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NURSING PHARMACOLOGY

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FOCUS ON NURSING PHARMACOLOGY

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Chapter 1: Introduction to Drugs


Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing process
1.A nurse working in radiology administers iodine to a patient who is having a
computerized axial tomography (CAT) scan. A nurse working on an oncology unit
administers chemotherapy to patients who have cancer. At the Public Health
Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14-
month-old child as a routine immunization. Which branch of pharmacology best
describes the actions of all three nurses?
A) Pharmacoeconomics
B) Pharmacotherapeutics
C) Pharmacodynamics
D) Pharmacokinetics
Ans: B
Response:
Pharmacology is the study of the biologic effects of chemicals. Nurses are involved
with clinical pharmacology or pharmacotherapeutics, which is a branch of




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pharmacology that deals with the uses of drugs to treat, prevent, and diagnose
disease. The nurse working in radiology is administering a drug to help diagnose a




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disease. The nurse working on an oncology unit is administering a drug to help treat a
disease. Pharmacoeconomics includes any costs involved in drug therapy.




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Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is
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how the body acts on the drug.
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Cognitive Level: Comprehension
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Difficulty: Easy
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Integrated Process: Nursing process
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2.A physician has ordered intramuscular injections of morphine, a narcotic, every 4
hours as needed for pain for a motor vehicle accident victim. The nurse is aware that
there is a high abuse potential for this drug; therefore, morphine is categorized as a:
A) Schedule I drug
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B) Schedule II drug
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C) Schedule III drug
D) Schedule IV drug
Ans: B
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Response:
Narcotics such as morphine are considered schedule II drugs because of the high
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abuse potential with severe dependence liability. Schedule I drugs have high abuse
potential and no accepted medical use. Schedule III drugs have a lesser abuse
potential than schedule II drugs and an accepted medical use. Schedule IV drugs have
low abuse potential and limited dependence liability.


Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Communication and documentation
3.A nurse working for a drug company is involved in phase III drug evaluation studies.
Which of the following might the nurse be responsible for during this stage of drug
development?


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Chapter 1: Introduction to Drugs


A) Working with animals who are given experimental drugs
B) Monitoring drug effects in patients who are selected to participate in a study,
who have the disease that the drug is meant to treat
C) Collecting records of symptoms that participants experience while taking a
drug and determining whether they are caused by the disease or the drug
D) Informing healthy, young volunteer participants of possible risks that could
occur from taking an experimental drug
Ans: C
Response:
Phase III studies involve use of a drug in a vast clinical market where patients are
asked to record any symptoms they experience while taking the drugs. Nurses may be
responsible for helping collect and analyze the information to be shared with the
Food and Drug Administration (FDA). Use of animals in drug testing is done in the
preclinical trials. A select group of patients who are involved in phase II studies
participate in studies where the participants have the disease the drug is intended to
treat. These patients are monitored closely for drug effects. Phase I studies involve
healthy human volunteers who are usually paid for their participation. Nurses may




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observe for adverse effects and toxicity.




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Cognitive Level: Comprehension




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Difficulty: Moderate rs e
Integrated Process: Nursing Process
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4.Which of the following concepts is considered when generic drugs are substituted for
brand-name drugs?
A) Bioavailability
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B) Critical concentration
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C) Distribution
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D) Half-life
Ans: A
Response:
Bioavailability is the portion of a dose of a drug that reaches the systemic circulation
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and is available to act on body cells. Binders used in a generic drug may not be the
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same as those used in the brand-name drug. Therefore, the way the body breaks down
and uses the drug may differ, which may eliminate a substitution. Critical
concentration is the amount of a drug that is needed to cause a therapeutic effect.
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Distribution is the phase of pharmacokinetics that involves the movement of a drug to
the body's tissues. A drug's half-life is the time it takes for the amount of drug to
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decrease to one-half of the peak level.


Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Teaching/learning
5.A nurse is teaching her patient about the use of over-the-counter (OTC) drugs. Which
of the following statements best informs the patient about their safe use?
A) “OTC drugs are products that are available without prescription for self-
treatment of minor complaints.”
B) “OTC drugs are considered medications and should be reported on a drug
history.”


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Chapter 1: Introduction to Drugs


C) “OTC drugs were approved as prescription drugs but later were found to be
safe without the need for a prescription.”
D) “OTC drugs need to be taken with caution. They can mask the signs and
symptoms of an underlying disease and interfere with prescription drug
therapy.”
Ans: D
Response:
OTC drugs are considered medications and should be reported. OTC drugs are
available without a prescription, although some were first approved as prescription
drugs. The most important teaching should relate to their safe use and that OTC drugs
can mask symptoms of disease and interfere with prescribed drugs.


Cognitive Level: Knowledge
Difficulty: Easy
Integrated Process: Nursing Process
6.Which of the following legislative acts allowed the Food and Drug Administration




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er as
(FDA) to tighten control over the quality of drugs and required that safety and
efficacy standards be established?




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A) Pure Food and Drug Act of 1906
B) Federal Food, Drug, and Cosmetic Act of 1938




o.
C) Durham Humphrey Amendment of 1951
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D) Kefauver-Harris Act of 1962
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Ans: D
Response:
The Kefauver-Harris Act was the result of the use of the 1960s drug thalidomide
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(Thalomid). The public concern led to the legislation that gave the FDA regulatory
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control over testing and evaluating of drugs and allowed it to set standards for
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efficacy and safety. The Pure Food and Drug Act required labeling to eliminate false
claims. The Federal Food, Drug, and Cosmetic Act gave the FDA the power to
enforce standards for testing drug toxicity and monitoring labeling. The Durham-
Humphrey Amendment enforced prescriptions for distribution.
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Cognitive Level: Application
Difficulty: Moderate
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Integrated Process: Teaching/learning
7.A nurse is instructing a pregnant patient concerning the potential risk to her fetus
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from a pregnancy category B drug. The nurse would inform the patient that:
A) “Adequate studies in pregnant women have demonstrated there is no risk to the
fetus.”
B) “Animal studies have not demonstrated a risk to the fetus but there have been
no adequate studies in pregnant women.”
C) “Animal studies have shown an adverse effect on the fetus but there are no
adequate studies in pregnant women.”
D) “There is evidence of human fetal risk but the potential benefits from use of the
drug may be acceptable despite potential risks.”
Ans: B
Response:
Category B indicates that animal studies have not demonstrated a risk to the fetus but


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