TEST BANK For Pharmacology A Patient-Centered Nursing Process Approach,
11th Edition by Linda E. McCuistion | Verified Chapter's 1 - 58 | Complete
Chapter : Pharmacokinetics and Pharmacodynamics
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11thEdition
MULTIPLE CHOICE
• Which drug will go through a disintegration process after it is administered?
a. Intramuscular (IM) cephalosporins
b. Intravenous (IV) vasopressors
c. Oral analgesics
d. Subcutaneous insulin
ANS: C
When drugs are administered parenterally, there is no disintegration process, which occurs
whena drug administered orally is broken down into smaller particles, eventually dissolving
and becoming available for the body to absorb.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer an oral medication and wants to ensure a rapid drug
action.Which form of the medication will the nurse prefer to administer?
a. Capsule
b. Enteric-coated pill
c. Liquid suspension
d. Tablet
ANS: C
Liquid drugs are already in solution, which is the form necessary for absorption in
the gastrointestinal (GI) tract. The other forms must disintegrate into small particles
and thendissolve before being absorbed.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is teaching a patient who will be discharged home with a prescription for an
enteric-coated tablet. Which statement by the patient indicates understanding of the
teaching?
a. “I may crush the tablet and put it in applesauce to improve absorption.”
b. “I should consume acidic foods to enhance absorption of this medication.”
c. “I should expect a delay in onset of the drug’s effects after taking the tablet.”
, d. “I should take this medication with high-fat foods to improve its action.”
ANS: C
Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of
actions after taking these medications. Enteric-coated tablets should not be crushed or
chewed, which would alter the time and location of absorption. Acidic foods will not
enhance the absorption of the medication. The patient should not eat high-fat food before
ingesting an enteric-coated tabletbecause high-fat foods decrease the absorption rate.
DIF: Cognitive Level: Applying
(Application)TOP: Nursing Process:
Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be
givenby subcutaneous injection instead of by mouth. The nurse will explain that this is
because
a. absorption is diminished by the first-pass effects in the liver.
b. absorption is faster when insulin is given subcutaneously.
c. digestive enzymes in the GI tract break down the drug and prevent absorption.
d. the oral form is less predictable with more adverse effects.
ANS: C
Insulin, growth hormones, and other protein-based drugs are destroyed in the GI tract by
digestive enzymes and must be given parenterally. Because insulin is destroyed bydigestive
enzymes, it must be given parenterally and would not make it to the liver for metabolism
with afirst-pass effect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer an oral medication that is water soluble.
The nurseunderstands that this drug
a. must be taken on an empty stomach.
b. requires active transport for absorption.
c. should be taken with fatty foods.
d. will readily diffuse into the GI tract.
ANS: B
Water-soluble drugs require a carrier enzyme or protein to pass through the GI
membrane forabsorption.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing an injectable drug and wants to administer it via the route that will
allowfor the most rapid absorption possible. How will the nurse give this medication (if
possible)?
,a. IM into the deltoid muscle
, b. IM into the gluteal muscle
c. SQ into abdominal tissue
d. SQ into the upper arm
ANS: A
Drugs given IM are absorbed faster in muscles that have the highest blood flow, suchas the
deltoid, rather than those with fewer blood vessels, such as the gluteals.
Subcutaneous absorptionis slower when compared to IM drug administration.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
PlanningMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is reviewing medication information with a nursing student prior to
administering an oral drug and notes that the drug has extensive first-pass effects.
Which statement by the studentindicates an understanding of the first-pass effect?
a. “The first-pass effect means the drug has 100% bioavailability.”
b. “The first-pass effect means the drug is absorbed from the GI tract intothe
portalvein where it is transported to the liver and metabolized.”
c. “The first-pass effect means the drug was given by injection and
immediatelymetabolized.”
d. “The first-pass effect means the drug may be unchanged as it passes
through theliver.”
ANS: B
Drugs that undergo first-pass metabolism are absorbed into the portal vein from the
intestinal lumen and go through the liver, where they are metabolized to an inactive or a
more active form.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer a drug that is eliminated through the kidneys. The
nurse reviews the patient’s chart and notes that the patient has increased serum
creatinine and bloodurea nitrogen (BUN) and a low estimated glomerular filtration rate
(eGFR). The nurse will perform which action?
a. Administer the drug as ordered.
b. Anticipate a shorter than usual half-life of the drug.
c. Expect decreased drug effects when the drug is given.
d. Verify that the dose ordered is appropriate based on the patient’s kidney function.
ANS: D
Increased creatinine and BUN and a low eGFR indicate impaired kidney function, so adrug
thatis eliminated through the kidneys can accumulate leading to toxicity. The nurse should
verify that the ordered dose is appropriate based on the patient’s kidney function, and if
not, discuss a lower dose or alternative medication with the provider.
The drug will have a longer half-life andwill exhibit increased effects with decreased
kidney function.
DIF: Cognitive Level: Applying
(Application)TOP: Nursing Process:
11th Edition by Linda E. McCuistion | Verified Chapter's 1 - 58 | Complete
Chapter : Pharmacokinetics and Pharmacodynamics
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11thEdition
MULTIPLE CHOICE
• Which drug will go through a disintegration process after it is administered?
a. Intramuscular (IM) cephalosporins
b. Intravenous (IV) vasopressors
c. Oral analgesics
d. Subcutaneous insulin
ANS: C
When drugs are administered parenterally, there is no disintegration process, which occurs
whena drug administered orally is broken down into smaller particles, eventually dissolving
and becoming available for the body to absorb.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer an oral medication and wants to ensure a rapid drug
action.Which form of the medication will the nurse prefer to administer?
a. Capsule
b. Enteric-coated pill
c. Liquid suspension
d. Tablet
ANS: C
Liquid drugs are already in solution, which is the form necessary for absorption in
the gastrointestinal (GI) tract. The other forms must disintegrate into small particles
and thendissolve before being absorbed.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is teaching a patient who will be discharged home with a prescription for an
enteric-coated tablet. Which statement by the patient indicates understanding of the
teaching?
a. “I may crush the tablet and put it in applesauce to improve absorption.”
b. “I should consume acidic foods to enhance absorption of this medication.”
c. “I should expect a delay in onset of the drug’s effects after taking the tablet.”
, d. “I should take this medication with high-fat foods to improve its action.”
ANS: C
Enteric-coated tablets resist disintegration in the acidic environment of the stomach and
disintegrate when they reach the small intestine. There is usually some delay in onset of
actions after taking these medications. Enteric-coated tablets should not be crushed or
chewed, which would alter the time and location of absorption. Acidic foods will not
enhance the absorption of the medication. The patient should not eat high-fat food before
ingesting an enteric-coated tabletbecause high-fat foods decrease the absorption rate.
DIF: Cognitive Level: Applying
(Application)TOP: Nursing Process:
Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be
givenby subcutaneous injection instead of by mouth. The nurse will explain that this is
because
a. absorption is diminished by the first-pass effects in the liver.
b. absorption is faster when insulin is given subcutaneously.
c. digestive enzymes in the GI tract break down the drug and prevent absorption.
d. the oral form is less predictable with more adverse effects.
ANS: C
Insulin, growth hormones, and other protein-based drugs are destroyed in the GI tract by
digestive enzymes and must be given parenterally. Because insulin is destroyed bydigestive
enzymes, it must be given parenterally and would not make it to the liver for metabolism
with afirst-pass effect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer an oral medication that is water soluble.
The nurseunderstands that this drug
a. must be taken on an empty stomach.
b. requires active transport for absorption.
c. should be taken with fatty foods.
d. will readily diffuse into the GI tract.
ANS: B
Water-soluble drugs require a carrier enzyme or protein to pass through the GI
membrane forabsorption.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing an injectable drug and wants to administer it via the route that will
allowfor the most rapid absorption possible. How will the nurse give this medication (if
possible)?
,a. IM into the deltoid muscle
, b. IM into the gluteal muscle
c. SQ into abdominal tissue
d. SQ into the upper arm
ANS: A
Drugs given IM are absorbed faster in muscles that have the highest blood flow, suchas the
deltoid, rather than those with fewer blood vessels, such as the gluteals.
Subcutaneous absorptionis slower when compared to IM drug administration.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
PlanningMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is reviewing medication information with a nursing student prior to
administering an oral drug and notes that the drug has extensive first-pass effects.
Which statement by the studentindicates an understanding of the first-pass effect?
a. “The first-pass effect means the drug has 100% bioavailability.”
b. “The first-pass effect means the drug is absorbed from the GI tract intothe
portalvein where it is transported to the liver and metabolized.”
c. “The first-pass effect means the drug was given by injection and
immediatelymetabolized.”
d. “The first-pass effect means the drug may be unchanged as it passes
through theliver.”
ANS: B
Drugs that undergo first-pass metabolism are absorbed into the portal vein from the
intestinal lumen and go through the liver, where they are metabolized to an inactive or a
more active form.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
• The nurse is preparing to administer a drug that is eliminated through the kidneys. The
nurse reviews the patient’s chart and notes that the patient has increased serum
creatinine and bloodurea nitrogen (BUN) and a low estimated glomerular filtration rate
(eGFR). The nurse will perform which action?
a. Administer the drug as ordered.
b. Anticipate a shorter than usual half-life of the drug.
c. Expect decreased drug effects when the drug is given.
d. Verify that the dose ordered is appropriate based on the patient’s kidney function.
ANS: D
Increased creatinine and BUN and a low eGFR indicate impaired kidney function, so adrug
thatis eliminated through the kidneys can accumulate leading to toxicity. The nurse should
verify that the ordered dose is appropriate based on the patient’s kidney function, and if
not, discuss a lower dose or alternative medication with the provider.
The drug will have a longer half-life andwill exhibit increased effects with decreased
kidney function.
DIF: Cognitive Level: Applying
(Application)TOP: Nursing Process:
