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Chapter 04: Pharmacokinetics

Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum

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Chapter 04: Pharmacokinetics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A patient tells the nurse that the oral drug that has been prescribed has caused a lot of stomach discomfort in the past. What will the nurse ask the prescriber?
a. Whether a sublingual form of the medication can be given
b. Whether the medication can be given by a parenteral route instead
c. Whether an enteric-coated form of the drug is available
d. Whether the patient can receive a sustained-release preparation of the drug

 

 

ANS:  C

Enteric-coated drugs are preparations that have been coated with a material that dissolves in the intestines, not the stomach. This coating is used either to protect the drug from stomach acid and pepsin or to protect the stomach from a drug that can cause gastric upset. Sublingual forms often are used for drugs that undergo rapid inactivation during the first pass through the hepatic circulation so that the drug can be absorbed directly into the systemic circulation. Parenteral routes are more costly and less safe than oral administration and should not be used unless necessary. A sustained-release preparation is used to release the drug into the body over a specific period to reduce the number of daily doses required to sustain therapeutic drug levels.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 31

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

  1. A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely?
a. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect.
b. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical.
c. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug’s effects in the body.
d. The bioavailability of a drug is determined by the amount of the drug in each dose.

 

 

ANS:  C

Even if two brands of a drug are chemically equivalent (i.e., they have identical amounts of the same chemical compound), they can have different effects in the body if they differ in bioavailability. Tablets made by different manufacturers contain different binders and fillers, which disintegrate and dissolve at different rates and affect the bioavailability of the drug. Two brands may be chemically equivalent and still differ in bioavailability, which is not determined by the amount of drug in the dose.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 31-32

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

  1. A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
a. Administer the drug at intervals longer than the drug half-life.
b. Administer this medication intravenously.
c. Monitor plasma drug levels.
d. Teach the patient that maximum drug effects will occur within a short period.

 

 

ANS:  C

A drug with a narrow therapeutic range is more difficult to administer safely, because the difference between the minimum effective concentration and the toxic concentration is small. Patients taking these medications must have their plasma drug levels monitored closely to ensure that they are getting an effective dose that is not toxic. Administering medications at longer intervals only increases the time required to reach effective plasma drug levels. Drugs that have a narrow therapeutic range may be given by any route and do not differ from other medications in the amount of time it takes for them to take effect, which is a function of a drug’s half-life and dosing frequency.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 39-40

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

  1. A patient is given a prescription for azithromycin [Zithromax] and asks the nurse why the dose on the first day is twice the amount of the dose on the next 4 days. Which reply by the nurse is correct?
a. “A large initial dose helps to get the drug to optimal levels in the body faster.”
b. “The first dose is larger to minimize the first pass effect of the liver.”
c. “The four smaller doses help the body taper the amount of drug more gradually.”

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