,Chapter 01: Drug Regulation, Actions, and Responses
MULTIPLE CHOICE BASIC CONCEPTS
1. Which health care professional has the major responsibility for dispensing prescribed drugs
under the direction of a pharmacist?
a. Physician
b. Nurse practitioner
c. Licensed nurse
d. Pharmacy technician
ANS: D
The physician and nurse practitioner have the major responsibility for prescribing drugs, not
dispensing them. The licensed nurse has the primary responsibility for administering drugs,
although under some circumstances a licensed nurse may dispense prescribed drugs but this is not
his or her major responsibility in drug therapy. The pharmacy technician has the major
responsibility of dispensing prescribed drugs under the direction of a licensed pharmacist.
DIF: Cognitive Level: Remembering REF: p. 3
2. Which term describes the effect of a drug that improves body function?
a. Side effect
b. Intended action
c. Adverse reaction
d. Idiosyncratic response
ANS: B
The purpose of drug therapy is to take a drug to prevent, reduce, or correct a health problem. This
response is any drug’s intended action also known as a therapeutic response.
DIF: Cognitive Level: Remembering REF: p. 3
3. Which type of drug name is “owned” by the company that manufactures it?
a. Generic name
b. Chemical name
c. Category name
d. Trade name
ANS: D
The chemical name is a drug’s exact chemical composition. The generic name is the name
assigned to the drug by the U.S. Adopted Names Council and is not owned by anyone. The
category name refers to the type of drug (what it does or what it is used for) and is not an actual
drug name. The trade name (brand name) is the name provided and owned by a specific drug’s
manufacturer.
DIF: Cognitive Level: Remembering REF: p. 4
,4. Which drug or drug class is a “high alert” drug?
a. Penicillin
b. Insulin
c. NSAIDs
d. Calcium
ANS: B
A high alert drug is one in which harm is likely to result if given at the wrong dose, to the
wrong patient, or not given to the correct patient. Drugs classified as high alert drugs include
potassium, narcotics (opioids), insulin, cancer chemotherapy drugs, and heparin (or any drug
that strongly affects blood clotting). Penicillin, NSAIDs, and calcium are not considered high
alert drugs.
DIF: Cognitive Level: Remembering REF: p. 4
5. What is the term for a drug that has the same action as a naturally occurring body hormone or
enzyme?
a. Agonist
b. Blocking agent
c. Chemical
d. Duplicator
ANS: A
A drug agonist is an extrinsic drug that activates the receptor sites of a cell and mimics the
actions of naturally occurring body substances (intrinsic drugs). A blocking agent is a drug
antagonist. A chemical would not necessarily be a drug at all. A duplicator is not a
pharmacologic term.
DIF: Cognitive Level: Remembering REF: pp. 6-7
6. Which term describes how the body affects drug activity?
a. Drug potency
b. Pharmacodynamics
c. Therapeutic effect
d. Pharmacokinetics
ANS: D
The term pharmacokinetics refers to drug metabolism and how the body changes a drug.
Pharmacodynamics refers to how a drug works to change body function. Drug potency refers
to how strongly or to what degree a drug exerts its effects. The therapeutic effect is closer to
pharmacodynamics, meaning how a drug works to change body function.
DIF: Cognitive Level: Remembering REF: p. 10
7. In the United States, which group is responsible for enforcing established standards for drug
manufacturing?
a. U.S. Pharmacopeia
b. National Institutes of Health
c. Food and Drug Administration
d. Association of Pharmaceutical Manufacturers
ANS: C
The standards for drug manufacture are established by the U.S. Pharmacopeia. These
standards are enforced by the Food and Drug Administration. Neither the National Institutes
of Health nor the Association of Pharmaceutical Manufacturers has any authority to enforce
drug standards.
, DIF: Cognitive Level: Remembering REF: p. 5
8. Which factor is a major disadvantage of the transdermal drug delivery route?
a. Only a prescriber can administer drugs by the transdermal route.
b. Transdermal drugs must be sterile rather than clean.
c. First pass drug loss by this route is the most extensive.
d. Drug absorption is dependent on adequate circulation.
ANS: D
Once a transdermal drug moves through the skin, it must enter the bloodstream to reach its
target tissue. If circulation is poor to the area where the transdermal drug is applied, very little,
if any, of the drug will reach its target tissue.
DIF: Cognitive Level: Remembering REF: p. 12
9. How are intrinsic drugs different from extrinsic drugs?
a. Intrinsic drugs are made by the body, whereas extrinsic drugs are made outside the
body.
b. Intrinsic drugs are administered by the parenteral route, whereas extrinsic drugs
are administered by the oral route.
c. Extrinsic drugs can only be applied to the skin or mucous membranes, whereas
d. intrinsic drugs are taken internally Extrinsic drugs require a prescription for
administration, whereas intrinsic drugs are available over-the-counter.
ANS: A
Intrinsic drugs are the hormones, enzymes, and other chemicals made by the body that change
cell activity. Extrinsic drugs are manufactured from chemical, animal, or plant sources and
must have a means of entering the body in order to change cell activity.
DIF: Cognitive Level: Understanding REF: p. 3
10. A patient asks why his drug to control high blood pressure has only one generic name and two
different trade names. What is your best response?
a. “Most drugs have different trade names that indicate different dosages.”
b. “The two different trade names indicate that one is a more pure and safer drug than
the other.”
c. “The generic name is the actual official drug name and the trade name is a brand
owned by a specific manufacturer.”
d. “If you have insurance, you can get the trade name drug, which is usually more
expensive than the generic named drug.”
ANS: C
The generic name is the name assigned to the drug by the U.S. Adopted Names Council and is
not owned by anyone. The trade name (brand name) is the name provided and owned by a
specific drug’s manufacturer. More than one manufacturer can make and sell the same drug at
the same time under a different trade name. Regardless of trade name, all drugs that have the
same generic name must be alike in their chemical composition and strength.
DIF: Cognitive Level: Applying or Higher REF: pp. 3-4
11. How are the terms drug and medication different in the health care environment?
a. Medications must be prescribed, whereas drugs are available over-the-counter.
b. Medications are used to treat health problems, whereas drugs can be misused.
c. Drugs are always illegal, whereas medications are legal.
d. There is no difference between these two terms.
, ANS: D
Although the lay public may think there is a distinction between these two terms, in health
care they mean the same thing. Both are used to treat health problems and both can be
misused.
DIF: Cognitive Level: Understanding REF: p. 2
12. The prescriber tells a patient with allergies to use oral diphenhydramine (Benadryl)
over-the-counter (OTC) to help manage her symptoms. She tells you that she would rather
have a prescription for the “real” Benadryl because she knows it is stronger and will work
better than the nonprescription form. What is your best response?
a. “If you receive a prescription for this drug your name will be added to a controlled
substances list.”
b. “It is better to use the OTC Benadryl rather than the prescribed form because it has
fewer side effects.”
c. “The OTC form of Benadryl is the same strength as the one that was available by
prescription only.”
d. “You are correct. I will ask the health care provider to write a prescription so that
you can get the most effective drug.”
ANS: C
Diphenhydramine (Benadryl) is no longer available by prescription only. The OTC form has
the same strength, action, and side effects that the prescription only drug had.
DIF: Cognitive Level: Applying or Higher REF: p. 4
13. Why is it important to always ask a patient about his or her use of any herbal supplements or
botanicals?
a. Many states do not have regulations about herbal supplements or botanicals.
b. These substances are illegal and their use by patients must be reported.
c. Patients who use botanicals seldom take their prescribed drugs.
d. These substances can interact with a prescribed drug.
ANS: D
Many herbal supplements and botanicals have effects on cell activity. Sometimes these agents
can make drug side effects worse or can reduce the effectiveness of a prescribed drug. Others
can actually cause health problems.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 5
14. How are the effects of naturally occurring testosterone changed when a patient is taking a
drug that is a testosterone agonist?
a. Effects are increased.
b. Effects are decreased.
c. Effects are eliminated.
d. Effects are unchanged.
ANS: A
An agonist drug has the same effects of the naturally occurring drug. So, taking a testosterone
agonist adds to the effects of the patient’s naturally occurring testosterone.
DIF: Cognitive Level: Understanding REF: pp. 6-7
15. Which feature of a drug agonist increases its potency?
a. It is water soluble.
b. It binds tighter and longer to its receptors than do other drugs.
c. It is excreted through the intestinal tract rather than through the kidneys.
d. It is administered intramuscularly rather than by the intravenous route.
, ANS: B
A drug agonist binds to its receptors to cause a change in the cells and tissues. The longer a
drug remains bound to its receptors and the more tightly it binds increases its duration of
response, making it more potent than a drug that binds with its receptors for a shorter time.
DIF: CognitiveLevel:Understanding REF: p. 6-7
16. Which statement about agonist and antagonist drugs is true?
a. The target tissues for these types of drugs are invading bacteria and viruses.
b. Both agonist and antagonist drugs must interact with receptors to produce their
intended responses.
c. Antagonist drugs produce only intended responses and agonist drugs produce both
intended responses and side effects.
d. These types of drugs are less likely to cause allergic responses than drugs that are
neither agonists nor antagonists.
ANS: B
Agonist drugs excite a receptor to produce their intended responses on a cell or tissue in the
same way that a naturally occurring substance does. Antagonist drugs produce their intended
responses by binding to and blocking receptors.
DIF: Cognitive Level: Understanding REF: pp. 6-7
17. A patient asks why he must take a “loading dose” for the first dose of his prescribed drug and
then take lower doses after that. What is your best response?
a. “The loading dose allows the first dose of this drug to get into your bloodstream
faster and because it stays in the bloodstream a long time, you can take lower
doses after that.”
b. “The first dose of a drug has to be higher to reach the bloodstream because the
liver destroys it before it has a chance to start its action and work for you.”
c. “By taking the highest dose first and just once, you are reducing the likelihood of
having a bad reaction or other side effects to this drug.”
d. “This schedule helps by ensuring that the drug is having an effect even if you
forget to take the rest of the doses.”
ANS: A
A loading dose is most often used with drugs that have a long half-life. Giving a higher dose
for the first dose allows it to reach the bloodstream rapidly and stay there. Smaller doses
follow it to keep the blood drug level at a steady state without increasing the risk for a drug
over dose.
DIF: Cognitive Level: Applying or Higher REF: p. 16
18. Which action could make a drug more potent?
a. Slow drug absorption
b. Slow drug elimination
c. Normal drug elimination
d. Fast drug elimination
ANS: B
Any condition that keeps a drug active inside the body longer can increase its potency. Slow
drug elimination allows a drug to remain longer in the body. Normal or fast elimination does
not. Slow drug absorption does not contribute to potency.
DIF: Cognitive Level: Understanding REF: p. 15
19. When teaching a patient about adverse drug reactions (ADRs), which precaution is most
important to include?
MULTIPLE CHOICE BASIC CONCEPTS
1. Which health care professional has the major responsibility for dispensing prescribed drugs
under the direction of a pharmacist?
a. Physician
b. Nurse practitioner
c. Licensed nurse
d. Pharmacy technician
ANS: D
The physician and nurse practitioner have the major responsibility for prescribing drugs, not
dispensing them. The licensed nurse has the primary responsibility for administering drugs,
although under some circumstances a licensed nurse may dispense prescribed drugs but this is not
his or her major responsibility in drug therapy. The pharmacy technician has the major
responsibility of dispensing prescribed drugs under the direction of a licensed pharmacist.
DIF: Cognitive Level: Remembering REF: p. 3
2. Which term describes the effect of a drug that improves body function?
a. Side effect
b. Intended action
c. Adverse reaction
d. Idiosyncratic response
ANS: B
The purpose of drug therapy is to take a drug to prevent, reduce, or correct a health problem. This
response is any drug’s intended action also known as a therapeutic response.
DIF: Cognitive Level: Remembering REF: p. 3
3. Which type of drug name is “owned” by the company that manufactures it?
a. Generic name
b. Chemical name
c. Category name
d. Trade name
ANS: D
The chemical name is a drug’s exact chemical composition. The generic name is the name
assigned to the drug by the U.S. Adopted Names Council and is not owned by anyone. The
category name refers to the type of drug (what it does or what it is used for) and is not an actual
drug name. The trade name (brand name) is the name provided and owned by a specific drug’s
manufacturer.
DIF: Cognitive Level: Remembering REF: p. 4
,4. Which drug or drug class is a “high alert” drug?
a. Penicillin
b. Insulin
c. NSAIDs
d. Calcium
ANS: B
A high alert drug is one in which harm is likely to result if given at the wrong dose, to the
wrong patient, or not given to the correct patient. Drugs classified as high alert drugs include
potassium, narcotics (opioids), insulin, cancer chemotherapy drugs, and heparin (or any drug
that strongly affects blood clotting). Penicillin, NSAIDs, and calcium are not considered high
alert drugs.
DIF: Cognitive Level: Remembering REF: p. 4
5. What is the term for a drug that has the same action as a naturally occurring body hormone or
enzyme?
a. Agonist
b. Blocking agent
c. Chemical
d. Duplicator
ANS: A
A drug agonist is an extrinsic drug that activates the receptor sites of a cell and mimics the
actions of naturally occurring body substances (intrinsic drugs). A blocking agent is a drug
antagonist. A chemical would not necessarily be a drug at all. A duplicator is not a
pharmacologic term.
DIF: Cognitive Level: Remembering REF: pp. 6-7
6. Which term describes how the body affects drug activity?
a. Drug potency
b. Pharmacodynamics
c. Therapeutic effect
d. Pharmacokinetics
ANS: D
The term pharmacokinetics refers to drug metabolism and how the body changes a drug.
Pharmacodynamics refers to how a drug works to change body function. Drug potency refers
to how strongly or to what degree a drug exerts its effects. The therapeutic effect is closer to
pharmacodynamics, meaning how a drug works to change body function.
DIF: Cognitive Level: Remembering REF: p. 10
7. In the United States, which group is responsible for enforcing established standards for drug
manufacturing?
a. U.S. Pharmacopeia
b. National Institutes of Health
c. Food and Drug Administration
d. Association of Pharmaceutical Manufacturers
ANS: C
The standards for drug manufacture are established by the U.S. Pharmacopeia. These
standards are enforced by the Food and Drug Administration. Neither the National Institutes
of Health nor the Association of Pharmaceutical Manufacturers has any authority to enforce
drug standards.
, DIF: Cognitive Level: Remembering REF: p. 5
8. Which factor is a major disadvantage of the transdermal drug delivery route?
a. Only a prescriber can administer drugs by the transdermal route.
b. Transdermal drugs must be sterile rather than clean.
c. First pass drug loss by this route is the most extensive.
d. Drug absorption is dependent on adequate circulation.
ANS: D
Once a transdermal drug moves through the skin, it must enter the bloodstream to reach its
target tissue. If circulation is poor to the area where the transdermal drug is applied, very little,
if any, of the drug will reach its target tissue.
DIF: Cognitive Level: Remembering REF: p. 12
9. How are intrinsic drugs different from extrinsic drugs?
a. Intrinsic drugs are made by the body, whereas extrinsic drugs are made outside the
body.
b. Intrinsic drugs are administered by the parenteral route, whereas extrinsic drugs
are administered by the oral route.
c. Extrinsic drugs can only be applied to the skin or mucous membranes, whereas
d. intrinsic drugs are taken internally Extrinsic drugs require a prescription for
administration, whereas intrinsic drugs are available over-the-counter.
ANS: A
Intrinsic drugs are the hormones, enzymes, and other chemicals made by the body that change
cell activity. Extrinsic drugs are manufactured from chemical, animal, or plant sources and
must have a means of entering the body in order to change cell activity.
DIF: Cognitive Level: Understanding REF: p. 3
10. A patient asks why his drug to control high blood pressure has only one generic name and two
different trade names. What is your best response?
a. “Most drugs have different trade names that indicate different dosages.”
b. “The two different trade names indicate that one is a more pure and safer drug than
the other.”
c. “The generic name is the actual official drug name and the trade name is a brand
owned by a specific manufacturer.”
d. “If you have insurance, you can get the trade name drug, which is usually more
expensive than the generic named drug.”
ANS: C
The generic name is the name assigned to the drug by the U.S. Adopted Names Council and is
not owned by anyone. The trade name (brand name) is the name provided and owned by a
specific drug’s manufacturer. More than one manufacturer can make and sell the same drug at
the same time under a different trade name. Regardless of trade name, all drugs that have the
same generic name must be alike in their chemical composition and strength.
DIF: Cognitive Level: Applying or Higher REF: pp. 3-4
11. How are the terms drug and medication different in the health care environment?
a. Medications must be prescribed, whereas drugs are available over-the-counter.
b. Medications are used to treat health problems, whereas drugs can be misused.
c. Drugs are always illegal, whereas medications are legal.
d. There is no difference between these two terms.
, ANS: D
Although the lay public may think there is a distinction between these two terms, in health
care they mean the same thing. Both are used to treat health problems and both can be
misused.
DIF: Cognitive Level: Understanding REF: p. 2
12. The prescriber tells a patient with allergies to use oral diphenhydramine (Benadryl)
over-the-counter (OTC) to help manage her symptoms. She tells you that she would rather
have a prescription for the “real” Benadryl because she knows it is stronger and will work
better than the nonprescription form. What is your best response?
a. “If you receive a prescription for this drug your name will be added to a controlled
substances list.”
b. “It is better to use the OTC Benadryl rather than the prescribed form because it has
fewer side effects.”
c. “The OTC form of Benadryl is the same strength as the one that was available by
prescription only.”
d. “You are correct. I will ask the health care provider to write a prescription so that
you can get the most effective drug.”
ANS: C
Diphenhydramine (Benadryl) is no longer available by prescription only. The OTC form has
the same strength, action, and side effects that the prescription only drug had.
DIF: Cognitive Level: Applying or Higher REF: p. 4
13. Why is it important to always ask a patient about his or her use of any herbal supplements or
botanicals?
a. Many states do not have regulations about herbal supplements or botanicals.
b. These substances are illegal and their use by patients must be reported.
c. Patients who use botanicals seldom take their prescribed drugs.
d. These substances can interact with a prescribed drug.
ANS: D
Many herbal supplements and botanicals have effects on cell activity. Sometimes these agents
can make drug side effects worse or can reduce the effectiveness of a prescribed drug. Others
can actually cause health problems.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 5
14. How are the effects of naturally occurring testosterone changed when a patient is taking a
drug that is a testosterone agonist?
a. Effects are increased.
b. Effects are decreased.
c. Effects are eliminated.
d. Effects are unchanged.
ANS: A
An agonist drug has the same effects of the naturally occurring drug. So, taking a testosterone
agonist adds to the effects of the patient’s naturally occurring testosterone.
DIF: Cognitive Level: Understanding REF: pp. 6-7
15. Which feature of a drug agonist increases its potency?
a. It is water soluble.
b. It binds tighter and longer to its receptors than do other drugs.
c. It is excreted through the intestinal tract rather than through the kidneys.
d. It is administered intramuscularly rather than by the intravenous route.
, ANS: B
A drug agonist binds to its receptors to cause a change in the cells and tissues. The longer a
drug remains bound to its receptors and the more tightly it binds increases its duration of
response, making it more potent than a drug that binds with its receptors for a shorter time.
DIF: CognitiveLevel:Understanding REF: p. 6-7
16. Which statement about agonist and antagonist drugs is true?
a. The target tissues for these types of drugs are invading bacteria and viruses.
b. Both agonist and antagonist drugs must interact with receptors to produce their
intended responses.
c. Antagonist drugs produce only intended responses and agonist drugs produce both
intended responses and side effects.
d. These types of drugs are less likely to cause allergic responses than drugs that are
neither agonists nor antagonists.
ANS: B
Agonist drugs excite a receptor to produce their intended responses on a cell or tissue in the
same way that a naturally occurring substance does. Antagonist drugs produce their intended
responses by binding to and blocking receptors.
DIF: Cognitive Level: Understanding REF: pp. 6-7
17. A patient asks why he must take a “loading dose” for the first dose of his prescribed drug and
then take lower doses after that. What is your best response?
a. “The loading dose allows the first dose of this drug to get into your bloodstream
faster and because it stays in the bloodstream a long time, you can take lower
doses after that.”
b. “The first dose of a drug has to be higher to reach the bloodstream because the
liver destroys it before it has a chance to start its action and work for you.”
c. “By taking the highest dose first and just once, you are reducing the likelihood of
having a bad reaction or other side effects to this drug.”
d. “This schedule helps by ensuring that the drug is having an effect even if you
forget to take the rest of the doses.”
ANS: A
A loading dose is most often used with drugs that have a long half-life. Giving a higher dose
for the first dose allows it to reach the bloodstream rapidly and stay there. Smaller doses
follow it to keep the blood drug level at a steady state without increasing the risk for a drug
over dose.
DIF: Cognitive Level: Applying or Higher REF: p. 16
18. Which action could make a drug more potent?
a. Slow drug absorption
b. Slow drug elimination
c. Normal drug elimination
d. Fast drug elimination
ANS: B
Any condition that keeps a drug active inside the body longer can increase its potency. Slow
drug elimination allows a drug to remain longer in the body. Normal or fast elimination does
not. Slow drug absorption does not contribute to potency.
DIF: Cognitive Level: Understanding REF: p. 15
19. When teaching a patient about adverse drug reactions (ADRs), which precaution is most
important to include?
