NURS-6521 Advanced Pharmacology Week 1 – Quiz
Course: NURS-6521N-27, Advanced Pharmacology
Attempt Score: 39 out of 40 points
Time Elapsed: 1 hour, 0 minute out of 1 hour and 40 minutes
Instructions: Please answer each question below and click Submit when you have completed the Quiz.
Results Displayed: Feedback
Question 1: 1 out of 1 point
A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F, into the emergency department. The physician orders acetaminophen (Tylenol) for the fever. What is the best form of Tylenol to give the child considering her symptoms?
Response Feedback: Since the child is vomiting, administering medication via liquid, lozenge, or tablet forms may lead to aspiration or loss of the medication through vomiting. A suppository would be the safest method to administer the medication.
Question 2: 1 out of 1 point
A nurse’s assessment suggests that a community-dwelling adult may have undocumented drug allergies. What statement by the client would confirm an allergic reaction?
Response Feedback: True allergic reactions include rash, hives, itching, swelling, difficulty breathing, and anaphylactic shock. Nausea and vomiting are considered adverse effects, not allergic reactions.
Question 3: 1 out of 1 point
An older adult patient with Alzheimer’s disease and chronic health issues struggles to swallow pills. Which medication could the nurse crush before administering?
Response Feedback: Immediate-release tablets can generally be crushed safely. However, enteric-coated, sustained-release, and sublingual tablets should not be crushed due to the alteration of their intended release properties.
Question 4: 1 out of 1 point
The nurse administers an antiemetic through an IV piggyback. What is the rationale for using IV piggyback?
Response Feedback: IV piggyback is used when a patient is receiving continuous IV fluids and intermittent IV drug therapy. The secondary IV tubing, added to the primary tubing at a Y port, allows the drug to be administered while the primary IV continues.
Question 5: 1 out of 1 point
A patient who recently moved from Vermont to Florida is experiencing dizziness and weakness while taking antihypertensive medication. What could be causing this?
Response Feedback: Warm climates can cause blood vessel dilation, leading to a drop in blood pressure, especially in patients taking antihypertensive drugs. This could explain the patient’s dizziness and weakness.
Question 6: 1 out of 1 point
A 60-year-old African-American man has several chronic health conditions. How might genetic factors influence his health or treatment?
Response Feedback: African-Americans have a higher incidence of hypertension and may respond differently to certain antihypertensive medications than other ethnic groups.
Question 7: 1 out of 1 point
30 ml = ________ tbsp?
Question 8: 1 out of 1 point
A 56-year-old female patient has been prescribed a new medication for chronic muscle spasms. She has poorly documented allergies to eggs, synthetic clothes, and perfumes. What should the nurse do to prevent an allergic reaction?
Response Feedback: The nurse should document the patient’s allergies in her chart and ensure it is visible to all staff, including dietary staff, to avoid errors. Ensuring clear communication prevents potential allergic reactions.
Question 9: 1 out of 1 point
Tylenol 325 mg/tablet, patient requires 650 mg. How many tablets should the patient take?
Question 10: 1 out of 1 point
An elderly postsurgical patient has developed pneumonia and is on several medications. Which medication will have the slowest absorption?
Response Feedback: Absorption is fastest through IV, IM, and sublingual routes. Oral medications have the slowest absorption rate.
NURS-6521 Advanced Pharmacology Week 1 Quiz
Question 11:
Which of the following affects drug distribution throughout the body?
Response Feedback:
Drug distribution is influenced by factors such as protein binding and the pH of extracellular fluids. While food in the gastrointestinal tract affects drug absorption, and increased hepatic enzyme activity affects metabolism, high blood levels are not directly linked to changes in drug pharmacokinetics.
Question 12:
Which statement best defines how a chemical is termed a drug?
Response Feedback:
A chemical must undergo rigorous testing to assess its therapeutic value and safety before it can be called a drug. This includes determining its efficacy and ensuring it does not have severe toxicity or harmful properties. The FDA reviews these test results to decide whether to approve the chemical as a drug.
Question 13:
A nurse is switching a patient’s medication from intramuscular (IM) to oral. The nurse notices the oral dose is much higher than the IM dose. Why?
Response Feedback:
The first-pass effect explains why oral dosages are higher than parenteral doses. When a drug is taken orally, it is absorbed through the small intestine and transported to the liver, where a large percentage is metabolized before reaching systemic circulation. This requires higher oral dosages to achieve therapeutic effects.
Question 14:
A patient takes a hypnotic to sleep but is found two hours later full of energy and cleaning. How should the nurse evaluate this response?
Response Feedback:
This is an idiosyncratic response, an unusual or opposite reaction to a drug. It is not related to the dose but to the individual’s unique reaction to the medication. This differs from an allergic reaction, which involves the immune system, or a synergistic effect, where two drugs combined have a greater effect.
Question 15:
A drug is 96% protein bound according to the United States Pharmacopeia–National Formulary. What does this mean for treatment?
Response Feedback:
When a drug is 96% protein bound, only 4% of the drug is free and active in the bloodstream. This necessitates a higher dosage to achieve therapeutic effects. It does not speed up absorption or excretion and does not indicate a need for increased dietary protein.
Question 16:
A patient is prescribed a thiazide diuretic and metoprolol for hypertension. Why are two medications used?
Response Feedback:
A synergistic effect occurs when two medications with different mechanisms of action are combined, leading to a greater therapeutic effect than either drug alone. In this case, combining the two drugs may better control the patient’s hypertension than using one drug alone.
Question 17:
5 ml = ________ tsp
Question 18:
A patient on antibiotics for a leg infection develops a rash. What does this indicate about the drug’s effects?
Response Feedback:
This rash is an example of pharmacodynamics, which involves the biological, chemical, and physiological effects of a drug, including adverse reactions. Pharmacodynamics explains how a drug affects the body, while pharmacokinetics focuses on how the body processes the drug.
Question 19:
A patient has been on regular doses of an agonist for two weeks. What should the nurse anticipate?
Response Feedback:
Receptors in the body can become desensitized to a drug when continuously stimulated, leading to reduced effectiveness over time. The nurse should expect that the drug may become less effective, necessitating a potential dosage adjustment.
Question 20:
How can a nurse promote therapeutic drug effects?
Response Feedback:
Encouraging patients to take medications at the prescribed times helps maintain therapeutic drug levels. Food may alter absorption, so it should be taken only when recommended. Patients should consult their prescriber before adjusting doses or incorporating alternative therapies.
Question 21:
Talwin is given with Vistaril to reduce nausea. What type of drug interaction is this?
Response Feedback:
This is an antagonistic interaction, where one drug reduces the adverse effects of another, leading to a lesser therapeutic effect. This differs from an additive effect (where two similar drugs are combined) or a synergistic effect (where two different drugs create a greater combined effect). Potentiation increases the effect of one drug when used with another.
Question 22: An unconscious patient is brought to the hospital, and the physician orders a life-saving drug to be administered parenterally. What is the most appropriate method for the nurse to use to administer the medication?
Response Feedback: Intravenous (IV) infusion is the preferred method for emergency situations when rapid drug effects are required, as the drug is immediately delivered into the bloodstream. While subcutaneous (SC) and intramuscular (IM) routes could be used, they do not guarantee the same rapid effect. Intrathecal administration is typically performed by a physician or specialized healthcare provider.
Question 23: A nurse is instructing a patient about a newly prescribed drug. What should be included to help ensure patient compliance and safety?
Response Feedback: Educating patients about potential adverse effects and how to manage or minimize discomfort increases the likelihood that they will continue taking the medication and follow safe administration practices. While a list of pharmacies, information on generic versus brand costs, and drug testing statistics may be useful, they are not directly linked to patient safety or compliance.
Question 24: In which type of patient should the nurse expect alterations in drug metabolism?
Response Feedback: The liver is crucial for drug metabolism. In patients with liver conditions like cirrhosis, normal drug metabolism may be impaired, potentially leading to toxic drug levels. This would necessitate adjustments to drug dosage. In contrast, patients with kidney stones or acute renal failure may have issues with drug excretion, not metabolism.
Question 25: A patient’s blood serum drug level is 50 units/mL with a drug half-life of 1 hour. If levels above 25 units/mL are toxic and no more of the drug is given, how long will it take to reach the non-toxic range?
Response Feedback: A drug’s half-life is the time it takes for its serum concentration to decrease by 50%. After 1 hour, the concentration would drop to 25 units/mL (50/2), which is within the non-toxic range.
Question 26: A 79-year-old woman with osteoporosis has recently moved to a long-term care facility. Her medication list includes calcitonin, salmon. What is the most likely route for administering this drug?
Response Feedback: For postmenopausal osteoporosis, calcitonin is commonly administered via a 200 IU intranasal spray, alternating nostrils daily to reduce nasal irritation. This method is preferred over IM, SC, or IV routes.
Question 27: A 70-year-old woman is starting a new acidic drug. How can food and nutrient intake affect drug excretion?
Response Feedback: The nurse will assess the patient’s diet, particularly her intake of meat and vegetables, which can affect urine pH. A diet rich in either can alter renal drug excretion since drugs are often weak organic acids or bases. A low-protein diet can increase free drug levels, heightening the risk of adverse effects, while reduced sodium intake can affect drug reabsorption in the kidneys.
Question 28: A 72-year-old man taking Adderall XR for narcolepsy has difficulty swallowing capsules. How should the nurse advise him?
Response Feedback: The nurse should advise the patient that Adderall XR capsules can be opened, and the beads sprinkled onto applesauce. However, the beads should not be crushed, as this alters the drug’s absorption. Suggesting an alternative drug or increased water intake is not appropriate.
Question 29: A 90-year-old woman with a fractured hip and respiratory distress is scheduled for surgery. Succinylcholine will be used for rapid intubation. What is the most appropriate nursing diagnosis?
Response Feedback: The most relevant nursing diagnosis is Impaired Physical Mobility related to drug-induced paralysis, as succinylcholine will cause temporary immobility, increasing the risk of pressure sores. Other diagnoses, such as Impaired Spontaneous Ventilation or Fear, are less directly related to the risk of skin breakdown.
Question 30: An 80-year-old man prescribed oxycodone for chronic pain asks if he can crush the tablet for easier swallowing. What should the nurse advise?
Response Feedback: The nurse should inform the patient that crushing oxycodone can release the entire dose at once, leading to severe adverse effects. Extended-release tablets are designed to release medication slowly and should not be crushed.
Question 31: A nurse is educating older adults about preventing drug interactions. What should the nurse emphasize?
Response Feedback: The nurse should emphasize that older adults should consult with healthcare providers before introducing new drugs to their regimen, as doing so without professional guidance can increase the risk of drug interactions.
Question 32: An 80-year-old patient has been taking lorazepam since his wife’s death. The drug is being discontinued before he moves into assisted living. How should the nurse plan his care?
Response Feedback: Lorazepam should be gradually tapered to prevent withdrawal symptoms, as the patient has been using the drug for an extended period. Sudden discontinuation could lead to withdrawal.
Question 33: An elderly man admitted to a care facility has a history of taking bicalutamide (Casodex). The nurse recognizes that this drug is used to treat what condition?
Response Feedback: Bicalutamide is an antiandrogen used to treat prostate cancer in men.
Question 34: A 70-year-old woman diagnosed with chronic heart failure is prescribed digoxin. What should the nurse teach her about this medication?
Response Feedback: Digoxin helps maintain clinical stability and improve symptoms in heart failure patients but does not reduce mortality or cure the condition. Its effect is not primarily related to diuresis or blood pressure control.
Question 35: A nurse notices new drug orders for a patient already taking multiple medications. What is the most important consideration?
Response Feedback: The most critical factor to consider is the potential for drug–drug interactions. Other factors, such as the schedule and monitoring for side effects, are also important but secondary to drug interactions.
Question 36: A 76-year-old woman with impaired lung function is scheduled for surgery and will receive isoflurane. How might her condition influence the use of this anesthetic?
Response Feedback: Impaired lung function is a key concern when using isoflurane, as it can complicate administration. While age, endocrine, and nutritional status are important, lung function plays a more significant role in this case.
Question 37: Mr. Nguyen, a 71-year-old patient, is being discharged after coronary artery bypass surgery. What should the nurse prioritize in his discharge education?
Response Feedback: The nurse should prioritize teaching Mr. Nguyen about potential adverse effects of his medications and how to minimize them. This is more important than understanding the prescriber’s rationale or age-related drug considerations.
Question 38: A nurse is assessing a patient who has had recent changes to her drug regimen. What question best addresses the safety of her drug therapy?
Response Feedback: Asking about the use of alternative medicines and herbal treatments is crucial, as these can interact with prescribed medications, especially in older adults who are at higher risk for drug interactions.
Question 39: A 73-year-old man shows signs of renal system decline, but his creatinine level remains normal. What does this indicate?
Response Feedback: Creatinine levels may appear normal in older adults despite decreased kidney function due to reduced muscle mass. A normal creatinine level should not be taken as an indicator of normal renal function.
Question 40: An older adult starting on losartan for hypertension is at risk for what?
Response Feedback: Losartan, an angiotensin II receptor blocker, increases the risk of dizziness, which may lead to falls, particularly in older adults.
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