to the plasma protein albumin and circulates through the body (2)
d. A drug moves from the intestinal lumen into the mesenteric blood system (1)
7. The nurse is reviewing the various forms of topical medications. Which of these are considered
topical medications? Select all that apply
a. Rectal ointment for hemorrhoids
b. Eye drops for inflammation
c. Sublingual tablet for chest pain
d. Inhaled medication for asthma
e. Intradermal injection for tuberculosis testing
Chapter 3 - Lifespan Considerations
,1. The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which
factors put the neonatal patient at risk with regards to drug therapy?
a. Higher gastric pH
b. Increased peristalsis in the GI tract
c. Immature renal function
d. Reduced first-pass elimination in the liver
e. Decreased protein-binding of medications
2. The physiologic differences in the pediatric patient compared with the adult patient affect the
amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main
differences is that infants have which of these factors?
a. Increased protein in circulation
b. Fat composition lower than 0.001%
c. More muscular body composition
d. Water composition of approximately 75%
3. While teaching a 76-year-old patient about the adverse effects of his medication, the nurse encourages
him to keep a journal of the adverse effects he experiences. This intervention is important for the
older adult patient because of which alteration in pharmacokinetics?
a. Increased renal excretion of protein-bound drugs
b. More alkaline gastric pH, resulting in more adverse effects
c. Decreased blood flow to the liver, resulting in altered metabolism
d. Less adipose tissue to store fat-soluble drugs
4. When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, “I
get dizzy when I stand up.” She also states that she has nearly fainted “a time or two” in the
afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of
medication may be responsible for these effects?
a. Nonsteroidal antiinflammatory drugs (nSAIDS)
b. Cardiac glycosides
c. Anticoagulants
d. Antihypertensives
5. A pregnant patient who is at 32 weeks gestation has a cold and calls the office to ask about taking an
over-the-counter medication that is rated as pregnancy category A. What answer by the nurse is
correct?
a. This drug causes problems in the human fetus, so you should not take this medication
b. This drug may cause problems in the human fetus, but nothing has been proven in
clinical trials. It is best not to take this medication
c. This drug has not caused problems in animals, but no testing has been done in humans. It
is probably safe to take
d. Studies indicate that there is no risk to the human fetus, so it is okay to take this
medication as directed if you need it
6. The nurse is preparing to administer an injection to a preschool-age child. Which approaches
are appropriate for this age group? Select all that apply
a. Explain to the child in advance about the injection
b. Provide a brief, concrete explanation about the injection
c. Encourage participation in the procedure
d. Make use of magical thinking
e. Provide comfort measure after the injection
7. An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse
is assessing the current medications he is taking at home. Which method is the best way to assess his
home medications?
a. Ask the patient what medications he takes at home
b. Ask the patient’s wife what medications he takes at home
c. Ask the patient’s wife to bring his medications to the hospital in their original container
d. Contact the patient pharmacy for a list of the patient's current medications
, Chapter 4-cultural, legal, and ethical considerations
1. A patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the
nurse, “I would like to try to live long enough to see my granddaughter graduate in 3 months, but
after that I don’t want any extra treatments.'' This patient is demonstrating which of these?
a. Veracity
b. Beneficence
c. Maleficence
d. Autonomy
2. When caring for an older Chinese patient, the nurse recognizes which of these cultural issues that
may influence the care of this patient?
a. Chest x-ray are seen as a break in the soul’s integrity
b. Hospital diet are interpreted as being healing and healthful
c. The use of herbal products may be important practice for this patient
d. Being hospitalized is a source of peace and socialization for this culture
3. A patient is being counseled for possible participation in a clinical trial for a new medication. After the
patient meets with the physician, the nurse is asked to obtain the patient’s signature on the consent
forms. The nurse knows that this “informed consent” indicates which of these?
a. Once therapy has begun, the patient cannot withdraw from the clinical trial
b. The patient has been informed of all potential hazards and benefits of the therapy
c. The patient has received only the information that will help to make the clinical trial a success
d. No matter what happens, the patient will not be able to sue the researchers for damage
4. A new drug has been approved for use, and the drug manufacturer has made it available for sale.
During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered
during the testing and considers withdrawing the drug. This illustrates which phase of investigational
drug studies?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
5. A patient of Japanese descent says that members of her family often have “strong reactions” after
taking certain medications, but her white friends have no problem with the same dosages of the
same drug. The nurse recognizes that, because of this trait, which statement applies?
a. She may need lower doses of the medication prescribed
b. She may need higher doses of the medication prescribed
c. She should not receive these medications because of potential problems with metabolism
d. These situations vary greatly, and her account may not indicate a valid cause for concern
6. When evaluating polymorphism and medication administration the nurse considers which factors?
Select all that apply
a. Nutritional status
b. Drug route
c. Genetic factors
d. Cultural beliefs
e. Patient’s age
7. A patient shows the nurse an article in the newspaper about a new blackbox warning and states, “I take
this drug! Is it safe for me to take now?” which of these statements about black box warnings is true?
Select all that apply
a. Serious adverse effects from the drug have been reported
b. The FDA is asking for a mandatory recall of this drug
c. Serious adverse effects have been reported with this drug, and the patient will not be able
to take it again because the risks outweigh the benefits
d. It can still be prescribed as long as the prescriber and patient are aware of the potential
risk
