KARCH Chapter 2: Bonus Test 1 Drugs & the Body PREP U

One week ago, a 74-year-old patient was started on a benzodiazapine for the treatment of an anxiety disorder. The patient comes into the clinic for a follow-up visit and states that she is nervous, can't sleep, and feels hyperactive. What does the nurse u

Paradoxical excitement

The nurse is reviewing the history of a patient for possible factors that might affect the pharmacokinetics of a prescribed drug. A possible problem with absorption might occur if the patient has a history of which of the following?
a) Vascular disease

Gastrointestinal disease

Which statement best reflects the placebo effect?
a) "I hope this drug is better than the first one."
b) "A low fat diet would work better than this drug."
c) "I'm not the type of person who likes to take pills."
d) "I know this drug will work to cure my

I know this drug will work to cure my infection.

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?
a) Excretion
b) Distribution
c) Metabolis


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


A nurse is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen?
a) "What effect are you expecting that

Do you take any herbal supplements or alternative medications?

A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to
a) increased levels of plasma albumin.
b) decreased gastrointestinal mo

decreased blood flow to tissues and muscles.

An instructor is describing a specific area on a cell membrane where most drugs are thought to act. The students demonstrate understanding of this information when they identify this area as which of the following?
a) Lock
b) Enzyme system
c) Agonist
d) R

Receptor site

An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?

An oral antidepressant that the patient has been taking daily for several years

Only drugs that are lipid soluble or have a transport system have the ability to:
a) Inhibit abnormal cellular function.
b) Cross the blood-brain barrier.
c) Achieve therapeutic drug levels.
d) Achieve 100% bioavailability.

Cross the blood-brain barrier.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean which of the following?
a) The drug will lead to toxicity when given.
b) The drug will be released fairly quickly.

The drug will have a long duration of action.

The elderly client is taking five prescription and over-the-counter medications. The nurse calculates the client is at risk for two-drug combinations that could interact to produce an adverse effect. The number of these two-drug combinations is
a) 5
b) 8


A drug is 100% bioavailable when it is administered by what routes?
a) Rectal
b) Parenteral
c) Oral
d) Intravenous


An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day,

Digoxin and lanoxin are the same medications.

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?
a) 15.625 mg
b) 62.5 mg
c) 31.25 mg
d) 125 mg

31.25 mg

A patient has been brought to the emergency department (ED) following a cold water incident. Which of the following would be a potential effect of medication absorption from this clinical manifestation?
a) Toxic effect of the drug
b) Less than therapeutic

Less than therapeutic effect

In the first-pass effect or presystemic metabolism, a drug is extensively metabolized in the liver, with only part of the drug dose reaching the systemic circulation for distribution to sites of action. The first-pass effect occurs when some drugs are giv


A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient's care, the nurse sh


A 73-year-old patient has been given metoclopramine to take before meals. The patient tells the nurse that she has noticed tremors of the hands and that her head has been shaking. What does the nurse understand may be occurring with this patient?
a) The p

The patient is having parkinsonian effects from the metoclopramide.

An elderly patient comes into the clinic with a family member. The patient reports back pain. The physician prescribes cyclobenzaprine (Flexaril) for the patient. What type of adverse effects should the nurse educate the patient and family about?
a) Anti-

Anti-cholinergic side effects such as sedation and weakness

The elderly client has been noncompliant with taking a prescribed medication. The nurse next asks the client
a) "Are you having difficulty remembering to take the medication?"
b) "Is there anyone who can help you to adhere to the planned schedule?"
c) "Do

What is the reason you have not taken the medication?

The 68-year-old patient states, "I have been taking aspirin on occasion for my arthritis for many years but notice that it takes longer for it to start working now." What is the best response by the nurse?
a) "As you get older, absorption is quicker and t

As you get older, absorption is prolonged and make take a little longer to act than normal.

The nurse knows that when caring for the older adult, there are several normal aging processes that put the patient at risk for toxicity. What factor puts such patients at increased risk for drug toxicity?
a) Reduced plasma protein levels
b) Reduced effic

Reduced efficiency of renal function

n which of the following patients would a nurse expect to experience alterations in drug metabolism?
a) A 50-year-old man with cirrhosis of the liver
b) A 35-year-old woman with cervical cancer
c) A 41-year-old man with kidney stones
d) A 62-year-old woma

A 50-year-old man with cirrhosis of the liver

Drugs are chemicals that alter basic processes in body cells. That means that:
a) Most drugs are given for local effects on body cells.
b) Drugs can stimulate or inhibit normal cellular functions; they cannot add functions.
c) Therapeutic levels are depen

Drugs can stimulate or inhibit normal cellular functions; they cannot add functions.

Urine acidity can play an important role in drug excretion.
a) False
b) True


An elderly patient calls the physician's office and tells the nurse that prescriptions for three medications have run out and the pharmacy will not refill them this close together. A home health referral is made and the patient is found to be taking her m

Nonadherence to therapeutic medication regimen

When determining the half-life of a drug, which of the following must be taken into account? Select all that apply.
a) Excretion rate
b) Patient acuity
c) Rate of absorption
d) Distribution to the tissues
e) Patient self-care ability

� Excretion rate
� Rate of absorption
� Distribution to the tissues

Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about
a) the need to have a younger fami

potential adverse effects of the drugs that Mr. Nguyen will be taking

As the nurse caring for a patient who has been diagnosed with hypoalbuminemia, which effect do you know will occur if you administer a drug that is highly protein bound?
a) Increased rate of absorption of the drug, leading to toxicity
b) Increased rate of

Increased rate of distribution of the drug, leading to toxicity

A 38-year-old patient is obese and has abscesses around his inner thigh muscles. He is receiving IV antibiotics, but no improvement has been seen. The patient questions the nurse about the most likely cause for the drug therapy failure. The nurse explains

distribution of the drug to the area of the abscesses is impaired.

Drug evaluation studies are used to determine critical concentration. The nurse understands that the critical concentration is the amount of the drug needed to cause which of the following?
a) Lethal effect
b) Therapeutic effect
c) Minimal effect
d) Toxic

Therapeutic effect

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that

Integrating the new drug into the patient's existing schedule promotes adherence

When a drug is discontinued, what percentage of that drug will remain in the body after three half-lives?
a) 50%
b) 12.5%
c) 25%
d) 75%


The nurse is caring for an older adult and is reviewing the normal age-related changes that occur in this group of patients and realizes that such changes extend the half-life of drugs. What is the physiologic change that causes this to occur?
a) Reduced

Reduced oxidation in phase I of hepatic metabolism

Which of the following represents a pharmacokinetic phase? Select all that apply.
a) Absorption
b) Distribution
c) Excretion
d) Administration
e) Metabolism

� Absorption
� Distribution
� Metabolism
� Excretion

For what reason is the creatinine level alone not a good indicator of renal function in the older adult?
a) There is a decline in overall muscle mass, which produces a lower creatinine level.
b) Increased renal tubular secretion of creatinine causes abnor

There is a decline in overall muscle mass, which produces a lower creatinine level.

When considering the physiologic differences between men and women and drug effects, which of the following would a nurse need to keep in mind?
a) Women are at greater risk for electrolyte imbalances, which could alter a drug's effect.
b) Women have more

Women have more fat cells so drugs depositing in fat will have a prolonged effect.

A nurse is caring for a 92-year-old patient who is taking multiple drugs and displaying increased cognitive impairment and memory loss. The initial action of the nurse would be to
a) try to distinguish between normal signs of aging and the adverse drug ef

try to distinguish between normal signs of aging and the adverse drug effects.

Penicillin causes bacterial cell death without disrupting normal human cell functioning. This is an example of which of the following?
a) Critical concentration
b) Enzyme induction
c) Selective toxicity
d) First-pass effect

Selective toxicity

A gerontological nurse is conducting a medication assessment of a new patient on a subacute medicine unit. Which of the patient's statements should signal to the nurse a need for patient education?
a) "My family doctor has me on so many different pills no

I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural.