Pharmacology Exam 1
1.Phases of pharmacokinetics: Absorption
Distribution
Metabolism
Excretion
2.Six Rights of medication administration: Right patient
Right medication
Right dose
Right route
Right time
Right documentation
3.Right patient: requires confirmation/verifying two forms of identification (name and date of birth) and compare with ID band
and MAR
Verify name with family member if present and be aware of 'name alerts' (patients have the same name)
4. Right drug: Order must be prescribed by licensed health care provider.
Drug label must be read three times (two at the medication cart, once in the room), and check dose calculations.
Nurse should be familiar with patient's health record, allergies, lab results, and vital signs. Checking start and end date of
medication administration.
why the patient is receiving medication and if it reflects the patient's diagnosis.
5. Right dose: Verify the dosage calculation and ensure that the drug is safe for the patient; weigh the patient if dose is
dependent upon the weight
Validate dose of high risk medications with 2 RN's (Insulin, Heparin, Opiates) ****Cannot use LPNs, must be RN or higher degree
6. Right time: Give with drugs that irritate the stomach; Drugs that are affected by food are given 1 hour before or after meals.
Check for scheduled procedures
Administer medications at even intervals; Use of military time reduces errors
***Hold antihypertensives prior to dialysis; check with dialysis nurse
7. Right route: Assess patient's ability to swallow prior to administering oral medications; if there are any issues, new route
needs to be ordered by provider for proper administration
, Pharmacology Exam 1
Do not crush or mix medications without validation or consultation
Offer water for patient to take with medications, not juice (Iron can be taken with orange juice.)
Use aseptic technique
8. Right documentation: Record drug administration immediately after administration (not prior)
Record of the drug name, dose, route, time, date, and nurses signature/initials; reason for medication being held or refused
should be documented
document patient's response to drug (very important for analgesics, sedatives, and antiemetics)
9. Black box warning: strongest drug safety actions that the US Food and Drug administration can implement; often warns of
serious risks.
10. drug reconciliation: The process of identifying the most accurate list of all medications a patient is taking
***advise patient to always carry a current, updated list of personal drug information; this includes all prescribed medications and
when/reasoning for taking, vitamins, otc medications, herbal supplements, etc.
11. Proper disposal of medications: Do not flush down toilet; Label with patient identifiers should be removed and
medication should be placed in a container with an undesirable substance.
Drugs should be returned to community "drug take-back" program
12. Drug absorption (definition and factors affecting): Drug movement from the GI tract to the bloodstream
Factors: blood circulation, pain, stress, exercise, food texture, fat content, temperature, pH, route of administration
13. Disintegration: breakdown of oral drug form into small particles
the rate is the time it takes the drug to disintegrate and dissolve to become available for the body to absorb it
14. Dissolution: process of combining small drug particles with liquid to form a solution
15. drug metabolism (biotransformation): process of body chemically changing drug into a form to be excreted
16. ways drugs can be excreted (elimination): •Kidneys (kidney function is measured by BUN/Cre-
atinine, GFR)
•Liver
•Lungs
•Saliva
, Pharmacology Exam 1
•Sweat
•Breast milk
17. Pharmacodynamics: Study of the way drugs affect the body; drugs act within the body to mimic the actions of the body's
own chemical messengers
Primary effect: desirable response
Secondary effect: Desirable or undesirable.
18. A patient has liver and kidney disease. He is given a medication with a half-life of 30 hours. The nurse expects the duration
of this medication to
A. Increase
B. Decrease
C. Remain unchanged
D. Dissipate: A. Increase
Metabolism and elimination affect the half-life of a drug. With liver or kidney dysfunction, the half-life of the drug is prolonged,
and less drug is metabolized and eliminated.
19. What is needed for medications to work properly: high protein
20. effects medication absorption: hydration
21. When assessing older adults and those with renal dysfunction, the nurse knows that creatinine clearance is usually
A.substantially increased.
B.slightly increased.
C.decreased.
D.in the normal range.: C.decreased.
Creatinine clearance is the most accurate test to determine renal function. Creatinine is a metabolic byproduct of muscle that is
excreted by the kidneys. Creatinine clearance varies with age and gender. Lower values are expected in older adult and female
patients because of their decreased muscle mass. A decrease in renal GFR (common in older adults) results in a decrease in urine
creatinine clearance.
22. A patient sustains significant burns to the skin and is experiencing fluid shift associated with edema in the fluid overload
phase. The nurse would anticipate that this will interfere most with which phase of pharmacodynamics?
A. Absorption
B. Distribution
, Pharmacology Exam 1
C. Metabolism
D. Excretion: B. Distribution
Distribution is the process by which the drug becomes available to body fluids and body tissues. Drug distribution is influenced by
blood flow, the drug's affinity to tissue, and the protein-binding effect. This distribution can be affected by the effects of edema in
the fluid overload phase.
23. Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic
index?
A.Monitoring a patient's urine output
B.Assessing vital signs hourly
C.Maintaining strict isolation precautions
D.Monitoring serum peak and trough levels: D. Monitoring serum peak and trough levels
Serum peak level is the highest plasma concentration of a drug at a specific time, indicating rate of absorption. Serum trough leve
is the lowest plasma concentration of a drug. They are drawn immediately before the next dose of the drug is to be administered
Trough levels indicate the rate of elimination of the drug. If either the peak or the trough level is too high, toxicity can occur. If the
peak is too low, no therapeutic effect is achieved.
24. Most drugs are metabolized in the
A. kidney.
B. small intestine.
C. liver.
D. brain.: C. Liver
Drugs can be metabolized in the gastrointestinal tract; however, the liver is the primary site of metabolism. Liver diseases
(like cirrhosis and hepatitis) causes a decrease in metabolism rate and causes toxicity
25. The patient's bioavailability of a drug is altered. The nurse interprets this to mean that (USLO 1, 2)
A) The drug's metabolism is affected
B) The drug's absorption is affected
C) The drug's distribution is affected
D) The drug's excretion is affected: A) the drug's metabolism is affected
26. The nurse reads that the half-life of the medication being administered is 12 hours. What interpretation will guide the nurse's
care of this patient?
A) The medication will be administered every 6 hours to maintain consistent blood levels.
1.Phases of pharmacokinetics: Absorption
Distribution
Metabolism
Excretion
2.Six Rights of medication administration: Right patient
Right medication
Right dose
Right route
Right time
Right documentation
3.Right patient: requires confirmation/verifying two forms of identification (name and date of birth) and compare with ID band
and MAR
Verify name with family member if present and be aware of 'name alerts' (patients have the same name)
4. Right drug: Order must be prescribed by licensed health care provider.
Drug label must be read three times (two at the medication cart, once in the room), and check dose calculations.
Nurse should be familiar with patient's health record, allergies, lab results, and vital signs. Checking start and end date of
medication administration.
why the patient is receiving medication and if it reflects the patient's diagnosis.
5. Right dose: Verify the dosage calculation and ensure that the drug is safe for the patient; weigh the patient if dose is
dependent upon the weight
Validate dose of high risk medications with 2 RN's (Insulin, Heparin, Opiates) ****Cannot use LPNs, must be RN or higher degree
6. Right time: Give with drugs that irritate the stomach; Drugs that are affected by food are given 1 hour before or after meals.
Check for scheduled procedures
Administer medications at even intervals; Use of military time reduces errors
***Hold antihypertensives prior to dialysis; check with dialysis nurse
7. Right route: Assess patient's ability to swallow prior to administering oral medications; if there are any issues, new route
needs to be ordered by provider for proper administration
, Pharmacology Exam 1
Do not crush or mix medications without validation or consultation
Offer water for patient to take with medications, not juice (Iron can be taken with orange juice.)
Use aseptic technique
8. Right documentation: Record drug administration immediately after administration (not prior)
Record of the drug name, dose, route, time, date, and nurses signature/initials; reason for medication being held or refused
should be documented
document patient's response to drug (very important for analgesics, sedatives, and antiemetics)
9. Black box warning: strongest drug safety actions that the US Food and Drug administration can implement; often warns of
serious risks.
10. drug reconciliation: The process of identifying the most accurate list of all medications a patient is taking
***advise patient to always carry a current, updated list of personal drug information; this includes all prescribed medications and
when/reasoning for taking, vitamins, otc medications, herbal supplements, etc.
11. Proper disposal of medications: Do not flush down toilet; Label with patient identifiers should be removed and
medication should be placed in a container with an undesirable substance.
Drugs should be returned to community "drug take-back" program
12. Drug absorption (definition and factors affecting): Drug movement from the GI tract to the bloodstream
Factors: blood circulation, pain, stress, exercise, food texture, fat content, temperature, pH, route of administration
13. Disintegration: breakdown of oral drug form into small particles
the rate is the time it takes the drug to disintegrate and dissolve to become available for the body to absorb it
14. Dissolution: process of combining small drug particles with liquid to form a solution
15. drug metabolism (biotransformation): process of body chemically changing drug into a form to be excreted
16. ways drugs can be excreted (elimination): •Kidneys (kidney function is measured by BUN/Cre-
atinine, GFR)
•Liver
•Lungs
•Saliva
, Pharmacology Exam 1
•Sweat
•Breast milk
17. Pharmacodynamics: Study of the way drugs affect the body; drugs act within the body to mimic the actions of the body's
own chemical messengers
Primary effect: desirable response
Secondary effect: Desirable or undesirable.
18. A patient has liver and kidney disease. He is given a medication with a half-life of 30 hours. The nurse expects the duration
of this medication to
A. Increase
B. Decrease
C. Remain unchanged
D. Dissipate: A. Increase
Metabolism and elimination affect the half-life of a drug. With liver or kidney dysfunction, the half-life of the drug is prolonged,
and less drug is metabolized and eliminated.
19. What is needed for medications to work properly: high protein
20. effects medication absorption: hydration
21. When assessing older adults and those with renal dysfunction, the nurse knows that creatinine clearance is usually
A.substantially increased.
B.slightly increased.
C.decreased.
D.in the normal range.: C.decreased.
Creatinine clearance is the most accurate test to determine renal function. Creatinine is a metabolic byproduct of muscle that is
excreted by the kidneys. Creatinine clearance varies with age and gender. Lower values are expected in older adult and female
patients because of their decreased muscle mass. A decrease in renal GFR (common in older adults) results in a decrease in urine
creatinine clearance.
22. A patient sustains significant burns to the skin and is experiencing fluid shift associated with edema in the fluid overload
phase. The nurse would anticipate that this will interfere most with which phase of pharmacodynamics?
A. Absorption
B. Distribution
, Pharmacology Exam 1
C. Metabolism
D. Excretion: B. Distribution
Distribution is the process by which the drug becomes available to body fluids and body tissues. Drug distribution is influenced by
blood flow, the drug's affinity to tissue, and the protein-binding effect. This distribution can be affected by the effects of edema in
the fluid overload phase.
23. Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic
index?
A.Monitoring a patient's urine output
B.Assessing vital signs hourly
C.Maintaining strict isolation precautions
D.Monitoring serum peak and trough levels: D. Monitoring serum peak and trough levels
Serum peak level is the highest plasma concentration of a drug at a specific time, indicating rate of absorption. Serum trough leve
is the lowest plasma concentration of a drug. They are drawn immediately before the next dose of the drug is to be administered
Trough levels indicate the rate of elimination of the drug. If either the peak or the trough level is too high, toxicity can occur. If the
peak is too low, no therapeutic effect is achieved.
24. Most drugs are metabolized in the
A. kidney.
B. small intestine.
C. liver.
D. brain.: C. Liver
Drugs can be metabolized in the gastrointestinal tract; however, the liver is the primary site of metabolism. Liver diseases
(like cirrhosis and hepatitis) causes a decrease in metabolism rate and causes toxicity
25. The patient's bioavailability of a drug is altered. The nurse interprets this to mean that (USLO 1, 2)
A) The drug's metabolism is affected
B) The drug's absorption is affected
C) The drug's distribution is affected
D) The drug's excretion is affected: A) the drug's metabolism is affected
26. The nurse reads that the half-life of the medication being administered is 12 hours. What interpretation will guide the nurse's
care of this patient?
A) The medication will be administered every 6 hours to maintain consistent blood levels.
