Test Bank For Abrams’ Clinical Drug Therapy Rationales for Nursing Practice by Geralyn Frandsen

1.

Which cellular structure stores hormones and other substances and packages these substances into secretory granules?

A)

Golgi apparatus

B)

Endoplasmic reticulum

C)

Mitochondria

D)

Lysosome

Ans:

A

Feedback:

The golgi apparatus stores hormones and other substances. The endoplasmic reticulum contains ribosomes, which synthesize proteins, including enzymes that synthesize glycogen, triglycerides, and steroids and those that metabolize drugs and other chemicals. The mitochondria generate energy for cellular activities and require oxygen. Lysosomes are membrane-enclosed vesicles that contain enzymes capable of digesting nutrients (proteins, carbohydrates, fats), damaged cellular structures, foreign substances (bacteria), and the cell itself.

2.

A patient is suffering from a cough associated with an upper respiratory infection. Which oral medication will likely produce the most therapeutic effect?

A)

A tablet

B)

An expectorant

C)

A topical spray

D)

A timed-release tablet

Ans:

B

Feedback:

Liquid medications are absorbed faster than tablets or capsules. Expectorants are liquid medications. A tablet is an oral medication that has a slower onset of action than a liquid medication. A topical spray can be sprayed to the back of the throat and provides only a local effect. A timed-release tablet is an oral medication that has a slower onset and longer duration of action.

3.

A patient is administered an oral contraceptive. Which of the following is the process that occurs between the time the drug enters the body and the time that it enters the bloodstream?

A)

Absorption

B)

Distribution

C)

Metabolism

D)

Excretion

Ans:

A

Feedback:

Absorption is the process that occurs from the time the drug enters the body to the time it enters the bloodstream to be circulated. Distribution involves the transport of drug molecules within the body. Metabolism is the method by which drugs are inactivated or biotransformed by the body. Excretion refers to elimination of a drug from the body.

4.

Which of the following sites of drug absorption is considered to have an exceptionally large surface area for drug absorption?

A)

Rectum

B)

Fundus of the stomach

C)

Esophagus

D)

Lungs

Ans:

D

Feedback:

The lungs have a large surface area for absorption of anesthetic gases and a few other drugs. The rectum absorbs the medication through the mucous membranes and has a smaller surface area than the lungs. The fundus and esophagus have comparatively small surface areas.

5.

A nurse is aware of the importance of adhering to the intended route of a medication. Which of the following drugs are formulated to be absorbed through the skin?

A)

Amoxicillin, tetracycline, and penicillin

B)

Clonidine, fentanyl, and nitroglycerin

C)

Digoxin, lidocaine, and propranolol

D)

Insulin, heparin, and morphine

Ans:

B

Feedback:

Some drugs are formulated in adhesive skin patches for absorption through the skin. Clonidine, fentanyl, and nitroglycerin are examples of drugs that are formulated in adhesive skin patch form to be absorbed through the skin. Amoxicillin, tetracycline, and penicillin are administered orally. Digoxin and propranolol are administered orally, and lidocaine can be administered intravenously, subcutaneously, or topically. Insulin and heparin are administered intravenously and subcutaneously. Morphine is administered orally, intramuscularly, and intravenously.

6.

An 85-year-old patient has an elevated serum creatinine level, indicating impaired kidney function. When the patient is administered a medication, this patient is at risk for which of the following medication-related effects?

A)

Toxicity

B)

Increased absorption

C)

Delayed gastric emptying

D)

Idiosyncratic effects

Ans:

A

Feedback:

An elevated creatinine level is indicative of diminished kidney function, which will result in serum drug toxicity. The creatinine level indicates kidney function, does not affect absorption, and has no effect on gastric emptying.

7.

Protein binding is an important aspect of pharmacokinetics. Protein binding ultimately has which of the following effects on drug action?

A)

Increases the drug’s speed of action

B)

Decreases the drug’s speed of action

C)

Increases the rate of excretion

D)

Averts adverse effects

Ans:

B

Feedback:

Protein binding allows part of a drug to be stored and released as needed. Drugs that are highly bound to plasma proteins or stored extensively in other tissues have a long duration of action. Protein binding does not increase the speed of action, increase the excretion rate, or avert adverse effects. Protein binding decreases the speed of action by storing the drug to be released when needed.

8.

A patient is taking a medication that is metabolized by the CYP enzymes. Which of the following medications inhibits several of the CYP enzymes?

A)

Cisplatin

B)

Acebutolol hydrochloride

C)

Cimetidine

D)

Dicloxacillin sodium

Ans:

C

Feedback:

Cimetidine is a gastric acid suppressor that inhibits several CYP enzymes and can greatly decrease drug metabolism. The other listed drugs do not have this specific effect.

9.

A nurse is aware that the dosing scheduling of a patient’s new medication takes into account the serum half-life of the drug. What is the serum half-life of a medication?

A)

The time required for IV medications to penetrate the brain tissue

B)

The time needed for the serum level to fall by 50%

C)

The safest margin to prevent toxicity

D)

The dose adjustment that reduces the risk of adverse effects by one half

Ans:

B

Feedback:

Serum half-life is the time required for the serum concentration of a drug to decrease by 50%. Although many IV medications penetrate the brain tissue, this action does not describe the half-life. The safest margin to prevent toxicity depends on the rate of metabolism and excretion. The half-life of the medication does not relate directly to a specific reduction in adverse effects.

10.

A patient has increased intracranial pressure and is ordered to receive a diuretic. Which of the following diuretics does not act on receptor sites to produce diuresis?

A)

Furosemide (Lasix)

B)

Hydrochlorothiazide (HCTZ)

C)

Spironolactone (Aldactone)

D)

Mannitol (Osmitrol)

Ans:

D

Feedback:

Mannitol (Osmitrol) is an osmotic diuretic that increases the osmolarity of plasma and pulls water out of the tissues into the bloodstream. It does not act on receptor sites. Furosemide (Lasix) is a loop diuretic that inhibits the reabsorption of sodium and chloride in the loop of Henle. Hydrochlorothiazide is associated with drug interference with absorption of sodium ions across the distal renal tubule. Spironolactone acts by competing with aldosterone for cellular receptor sites.