- Morphine, Codeine, and Methadone have a high potential for abuse or physical or psychological dependency. Which schedule of drugs do these belong in?
- Schedule I
- Schedule II
- Schedule III
- Schedule IV
- In FDA pregnancy categories, what do most drugs fall under?
- Where are most oral drugs absorbed?
- Small intestine
- True or false. In the first-pass effect, an oral medication is metabolized in the kidneys before it gets into the blood stream.
- Which medication administration method avoids the first-pass effect?
- Kayexalate is given via which administration method?
- Retention enema
- Topical creams and gels are based from what?
- True or false. Topical medications are absorbed into the skin slowly.
- NTG paste is measured in:
- Not measured, it comes in a full patch
10. Which method of medication administration is considered the least safe?
11. What does IVP stand for?
- IV piggyback
- IV push
- Both B and C
12. Drug interactions at the cellular level between the drug and the receptor is:
- Drug action
- Drug effect
- Lock and Key
13. Narcan is an example of:
14. The process by which a drug gets from the dosage form into a biological substance that can pass through or across tissues into blood is called:
15. What is the main organ for metabolizing drugs? ___________________
16. What is the main organ for excreting drugs? _____________________
17. If the drug half-life is 6 hours, when would it be completely eliminated from the bloodstream?
- 12 hours
- 18 hours
- 24 hours
- 30 hours
18. When is a maintained concentration typically reached?
- 1 half-life
- 2 half-lives
- 4 half-lives
- 5 half-lives
19. True or false: A loading dose can be given at once to reach a therapeutic level at once.
20. An adverse drug effect induced by the prescribed drug that may cause a pathological disorder is called:
- Iatrogenic drug effect
- Unlabeled drug use
- Idiosyncratic reaction
21. What pages of the PDR (Physicians drug reference) book will have an index of drugs by brand and alphabetized? (The pages the nurses would most often look)
22. Which of these precautions should staff include in the care of a client who is receiving a sealed source of radiation therapy for uterine cancer?
- Limiting a staff member’s time with client to less than 30 minutes per shift.
- Keeping a zinc-lined container and forceps in the client’s room
- Instructing the visitors to maintain a distance of about 3 feet from the client
- Reminding the client to flush the toilet several times after each use.
23. A client has pain because of cancer. The client’s pain management plan should include one of these recommendations from the World Health Organization?
- The potential problem of pain medications for cancer are overdose and addiction.
- Medication and biofeedback should not be suggested because the have been proven ineffective in pain relief.
- Pain medications are best absorbed by the oral route.
- The pain ladder concept should be used to decide what medications to use for cancer pain.
24. A client who is about to undergo chemotherapy tells you that she is more terrified of losing hair than of the drug. The client intends to take an herbal remedy to prevent baldness. The most important nursing intervention is to:
- Inform the client that herbal remedies will antagonize chemotherapy effects.
- Tell the client that she must tell the physician, since herbs may or may not be harmful.
- Encourage as many herbal remedies as possible, since chemotherapy is so toxic.
- Tell the client that being bald and surviving is better than having hair and not being treated.
25. An 11-year old client has been complaining of severe pain since surgery two days ago. The client is currently in the play room, avidly playing video games, and shows no evidence of pain. When the nurse has the client return to bed, the client begins complaining of severe pain again. Which of the following is probably true about this pain?
- The client is addicted to pain medication, so pain management must be carefully monitored.
- Pain medications wore off as the client went to bed.
- The client probably said there was no pain so bedrest wouldn’t be implicated.
- The distraction of playing video games is an important adjunct to other pain-management techniques.
26. Which of these steps in the administration of eye drops to a client is correct?
- Warming the medication to body temperature
- Having the client look downward as the head is tilted forward before administration
- Placing the number of prescribed drops directly on the cornea.
- Applying gentle finger pressure to the client’s inner canthus for one or two minutes after administration.
27. When administering medications to a client, the nurse should:
- Double check the medication orders before administering
- Call the patient by name upon entering the room in order to verify the patient.
- Check the patients armband before administering the medication
- Prepare medications for all client’s first, and then administer by room in order to manage time more efficiently.
28. For which of the following activities is the nurse responsible during the evaluation phase of drug administration?
- Preparing and administering medication safely and as ordered.
- Planning measurable outcomes for the patient related to drug therapy.
- Monitoring the patient continuously for therapeutic as well as adverse effects
- Gathering data in a drug and dietary history.
29. Drugs can exert their action on the body by: (circle all that apply)
- Interaction with receptors
- Making the cell perform a new function
- Inhibiting the action of a specific enzyme
- Altering metabolic chemical processes.
30. Another name for biotransformation of a drug is:
31. Drugs given by which route is altered by the first-pass effect?
32. Drug half-life is defined as the amount of time required for 50% of the drug to:
- Be absorbed by the body
- Exert a response
- Be eliminated by the body
- Reach a therapeutic level
33. Highly protein-bound drugs:
- Increase the risk of drug-drug interactions
- Typically provide a short duration of action
- Must be administered with 8 ounces of water
- Have a decreased effect in patients with low albumin levels.
34. Patients with renal failure would most likely have problems with drug:
35. The ratio between drugs therapeutic effect and toxic effect is:
- Cumulative effect
- Therapeutic ratio
36. When calculating pediatric doses, the nurse understands that:
- Clark’s rules calculates dosage based on the client’s age and uses a nomogram to determine body surface area.
- Freid and Young’s rules calculate the dosage based on milligrams of drug per pound of body weight.
- Dosage calculation according to the body weight is the most accurate method because it takes into account differences of maturational development.
- Dosage calculation by body surface area is the most accurate method because it takes into the account the differences in size of the child and/or neonate
37. The physiologic changes that normally occur in the older adult have which of the following implications for the nurse who is assessing drug responses in this patient?
- Drug half-life is lengthened.
- Drug metabolism is faster
- Drug elimination is faster
- Protein binding is more efficient.
38. When assessing a client for adverse effects related to morphine, which of the following would the nurse not expect?
- Decreased peristalsis
- Delayed gastric emptying
- Common bile duct spasm
39. When assessing for the most serious adverse reaction to a narcotic, the nurse is careful to monitor the patients:
- Respiratory rate
- Heart rate
- Blood pressure
- Mental status
- B. Schedule II drugs are highly regulated.
- C; uncertain risk. Most drugs fall under this category.
- D. Absorbed in small intestine to live to circulation.
- False. It is metabolized in the liver. It is excreted through the kidneys.
- D. Sublingual and Buccal methods have a very fast absorption rate.
- B. It is given to decrease Potassium levels in the body.
- B. Topical corticosteroids are the most common.
10. C. ALWAYS double check order.
11. D. Bolus and IV push is the same thing.
13. B. It is a competitive antagonist. It cancels out the actions of morphine.
22. A. To protect nurses and others from excessive radiation exposure, the principles of distance, time, and shielding are important. It is recommended that a staff member limits direct care to a client as described to 30 minutes per shift.
23. D. Less than 1% of cancer clients in pain experience overdose or addiction problems.
24. B. The client must understand that the provider must be informed of all medications (herbal, OTC, prescriptions) because they may not be safe.
25. D. Nonpharmacologic interventions, including distractions, are an important component of pain relief modalities.
26. The major rationale for applying pressure to the inner canthus of the eye is to prevent systemic absorption of the eye drops. In addition, absorption in the eye is promoted, and drainage into the nose and throat is minimized.
27. C. Armband is the most accurate form of identifiably.
28. C. Ongoing monitoring of the patient evaluates the effect of the drug on the patient. All of the other answers refer to the different steps in the nursing process.
29. A, C, D. Drugs cannot make the cell perform a new function; only alter the way it performs its current function.
30. D. Metabolism connoted the breakdown of a product. Biotransformation is a more accurate term because some drugs are actually changed into an active form in the liver in contrast to being broken down for excretion.
31. C. Medications are absorbed in the stomach and small intestine travel through the portal system and are metabolized by the liver before they reach the general circulation.
32. C. Half-life refers to the time it takes to excrete a drug from the body.
33. A. When administering 2 drugs that are protein bound, one of the drugs will have fewer sites to which to bind and thus more drug available for the activity, thus increasing the risk for toxicity.
34. A. The kidneys are responsible for the majority of drug secretion.
38. B. Morphine causes a decrease in GI mobility, leading to constipation, not diarrhea.
39. A. The most serious adverse effect would be respiratory depression.