LEHNE’S PharmacoTherapeutics For Advanced Practice
Nurses And Physician Assistants 2nd Edition Rosenthal
Test Bank Questions And Answers Verified 100% Correct
A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient's adherence to the treatment
regimen?Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour intervals. -
ANSWER ANS: A,B,C,E
Lack of insurance coverage can inhibit the patient from purchasing the medications,
limiting his access to treatment. Having three part-time jobs indicates that the patient
has a busy schedule, which contributes to forgetfulness and poor adherence. The more
complex the medication regimen, the more difficult it is to maintain patient adherence.
Although a patient with an eighth-grade reading comprehension level may have
difficulty understanding professional medical language, medication teaching can be
adjusted to meet the patient's learning needs.
DIF: Cognitive Level:
ComprehensionREF: pp. 13-14TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Reduction of Risk Potential
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is
most important to determine if the therapeutic level is maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects. - ANSWER ANS: C Therapeutic serum levels
are determined through periodic laboratory testing. Preadministration blood work may
be necessary to determine the patient's physical condition but will not determine
therapeutic levels. Scheduling medication administration at regular intervals will help
to ensure medication is absorbed and metabolized predictably, but will not determine
therapeutic blood levels. Assessing the patient for
physical signs of adverse effects does not determine if a therapeutic level has been
obtained.
,DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Evaluation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of
which action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical alterations -
ANSWER ANS: C
Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist
would increase the effects of morphine. Naloxone does not affect serum pH or excretion
of opioids. Naloxone does not alter the sensitivity of opioid receptors.
DIF: Cognitive Level: AnalysisREF: p. 31TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
A patient is taking drug X and receives a new prescription for drug Y, which is listed as
an inducing agent. The nurse caring for this patient understands that this patient may
require __ doses of drug __.
a. lower; X
b. lower; Y
c. higher; X
d. higher; Y - ANSWER ANS: C
An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the
metabolism of other drugs as much as two- to threefold, thereby lowering the level of
those drugs in the body and requiring higher doses to maintain drug effectiveness.
DIF: Cognitive Level: ApplicationREF: p. 36TOP: Nursing Process: Planning MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's
parents ask why the drug cannot be given in an oral liquid form. What is the nurse's
reply?
a. "This drug causes severe gastric upset if given orally."
b. "This drug has a narrow therapeutic range, and the dose must be tightly controlled."
,c. "This drug is absorbed much too quickly in an oral form."
d. "This drug would be inactivated by enzymes in the stomach." - ANSWER
ANS: D
Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given
orally. It does not have a narrow therapeutic range.
DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
Which statement about food and drug interactions is true?
a. Foods alter drug absorption and metabolism but not drug action.
b. Medications are best absorbed on an empty stomach.
c. Patient discomfort is the food and drug interaction of most concern.
d. Some foods can inhibit CYP isoenzymes and alter drug metabolism. - CORRECT
ANSWER ANS: D
Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading
to toxic effects of drugs affected by these isoenzymes. Foods can alter all
pharmacokinetic and pharmacodynamic processes. Not all medications are absorbed
better on an empty stomach; some require certain foods to enhance absorption. Patient
comfort is a concern, but it is not as important as more severe and possibly
lifethreatening food and drug interactions.
DIF: Cognitive Level:
AnalysisREF: p. 39TOP: Nursing Process: Assessment MSC: NCLEX Client Needs
Category: Physiologic Integrity: Reduction of Risk Potential
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will
explain that this drug may cause which effect on other drugs?
a. Decreased absorption in the intestines
b. Decreased elimination through the kidneys
c. Increased brain exposure
d. Increased fetal absorption - ANSWER ANS: B
Drugs that induce PGP can increase drug export from cells of the intestinal epithelium
into the intestinal lumen, thus decreasing absorption of the drug. PGP inducers also
increase drug elimination and decrease brain and fetal drug exposure.
DIF: Cognitive Level: AnalysisREF: p. 36TOP: Nursing Process: Assessment MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
, A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet
of Brand Y of the same drug. Both brands contain the same amount of the active
ingredient. What does the nurse know to be most likely?
a. Advertising by pharmaceutical companies can enhance patient expectations of one
brand over another, leading to a placebo effect.
b. Because the drug preparations are chemically equivalent, the effects of the two
brands must be identical.
c. Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug's effects in the body.
d. The bioavailability of a drug is determined by the amount of the drug in each dose. -
ANSWER ANS: C
Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts
of the same chemical compound), they can have different effects in the body if they
differ in bioavailability. Tablets made by different manufacturers contain different
binders and fillers, which disintegrate and dissolve at different rates and affect the
bioavailability of the drug. Two brands may be chemically equivalent and still differ in
bioavailability, which is not determined by the amount of drug in the dose.
DIF: Cognitive Level: ApplicationREF: p. 19TOP: Nursing Process: Diagnosis MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
Two nurses are discussing theories of drug-receptor interaction. Which statements are
true regarding the affinity of a drug and its receptor?Select all that apply.
a. Affinity and intrinsic activity are dependent properties.
b. Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
d. Drugs with low affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency. - CORRECT
ANSWER ANS: B,C,E
Affinity refers to the strength of the attraction between a drug and its receptor. Drugs
with high affinity are strongly attracted to their receptors, and the affinity of a drug and
its receptors is reflected in its potency. Affinity and intrinsic activity are independent
properties. Drugs with low affinity are weakly attracted to their receptors.
DIF: Cognitive Level: ComprehensionREF: pp. 30- 31TOP: Nursing Process: Diagnosis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
A patient receives a drug that has a narrow therapeutic range. The nurse administering
this medication will expect to do what?
Nurses And Physician Assistants 2nd Edition Rosenthal
Test Bank Questions And Answers Verified 100% Correct
A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient's adherence to the treatment
regimen?Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour intervals. -
ANSWER ANS: A,B,C,E
Lack of insurance coverage can inhibit the patient from purchasing the medications,
limiting his access to treatment. Having three part-time jobs indicates that the patient
has a busy schedule, which contributes to forgetfulness and poor adherence. The more
complex the medication regimen, the more difficult it is to maintain patient adherence.
Although a patient with an eighth-grade reading comprehension level may have
difficulty understanding professional medical language, medication teaching can be
adjusted to meet the patient's learning needs.
DIF: Cognitive Level:
ComprehensionREF: pp. 13-14TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Reduction of Risk Potential
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is
most important to determine if the therapeutic level is maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects. - ANSWER ANS: C Therapeutic serum levels
are determined through periodic laboratory testing. Preadministration blood work may
be necessary to determine the patient's physical condition but will not determine
therapeutic levels. Scheduling medication administration at regular intervals will help
to ensure medication is absorbed and metabolized predictably, but will not determine
therapeutic blood levels. Assessing the patient for
physical signs of adverse effects does not determine if a therapeutic level has been
obtained.
,DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Evaluation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of
which action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical alterations -
ANSWER ANS: C
Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist
would increase the effects of morphine. Naloxone does not affect serum pH or excretion
of opioids. Naloxone does not alter the sensitivity of opioid receptors.
DIF: Cognitive Level: AnalysisREF: p. 31TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
A patient is taking drug X and receives a new prescription for drug Y, which is listed as
an inducing agent. The nurse caring for this patient understands that this patient may
require __ doses of drug __.
a. lower; X
b. lower; Y
c. higher; X
d. higher; Y - ANSWER ANS: C
An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the
metabolism of other drugs as much as two- to threefold, thereby lowering the level of
those drugs in the body and requiring higher doses to maintain drug effectiveness.
DIF: Cognitive Level: ApplicationREF: p. 36TOP: Nursing Process: Planning MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's
parents ask why the drug cannot be given in an oral liquid form. What is the nurse's
reply?
a. "This drug causes severe gastric upset if given orally."
b. "This drug has a narrow therapeutic range, and the dose must be tightly controlled."
,c. "This drug is absorbed much too quickly in an oral form."
d. "This drug would be inactivated by enzymes in the stomach." - ANSWER
ANS: D
Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given
orally. It does not have a narrow therapeutic range.
DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
Which statement about food and drug interactions is true?
a. Foods alter drug absorption and metabolism but not drug action.
b. Medications are best absorbed on an empty stomach.
c. Patient discomfort is the food and drug interaction of most concern.
d. Some foods can inhibit CYP isoenzymes and alter drug metabolism. - CORRECT
ANSWER ANS: D
Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading
to toxic effects of drugs affected by these isoenzymes. Foods can alter all
pharmacokinetic and pharmacodynamic processes. Not all medications are absorbed
better on an empty stomach; some require certain foods to enhance absorption. Patient
comfort is a concern, but it is not as important as more severe and possibly
lifethreatening food and drug interactions.
DIF: Cognitive Level:
AnalysisREF: p. 39TOP: Nursing Process: Assessment MSC: NCLEX Client Needs
Category: Physiologic Integrity: Reduction of Risk Potential
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will
explain that this drug may cause which effect on other drugs?
a. Decreased absorption in the intestines
b. Decreased elimination through the kidneys
c. Increased brain exposure
d. Increased fetal absorption - ANSWER ANS: B
Drugs that induce PGP can increase drug export from cells of the intestinal epithelium
into the intestinal lumen, thus decreasing absorption of the drug. PGP inducers also
increase drug elimination and decrease brain and fetal drug exposure.
DIF: Cognitive Level: AnalysisREF: p. 36TOP: Nursing Process: Assessment MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
, A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet
of Brand Y of the same drug. Both brands contain the same amount of the active
ingredient. What does the nurse know to be most likely?
a. Advertising by pharmaceutical companies can enhance patient expectations of one
brand over another, leading to a placebo effect.
b. Because the drug preparations are chemically equivalent, the effects of the two
brands must be identical.
c. Tablets can differ in composition and can have differing rates of disintegration and
dissolution, which can alter the drug's effects in the body.
d. The bioavailability of a drug is determined by the amount of the drug in each dose. -
ANSWER ANS: C
Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts
of the same chemical compound), they can have different effects in the body if they
differ in bioavailability. Tablets made by different manufacturers contain different
binders and fillers, which disintegrate and dissolve at different rates and affect the
bioavailability of the drug. Two brands may be chemically equivalent and still differ in
bioavailability, which is not determined by the amount of drug in the dose.
DIF: Cognitive Level: ApplicationREF: p. 19TOP: Nursing Process: Diagnosis MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
Two nurses are discussing theories of drug-receptor interaction. Which statements are
true regarding the affinity of a drug and its receptor?Select all that apply.
a. Affinity and intrinsic activity are dependent properties.
b. Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
d. Drugs with low affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency. - CORRECT
ANSWER ANS: B,C,E
Affinity refers to the strength of the attraction between a drug and its receptor. Drugs
with high affinity are strongly attracted to their receptors, and the affinity of a drug and
its receptors is reflected in its potency. Affinity and intrinsic activity are independent
properties. Drugs with low affinity are weakly attracted to their receptors.
DIF: Cognitive Level: ComprehensionREF: pp. 30- 31TOP: Nursing Process: Diagnosis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
A patient receives a drug that has a narrow therapeutic range. The nurse administering
this medication will expect to do what?
