Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A 70-year-old man is being treated for chronic obstructive pulmonary disease
(COPD) with theophylline (Theo-Dur). What will be a priority assessment by the
nurse?
a. Ingestion of fatty foods
b. Weight
c. Activity level
d. Use of nicotine
Ans: D
Feedback:
Nutritional status, weight, and activity level would be important for a nurse to know
about a COPD patient. However, it would be most important for the nurse to know
whether the patient smokes or uses tobacco in other ways or smoking cessation
methods that involve nicotine. Nicotine increases the metabolism of theophyllines; the
dosage may need to be increased to produce a therapeutic effect.
2. A 6-year-old child weighing 52 pounds has had a loading dose of aminophylline
(Truphylline). The nurse is ready to administer the regular prescribed dose of 4
mg/kg every 4 hours for three doses. How many milligram will the patient receive
in 12 hours?
a. 44 mg
b. 94 mg
c. 284 mg
d. 344 mg
Ans: C
Feedback:
First, using the formula: 2.2 pounds and 52 pounds: times kg, determine the child’s
weight in kg (52/2.2 = 23.64). Next, using the formula of amount of drug prescribed
times weight in kg, determine the amount the child will receive in one dose (4 times
23.64 = 94.56). To determine the mg in a 12-hour period multiply 94.56 times 3 =
283.68. Round to 284 mg. Options A, B, and D are not correct.
3. A patient is in the clinic to have blood drawn to assess his or her theophylline
level. The patient is taking theophylline (Theo-Dur) and appears to being doing
well on the drug. He or she reports no problems. What serum level will the nurse
expect the patient to have?
, a. Between 0.5 to 5 mcg/mL
b. Between 10 to 20 mcg/mL
c. Between 25 to 35 mcg/mL
d. Between 40 to 50 mcg/mL
Ans: B
Feedback:
Therapeutic theophylline levels should be between 10 and 20 mcg/mL. A level
between 0.5 and 5 mcg/mL would be low and would not produce a therapeutic effect.
Levels between 25 and 50 mcg/mL would be too high and could cause serious adverse
effects.
4. A patient presents to the emergency department (ED) having an acute asthma
attack. An ED physician has ordered a sympathomimetic (epinephrine). The nurse
expects what as the therapeutic effect of this drug?
a. Decrease the inflammatory response in the airways
b. Reduce the surface tension within the alveoli allowing for gas exchange
c. Inhibit the release of histamine and slow-reacting substance of anaphylaxis
(SRSA) to prevent the allergic asthmatic response
d. Cause dilation of the bronchi with increased rate and depth of respiration
Ans: D
Feedback:
Epinephrine will cause the bronchi to dilate and also cause the rate and depth of
respiration to increase. Inhaled steroids decrease the inflammatory response and lung
surfactants reduce the surface tension within the alveoli. Mast cell stabilizers inhibit
the release of histamine and SRSA to prevent the allergic response. Options A, B, and
C are not correct.
5. An inhaled sympathomimetic drug has been ordered for a teenage athlete who has
exercise-induced asthma. What should the patient be instructed to do?
a. Use the inhaler every day at the same time each day.
b. Use the inhaler as soon as the symptoms start.
c. Use the inhaler 30 to 60 minutes before exercising to ensure peak
therapeutic levels when needed.
d. Use the inhaler 2 to 3 hours before exercising to ensure peak effectiveness.
Ans: C
Feedback:
Teaching a patient about using an inhaled sympathomimetic for management of
exercise-induced asthma should include instructions to use the inhaler 30 to 60
minutes before exercising to ensure therapeutic levels when needed. The inhaler
would not be used daily and waiting until symptoms occur will be too late for
prevention. Options B and D are not correct.
1. A 70-year-old man is being treated for chronic obstructive pulmonary disease
(COPD) with theophylline (Theo-Dur). What will be a priority assessment by the
nurse?
a. Ingestion of fatty foods
b. Weight
c. Activity level
d. Use of nicotine
Ans: D
Feedback:
Nutritional status, weight, and activity level would be important for a nurse to know
about a COPD patient. However, it would be most important for the nurse to know
whether the patient smokes or uses tobacco in other ways or smoking cessation
methods that involve nicotine. Nicotine increases the metabolism of theophyllines; the
dosage may need to be increased to produce a therapeutic effect.
2. A 6-year-old child weighing 52 pounds has had a loading dose of aminophylline
(Truphylline). The nurse is ready to administer the regular prescribed dose of 4
mg/kg every 4 hours for three doses. How many milligram will the patient receive
in 12 hours?
a. 44 mg
b. 94 mg
c. 284 mg
d. 344 mg
Ans: C
Feedback:
First, using the formula: 2.2 pounds and 52 pounds: times kg, determine the child’s
weight in kg (52/2.2 = 23.64). Next, using the formula of amount of drug prescribed
times weight in kg, determine the amount the child will receive in one dose (4 times
23.64 = 94.56). To determine the mg in a 12-hour period multiply 94.56 times 3 =
283.68. Round to 284 mg. Options A, B, and D are not correct.
3. A patient is in the clinic to have blood drawn to assess his or her theophylline
level. The patient is taking theophylline (Theo-Dur) and appears to being doing
well on the drug. He or she reports no problems. What serum level will the nurse
expect the patient to have?
, a. Between 0.5 to 5 mcg/mL
b. Between 10 to 20 mcg/mL
c. Between 25 to 35 mcg/mL
d. Between 40 to 50 mcg/mL
Ans: B
Feedback:
Therapeutic theophylline levels should be between 10 and 20 mcg/mL. A level
between 0.5 and 5 mcg/mL would be low and would not produce a therapeutic effect.
Levels between 25 and 50 mcg/mL would be too high and could cause serious adverse
effects.
4. A patient presents to the emergency department (ED) having an acute asthma
attack. An ED physician has ordered a sympathomimetic (epinephrine). The nurse
expects what as the therapeutic effect of this drug?
a. Decrease the inflammatory response in the airways
b. Reduce the surface tension within the alveoli allowing for gas exchange
c. Inhibit the release of histamine and slow-reacting substance of anaphylaxis
(SRSA) to prevent the allergic asthmatic response
d. Cause dilation of the bronchi with increased rate and depth of respiration
Ans: D
Feedback:
Epinephrine will cause the bronchi to dilate and also cause the rate and depth of
respiration to increase. Inhaled steroids decrease the inflammatory response and lung
surfactants reduce the surface tension within the alveoli. Mast cell stabilizers inhibit
the release of histamine and SRSA to prevent the allergic response. Options A, B, and
C are not correct.
5. An inhaled sympathomimetic drug has been ordered for a teenage athlete who has
exercise-induced asthma. What should the patient be instructed to do?
a. Use the inhaler every day at the same time each day.
b. Use the inhaler as soon as the symptoms start.
c. Use the inhaler 30 to 60 minutes before exercising to ensure peak
therapeutic levels when needed.
d. Use the inhaler 2 to 3 hours before exercising to ensure peak effectiveness.
Ans: C
Feedback:
Teaching a patient about using an inhaled sympathomimetic for management of
exercise-induced asthma should include instructions to use the inhaler 30 to 60
minutes before exercising to ensure therapeutic levels when needed. The inhaler
would not be used daily and waiting until symptoms occur will be too late for
prevention. Options B and D are not correct.
