Pharmacology Illustrated Reviews 7th Edition Whalen

 Test Bank

Chapter 1: Pharmacokinetics

MULTIPLE CHOICE

1. Which drugs will go through a pharmaceutic phase after it is administered?

a. Intramuscular cephalosporins

b. Intravenous vasopressors

c. Oral analgesics

d. Subcutaneous antiglycemics

ANS: C

When drugs are administered parenterally, there is no pharmaceutic phase, which occurs when a

drug becomes a solution that can cross the biologic membrane.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3

TOP: NURSING PROCESS: Assessment

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The nurse is preparing to administer an oral medication and wants to ensure a rapid drug

action. Which form of the medication will the nurse administer?

a. Capsule

b. Enteric-coated pill

c. Liquid suspension

d. Tablet

ANS: C

Liquid drugs are already in solution, which is the form necessary for absorption in the GI tract.

The other forms must disintegrate into small particles and then dissolve before being

absorbed.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3

TOP: NURSING PROCESS: Nursing Intervention

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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3. The nurse is teaching a patient who will be discharged home with a prescription for an entericcoated tablet. Which statement by the patient indicates understanding of the teaching?

a. I may crush the tablet and put it in applesauce to improve absorption.

b. I should consume acidic foods to enhance absorption of this medication.

c. I should expect a delay in onset of the drugs effects after taking the tablet.

d. I should take this medication with high-fat foods to improve its action.

ANS: C

Enteric-coated tablets resist disintegration in the acidic environment of the stomach and

disintegrate when they reach the small intestine. There is usually some delay in onset of actions

after taking these medications. Enteric-coated tablets should not be crushed or chewed, which

would alter the time and location of absorption. Acidic foods will not enhance the absorption of

the medication. The patient should not to eat high-fat food before ingesting an enteric-coated

tablet, because high-fat foods decrease the absorption rate.

DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 3

TOP: NURSING PROCESS: Nursing Intervention

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be

given by subcutaneous injection instead of by mouth. The nurse will explain that this is because

a. absorption is diminished by the first-pass effects in the liver.

b. absorption is faster when insulin is given subcutaneously.

c. digestive enzymes in the gastrointestinal tract prevent absorption.

d. the oral form is less predictable with more adverse effects.

ANS: C

Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine by

digestive enzymes and must be given parenterally. Because insulin is destroyed by digestive

enzymes, it would not make it to the liver for metabolism with a first-pass effect. Subcutaneous

tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin is given

subcutaneously because it is desirable to have it absorb slowly.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 3

TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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5. The nurse is preparing to administer an oral medication that is water-soluble. The nurse

understands that this drug

a. must be taken on an empty stomach.

b. requires active transport for absorption.

c. should be taken with fatty foods.

d. will readily diffuse into the gastrointestinal tract.

ANS: B

Water-soluble drugs require a carrier enzyme or protein to pass through the GI membrane.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 4

TOP: NURSING PROCESS: Nursing Intervention

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A nurse is preparing to administer an oral drug that is best absorbed in an acidic environment.

How will the nurse give the drug?

a. On an empty stomach

b. With a full glass of water

c. With food

d. With high-fat food

ANS: C

Food can stimulate the production of gastric acid so medications requiring an acidic environment

should be given with a meal. High-fat foods are useful for drugs that are lipid soluble.

DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 4

TOP: NURSING PROCESS: Nursing Intervention

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse is preparing an injectable drug and wants to administer it for rapid absorption. How

will the nurse give this medication?

a. IM into the deltoid muscle

b. IM into the gluteal muscle

c. SubQ into abdominal tissue

d. SubQ into the upper arm

ANS: A

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Drugs given IM are absorbed faster in muscles that have more blood vessels, such as the deltoid,

rather than those with fewer blood vessels, such as the gluteals. Subcutaneous routes are used

when absorption needs to be slower and more sustained.

DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 4

TOP: NURSING PROCESS: Planning

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The nurse is reviewing medication information with a nursing student prior to administering

an oral drug and notes that the drug has extensive first-pass effects. Which statement by the

student indicates a need for further teaching about this medication?

a. The first-pass effect means the drug may be absorbed into systemic circulation from the

intestinal lumen.

b. The first-pass effect means the drug may be changed to an inactive form and excreted.

c. The first-pass effect means the drug may be changed to a metabolite, which may be more

active than the original.

d. The first-pass effect means the drug may be unchanged as it passes through the liver.

ANS: A

Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal

lumen and go through the liver where they are either unchanged or are metabolized to an inactive

or a more active form.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 4

TOP: NURSING PROCESS: Nursing Intervention

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse prepares to change a patients medication from an intravenous to an oral form and

notes that the oral form is ordered in a higher dose. The nurse understands that this is due to

differences in

a. bioavailability.

b. pinocytosis.

c. protein binding.

d. tachyphylaxis.

ANS: A

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