Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A nurse has admitted a 10-year-old child to the short-stay unit. The child has
complained of chronic headaches and his or her mother reports that he or she gives
him or her acetaminophen (Tylenol) at least twice a day. What will the nurse
evaluate?
a. Renal function
b. Hepatic function
c. Respiratory function
d. Cardiac function
Ans: B
Feedback:
The nurse should evaluate the patient’s hepatic function. Severe hepatotoxicity can
occur from overuse of acetaminophen. Significant interferences do not occur in the
kidney, heart, or lung with acetaminophen.
2. The nurse is discussing ethnic differences in response to medication with your
nursing students. What group of people would the nurse tell the students may have
a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and
should be educated concerning signs and symptoms of gastrointestinal bleeding
from use of these drugs?
a. African Americans
b. White Americans
c. Hispanics
d. Asians
, Ans: A
Feedback:
African Americans have a documented decreased sensitivity to pain-relieving effects
of many antiinflammatory drugs. They also have an increased risk of developing GI
adverse effects to these drugs. In general, White Americans, Hispanics, and Asians
are at lower risk for these problems.
3. A patient, newly diagnosed with ulcerative colitis, has been admitted to the short-
stay unit. What salicylates does the nurse anticipate will be ordered for this patient?
a. Balsalazide (Colazal)
b. Sodium thiosalicylate (generic)
c. Choline magnesium trisalicylate (Tricosal)
d. Salsalate (Argesic)
Ans: A
Feedback:
Balsalazide is delivered intact to the colon, where it delivers a local anti-inflammatory
effect that is most effective for patients with ulcerative colitis. Choline salicylate and
salsalate are used to treat pain, fever, and inflammation. Sodium thiosalicylate is used
mainly for episodes of acute gout, for muscular pain, and to treat rheumatic fever.
4. The nurse is caring for a 66-pound child with orders for choline magnesium
trisalicylate (Tricosal). The orders read 50 mg/kg/d PO in two divided doses. How
many milligram will the patient receive per dose?
a. 250 mg
b. 500 mg
c. 750 mg
d. 1,000 mg
Ans: C
Feedback:
First, the nurse must determine the child’s weight in kilogram. One kg is equal to 2.2
pounds. Divide 2.2 into 66 to equal 30 kg. Multiply 50 mg times 30 kg to equal 1,500
mg. Divide 1,500 by 2 for the divided doses, which will equal 750 mg per dose.
5. A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-
inflammatory agents on a regular basis. What medication should the nurse question
if ordered by the physician to be taken in addition to the anti-inflammatory agent?
a. Oral antidiabetic agent
b. Calcium channel blocker
c. Beta-blocker
d. Antibiotic
Ans: C
, Feedback:
Nonsteroidal anti-inflammatory drugs have the potential to decrease antihypertensive
effects from beta blockers if these drugs are taken at the same time. Patients who
receive these combinations should be monitored closely and appropriate dosage
adjustments made if needed. Drug interactions do not usually occur with oral
antidiabetic agents, calcium channel blocking medications, or antibiotics.
6. A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory
drugs (NSAID). What statement by the patient indicates to the nurse that the
patient has a good understanding of the use of this therapy?
a. I drink a glass of wine just about every night.
b. I asked my doctor to check for blood in my stool regularly.
c. I do not like to swallow tablets so I crush them.
d. I drink as little water as possible when I take my medication.
Ans: B
Feedback:
Taking certain anti-inflammatory drugs can irritate the gastric mucosa and increase
the risk of bleeding; therefore, by asking his or her doctor to check his or her stool for
bleeding, the nurse knows that the patient is aware of this. Alcohol and crushing the
tablets can interfere with anti-inflammatory metabolism. A full glass of water should
be taken with this medication to increase absorption.
7. A salicylate has been prescribed for a 15-year-old patient who has been diagnosed
with arthritis. The mother is concerned about giving her child a salicylate. What
salicylates could the nurse tell this mother are recommended for use in children?
a. Salsalate (Argesic)
b. Olsalazine (Dipentum)
c. Sodium thiosalicylate (generic)
d. Choline magnesium trisalicylate (Tricosal)
Ans: D
Feedback:
Aspirin and choline magnesium trisalicylate are the only salicylates recommended for
use in children. They should not be used when any risk of Reye’s syndrome exists.
Salsalate (Argesic), olsalazine (Dipentum), and sodium thiosalicylate (generic) have
not been approved for pediatric use and do not provide pediatric dosing guidelines as
a result.
8. A mother has brought her 6-year-old child to the clinic. The child has a fever of
102.8ºF and is diagnosed with the flu. What medication will the nurse suggest for
this child?
a. Etanercept (Enbrel)
b. Penicillamine (Depen)
, c. Acetaminophen (Tylenol)
d. Aspirin (Bayer)
Ans: C
Feedback:
Acetaminophen would be the suggested medication. It is prescribed for relief of pain
and fever for influenza in children. Aspirin would be contraindicated because it
increases the risk for Reye’s syndrome. Etanercept and penicillamine are given for
severe rheumatoid arthritis therapy.
9. A nurse is presenting an educational event for a group of new parents. One topic
that the nurse addresses is the overuse of acetaminophen, which can cause liver
toxicity. What would the nurse tell the parents it is important to do?
a. Do not give acetaminophen (Tylenol) unless you receive a doctor’s order.
b. Check the label of over-the-counter (OTC) medications carefully to watch
for inclusions of acetaminophen in the ingredients.
c. Monitor their child’s temperature carefully and regulate the Tylenol dose
based on the fever.
d. Mix OTC children’s medications to get the best coverage for their child’s
symptoms.
Ans: B
Feedback:
Inadvertent overdose with acetaminophen frequently occurs because of the combining
of OTC drugs that contain the same ingredients. Parents should be taught to carefully
check the labels of OTC products and follow the dosage guidelines. A prescription is
not required for acetaminophen. Dosage guidelines are the best guide to follow to
prevent overdose.
10. A mother asks the nurse how acetaminophen works. What statement best describes
the therapeutic action of acetaminophen?
a. Acetaminophen (Tylenol) works by blocking the increase of interleukin-1.
b. Acetaminophen reacts with free-floating tumor necrosis (TNF) factor
released by active leukocytes.
c. Acetaminophen acts directly on the hypothalamus to cause vasodilation and
sweating.
d. Acetaminophen is taken up by macrophages, thus inhibiting phagocytosis
and release of lysosomal enzymes.
Ans: C
Feedback:
Acetaminophen acts on the hypothalamus to cause vasodilation and sweating to
reduce fever. The mechanism of action as an analgesic is not understood. Anakinra
(Kineret) blocks the increased interleukin-1, which is responsible for the degradation
1. A nurse has admitted a 10-year-old child to the short-stay unit. The child has
complained of chronic headaches and his or her mother reports that he or she gives
him or her acetaminophen (Tylenol) at least twice a day. What will the nurse
evaluate?
a. Renal function
b. Hepatic function
c. Respiratory function
d. Cardiac function
Ans: B
Feedback:
The nurse should evaluate the patient’s hepatic function. Severe hepatotoxicity can
occur from overuse of acetaminophen. Significant interferences do not occur in the
kidney, heart, or lung with acetaminophen.
2. The nurse is discussing ethnic differences in response to medication with your
nursing students. What group of people would the nurse tell the students may have
a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and
should be educated concerning signs and symptoms of gastrointestinal bleeding
from use of these drugs?
a. African Americans
b. White Americans
c. Hispanics
d. Asians
, Ans: A
Feedback:
African Americans have a documented decreased sensitivity to pain-relieving effects
of many antiinflammatory drugs. They also have an increased risk of developing GI
adverse effects to these drugs. In general, White Americans, Hispanics, and Asians
are at lower risk for these problems.
3. A patient, newly diagnosed with ulcerative colitis, has been admitted to the short-
stay unit. What salicylates does the nurse anticipate will be ordered for this patient?
a. Balsalazide (Colazal)
b. Sodium thiosalicylate (generic)
c. Choline magnesium trisalicylate (Tricosal)
d. Salsalate (Argesic)
Ans: A
Feedback:
Balsalazide is delivered intact to the colon, where it delivers a local anti-inflammatory
effect that is most effective for patients with ulcerative colitis. Choline salicylate and
salsalate are used to treat pain, fever, and inflammation. Sodium thiosalicylate is used
mainly for episodes of acute gout, for muscular pain, and to treat rheumatic fever.
4. The nurse is caring for a 66-pound child with orders for choline magnesium
trisalicylate (Tricosal). The orders read 50 mg/kg/d PO in two divided doses. How
many milligram will the patient receive per dose?
a. 250 mg
b. 500 mg
c. 750 mg
d. 1,000 mg
Ans: C
Feedback:
First, the nurse must determine the child’s weight in kilogram. One kg is equal to 2.2
pounds. Divide 2.2 into 66 to equal 30 kg. Multiply 50 mg times 30 kg to equal 1,500
mg. Divide 1,500 by 2 for the divided doses, which will equal 750 mg per dose.
5. A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-
inflammatory agents on a regular basis. What medication should the nurse question
if ordered by the physician to be taken in addition to the anti-inflammatory agent?
a. Oral antidiabetic agent
b. Calcium channel blocker
c. Beta-blocker
d. Antibiotic
Ans: C
, Feedback:
Nonsteroidal anti-inflammatory drugs have the potential to decrease antihypertensive
effects from beta blockers if these drugs are taken at the same time. Patients who
receive these combinations should be monitored closely and appropriate dosage
adjustments made if needed. Drug interactions do not usually occur with oral
antidiabetic agents, calcium channel blocking medications, or antibiotics.
6. A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory
drugs (NSAID). What statement by the patient indicates to the nurse that the
patient has a good understanding of the use of this therapy?
a. I drink a glass of wine just about every night.
b. I asked my doctor to check for blood in my stool regularly.
c. I do not like to swallow tablets so I crush them.
d. I drink as little water as possible when I take my medication.
Ans: B
Feedback:
Taking certain anti-inflammatory drugs can irritate the gastric mucosa and increase
the risk of bleeding; therefore, by asking his or her doctor to check his or her stool for
bleeding, the nurse knows that the patient is aware of this. Alcohol and crushing the
tablets can interfere with anti-inflammatory metabolism. A full glass of water should
be taken with this medication to increase absorption.
7. A salicylate has been prescribed for a 15-year-old patient who has been diagnosed
with arthritis. The mother is concerned about giving her child a salicylate. What
salicylates could the nurse tell this mother are recommended for use in children?
a. Salsalate (Argesic)
b. Olsalazine (Dipentum)
c. Sodium thiosalicylate (generic)
d. Choline magnesium trisalicylate (Tricosal)
Ans: D
Feedback:
Aspirin and choline magnesium trisalicylate are the only salicylates recommended for
use in children. They should not be used when any risk of Reye’s syndrome exists.
Salsalate (Argesic), olsalazine (Dipentum), and sodium thiosalicylate (generic) have
not been approved for pediatric use and do not provide pediatric dosing guidelines as
a result.
8. A mother has brought her 6-year-old child to the clinic. The child has a fever of
102.8ºF and is diagnosed with the flu. What medication will the nurse suggest for
this child?
a. Etanercept (Enbrel)
b. Penicillamine (Depen)
, c. Acetaminophen (Tylenol)
d. Aspirin (Bayer)
Ans: C
Feedback:
Acetaminophen would be the suggested medication. It is prescribed for relief of pain
and fever for influenza in children. Aspirin would be contraindicated because it
increases the risk for Reye’s syndrome. Etanercept and penicillamine are given for
severe rheumatoid arthritis therapy.
9. A nurse is presenting an educational event for a group of new parents. One topic
that the nurse addresses is the overuse of acetaminophen, which can cause liver
toxicity. What would the nurse tell the parents it is important to do?
a. Do not give acetaminophen (Tylenol) unless you receive a doctor’s order.
b. Check the label of over-the-counter (OTC) medications carefully to watch
for inclusions of acetaminophen in the ingredients.
c. Monitor their child’s temperature carefully and regulate the Tylenol dose
based on the fever.
d. Mix OTC children’s medications to get the best coverage for their child’s
symptoms.
Ans: B
Feedback:
Inadvertent overdose with acetaminophen frequently occurs because of the combining
of OTC drugs that contain the same ingredients. Parents should be taught to carefully
check the labels of OTC products and follow the dosage guidelines. A prescription is
not required for acetaminophen. Dosage guidelines are the best guide to follow to
prevent overdose.
10. A mother asks the nurse how acetaminophen works. What statement best describes
the therapeutic action of acetaminophen?
a. Acetaminophen (Tylenol) works by blocking the increase of interleukin-1.
b. Acetaminophen reacts with free-floating tumor necrosis (TNF) factor
released by active leukocytes.
c. Acetaminophen acts directly on the hypothalamus to cause vasodilation and
sweating.
d. Acetaminophen is taken up by macrophages, thus inhibiting phagocytosis
and release of lysosomal enzymes.
Ans: C
Feedback:
Acetaminophen acts on the hypothalamus to cause vasodilation and sweating to
reduce fever. The mechanism of action as an analgesic is not understood. Anakinra
(Kineret) blocks the increased interleukin-1, which is responsible for the degradation
