ECPI NUR 138 Pharmacology Exam 1
A patient arrives at the urgent care center complaining of leg pain after a fall when rock
climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The
patient says he drives a truck and does not want to take anything strong because he
needs to stay awake. Which statement by the nurse is most appropriate?
A. "It would be best for you not to take anything if you are planning to drive your truck."
B. "You can take acetaminophen, also known as Tylenol, for pain, but no more than
3000 mg per day."
C. "You can take acetaminophen, also known as Tylenol, for pain, but no more than
1000 mg per day."
D. "We will discuss with your doctor about taking an opioid because that would work
best for your pain." - CORRECT ANSWER-B. "You can take acetaminophen, also
known as Tylenol, for pain, but no more than 3000 mg per day."
Rationale: Acetaminophen is indicated for mild-to-moderate pain and does not cause
drowsiness, as an opioid would. Currently, the maximum daily amount of
acetaminophen is 3000 mg/day. The 1000-mg amount per day is too low. Telling the
patient not to take any pain medications is incorrect.
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's
medication administration record and recognizes that which adjuvant medication is most
appropriate for this type of pain?
A. Corticosteroid
B. Local anesthesia
C. Anticonvulsant
D. Antidepressant - CORRECT ANSWER-A. Corticosteroid
Rationale: Corticosteroids have an anti-inflammatory effect, which may help to reduce
pain. The other medications do not have anti-inflammatory properties.
The nurse is administering medications to the patient who is in renal failure resulting
from end-stage renal disease. The nurse is aware that patients with kidney failure would
most likely have problems with which pharmacokinetic phase?
A. Excretion
B. Absorption
C. Metabolism
,D. Distribution - CORRECT ANSWER-A. Excretion
Rationale: The kidneys are the organs that are most responsible for drug excretion.
Renal function does not affect the absorption and distribution of a drug. Renal function
may affect metabolism of drugs to a small extent.
The patient is complaining of a headache and asks the nurse which over-the-counter
medication form would work the fastest to help reduce the pain. Which medication form
will the nurse suggest?
A. A tablet
B. A capsule
C. A powder
D. An enteric-coated tablet - CORRECT ANSWER-C. A powder
Rationale: Of the types of oral medications listed, the powder form would be absorbed
the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-
coated tablet would be absorbed next, in that order.
Which drugs would be affected by the first-pass effect? (Select all that apply.)
A. Sublingual nitroglycerin tablets
B. Levothyroxine (Synthroid) tablets
C. Diphenhydramine (Benadryl) elixir
D. Penicillin given by IV piggyback infusion
E. Morphine given by IV push injection
F. Esomeprazole (Nexium) capsules
G. Transdermal nicotine patches - CORRECT ANSWER-B. Levothyroxine (Synthroid)
tablets
C. Diphenhydramine (Benadryl) elixir
F. Esomeprazole (Nexium) capsules
For accurate medication administration to pediatric patients, the nurse must take into
account which criteria?
A. Renal output
B. Height
C. Body temperature
D. Organ maturity - CORRECT ANSWER-D. Organ maturity
Rationale: To administer medications to pediatric patients accurately, one must take into
account organ maturity, body surface area, age, and weight. The other options are
incorrect: renal output and body temperature are not considerations, and height alone is
not sufficient.
, The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was
busy and gave the medication 2 hours after the scheduled dose was due. What type of
problem does this represent?
A. "Right route"
B. "Right medication"
C. "Right dose"
D. "Right time" - CORRECT ANSWER-D. "Right time"
Rationale: "Right time" is correct because the medication was given more than 30
minutes after the scheduled dose was due. "Dose" is incorrect because the dose is not
related to the time the medication administration is scheduled. "Route" is incorrect
because the route is not affected. "Medication" is incorrect because the medication
ordered will not change.
The nurse is administering parenteral drugs. Which statement is true regarding
parenteral drugs?
A. Parenteral drugs bypass the first-pass effect.
B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
C. Absorption of parenteral drugs is faster when the stomach is empty.
D. Parenteral drugs exert their effects while circulating in the bloodstream. - CORRECT
ANSWER-A. Parenteral drugs bypass the first-pass effect.
Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced
blood flow to the stomach and the presence of food in the stomach apply to enteral
drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into
cells and tissues from the circulation before they can exert their effects: they do not
exert their effects while circulating in the bloodstream.
During discharge patient teaching, the nurse reviews prescriptions with a patient. Which
statement is correct about refills for an analgesic that is classified as Schedule C-III?
A. The patient may have no more than five refills in a 6-month period.
B. Refills are allowed only by written prescription.
C. Written prescriptions expire in 12 months.
D. No prescription refills are permitted. - CORRECT ANSWER-A. The patient may have
no more than five refills in a 6-month period.
Rationale: Schedule C-III medications may be refilled no more than five times in a 6-
month period. The patient should be informed of this regulation. No prescription refills
are permitted for Schedule C-II drugs. Requiring refills by written prescription only
applies to Schedule C-II drugs. Schedule C-III prescriptions (written or oral) expire in 6
months.
A patient arrives at the urgent care center complaining of leg pain after a fall when rock
climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The
patient says he drives a truck and does not want to take anything strong because he
needs to stay awake. Which statement by the nurse is most appropriate?
A. "It would be best for you not to take anything if you are planning to drive your truck."
B. "You can take acetaminophen, also known as Tylenol, for pain, but no more than
3000 mg per day."
C. "You can take acetaminophen, also known as Tylenol, for pain, but no more than
1000 mg per day."
D. "We will discuss with your doctor about taking an opioid because that would work
best for your pain." - CORRECT ANSWER-B. "You can take acetaminophen, also
known as Tylenol, for pain, but no more than 3000 mg per day."
Rationale: Acetaminophen is indicated for mild-to-moderate pain and does not cause
drowsiness, as an opioid would. Currently, the maximum daily amount of
acetaminophen is 3000 mg/day. The 1000-mg amount per day is too low. Telling the
patient not to take any pain medications is incorrect.
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's
medication administration record and recognizes that which adjuvant medication is most
appropriate for this type of pain?
A. Corticosteroid
B. Local anesthesia
C. Anticonvulsant
D. Antidepressant - CORRECT ANSWER-A. Corticosteroid
Rationale: Corticosteroids have an anti-inflammatory effect, which may help to reduce
pain. The other medications do not have anti-inflammatory properties.
The nurse is administering medications to the patient who is in renal failure resulting
from end-stage renal disease. The nurse is aware that patients with kidney failure would
most likely have problems with which pharmacokinetic phase?
A. Excretion
B. Absorption
C. Metabolism
,D. Distribution - CORRECT ANSWER-A. Excretion
Rationale: The kidneys are the organs that are most responsible for drug excretion.
Renal function does not affect the absorption and distribution of a drug. Renal function
may affect metabolism of drugs to a small extent.
The patient is complaining of a headache and asks the nurse which over-the-counter
medication form would work the fastest to help reduce the pain. Which medication form
will the nurse suggest?
A. A tablet
B. A capsule
C. A powder
D. An enteric-coated tablet - CORRECT ANSWER-C. A powder
Rationale: Of the types of oral medications listed, the powder form would be absorbed
the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-
coated tablet would be absorbed next, in that order.
Which drugs would be affected by the first-pass effect? (Select all that apply.)
A. Sublingual nitroglycerin tablets
B. Levothyroxine (Synthroid) tablets
C. Diphenhydramine (Benadryl) elixir
D. Penicillin given by IV piggyback infusion
E. Morphine given by IV push injection
F. Esomeprazole (Nexium) capsules
G. Transdermal nicotine patches - CORRECT ANSWER-B. Levothyroxine (Synthroid)
tablets
C. Diphenhydramine (Benadryl) elixir
F. Esomeprazole (Nexium) capsules
For accurate medication administration to pediatric patients, the nurse must take into
account which criteria?
A. Renal output
B. Height
C. Body temperature
D. Organ maturity - CORRECT ANSWER-D. Organ maturity
Rationale: To administer medications to pediatric patients accurately, one must take into
account organ maturity, body surface area, age, and weight. The other options are
incorrect: renal output and body temperature are not considerations, and height alone is
not sufficient.
, The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was
busy and gave the medication 2 hours after the scheduled dose was due. What type of
problem does this represent?
A. "Right route"
B. "Right medication"
C. "Right dose"
D. "Right time" - CORRECT ANSWER-D. "Right time"
Rationale: "Right time" is correct because the medication was given more than 30
minutes after the scheduled dose was due. "Dose" is incorrect because the dose is not
related to the time the medication administration is scheduled. "Route" is incorrect
because the route is not affected. "Medication" is incorrect because the medication
ordered will not change.
The nurse is administering parenteral drugs. Which statement is true regarding
parenteral drugs?
A. Parenteral drugs bypass the first-pass effect.
B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
C. Absorption of parenteral drugs is faster when the stomach is empty.
D. Parenteral drugs exert their effects while circulating in the bloodstream. - CORRECT
ANSWER-A. Parenteral drugs bypass the first-pass effect.
Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced
blood flow to the stomach and the presence of food in the stomach apply to enteral
drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into
cells and tissues from the circulation before they can exert their effects: they do not
exert their effects while circulating in the bloodstream.
During discharge patient teaching, the nurse reviews prescriptions with a patient. Which
statement is correct about refills for an analgesic that is classified as Schedule C-III?
A. The patient may have no more than five refills in a 6-month period.
B. Refills are allowed only by written prescription.
C. Written prescriptions expire in 12 months.
D. No prescription refills are permitted. - CORRECT ANSWER-A. The patient may have
no more than five refills in a 6-month period.
Rationale: Schedule C-III medications may be refilled no more than five times in a 6-
month period. The patient should be informed of this regulation. No prescription refills
are permitted for Schedule C-II drugs. Requiring refills by written prescription only
applies to Schedule C-II drugs. Schedule C-III prescriptions (written or oral) expire in 6
months.
