C HAPTER 03: D RUG A CTION A CROSS THE L IFE
S PAN
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which age-related change would affect transdermal drug absorption in
geriatric patients the most?
a. Difficult y swallowing
b. Diminished kidney function
c. Changes in pigmentation
d. Altered circulator y status
ANS: D
The decreased circulation that occurs with aging will affect transdermal drug
absorption. Difficulty swallowing would not affect transdermal drugs being
absorbed. Kidney function affects drug excretion. Changes in pigmentation
would not affect transdermal drug absorption.
DIF: Cognitive Level: Comprehension REF: p. 25 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment
CON: Clinical Judgment | Safet y | Patient Education | Development
2. Which intervention would be considered to reduce accumulation of a drug
in a patient who has decreased liver function?
a. Decreasing the time interval between dosages
, b. Reducing the dosage
c. Administering the medication intravenousl y
d. Changing the drug to one that has a longer half-life
ANS: B
Dosages must be reduced to prevent accumulation. Decreasing the time
interval between dosages would increase the accumulation of the drug. The
intravenous route has the fastest absorption and with liver dysfunction wou ld
increase the accumulation of the drug. A similar drug with a longer half -life
would stay in the system longer; with impaired liver function, the result
would be increased accumulation.
DIF: Cognitive Level: Comprehension REF: p. 26 OBJ: 2
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Planning
CON: Clinical Judgment | Safet y | Patient Education | Health
Promotion
3. Which explanation by the nurse is most helpful when teaching an elderl y
patient with difficulty swall owing about medications?
a. “Enteric coated tablets can be crushed and taken with applesauce. ”
b. “Tablets that are scored can be broken in half. ”
c. “Medications labeled ‗SR ’ can be crushed.”
d. “Avoid taking medications in liquid form. ”
ANS: B
It is acceptable to break scored tablets in half to facilitate swallowing of the
medication. Enteric coated tables should never be crushed because of the
effect on the absorption rate and potential for toxicit y. Medications labeled
“SR” indicate “sustained release” and should not be crushed because of the
, effect on the absorption rate. Medication in liquid form may be easier to
swallow.
DIF: Cognitive Level: Appli cation REF: p. 31 OBJ: 4
NAT: NCLEX Client Needs Category: Health Promotion and
Maintenance
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Safet y | Patient Education
4. Which blood level determines the lowest amount of medication presen t in
the patient?
a. Peak
b. Serum
c. Therapeutic
d. Trough
ANS: D
The lowest amount of a medication in the blood is the trough. The peak is the
highest amount of medication in the blood. Serum level identifies the amount
of medication present. Therapeutic leve ls identify the range in which a
medication is effective.
DIF: Cognitive Level: Knowledge REF: p. 28 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment |
Safet y
5. Which patient would the nurse identify as having the lowest rate of
absorption of enteral medications?
a. A 5-year-old boy
b. An 18-year-old woman
S PAN
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which age-related change would affect transdermal drug absorption in
geriatric patients the most?
a. Difficult y swallowing
b. Diminished kidney function
c. Changes in pigmentation
d. Altered circulator y status
ANS: D
The decreased circulation that occurs with aging will affect transdermal drug
absorption. Difficulty swallowing would not affect transdermal drugs being
absorbed. Kidney function affects drug excretion. Changes in pigmentation
would not affect transdermal drug absorption.
DIF: Cognitive Level: Comprehension REF: p. 25 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment
CON: Clinical Judgment | Safet y | Patient Education | Development
2. Which intervention would be considered to reduce accumulation of a drug
in a patient who has decreased liver function?
a. Decreasing the time interval between dosages
, b. Reducing the dosage
c. Administering the medication intravenousl y
d. Changing the drug to one that has a longer half-life
ANS: B
Dosages must be reduced to prevent accumulation. Decreasing the time
interval between dosages would increase the accumulation of the drug. The
intravenous route has the fastest absorption and with liver dysfunction wou ld
increase the accumulation of the drug. A similar drug with a longer half -life
would stay in the system longer; with impaired liver function, the result
would be increased accumulation.
DIF: Cognitive Level: Comprehension REF: p. 26 OBJ: 2
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Planning
CON: Clinical Judgment | Safet y | Patient Education | Health
Promotion
3. Which explanation by the nurse is most helpful when teaching an elderl y
patient with difficulty swall owing about medications?
a. “Enteric coated tablets can be crushed and taken with applesauce. ”
b. “Tablets that are scored can be broken in half. ”
c. “Medications labeled ‗SR ’ can be crushed.”
d. “Avoid taking medications in liquid form. ”
ANS: B
It is acceptable to break scored tablets in half to facilitate swallowing of the
medication. Enteric coated tables should never be crushed because of the
effect on the absorption rate and potential for toxicit y. Medications labeled
“SR” indicate “sustained release” and should not be crushed because of the
, effect on the absorption rate. Medication in liquid form may be easier to
swallow.
DIF: Cognitive Level: Appli cation REF: p. 31 OBJ: 4
NAT: NCLEX Client Needs Category: Health Promotion and
Maintenance
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Safet y | Patient Education
4. Which blood level determines the lowest amount of medication presen t in
the patient?
a. Peak
b. Serum
c. Therapeutic
d. Trough
ANS: D
The lowest amount of a medication in the blood is the trough. The peak is the
highest amount of medication in the blood. Serum level identifies the amount
of medication present. Therapeutic leve ls identify the range in which a
medication is effective.
DIF: Cognitive Level: Knowledge REF: p. 28 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment |
Safet y
5. Which patient would the nurse identify as having the lowest rate of
absorption of enteral medications?
a. A 5-year-old boy
b. An 18-year-old woman
