Chap 4 PrepU Questions

Answer KeyQuestion 1:(see full question)

A nurse is explaining to a patient about the need to administer a loading dose of a drug. Which of the following statements best reflects the reason for administering the loading dose?

You selected: "We want to make sure that the drug becomes effective faster."

Correct

Explanation: A loading dose is recommended for use with drugs that may take a prolonged period to reach critical concentration so that the effects can be obtained more quickly. Size is unrelated to the use of a loading dose. Evaluating the body's response is not an indication for using a loading dose. Duration of action is not an indication for using a loading dose. (less)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4, Pharmacotherapeutics, Pharmacokinetics, and Pharmacodynamics, pp. 54-55.

Question 2:(see full question)

A patient is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

You selected: 31.25 mg

Correct

Explanation: This amount of drug is present after 36 hours. This amount of drug would be present after 12 hours. This amount of drug would be present after 24 hours. This amount of drug would b... (more)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4, Pharmacotherapeutics, Pharmacokinetics, and Pharmacodynamics, p. 51.


When a drug is discontinued, what percentage of that drug will remain in the body after three half-lives?

You selected: 25%

Incorrect

Correct response: 12.5%

Explanation: Each half-life removes 50% of the drug stored in the body.

Hence, after one half-life, the percentage of drug in the body would be 50%. After two half-lives, the percentage of drug in the body would be half of 50%, which is 25%. Consequently, after three half-lives, the percentage of drug would be 12.5%. (less)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4: Pharmacotherapeutics, Pharmacokinetics, and Pharmacodynamics, p. 51.


Your patient is taking low dose aspirin daily for their heart. You know that the patient is not receiving all the dosage of the aspirin that is being ingested. This occurs because of what?

You selected: Liver metabolism

Incorrect

Correct response: First-pass effect

Explanation: A large percentage of an oral dose is destroyed when it reaches the liver and never reaches the tissues. This phenomenon is known as the first-pass effect. Therefore Options A, C, ... (more)



The nursing students are learning about the half-life of drugs. A student asks the instructor to explain half-life. What would be the instructor's best response?

You selected: Half-life of a drug is the time it takes for the drug to reach ½ of its' potential peak level in the body.

Incorrect

Correct response: Half-life of a drug is the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved.

Explanation: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved. Therefore Options B, C, and D are ... (more)



Drugs do not metabolize the same in all people. In which of the following patients would a nurse expect to see an alteration in drug metabolism?

You selected: A 50-year-old male with cirrhosis of the liver

Correct

Explanation: The liver is the most important site of drug metabolism. If the liver is not functioning effectively like in patients with cirrhosis, drugs will not be metabolized normally and tox... (more)



The nurse is explaining the pharmacokinetics of a drug being administered to a client. What is meant by the term "pharmakokinetics?"

You selected: Actions of drugs

Correct

Explanation: Pharmacokinetics refers to the actions of drugs. The route of administration refers to the route or method by which a medication is administered. Treatment of overdoses and dosages... (more)



The nurse is preparing to administer a prescribed drug to a patient with a history of renal disease. The nurse expects a reduction in dosage based on the understanding that which of the following might be altered?

You selected: Metabolism

Incorrect

Correct response: Excretion

Explanation: If the kidneys are not functioning properly, a drug may not be excreted properly and could accumulate in the body. Metabolism may be altered if the patient has liver disease.... (more)



Urine acidity can play an important role in drug excretion.

You selected: True

Correct



The patient is a six-year-old who is taking 125 mg of Amoxicillin every 6 hours. Assuming that the half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child's body at the time of the next administration of the drug?

You selected: 31.25 mg

Correct

Explanation: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved. Option A would occur at 3 hours af... (more)



When drugs are bound to proteins in the blood they can be transported to different areas of the body. The protein-drug

complex is relatively large and cannot enter into capillaries and into tissues to react. What must occur for drugs to do their job in the body?

You selected: The drug must be freed from the protein binding site

Correct

Explanation: Most drugs are bound to some extent to proteins in the blood to be carried into circulation. The protein–drug complex is relatively large and cannot ente... (more)



Drugs that are highly lipid soluble are more likely to pass through the blood-brain barrier and reach the central nervous system.

You selected: True

Correct



Only drugs that are lipid soluble or have a transport system have the ability to:

You selected: Cross the blood-brain barrier.

Correct

Explanation: The blood-brain barrier is composed of tight walls, limiting movement of drug molecules. This barrier makes drug therapy for the CNS difficult because drug molecules cannot pass th... (more)



A pharmacology student asks the instructor what an

accurate description of a drug agonist is. What would be the instructor's best response?

You selected: A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site

Correct

Explanation: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Non-competitive antago... (more)



A client older than 65 years is more likely to experience drug reaction than a client younger than 50 years. Which of the following factors accounts for this developmental variation?

You selected: Age-related physiologic changes

Correct

Explanation: In older adults (65 years and older), physiologic changes may alter all pharmacokinetic processes. Although drugs crossing the blood–brain barrier affect drug reaction, this ... (more)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4, Pharmacotherapeutics, Pharmacokinetics, and Pharmcodynamics, p. 47.


Which of the following represents a pharmacokinetic phase? Select all that apply.

You selected: • Metabolism• Excretion• Distribution• Absorption

Correct

Explanation: The pharmacokinetic phases are absorption, distribution, metabolism, and excretion. The acronym A.D.M.E. is a

helpful way to remember to pharmacokinetic phases.... (more)



A nurse is to administer a drug that is loosely bound to protein. The nurse understands that this would mean which of the following?

You selected: The drug will lead to toxicity with other drugs.

Incorrect

Correct response: The drug will have a short duration of action.

Explanation: Drugs that are loosely bound to protein act very quickly and are excreted very quickly. Drugs that are tightly bound to protein are released very slowly. Drugs that are tightly bou... (more)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4, Pharmacotherapeutics, Pharmacokinetics, and Pharmacodynamics, pp. 44-46.


Pharmacotherapeutics is the achievement of the desired therapeutic goal of drug therapy. What standard does the FDA apply to a drug for approval?

You selected: The drug has to be statistically significantly more effective than placebo.

Correct

Explanation: If the clinical studies indicate that the effect a drug has on the desired treatment outcome is statistically significantly better than that achieved with a placebo (an inactive su... (more)

Reference: Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing, 4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012, Chapter 4: Pharmacotherapeutics, Pharmacokinetics, and Pharmacodynamics, p. 42.


A drug with a half-life of 4 hours is administered at a dosage of 100 mg. How much of the drug will be in the patient's system 8 hours after administration?

You selected: 25 mg

Correct

Explanation: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved. Option A would occur 2 hours after... (more)



The route medication must be given to achieve 100% bioavailability is given:

You selected: IV.

Correct

Explanation: Drugs given via the oral route, IM, and sub q routes are virtually always less than 100% available because some of the drug is absorbed in the GI or liver before reaching systemic ... (more)


Chap 4 PrepU Questions

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