Basic Principles of Pharmacology Rosenthal:
An older adult patient is admitted to the hospital for treatment of an exacerbation of a
chronic illness. Admission laboratory work reveals an extremely low serum drug level of
the drug used to treat this condition. The patient’s renal and hepatic function tests are
normal. What might the provider suspect as a likely cause of this finding?
A. Concurrent administration of two highly protein-bound drugs
B. Chronic constipation
C. Increased tolerance to the drug’s effects
D. Nonadherence to the medical regimen
D. Nonadherence to the medical regimen
A 5-year-old has gray teeth. When taking a medication history, the provider will ask about
previous use of which group of medications?
A. Glucocorticoids
B. Sulfonamides
C. Salicylates
D. Tetracyclines
D. Tetracyclines
An older adult patient is entering into the immediate postoperative period after a total
hip replacement. The patient's son concerned about related pain asks meperidine be
prescribed since, "I had it for severe pain when I injured when I was younger." What
action will the provider take to reduce the patient's risk for injury while addressing the
patient's pain?
,A. Offer to prescribe diazepam to reduce the patient's anxiety and thus reduce the need
for narcotics.
B. Prescribe meperidine and request the initiation of the fall risk protocol.
C. Prescribe morphine and discuss the rationale with the patient's son.
D. Provide a PRN order for diphenhydramine for the expected side effect of itching.
C. Prescribe morphine and discuss the rationale with the patient's son.
A medication prescribed for a neonate is eliminated primarily by hepatic metabolism.
What action will the prescriber take to minimize risk to the infant?
A. Prescribe a dose that is relatively higher than an adult dose when adjusted for body
surface area.
B. Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
C. Increase the frequency of medication dosing.
D. Discontinue the drug after one or two doses.
B. Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
A provider obtains a drug history from an older adult who is a new patient. Of the
multiple medications taken, which two, taken together, create a reason for concern?
A. Zolpidem and sertraline
B. Amitriptyline and diphenhydramine
C. Acetaminophen and oxycodone
D. Fexofenadine and an over-the-counter (OTC) laxative
B. Amitriptyline and diphenhydramine
A provider speaking to a class or a group of pregnant patients correctly teaches that the
highest risk of teratogen-induced gross malformations exists during which time period?
,A. During the first trimester
B. During the third trimester
C. During the second trimester
D. Immediately before conception
A. During the first trimester
Four older adult patients are taking multiple medications. For which patient is the
provider most concerned about the risk for adverse drug effects?
A. An obese patient
B. An underweight patient with a chronically low appetite
C. A patient with decreased serum creatinine
D. A patient who experiences chronic diarrhea
B. An underweight patient with a chronically low appetite
A pregnant patient asks her provider about the safe use of medications during the third
trimester. What will the provider tell her about drugs taken at this stage?
A. "They may need to be given in higher doses if they undergo renal clearance."
B. "They require lower doses if they are metabolized by the liver."
C. "They are less likely to cross the placenta and affect the fetus."
D. "Drugs are more likely to cause anatomical defects if they are taken during the second
trimester.
A. "They may need to be given in higher doses if they undergo renal clearance."
A provider prescribed methyldopa for a patient with hypertension. The patient is
educated about drug actions, adverse effects, and the ongoing blood tests necessary with
this drug. What additional statement should the provider include during the teaching?
A. "If you have a positive Coombs test result, you will need to discontinue the medication,
because this means you have hemolytic anemia."
B. "You will need to contact the office immediately and stop taking the medication if your
, eyes look yellow."
C. "Methyldopa can be used for its analgesic effects and for its hypertensive effects."
D. "Xerostomia and orthostatic hypotension are serious side effects and indications for
withdrawing the medication."
B. "You will need to contact the office immediately and stop taking the medication if your
eyes look yellow."
A patient will begin taking propranolol for hypertension. Which statement made by the
prescriber is important when teaching this patient about the medication?
A. "Take your pulse and do not take the medication if your heart rate is fast."
B. "Stop taking the drug if you become short of breath."
C. "It is safe to take this medication with your calcium channel blocker."
D. "Notify the clinic if you start waking at night with shortness of breath or have difficulty
lying flat."
D. "Notify the clinic if you start waking at night with shortness of breath or have difficulty
lying flat."
A male patient with benign prostatic hyperplasia (BPH) has stopped taking his α-
adrenergic antagonist medication because of ejaculatory difficulties. Which medication
will the provider to prescribe to best address the BPH and the patient's concerns?
A. Tamsulosin
B. Silodosin
C. Alfuzosin
D. Prazosin
C. Alfuzosin
An older adult patient who lives alone and admits to being "somewhat forgetful" has an
overactive bladder (OAB) and occasional constipation. The patient has tried behavioral
therapy to treat the OAB without success. Which treatment will the provider likely
prescribe for this patient?
An older adult patient is admitted to the hospital for treatment of an exacerbation of a
chronic illness. Admission laboratory work reveals an extremely low serum drug level of
the drug used to treat this condition. The patient’s renal and hepatic function tests are
normal. What might the provider suspect as a likely cause of this finding?
A. Concurrent administration of two highly protein-bound drugs
B. Chronic constipation
C. Increased tolerance to the drug’s effects
D. Nonadherence to the medical regimen
D. Nonadherence to the medical regimen
A 5-year-old has gray teeth. When taking a medication history, the provider will ask about
previous use of which group of medications?
A. Glucocorticoids
B. Sulfonamides
C. Salicylates
D. Tetracyclines
D. Tetracyclines
An older adult patient is entering into the immediate postoperative period after a total
hip replacement. The patient's son concerned about related pain asks meperidine be
prescribed since, "I had it for severe pain when I injured when I was younger." What
action will the provider take to reduce the patient's risk for injury while addressing the
patient's pain?
,A. Offer to prescribe diazepam to reduce the patient's anxiety and thus reduce the need
for narcotics.
B. Prescribe meperidine and request the initiation of the fall risk protocol.
C. Prescribe morphine and discuss the rationale with the patient's son.
D. Provide a PRN order for diphenhydramine for the expected side effect of itching.
C. Prescribe morphine and discuss the rationale with the patient's son.
A medication prescribed for a neonate is eliminated primarily by hepatic metabolism.
What action will the prescriber take to minimize risk to the infant?
A. Prescribe a dose that is relatively higher than an adult dose when adjusted for body
surface area.
B. Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
C. Increase the frequency of medication dosing.
D. Discontinue the drug after one or two doses.
B. Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
A provider obtains a drug history from an older adult who is a new patient. Of the
multiple medications taken, which two, taken together, create a reason for concern?
A. Zolpidem and sertraline
B. Amitriptyline and diphenhydramine
C. Acetaminophen and oxycodone
D. Fexofenadine and an over-the-counter (OTC) laxative
B. Amitriptyline and diphenhydramine
A provider speaking to a class or a group of pregnant patients correctly teaches that the
highest risk of teratogen-induced gross malformations exists during which time period?
,A. During the first trimester
B. During the third trimester
C. During the second trimester
D. Immediately before conception
A. During the first trimester
Four older adult patients are taking multiple medications. For which patient is the
provider most concerned about the risk for adverse drug effects?
A. An obese patient
B. An underweight patient with a chronically low appetite
C. A patient with decreased serum creatinine
D. A patient who experiences chronic diarrhea
B. An underweight patient with a chronically low appetite
A pregnant patient asks her provider about the safe use of medications during the third
trimester. What will the provider tell her about drugs taken at this stage?
A. "They may need to be given in higher doses if they undergo renal clearance."
B. "They require lower doses if they are metabolized by the liver."
C. "They are less likely to cross the placenta and affect the fetus."
D. "Drugs are more likely to cause anatomical defects if they are taken during the second
trimester.
A. "They may need to be given in higher doses if they undergo renal clearance."
A provider prescribed methyldopa for a patient with hypertension. The patient is
educated about drug actions, adverse effects, and the ongoing blood tests necessary with
this drug. What additional statement should the provider include during the teaching?
A. "If you have a positive Coombs test result, you will need to discontinue the medication,
because this means you have hemolytic anemia."
B. "You will need to contact the office immediately and stop taking the medication if your
, eyes look yellow."
C. "Methyldopa can be used for its analgesic effects and for its hypertensive effects."
D. "Xerostomia and orthostatic hypotension are serious side effects and indications for
withdrawing the medication."
B. "You will need to contact the office immediately and stop taking the medication if your
eyes look yellow."
A patient will begin taking propranolol for hypertension. Which statement made by the
prescriber is important when teaching this patient about the medication?
A. "Take your pulse and do not take the medication if your heart rate is fast."
B. "Stop taking the drug if you become short of breath."
C. "It is safe to take this medication with your calcium channel blocker."
D. "Notify the clinic if you start waking at night with shortness of breath or have difficulty
lying flat."
D. "Notify the clinic if you start waking at night with shortness of breath or have difficulty
lying flat."
A male patient with benign prostatic hyperplasia (BPH) has stopped taking his α-
adrenergic antagonist medication because of ejaculatory difficulties. Which medication
will the provider to prescribe to best address the BPH and the patient's concerns?
A. Tamsulosin
B. Silodosin
C. Alfuzosin
D. Prazosin
C. Alfuzosin
An older adult patient who lives alone and admits to being "somewhat forgetful" has an
overactive bladder (OAB) and occasional constipation. The patient has tried behavioral
therapy to treat the OAB without success. Which treatment will the provider likely
prescribe for this patient?
