@LECTSOLUTIONSSTUVIA
STUDY GUIDE
,Student Name Chapter 1 Date
Drug Definitions, Standards, and Information Sources 1
chapter
1
Define pharmacology. Differentiate among the chemical, generic, and
brand names of drugs.
1. A classmate of a nursing student asked why she
had to take a pharmacology course. The nursing 4. The chemical names of drugs are used to: (1)
student replied: (1) 1. describe the exact chemical makeup of the
1. “Pharmacology is the study of how medi- drug.
cations are administered.” 2. provide a simpler way to identify the drug
2. “Pharmacology is the study of medicines and being manufactured.
how they work.” 3. market the drug to the public.
3. “Pharmacology is the study of diseases that 4. identify illegal drugs.
cause illnesses.”
4. “Pharmacology is the study of how to spell,
pronounce, and remember drugs.” 5. The generic names of drugs are used to: (1)
1. describe the exact chemical makeup of the
2. Pharmacology attempts to clarify: (1) drug.
2. provide a simpler way to identify the drug
1. components of what make up drugs. being manufactured.
2. how to tell what the drug is by identifying the 3. market the drug to the public.
pill form.
3. the use of drugs for certain physiological 4. identify illegal drugs.
conditions.
4. the various therapeutic methods used to treat 6. The brand names of drugs are used to: (1)
diseases. 1. describe the exact chemical makeup of the
drug.
3. The need to study drugs and their effects on 2. provide a simpler way to identify the drug
physiologic conditions and diseases is impor- tant being manufactured.
because nurses need to: (Select all that apply.) (2) 3. market the drug to the public.
1. be aware of how to monitor the clinical ef- 4. identify illegal drugs.
fects of drugs.
2. understand the drugs that can be used to treat
different conditions. List official sources of American drug standards.
3. educate their patients about the drugs they take
and how they work. 7. Which resources are the most user-friendly for
4. memorize the chemical makeup of every nurses seeking information about prescription
drug administered. medications? (Select all that apply.) (3)
5. know the official name of each drug manu- 1. Natural Medicines Comprehensive Data- base
factured. 2. Physician’s Drug Reference
3. American Hospital Formulary Service,
Drug Information
4. Drug Interaction Facts
, @LECTSOLUTIONSSTUVIA
2 Chapter 1 Drug Definitions, Standards, and Information Sources
8. When educating the patient regarding new 12. Which one of the following would be con- sidered
medications that have been prescribed, the a quick and reliable source for drug information
nurse refers the patient to which source of for a nurse to consult with a drug question? (3)
information designed for patient use? (4) 1. Handbook of Nonprescription Drugs: An Inter-
1. Package inserts active Approach to Self-Care
2. Electronic databases such as MEDLINE 2. United States Pharmacopeia (USP)/National
3. American Drug Index Formulary (NF)
4. Pharmacology textbooks 3. Nursing journals such as AJN
4. Electronic databases such as CINAHL
9. A patient asked the nurse where to find infor- 5. Physician’s Drug Reference
mation about the drug she was prescribed. The best
response would be: (4)
1. “Ask your health care provider to discuss your Cite sources of credible drug information on the
case in detail. The Internet can be Internet.
misleading.”
2. “The best source for drug information is to just 13. A nurse is preparing a scholarly publication on the
Google it.” responses to and adverse effects of heparin. The
3. “We will give you all of the information you most efficient and effective means of con- ducting
will need about your medications; you do not an Internet search to gather informa- tion for this
have to look any further.” publication is to use: (4)
4. “A variety of sources are available to you. 1. a search engine such as Google or Yahoo.
We will provide information, you can ask 2. a consumer health website.
your physician, and you can research
information online. Just remember, not all 3. Wikipedia.
websites are accurate.” 4. MEDLINE database.
14. Credible sources of drug information on the
List literature resources for researching Internet include: (Select all that apply.) (4)
prescription and nonprescription drugs. 1. Krames Online.
2. Health on the Net Foundation.
10. While studying the difference between pre- 3. Micromedex.
scription and nonprescription drugs, the nurs- ing 4. Wikipedia.
student needs to remember that prescrip- tion 5. DailyMed.
drugs: (4)
1. are generally cheaper than nonprescription 15. As a health care professional, it is important that
drugs. the nurse determine the most accurate and up-to-
2. need to be obtained through a licensed date Internet information available for drugs, such
health care provider. as: (Select all that apply.) (4)
3. are identified using the brand name and 1. ePocrates.
nonprescription drugs use the generic name. 2. DailyMed.
4. do not have any serious side effects. 3. Yahoo.
4. Lexi-Comp.
11. A patient has been experiencing adverse ef- fects
from a hypertensive medication that was started. 5. Krames Online.
The nurse realizes that a reliable source to review
prescription drugs and their effects is: (3)
1. the American Drug Index.
2. the United States Pharmacopeia/National
Formulary.
3. pharmacology textbooks.
4. the Physician’s Drug Reference.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Chapter 1 Drug Definitions, Standards, and Information Sources 3
20. The drug morphine is listed under which
List legislative acts that control drug use and abuse. Schedule? (5)
1. I
16. The Controlled Substance Act came about 2. II
because of: (4)
3. III
1. the thalidomide tragedy.
2. certain labeling specifications and stan- 4. IV
dards.
3. abuse of certain drugs that are addictive. 21. A nurse is taking a drug out of the Pyxis ma- chine
and has prompted a count of the medica- tion. The
4. unfounded claims by drug manufacturers. nurse is puzzled about the need to count the number
of Fioricet (a compound of butalbital,
17. The effectiveness of drug legislation depends on acetaminophen, and caffeine). The drug is
the: (Select all that apply.) (4) considered to be under which Sched- ule? (5)
1. type of controlled drugs. 1. I
2. interest and cooperation of professional 2. II
people. 3. III
3. education of the public concerning the 4. IV
dangers of improper use of drugs.
4. developing and marketing new medica-
tions.
Describe the process involved in developing and
5. interest and cooperation of the public.
marketing new medications.
18. Failure to comply with the Controlled Sub-
stances Act is punishable by: (Select all that 22. Those patients who participate in “testing in
apply.) (5) humans” are part of which phase of new drug
1. loss of one’s professional license. development? (7)
2. suspension from work without pay for two 1. Preclinical research and development stage
months. 2. Clinical research and development stage
3. a fine payable to the courts. 3. New drug application review
4. a severe reprimand by one’s boss. 4. Postmarketing surveillance
5. imprisonment.
23. The phase of drug development dealing with the
therapeutic value and whether the drug appears to
Differentiate among Schedule I, II, III, be safe in animals is known as: (6)
IV, and V medications, and describe the nursing 1. preclinical research and development
stage.
responsibilities associated with the administration of
2. clinical research and development stage.
each type.
3. new drug application review.
4. postmarketing surveillance.
19. According to the Controlled Substances Act,
drugs with a high potential for abuse that have no
currently accepted medical use in the United 24. The Black Box warning indicates that a drug
States and that have a lack of accepted safety for which has already met FDA approval may have
use under medical supervision are classified under a(n): (7)
which schedule? (4) 1. associated risk of causing serious or life-
1. Schedule I threatening adverse effects.
2. Schedule II 2. extremely high cost associated with it.
3. Schedule III 3. effect that may cause nausea and vomiting.
4. Schedule IV 4. equally effective alternative drug.
, @LECTSOLUTIONSSTUVIA
4 Chapter 1 Drug Definitions, Standards, and Information Sources
Differentiate between the Canadian chemical drug 29. The reference book Patient Self-Care: Helping
and the proper name of a medicine. Patients Make Therapeutic Choices is: (Select all
that apply.) (3)
25. The nurse is discussing the names of drugs with 1. published annually by the Canadian Phar-
a patient in Canada, explaining that the macists Association.
difference between the chemical drug name and 2. a source for comprehensive information about
the proper name is the: (8) nonprescription drug products avail- able in
1. chemical name identifies the manufacturer. Canada.
2. proper name of the drug is also the generic 3. intended for health care professionals and
name of the drug. consumers alike.
3. proper name is most meaningful to the 4. published approximately every 4 years by the
patient. Canadian Pharmacists Association.
4. chemical name identifies the drug as a 5. recognized by the Canadian Food and
Drugs Act as an authoritative source of
recreational drug. drug standards.
26. The proper name of a Canadian drug refers to 30. The three categories of nonprescription drugs sold
the: (8) in the provinces of Canada are: (9)
1. generic name of the drug. 1. Schedule II, Schedule III, and unscheduled.
2. manufacturer. 2. Schedule I, Schedule II, and Schedule III.
3. classification of the drug. 3. Schedule II, Schedule III, and Schedule IV.
4. chemical property of the drug. 4. Schedule I, Schedule V, and unscheduled.
27. A nurse was explaining to a patient that the
difference between the generic name of the List Canadian legislative acts that control drug use
drug and the proper name is that: (8) and abuse.
1. the official name will be difficult to pro-
nounce.
2. generally there is no difference between the 31. Which of these Canadian legislative acts de-
two names. termines whether the drug will be considered
prescription or nonprescription? (9)
3. the proper name is easy to remember.
1. Therapeutic Products Directorate
4. the proper name is generally the generic
name of the drug. 2. Food and Drug Regulations Act
3. Food and Drugs Act
4. Food and Drugs Act and the Food and
List official sources of Canadian drug information. Drug Regulations Act
28. As a health care professional, it is important that 32. Under the Food and Drugs Act, insulin is con-
the nurse determine the most accurate and up-to- sidered as a drug included in: (9)
date information available for drugs, such as: 1. Schedule III.
(Select all that apply.) (3) 2. Schedule II.
1. British Pharmacopoeia. 3. unscheduled.
2. Spanish Pharmacopoeia. 4. Schedule I.
3. National Pharmacopoeia.
4. Pharmacopoeia Internationalis. 33. Which of the following drugs are part of Schedule
5. European Pharmacopoeia. F and are available by prescription only?
(Antibiotics, antineoplastics, corticoste- roids,
cardiovascular drugs, and antipsychotics are
Schedule F drugs.) (9)
1. aspirin, Lopressor, heparin
2. estrogens, ketorolac, nortriptylline
3. cefuroxime, prednisone, Tamoxifen
4. probenecid, Allegra, acyclovir
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
,Student Name Chapter 2 Dateand Drug Interactions
Basic Principles of Drug Action 5
chapter
2
Identify common drug administration routes. 5. When drugs are administered via the percuta-
neous route, their absorption is dependent on the:
1. The nurse knows that drugs are administered by (13)
which three most common routes? (Select all that 1. temperature at the site of delivery.
apply.) (12) 2. amount of oxygen present at the site.
1. enteral 3. thickness of the skin.
2. distribution 4. angle of the injection used.
3. percutaneous
4. parenteral 6. The nurse knows that drug absorption is best
5. liberation through which route? (13)
1. oral
2. The enteral route includes medications admin- 2. intravenous
istered: (12) 3. intramuscular
1. subcutaneously. 4. subcutaneous
2. orally.
3. transdermally.
4. intravenously. Describe nursing interventions that can enhance
drug absorption.
3. The nurse is explaining to the patient that the drug
insulin must be given as a subcutaneous injection 7. When administering drugs, the nurse needs to
because: (13) provide which of the following to enhance drug
1. excretion is best by this route. absorption? (Select all that apply.) (13)
2. taken orally, the drug will be deactivated by 1. An adequate amount of fluid with oral
stomach acids. drugs.
3. intramuscular administration would be too 2. Reconstitute and dilute drugs according to
painful. manufacturer’s instructions.
4. manufacturers get more money if they 3. Administer an enema prior to rectal medi-
make the drug in this form. cations.
4. Cool the site after administration of an
intramuscular injection.
Explain the potential problems associated with drug 5. Determine adequate blood flow when
absorption. administering drugs parenterally.
4. Drug absorption deals with how the drug is:
(13)
1. eliminated from the body.
2. transported by the plasma proteins.
3. deactivated by the body systems.
4. transferred from the site of entry into the
circulation.
, @LECTSOLUTIONSSTUVIA
6 Chapter 2 Basic Principles of Drug Action and Drug Interactions
8. The nurse can ensure adequate absorption of 12. Drugs that have been liberated into the circula- tory
medications via the parenteral route by: (13) system: (Select all that apply.) (13)
1. watching to make sure the patient has 1. may become bound to tissues other than
swallowed all the medications. those with active receptor sites.
2. pinching the skin after a subcutaneous 2. have a high affinity for adipose tissue if
injection for 30 seconds. they are lipid-soluble drugs.
3. timing each medication to be given exactly 10 3. are released from the lipid tissue when the
minutes apart. drug blood level drops.
4. determining blood flow prior to adminis- 4. are then selectively distributed through
tration of any injection. osmosis.
5. have to be bound to protein to be active.
9. Drug absorption for inhaled medications can be
enhanced when the nurse: (13)
1. asks the patient to lie on the left side when Describe how the body inactivates drugs.
administering inhalers.
2. determines the surface area of the lungs
prior to administration. 13. After a drug is absorbed, the body will deacti- vate
it in which way? (14)
3. encourages the patient to hold his breath after
administration. 1. through the GI tract to the feces
4. encourages short, shallow breaths after 2. through the enzyme systems of the liver
each inhaled dose. 3. through the renal tubules into the urine
4. through exhalation from the lungs
Describe the mechanisms of drug distribution. 14. The kidneys are a major organ of drug: (14)
1. metabolism.
10. Which explanation by the nurse to a patient 2. distribution.
regarding drug distribution is accurate? (13) 3. excretion.
1. “The stomach needs to first break down the 4. liberation.
drugs and they get absorbed into the
bloodstream from there.”
15. The nurse is reviewing the patient’s chart for the
2. “The medications that are swallowed are results of the most recent urinalysis and re- nal
absorbed into the bloodstream and are
function tests, because a patient with renal failure
circulated around until deactivated by the
will have difficulty with drug: (14)
spleen.”
3. “When the drug blood level drops, the blood 1. distribution.
will pick up more medication; other- wise it 2. metabolism.
gets stored in the liver.” 3. excretion.
4. “Drugs are circulated by the blood to vari- ous 4. deactivation.
organs that have receptors or sites of action
for the drugs.”
Identify the meaning and significance of the term
11. The distribution process is important because the: half-life when it is used in relation to drug therapy.
(14)
1. amount of drug that actually gets to the 16. A measure of the time required for elimination of a
receptor sites determines the response. drug from the body is the: (15)
2. smallest amount of drug is needed to acti- vate 1. expiration time.
receptors.
2. half-life.
3. blood-brain barrier needs the least amount of
drug to be crossed. 3. circulation time.
4. placental barrier keeps drugs from crossing to 4. minimum life.
the fetus.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Chapter 2 Basic Principles of Drug Action and Drug Interactions 7
Identify what drug interactions are, and give an
17. The nurse knows that the drug alprazolam (Xanax)
has a half-life of 12 hours, which means that how example.
much drug will be left circulat- ing in the body after
24 hours? (15) 22. Drug interactions are said to occur when: (Se- lect
1. 50% all that apply.) (17)
2. 25% 1. one drug enhances the pharmacologic ef- fect
3. 30% of another drug.
2. altered absorption takes place in the GI
4. 15% tract.
3. drugs are administered together.
18. The half-life of a drug may become consider- 4. the action of one drug is altered by the ac- tion
ably longer in patients who have: (Select all that of another drug.
apply.) (15)
5. drugs cause living cells to mutate.
1. impaired kidney function.
2. decreased thyroid function.
23. A drug is considered pharmacologically active
3. impaired immune system. when it is: (17)
4. impaired liver function. 1. bound to plasma proteins.
5. decreased amounts of hemoglobin. 2. unbound to plasma proteins.
3. distributed evenly throughout the body.
4. metabolized by the liver.
Compare and contrast the following terms used in
relationship to medications: desired action, side
24. What resources can the nurse use to aid in de-
effects, adverse effects, allergic reactions, and termining when a drug interaction will occur?
idiosyncratic reactions. (Select all that apply.) (17)
1. Consult with the pharmacist.
19. What is a desired drug action? (16) 2. Look up possible reactions in drug refer-
1. the predictable/usual response to the drug ence books.
2. an unusual or idiosyncratic response to a drug 3. Ask the patient when he or she expects the
3. a response capable of inducing cell muta- drugs to interact.
tions 4. Memorize all possible drug interactions.
4. the unpredictable/unusual response to the drug 5. Administer each drug several hours apart to
ensure nothing happens.
20. The nurse notices that the patient now requires a
higher dose of a pain medication to produce the
same effect once provided by a lower dose. This is Differentiate among the following terms used in
called: (16) relationship to drugs: additive effect, synergistic
1. placebo effect. effect, antagonistic effect,
2. tolerance. displacement, interference, and incompatibility.
3. drug dependence.
4. drug accumulation. 25. When a combination of two drugs will provide a
greater effect than the sum of the effect of each
21. Patients who have an anaphylactic reaction from drug if given alone, what is this called? (18)
an administered drug typically experi- ence 1. additive effect
which signs/symptoms? (Select all that apply.) 2. antagonistic effect
(16) 3. synergistic effect
1. severe itching 4. displacement
2. hives
3. diarrhea
4. respiratory distress
5. cardiovascular collapse
, @LECTSOLUTIONSSTUVIA
8 Chapter 2 Basic Principles of Drug Action and Drug Interactions
26. A partial agonist is a drug that does what? (12) Identify one way in which alterations in metabolism
1. Stimulates action at receptor sites within the create drug interactions.
circulating blood.
2. Stimulates one response and inhibits an- 31. The effect of one drug interfering with the ef- fect
other response. of another drug is called: (18)
3. Inhibits response when attached to a recep- tor 1. additive effect.
site. 2. synergistic effect.
4. Stimulates a response at a receptor site. 3. antagonistic effect.
4. displacement.
27. What is another name for an idiosyncratic reac-
tion? (16)
32. Enzyme inducers are drugs that will cause an
1. allergic reaction increase in drug: (18)
2. unexpected reaction 1. interactions.
3. teratogenic reaction 2. incompatibility.
4. drug overresponse 3. displacement.
4. metabolism.
Describe how a bound drug becomes unbound.
33. A common drug interaction that inhibits the
metabolism or excretion of a second drug,
28. Most drugs are bound to this in the blood. (17) thereby causing increased activity of the sec- ond
1. plasma proteins drug, is called: (18)
2. receptor sites 1. antagonistic effect.
3. circulating antibodies 2. incompatibility.
4. adipose tissue 3. interference.
4. additive effect.
29. The process by which a drug that is bound
becomes unbound is called: (15)
1. peak action.
2. replacement.
3. displacement.
4. desired action.
30. As a drug moves from the state of being bound to
being unbound, what will occur? (15)
1. The amount of free circulating drug will
decrease.
2. The amount of free circulating drug will
increase.
3. The drug level will remain unchanged.
4. The drug will be excreted faster from the
body.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Student Name Chapter 3 Date Across the Life Span
Drug Action 9
chapter
3
Explain the impact of the placebo effect and 3. The attitudes and expectations of the patient
nocebo effect. regarding the treatment of his or her condition
plays a major role in a patient’s response to
therapy. The nurse understands this to mean that
1. The nurse is explaining to a patient who is
patients with: (21)
entering into a research study that he may
actually get a placebo. Which statement by the 1. chronic silent conditions such as hyper-
patient indicates an understanding of the placebo tension are more likely to adhere to the
effect? (21) therapy prescribed.
1. “I will get the drug that they are testing for my 2. conditions such as arthritis are least likely to
condition.” adhere to the therapy prescribed.
2. “I could possibly get a pill that will have a 3. conditions that have rapid consequences if
negative effect on my condition.” therapy is not followed are more likely to
adhere to the therapy prescribed.
3. “The placebo is a drug that has no active
ingredients.” 4. previous negative experiences are more likely
to adhere to the therapy prescribed.
4. “The placebo will have the same effect as the
real drug.”
2. The difference between the placebo effect and the Identify the importance of drug dependence and
nocebo effect is the: (Select all that apply.) (21) drug accumulation.
1. nocebo effect has occurred because the pa-
tient had negative expectations about the 4. Drug dependence occurs when the patient is:
therapy. (22)
2. placebo effect has occurred because the 1. unable to ingest drugs.
patient had negative expectations about the 2. indicating adequate pain relief on opioids.
therapy.
3. considered incompetent to make any medi- cal
3. nocebo effect has occurred because the patient decisions.
had positive expectations about the therapy.
4. develops withdrawal symptoms if the drug is
4. placebo effect has occurred because the patient discontinued.
had positive expectations about the therapy.
5. nocebo effect has occurred because the pa-
tient had no particular expectations about the 5. The nurse suspects the patient has become
therapy. dependent on the drug oxycodone because the
patient: (22)
1. asks for pain medicine more frequently
than ordered.
2. is groggy and hard to arouse about an hour after
his dose.
3. indicates adequate pain relief with the
dose.
4. is worried about becoming addicted to
oxycodone and therefore will not take it.
STUDY GUIDE
,Student Name Chapter 1 Date
Drug Definitions, Standards, and Information Sources 1
chapter
1
Define pharmacology. Differentiate among the chemical, generic, and
brand names of drugs.
1. A classmate of a nursing student asked why she
had to take a pharmacology course. The nursing 4. The chemical names of drugs are used to: (1)
student replied: (1) 1. describe the exact chemical makeup of the
1. “Pharmacology is the study of how medi- drug.
cations are administered.” 2. provide a simpler way to identify the drug
2. “Pharmacology is the study of medicines and being manufactured.
how they work.” 3. market the drug to the public.
3. “Pharmacology is the study of diseases that 4. identify illegal drugs.
cause illnesses.”
4. “Pharmacology is the study of how to spell,
pronounce, and remember drugs.” 5. The generic names of drugs are used to: (1)
1. describe the exact chemical makeup of the
2. Pharmacology attempts to clarify: (1) drug.
2. provide a simpler way to identify the drug
1. components of what make up drugs. being manufactured.
2. how to tell what the drug is by identifying the 3. market the drug to the public.
pill form.
3. the use of drugs for certain physiological 4. identify illegal drugs.
conditions.
4. the various therapeutic methods used to treat 6. The brand names of drugs are used to: (1)
diseases. 1. describe the exact chemical makeup of the
drug.
3. The need to study drugs and their effects on 2. provide a simpler way to identify the drug
physiologic conditions and diseases is impor- tant being manufactured.
because nurses need to: (Select all that apply.) (2) 3. market the drug to the public.
1. be aware of how to monitor the clinical ef- 4. identify illegal drugs.
fects of drugs.
2. understand the drugs that can be used to treat
different conditions. List official sources of American drug standards.
3. educate their patients about the drugs they take
and how they work. 7. Which resources are the most user-friendly for
4. memorize the chemical makeup of every nurses seeking information about prescription
drug administered. medications? (Select all that apply.) (3)
5. know the official name of each drug manu- 1. Natural Medicines Comprehensive Data- base
factured. 2. Physician’s Drug Reference
3. American Hospital Formulary Service,
Drug Information
4. Drug Interaction Facts
, @LECTSOLUTIONSSTUVIA
2 Chapter 1 Drug Definitions, Standards, and Information Sources
8. When educating the patient regarding new 12. Which one of the following would be con- sidered
medications that have been prescribed, the a quick and reliable source for drug information
nurse refers the patient to which source of for a nurse to consult with a drug question? (3)
information designed for patient use? (4) 1. Handbook of Nonprescription Drugs: An Inter-
1. Package inserts active Approach to Self-Care
2. Electronic databases such as MEDLINE 2. United States Pharmacopeia (USP)/National
3. American Drug Index Formulary (NF)
4. Pharmacology textbooks 3. Nursing journals such as AJN
4. Electronic databases such as CINAHL
9. A patient asked the nurse where to find infor- 5. Physician’s Drug Reference
mation about the drug she was prescribed. The best
response would be: (4)
1. “Ask your health care provider to discuss your Cite sources of credible drug information on the
case in detail. The Internet can be Internet.
misleading.”
2. “The best source for drug information is to just 13. A nurse is preparing a scholarly publication on the
Google it.” responses to and adverse effects of heparin. The
3. “We will give you all of the information you most efficient and effective means of con- ducting
will need about your medications; you do not an Internet search to gather informa- tion for this
have to look any further.” publication is to use: (4)
4. “A variety of sources are available to you. 1. a search engine such as Google or Yahoo.
We will provide information, you can ask 2. a consumer health website.
your physician, and you can research
information online. Just remember, not all 3. Wikipedia.
websites are accurate.” 4. MEDLINE database.
14. Credible sources of drug information on the
List literature resources for researching Internet include: (Select all that apply.) (4)
prescription and nonprescription drugs. 1. Krames Online.
2. Health on the Net Foundation.
10. While studying the difference between pre- 3. Micromedex.
scription and nonprescription drugs, the nurs- ing 4. Wikipedia.
student needs to remember that prescrip- tion 5. DailyMed.
drugs: (4)
1. are generally cheaper than nonprescription 15. As a health care professional, it is important that
drugs. the nurse determine the most accurate and up-to-
2. need to be obtained through a licensed date Internet information available for drugs, such
health care provider. as: (Select all that apply.) (4)
3. are identified using the brand name and 1. ePocrates.
nonprescription drugs use the generic name. 2. DailyMed.
4. do not have any serious side effects. 3. Yahoo.
4. Lexi-Comp.
11. A patient has been experiencing adverse ef- fects
from a hypertensive medication that was started. 5. Krames Online.
The nurse realizes that a reliable source to review
prescription drugs and their effects is: (3)
1. the American Drug Index.
2. the United States Pharmacopeia/National
Formulary.
3. pharmacology textbooks.
4. the Physician’s Drug Reference.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Chapter 1 Drug Definitions, Standards, and Information Sources 3
20. The drug morphine is listed under which
List legislative acts that control drug use and abuse. Schedule? (5)
1. I
16. The Controlled Substance Act came about 2. II
because of: (4)
3. III
1. the thalidomide tragedy.
2. certain labeling specifications and stan- 4. IV
dards.
3. abuse of certain drugs that are addictive. 21. A nurse is taking a drug out of the Pyxis ma- chine
and has prompted a count of the medica- tion. The
4. unfounded claims by drug manufacturers. nurse is puzzled about the need to count the number
of Fioricet (a compound of butalbital,
17. The effectiveness of drug legislation depends on acetaminophen, and caffeine). The drug is
the: (Select all that apply.) (4) considered to be under which Sched- ule? (5)
1. type of controlled drugs. 1. I
2. interest and cooperation of professional 2. II
people. 3. III
3. education of the public concerning the 4. IV
dangers of improper use of drugs.
4. developing and marketing new medica-
tions.
Describe the process involved in developing and
5. interest and cooperation of the public.
marketing new medications.
18. Failure to comply with the Controlled Sub-
stances Act is punishable by: (Select all that 22. Those patients who participate in “testing in
apply.) (5) humans” are part of which phase of new drug
1. loss of one’s professional license. development? (7)
2. suspension from work without pay for two 1. Preclinical research and development stage
months. 2. Clinical research and development stage
3. a fine payable to the courts. 3. New drug application review
4. a severe reprimand by one’s boss. 4. Postmarketing surveillance
5. imprisonment.
23. The phase of drug development dealing with the
therapeutic value and whether the drug appears to
Differentiate among Schedule I, II, III, be safe in animals is known as: (6)
IV, and V medications, and describe the nursing 1. preclinical research and development
stage.
responsibilities associated with the administration of
2. clinical research and development stage.
each type.
3. new drug application review.
4. postmarketing surveillance.
19. According to the Controlled Substances Act,
drugs with a high potential for abuse that have no
currently accepted medical use in the United 24. The Black Box warning indicates that a drug
States and that have a lack of accepted safety for which has already met FDA approval may have
use under medical supervision are classified under a(n): (7)
which schedule? (4) 1. associated risk of causing serious or life-
1. Schedule I threatening adverse effects.
2. Schedule II 2. extremely high cost associated with it.
3. Schedule III 3. effect that may cause nausea and vomiting.
4. Schedule IV 4. equally effective alternative drug.
, @LECTSOLUTIONSSTUVIA
4 Chapter 1 Drug Definitions, Standards, and Information Sources
Differentiate between the Canadian chemical drug 29. The reference book Patient Self-Care: Helping
and the proper name of a medicine. Patients Make Therapeutic Choices is: (Select all
that apply.) (3)
25. The nurse is discussing the names of drugs with 1. published annually by the Canadian Phar-
a patient in Canada, explaining that the macists Association.
difference between the chemical drug name and 2. a source for comprehensive information about
the proper name is the: (8) nonprescription drug products avail- able in
1. chemical name identifies the manufacturer. Canada.
2. proper name of the drug is also the generic 3. intended for health care professionals and
name of the drug. consumers alike.
3. proper name is most meaningful to the 4. published approximately every 4 years by the
patient. Canadian Pharmacists Association.
4. chemical name identifies the drug as a 5. recognized by the Canadian Food and
Drugs Act as an authoritative source of
recreational drug. drug standards.
26. The proper name of a Canadian drug refers to 30. The three categories of nonprescription drugs sold
the: (8) in the provinces of Canada are: (9)
1. generic name of the drug. 1. Schedule II, Schedule III, and unscheduled.
2. manufacturer. 2. Schedule I, Schedule II, and Schedule III.
3. classification of the drug. 3. Schedule II, Schedule III, and Schedule IV.
4. chemical property of the drug. 4. Schedule I, Schedule V, and unscheduled.
27. A nurse was explaining to a patient that the
difference between the generic name of the List Canadian legislative acts that control drug use
drug and the proper name is that: (8) and abuse.
1. the official name will be difficult to pro-
nounce.
2. generally there is no difference between the 31. Which of these Canadian legislative acts de-
two names. termines whether the drug will be considered
prescription or nonprescription? (9)
3. the proper name is easy to remember.
1. Therapeutic Products Directorate
4. the proper name is generally the generic
name of the drug. 2. Food and Drug Regulations Act
3. Food and Drugs Act
4. Food and Drugs Act and the Food and
List official sources of Canadian drug information. Drug Regulations Act
28. As a health care professional, it is important that 32. Under the Food and Drugs Act, insulin is con-
the nurse determine the most accurate and up-to- sidered as a drug included in: (9)
date information available for drugs, such as: 1. Schedule III.
(Select all that apply.) (3) 2. Schedule II.
1. British Pharmacopoeia. 3. unscheduled.
2. Spanish Pharmacopoeia. 4. Schedule I.
3. National Pharmacopoeia.
4. Pharmacopoeia Internationalis. 33. Which of the following drugs are part of Schedule
5. European Pharmacopoeia. F and are available by prescription only?
(Antibiotics, antineoplastics, corticoste- roids,
cardiovascular drugs, and antipsychotics are
Schedule F drugs.) (9)
1. aspirin, Lopressor, heparin
2. estrogens, ketorolac, nortriptylline
3. cefuroxime, prednisone, Tamoxifen
4. probenecid, Allegra, acyclovir
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
,Student Name Chapter 2 Dateand Drug Interactions
Basic Principles of Drug Action 5
chapter
2
Identify common drug administration routes. 5. When drugs are administered via the percuta-
neous route, their absorption is dependent on the:
1. The nurse knows that drugs are administered by (13)
which three most common routes? (Select all that 1. temperature at the site of delivery.
apply.) (12) 2. amount of oxygen present at the site.
1. enteral 3. thickness of the skin.
2. distribution 4. angle of the injection used.
3. percutaneous
4. parenteral 6. The nurse knows that drug absorption is best
5. liberation through which route? (13)
1. oral
2. The enteral route includes medications admin- 2. intravenous
istered: (12) 3. intramuscular
1. subcutaneously. 4. subcutaneous
2. orally.
3. transdermally.
4. intravenously. Describe nursing interventions that can enhance
drug absorption.
3. The nurse is explaining to the patient that the drug
insulin must be given as a subcutaneous injection 7. When administering drugs, the nurse needs to
because: (13) provide which of the following to enhance drug
1. excretion is best by this route. absorption? (Select all that apply.) (13)
2. taken orally, the drug will be deactivated by 1. An adequate amount of fluid with oral
stomach acids. drugs.
3. intramuscular administration would be too 2. Reconstitute and dilute drugs according to
painful. manufacturer’s instructions.
4. manufacturers get more money if they 3. Administer an enema prior to rectal medi-
make the drug in this form. cations.
4. Cool the site after administration of an
intramuscular injection.
Explain the potential problems associated with drug 5. Determine adequate blood flow when
absorption. administering drugs parenterally.
4. Drug absorption deals with how the drug is:
(13)
1. eliminated from the body.
2. transported by the plasma proteins.
3. deactivated by the body systems.
4. transferred from the site of entry into the
circulation.
, @LECTSOLUTIONSSTUVIA
6 Chapter 2 Basic Principles of Drug Action and Drug Interactions
8. The nurse can ensure adequate absorption of 12. Drugs that have been liberated into the circula- tory
medications via the parenteral route by: (13) system: (Select all that apply.) (13)
1. watching to make sure the patient has 1. may become bound to tissues other than
swallowed all the medications. those with active receptor sites.
2. pinching the skin after a subcutaneous 2. have a high affinity for adipose tissue if
injection for 30 seconds. they are lipid-soluble drugs.
3. timing each medication to be given exactly 10 3. are released from the lipid tissue when the
minutes apart. drug blood level drops.
4. determining blood flow prior to adminis- 4. are then selectively distributed through
tration of any injection. osmosis.
5. have to be bound to protein to be active.
9. Drug absorption for inhaled medications can be
enhanced when the nurse: (13)
1. asks the patient to lie on the left side when Describe how the body inactivates drugs.
administering inhalers.
2. determines the surface area of the lungs
prior to administration. 13. After a drug is absorbed, the body will deacti- vate
it in which way? (14)
3. encourages the patient to hold his breath after
administration. 1. through the GI tract to the feces
4. encourages short, shallow breaths after 2. through the enzyme systems of the liver
each inhaled dose. 3. through the renal tubules into the urine
4. through exhalation from the lungs
Describe the mechanisms of drug distribution. 14. The kidneys are a major organ of drug: (14)
1. metabolism.
10. Which explanation by the nurse to a patient 2. distribution.
regarding drug distribution is accurate? (13) 3. excretion.
1. “The stomach needs to first break down the 4. liberation.
drugs and they get absorbed into the
bloodstream from there.”
15. The nurse is reviewing the patient’s chart for the
2. “The medications that are swallowed are results of the most recent urinalysis and re- nal
absorbed into the bloodstream and are
function tests, because a patient with renal failure
circulated around until deactivated by the
will have difficulty with drug: (14)
spleen.”
3. “When the drug blood level drops, the blood 1. distribution.
will pick up more medication; other- wise it 2. metabolism.
gets stored in the liver.” 3. excretion.
4. “Drugs are circulated by the blood to vari- ous 4. deactivation.
organs that have receptors or sites of action
for the drugs.”
Identify the meaning and significance of the term
11. The distribution process is important because the: half-life when it is used in relation to drug therapy.
(14)
1. amount of drug that actually gets to the 16. A measure of the time required for elimination of a
receptor sites determines the response. drug from the body is the: (15)
2. smallest amount of drug is needed to acti- vate 1. expiration time.
receptors.
2. half-life.
3. blood-brain barrier needs the least amount of
drug to be crossed. 3. circulation time.
4. placental barrier keeps drugs from crossing to 4. minimum life.
the fetus.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Chapter 2 Basic Principles of Drug Action and Drug Interactions 7
Identify what drug interactions are, and give an
17. The nurse knows that the drug alprazolam (Xanax)
has a half-life of 12 hours, which means that how example.
much drug will be left circulat- ing in the body after
24 hours? (15) 22. Drug interactions are said to occur when: (Se- lect
1. 50% all that apply.) (17)
2. 25% 1. one drug enhances the pharmacologic ef- fect
3. 30% of another drug.
2. altered absorption takes place in the GI
4. 15% tract.
3. drugs are administered together.
18. The half-life of a drug may become consider- 4. the action of one drug is altered by the ac- tion
ably longer in patients who have: (Select all that of another drug.
apply.) (15)
5. drugs cause living cells to mutate.
1. impaired kidney function.
2. decreased thyroid function.
23. A drug is considered pharmacologically active
3. impaired immune system. when it is: (17)
4. impaired liver function. 1. bound to plasma proteins.
5. decreased amounts of hemoglobin. 2. unbound to plasma proteins.
3. distributed evenly throughout the body.
4. metabolized by the liver.
Compare and contrast the following terms used in
relationship to medications: desired action, side
24. What resources can the nurse use to aid in de-
effects, adverse effects, allergic reactions, and termining when a drug interaction will occur?
idiosyncratic reactions. (Select all that apply.) (17)
1. Consult with the pharmacist.
19. What is a desired drug action? (16) 2. Look up possible reactions in drug refer-
1. the predictable/usual response to the drug ence books.
2. an unusual or idiosyncratic response to a drug 3. Ask the patient when he or she expects the
3. a response capable of inducing cell muta- drugs to interact.
tions 4. Memorize all possible drug interactions.
4. the unpredictable/unusual response to the drug 5. Administer each drug several hours apart to
ensure nothing happens.
20. The nurse notices that the patient now requires a
higher dose of a pain medication to produce the
same effect once provided by a lower dose. This is Differentiate among the following terms used in
called: (16) relationship to drugs: additive effect, synergistic
1. placebo effect. effect, antagonistic effect,
2. tolerance. displacement, interference, and incompatibility.
3. drug dependence.
4. drug accumulation. 25. When a combination of two drugs will provide a
greater effect than the sum of the effect of each
21. Patients who have an anaphylactic reaction from drug if given alone, what is this called? (18)
an administered drug typically experi- ence 1. additive effect
which signs/symptoms? (Select all that apply.) 2. antagonistic effect
(16) 3. synergistic effect
1. severe itching 4. displacement
2. hives
3. diarrhea
4. respiratory distress
5. cardiovascular collapse
, @LECTSOLUTIONSSTUVIA
8 Chapter 2 Basic Principles of Drug Action and Drug Interactions
26. A partial agonist is a drug that does what? (12) Identify one way in which alterations in metabolism
1. Stimulates action at receptor sites within the create drug interactions.
circulating blood.
2. Stimulates one response and inhibits an- 31. The effect of one drug interfering with the ef- fect
other response. of another drug is called: (18)
3. Inhibits response when attached to a recep- tor 1. additive effect.
site. 2. synergistic effect.
4. Stimulates a response at a receptor site. 3. antagonistic effect.
4. displacement.
27. What is another name for an idiosyncratic reac-
tion? (16)
32. Enzyme inducers are drugs that will cause an
1. allergic reaction increase in drug: (18)
2. unexpected reaction 1. interactions.
3. teratogenic reaction 2. incompatibility.
4. drug overresponse 3. displacement.
4. metabolism.
Describe how a bound drug becomes unbound.
33. A common drug interaction that inhibits the
metabolism or excretion of a second drug,
28. Most drugs are bound to this in the blood. (17) thereby causing increased activity of the sec- ond
1. plasma proteins drug, is called: (18)
2. receptor sites 1. antagonistic effect.
3. circulating antibodies 2. incompatibility.
4. adipose tissue 3. interference.
4. additive effect.
29. The process by which a drug that is bound
becomes unbound is called: (15)
1. peak action.
2. replacement.
3. displacement.
4. desired action.
30. As a drug moves from the state of being bound to
being unbound, what will occur? (15)
1. The amount of free circulating drug will
decrease.
2. The amount of free circulating drug will
increase.
3. The drug level will remain unchanged.
4. The drug will be excreted faster from the
body.
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2010, 2007, 2004, 2001, 1997 by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.
, Student Name Chapter 3 Date Across the Life Span
Drug Action 9
chapter
3
Explain the impact of the placebo effect and 3. The attitudes and expectations of the patient
nocebo effect. regarding the treatment of his or her condition
plays a major role in a patient’s response to
therapy. The nurse understands this to mean that
1. The nurse is explaining to a patient who is
patients with: (21)
entering into a research study that he may
actually get a placebo. Which statement by the 1. chronic silent conditions such as hyper-
patient indicates an understanding of the placebo tension are more likely to adhere to the
effect? (21) therapy prescribed.
1. “I will get the drug that they are testing for my 2. conditions such as arthritis are least likely to
condition.” adhere to the therapy prescribed.
2. “I could possibly get a pill that will have a 3. conditions that have rapid consequences if
negative effect on my condition.” therapy is not followed are more likely to
adhere to the therapy prescribed.
3. “The placebo is a drug that has no active
ingredients.” 4. previous negative experiences are more likely
to adhere to the therapy prescribed.
4. “The placebo will have the same effect as the
real drug.”
2. The difference between the placebo effect and the Identify the importance of drug dependence and
nocebo effect is the: (Select all that apply.) (21) drug accumulation.
1. nocebo effect has occurred because the pa-
tient had negative expectations about the 4. Drug dependence occurs when the patient is:
therapy. (22)
2. placebo effect has occurred because the 1. unable to ingest drugs.
patient had negative expectations about the 2. indicating adequate pain relief on opioids.
therapy.
3. considered incompetent to make any medi- cal
3. nocebo effect has occurred because the patient decisions.
had positive expectations about the therapy.
4. develops withdrawal symptoms if the drug is
4. placebo effect has occurred because the patient discontinued.
had positive expectations about the therapy.
5. nocebo effect has occurred because the pa-
tient had no particular expectations about the 5. The nurse suspects the patient has become
therapy. dependent on the drug oxycodone because the
patient: (22)
1. asks for pain medicine more frequently
than ordered.
2. is groggy and hard to arouse about an hour after
his dose.
3. indicates adequate pain relief with the
dose.
4. is worried about becoming addicted to
oxycodone and therefore will not take it.
