Abrams' Clinical Drug Therapy: Rationales for
Nursing Practice 12th Edition Frandsen Test Bank
Chapter 1 The Foundation of Pharmacology: Quality and
... [Show More] Safety
1.
A woman has been prescribed paroxetine
hydrochloride, which is an antidepressant
agent administered in pill form. The
medication is administered for her obsessivecompulsive disorder. This medication will
produce which of the following effects?
A) Curative
B) Systemic
C) Local
D) Parenteral
Ans: B
Feedback:
Drugs that produce systemic effects are taken
into the body, circulated through the
bloodstream to their sites of action in various
body tissues, and eventually eliminated from
the body. Curative agents are given to cure a
disease process. In this case, paroxetine
hydrochloride will control the symptoms but
not cure the disorder. Drugs with local effects,
such as sunscreen and local anesthetics, act
mainly at the site of application. Paroxetine
hydrochloride is not administered
parenterally. Parenteral agents are
administered subcutaneously, intramuscularly,
or intravenously.
2.
A patient has been prescribed an antibiotic.
This medication is a naturally occurring
substance that has been chemically modified.
What is another name for this type of
medication?
A) Synthetic drug
B) Semisynthetic drug
C) Biotechnology drug
D) Prototype drug
Ans: B
Feedback:
Semisynthetic drugs (e.g., many antibiotics)
are naturally occurring substances that have
been chemically modified. Synthetic drugs are
more standardized in their chemical
characteristics, more consistent in their
effects, and less likely to produce allergic
reactions. Biotechnology drugs involve
manipulating DNA and RNA and
recombining genes into hybrid molecules that
can be inserted into living organisms.
Prototype drugs are the first drug of
a
particular group to be developed.
3.
A patient is administered morphine. Morphine
is
a prototypical drug that can be classified in
different ways. Which of the following
classifications applies to morphine
?
A) Central nervous system depressant
B) Central nervous system stimulant
C) Anti
-inflammatory
D) Antihypertensive
Ans:
A
Feedback:
Drugs are classified according to their effects
on particular body systems, their therapeutic
uses, and their chemical characteristics. For
example, morphine can be classified as
a
central nervous system depressant and
a
narcotic or opioid analgesic.
A central nervous
system stimulant increases attention and
raises mood. An anti
-inflammatory agent
decreases inflammation at the site of tissue or
joint inflammation. An antihypertensive agent
reduces blood pressure.
4.
A patient is administered amoxicillin
(Amoxil). The generic name of this
medication indicates that it belongs to which
drug group?
A) Selective serotonin reuptake inhibitors
B) Diuretics
C) Penicillins
D) ACE inhibitors
Ans:
C
Feedback:
The generic name often indicates the drug
group (e.g., drugs with generic names ending
in “cillin” are penicillins). Selective serotonin
reuptake inhibitors are medications that have
antidepressant effects; SSRI is
a broad
classification, not
a generic name. Diuretics
are medications that increase urine output;
diuretic is
a broad classification, not
a generic
name. ACE inhibitor is the broad
classification for
the angiotensin
-converting
enzyme inhibitors, not the generic name.
5.
The administration of diphenhydramine
(Benadryl), which is an over
-the
-counter
medication, is regulated by which government
agency?
A) Public Health Service
B) Federal Trade Commission
C) Occupational Safety and Health
Administration
D) Food and Drug Administration
Ans:
D
Feedback:
The Food and Drug Administration approves
drugs for over
-the
-counter availability,
including the transfer of drugs from
prescription to OTC status
, and may require
clinical trials to determine the safety and
effectiveness of OTC use. The Public Health
Service is regulated by the state to maintain
the health of individual citizens of the state.
The Federal Trade Commission regulates
imports and exports throughout the nation.
The Occupational Safety and Health
Administration regulates safety within the
workplace.
6. The administration of anabolic steroids is
regulated by which of the following laws?
A) The Food, Drug, and Cosmetic Act of 1938
B)
The Comprehensive Drug Abuse Prevention
and Control Act
C) The Harrison Narcotic Act
D) The Shirley Amendment
Ans:
B
Feedback:
The Comprehensive Drug Abuse Prevention
and Control Act regulates the manufacture
and distribution of narcotics, stimulants,
depressants, hallucinogens, and anabolic
steroids. The Food, Drug, and Cosmetic Act
of 1938 revised and broadened FDA powers
and responsibilities, giving the FDA control
over drug safety. The Harrison Narcotic Act
restricted the importation, manufacture
, sale,
and use of opium, cocaine, marijuana, and
other drugs that the act defined as narcotics.
The Shirley Amendment of 1912 prohibited
fraudulent claims of drug effectiveness.
7.
A nurse is responsible for maintaining an
accurate count and record
o
f the controlled
substances on the nursing unit. This nursing
action is regulated by which of the following
laws or agencies?
A) Food, Drug, and Cosmetic Act of 1938
B) Public Health Service
C) Drug Enforcement Administration
D) Shirley Amendment
Ans:
C
Feedback:
The Drug Enforcement Administration
enforces the Controlled Substances Act.
Under this enforcement, nurses are
responsible for storing controlled substances
in locked containers, administering them only
to the people for whom they are prescribed,
recording each dose given, and maintaining
an accurate inventory. The Food, Drug, and
Cosmetic Act of 1938 revised and broadened
FDA powers and responsibilities, giving the
FDA control over drug safety. The Public
Health Service is regulated by the state to
maintain the health of individual citizens of
the state. The Shirley Amendment of 1912
prohibited fraudulent claims of drug
effectiveness.
8.
In Phase
I clinical trials, the potential uses and
effects of
a new drug are determined by
which of the following methods?
A) Administering doses to healthy volunteers
B) Administering doses to people with the
Disease
C) Administering in placebo
-controlled design
D) Calculating the risk
-to
-benefit ratio
Ans:
A
Feedback:
Phase
I studies allow for the administration of
the medication to healthy volunteers to
determine safe dosages, routes of
administration, absorption, metabolism,
excretion, and toxicity. In Phase II studies,
a
few doses are given to
a certain number of
subjects with the disease or symptom for
which the drug is being studied and responses
are compared with those of healthy subjects.
Placebo
-controlled designs are used in the
Phase III studies, in which half of the subjects
receive the new drug and half receive the
placebo. Calculating the risk
-to
-benefit ratio
is used in Phase II studies to determine
whether the potential benefits of the drug
outweigh the risks.
9.
A new medication for the treatment of
Alzheimer's disease is being administered to
a
group of subjects with the
disease. The
subjects receiving this medication are
unaware of whether they are being
administered the medication or whether they
are receiving
a placebo. This testing occurs in
which phase of the drug approval process?
A) Phase
I
B) Phase II
C) Phase II
I
D) Phase IV
Ans:
C
Feedback:
In Phase III, the drug is given to
a larger and
more representative group of subjects. In
double
-blind, placebo
-controlled designs, half
of the subjects receive the new drug and half
receive
a placebo (an inactive substance
similar in appearance to the actual drug), with
neither subjects nor researchers knowing
which subjects receive which formulation. In
Phase I,
a few doses are given to
a certain
number of healthy volunteers to determine
safe dosages, routes of administration,
absorption, metabolism, excretion, and
toxicity. In Phase II,
a few doses are given to
a certain number of subjects with the disease
or symptom for which the drug is being
studied and responses are compared with
those of healthy subjects. In Phas
e IV, the
FDA evaluates the data from the first three
phases for drug safety and effectiveness,
allows the drug to be marketed for general
use, and requires manufacturers to continue
monitoring the drug's effects.
10. Which organization is responsible
for
approving new drugs in the United States?
A) American Medical Association
B) American Pharmaceutical Association
C) Food and Drug Administration
D) United States Pharmacopeia
Ans:
C
Feedback:
The Food and Drug Administration is
responsible for approving new drugs in the
United States. The American Medical
Association represents the physicians of the
United States. The American Pharmaceutical
Association represents the pharmacists of the
United States. The United States
Pharmacopeia was adopted
i
n 1906 and is
issued every
5 years under the supervision of
a national committee of pharmacists,
scientists, and physicians.
11.
Which of the following reference books
provides information from the drug
manufacturers' inserts?
A) American Formulary Service
B) Drug Facts and Comparisons
C) Physicians' Desk Reference
D) Lippincott's Nursing Drug Guide
Ans:
C
Feedback:
The Physicians' Desk Reference is published
yearly and contains manufacturers' published
inserts for selected drugs. American
Formulary Service is an authoritative source
of drug information. Drug Facts and
Comparisons is an authoritative source of
drug information. Lippincott's Nursing Drug
Guide is an example of
a drug handbook, not
a compilation of manufacturers' inserts.
12.
A nursing student in
a pharmacology class
should be encouraged to study the
medications according to which
categorization?
A) Prototype
B) Controlled substance
C) Drug use
D) Generic names
Ans:
A
Feedback:
The nursing student should concentrate on
therapeutic classifications and their
prototypes. Controlled substances limit the
medications studied to one broad
classification. Drug use is only one part of the
broad classification. Generic names are only
one aspect of the medication.
13.
A patient with a long
-standing dermatological
health problem has been advised to use a drug
with
a local effect. The nurse should
recognize what characteristic of this drug?
A) It affects only the organ system in which it is
metabolized.
B) The drug requires application at multiple
sites.
C) It is effective only as long as it is in contact
with skin.
D) The drug acts primarily at the site where it is
applied.
Ans:
D
Feedback:
Drugs with local effects, such as sunscreen
lotions and local anesthetics, act mainly at the
site of application. Those with systemic
effects are taken into the body, circulated
through the bloodstream to their sites of
action in various body tissues, and eventually
eliminated from the body.
A drug with local
effect does not necessaril
y have to be applied
at multiple sites, and its action may affect
tissues long after contact.
14.
A patient with an autoimmune disorder has
just been prescribed
a synthetic drug. Which
of the following characteristics is
a noted
advantage of synthetic drugs?
A)
Synthetic drugs are less likely to cause an
allergic reaction than naturally occurring
substances.
B) Synthetic drugs typically require less frequent
dosing than naturally occurring substances.
C) Synthetic drugs are normally available on an
over
-the
-counter basis.
D)
Synthetic drugs are available in
a wider
variety of administration routes than naturally
occurring substances.
Ans:
A
Feedback:
Synthetic drugs are more standardized in their
chemical characteristics, more consistent in
their effects, and less likely to produce
allergic reactions. They do not necessarily
require less frequent dosing and may or may
not be available OTC. They are not noted to
be available in
a wider variety of
administration routes than naturally occurring
substances.
15.
A patient is confused about her care provider's
advice and has stated to the nurse, “I wasn't
sure whether he recommended Tylenol or
whether he recommended acetaminophen.”
The nurse should include which of the
following information in
a
n explanation of
generic and trade names?
A)
Prescribers should refer solely to generic
names in their recommendations and written
prescriptions.
B)
A generic name is independent of any
particular drug manufacturer.
C) Generic names change frequently, but trade
names are more consistent.
D)
Prescribers should refer solely to trade names
in their recommendations and written
prescriptions.
Ans:
B
Feedback: A generic name is related to the chemical or
official name and is independent of the
manufacturer. Drugs may be prescribed and
dispensed by generic or trade name. Generic
names do not change, while trade names vary
according to time and place.
16.
A nurse is aware that American drug laws
have
a long and complex history, with
numerous jurisdictions being involved. What
is the primary purpose of drug laws in the
United States?
A) To ensure maximum choice for consumers
B) To expedite the workload of care providers
C) To protect the safety of the public
D) To enhance the efficient delivery of health
Care
Ans:
C
Feedback:
The main goal of drugs laws is to protect the
public by ensuring that drugs marketed for
therapeutic purposes are safe and effective.
Efficiency and choice are valid considerations
but neither is the primary goal of American
drug legislation.
17.
A nurse who provides care on
a postsurgical
unit frequently administers Schedule II drugs
to patients. Which of the following aspects of
administering these drugs falls under the
auspices of the Drug Enforcement Agency?
A)
Performing
a thorough patient assessment
prior to administration
B) Recording each dose administration on an
agency narcotic sheet
C)
Informing patients of the potential risks and
benefits of Schedule II drugs prior to the first
dose
D) Assessing the patient shortly after
administration to ensure therapeutic effect
Ans:
B
Feedback:
Nurses are responsible for storing controlled
substances in locked containers, administering
them only to people for whom they are
prescribed, recording each dose given
o
n
agency narcotic sheets and on the patient's
medication administration record, maintaining
an accurate inventory, and reporting
discrepancies to the proper authorities. The
other given actions are appropriate nursing
activities, but they are not within th
e scope of
the DEA authority.
18.
Trials of
a new drug are scheduled to soon
begin and the testing methodology will
integrate the stipulations of the National
Institutes of Health (NIH) Revitalization Act.
According to this act, the manufacturer must
A) independently fund the entire testing process.
B) make the results of the testing process
publicly available.
C) include women and minorities in the testing
process.
D) exclude any potential for financial gain during
the testing process.
Ans:
CFeedback:
In 1993, Congress passed the National
Institutes of Health (NIH) Revitalization Act,
which formalized
a policy of the NIH that
women and minorities be included in human
subject research studies funded by the NIH
and that women and minorities be included in
clinical drug trials. This act does not
specifically address the financial structure of
testing or the accessibility of information.
19.
A hospital nurse is vigilant in ensuring the
safe use of medications and consistently
applies the rights of medication
administration. Which of the following is one
of the traditional rights of medication
administration?
A) Right to refuse
B) Right route
C) Right education
D) Right evaluation
Ans:
B
Feedback:
The traditional rights of medication
administration (right drug, right dose, right
patient, right route, right time, right reason,
and right documentation) now include
additional rights that should also be
considered (right education, right evaluation,
and right to refuse the medication).
20.
A patient's current medication administration
record includes
a drug that the nurse
recognizes as an Institute for Safe Medication
Practices (ISMP) high
-alert medication. This
designation signals the nurse to what
characteristic of the drug?
A) It
can only be administered by
a physician or
advanced practice nurse.
B) Administration must be cosigned by
a second
registered nurse or practical/vocational nurse.
C) It is currently undergoing Phase IV testing
and is pending full FDA approval.
D) Administration errors carry
a heightened risk
of causing significant patient harm.
Ans: D
Feedback:
The Institute for Safe Medication Practices
(ISMP) identifies drugs that when used in
error have a heightened risk of causing
significant patient harm. Such drugs are not
limited to physician or advanced practice
nurse administration. The drug would have
completed the testing and approval procedure
and administration does not necessarily
require a cosignature.
Chapter 2 Basic Concepts and Processes
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 [Show Less]