Answer Key

Question 1:
(see full question)

You selected:

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?
"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.

Question 3:
(see full question)

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.

Question 4:

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?

(see full question)

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)

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. 48.

Question 5:

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?

(see full question)

You selected:

Half-life of a drug is the time it takes for the drug to reach

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)
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.

Question 6:
(see full question)

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)

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. 46.

Question 7:
(see full question)

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)

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.

Question 8:
(see full question)

You selected:

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?
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)

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. 49.

Question 9:

Urine acidity can play an important role in drug excretion.

(see full question)

You selected:

True

Correct
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. 50.

Question 10:

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?

(see full question)

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)

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.
Question 11:
(see full question)

You selected:

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?
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 proteindrug
complex is relatively large and cannot ente... (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. 44.

Question 12:
(see full question)

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
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. 46.

Question 13:
(see full question)

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)

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. 46.

Question 14:

A pharmacology student asks the instructor what an

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

(see full question)

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. Noncompetitive antago... (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. 53.

Question 15:

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?

(see full question)

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 bloodbrain 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.

Question 16:
(see full question)

You selected:

Which of the following represents a pharmacokinetic

phase? Select all that apply.
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)

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.

Question 17:
(see full question)

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.

Question 18:

Pharmacotherapeutics is the achievement of the desired

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

(see full question)

You selected:
Correct

The drug has to be statistically significantly more effective

than placebo.

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.

Question 19:
(see full question)

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)

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.

Question 20:
(see full question)

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)

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. 43.

Answer Key
Question 1:

What does the lipid solubility of the drug influence?

(see full question)

You selected:

Absorption of the drug

Incorrect
Correct response:

Distribution of the drug

Explanation:

As with absorption, factors that can affect distribution

include the drug's lipid solubility and ionization and the
perfusion of the reactive tissue. The lipid solubility of a
drug... (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. 43.

Question 2:
(see full question)

Which of the following is a key process with drug

excretion?

You selected:

Active transport

Correct
Explanation:

Although active transport may be involved with absorption,

it is a very important process in drug excretion in the
kidney. Passive diffusion is the major process through
which drug... (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. 50.

Question 3:
(see full question)

You selected:

What types of medication can pass through the blood

brain barrier or the placenta? (Select all that apply.)
Water-soluble medications
Ionized medications
Lipophilic medications
Medications unbound to protein

Incorrect
Correct response:

Water-soluble medications
Lipophilic medications
Medications unbound to protein

Explanation:

The bloodbrain barrier and the placental barrier are

protective mechanisms in the body that protect the brain or
fetus from toxins. In order for a medication to pass throug...
(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. 46.

Question 4:

Which factors will decrease the rate of drug absorption?

Select all that apply.

(see full question)

You selected:

A disease that alters the stomach and small intestine

lining

Incorrect
Correct response:

Higher drug concentration in the circulatory system

Drug given by a subcutaneous route versus an
intramuscular route
A disease that alters the stomach and small intestine
lining

Explanation:

Increased blood flow will increase the rate of absorption,

but if there is a higher concentration of the drug already in
the blood, then the drug will not be absorbed as quickly.
D... (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. 43.

Question 5:
(see full question)

Which drug would most likely induce the effects of the

cytochrome P450 enzyme system?

You selected:

Ketoconazole

Incorrect
Correct response:

Nicotine

Explanation:

Nicotine, alcohol, and glucorticoids such as cortisone

induce the effects of the P450 enzyme system.
Ketoconazole, quinidine, and mexilitene inhibit the
effects.... (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,
Pharmacodynamics, p. 47. Karch, A.M. Focus on Nursing
Pharmacology, 5th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2011, Chapter 2:
Drugs and the Body, p. 48.

Question 6:
(see full question)

A method that describes the process of absorption,

distribution, and elimination of a drug in the body is known
as:

You selected:

Pharmacokinetics.

Correct
Explanation:

Route of administration is the way in which the drug is

introduced. Systemic drug effects are effects on body cells
distant from the site of administration. Drug distribution
invol... (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.

Question 7:

A patient presents to the emergency department with a

drug level of 50 units/mL. The half-life of this drug is 1 hour.
With this drug, concentrations above 25 units/mL are
considered toxic and no more drug is given. How long will
it take for the blood level to reach the non-toxic range?

(see full question)

You selected:

1 hour

Correct
Explanation:

Half-life is the time required for the serum concentration of

a drug to decrease by 50%. After 1 hour, the serum
concentration would be 25 units/mL (50/2). After 2 hours
the serum ... (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.

Question 8:

Fluoxitine is given to your patient at a dosage of 500 mg

every 6 hours. Assuming that the half-life of this drug is 3
hours at what point would the drug level in the body be
62.5 mg of the original dose?

(see full question)

You selected:

9 hours after the original dose

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. At a dose of 500 mg Option A would...
(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.

Question 9:

A nurse is administering digoxin to one of their patients.

When administering a drug the nurse needs to consider
the phases of what so that the drug they are administering
can be made as effective as possible?

(see full question)

You selected:

Pharmacotherapeutics

Incorrect
Correct response:

Pharmacokinetics

Explanation:

When administering a drug, the nurse needs to consider

the phases of pharmacokinetics so that the drug regimen
can be made as effective as possible. Pharmacogenomics
is the area of... (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.

Question 10:

The patient has a diagnosis of Multiple Sclerosis and is

taking the beta seron drug Rebiff. The patient takes this
drug by sub-q injection 3 times a week. The dosage is 44
mcg per injection. If the patient takes an injection on
Monday, how much of the drug would still be in the
patient's system when they take their next injection on
Wednesday assuming the half-life of the drug is 24 hours?

(see full question)

You selected:

11 mcg

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 24 hours afte...
(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.

Question 11:

Drugs are chemicals that alter basic processes in body

cells. That means that:

(see full question)

You selected:

Drugs can stimulate or inhibit normal cellular functions;

they cannot add functions.

Correct
Explanation:

Dosage form is a consideration in effectiveness but not a

major factor. Drugs are given for systemic effects, and
therapeutic levels are dependant upon multiple factors....
(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. 52.

Question 12:

Which drug would be considered an agonist?

(see full question)

You selected:

Insulin

Correct
Explanation:

Insulin is considered an agonist because it reacts with

specific receptor sites to change the cell membrane
permeability, interacting directly with the receptor sites to
cause the ... (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,
Pharmacodynamics, p. 47. Karch, A.M. Focus on Nursing
Pharmacology, 5th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2011, Chapter 2:
Drugs and the Body, p. 53.

Question 13:

A nurse is caring for a patient who has been receiving a

drug by the intramuscular (IM) route. The physician writes
discharge orders, which include an order for the drug to be
given orally. The nurse notices that the oral dosage is
considerably higher than the parenteral dose. What does
the nurse understand this is due to?

(see full question)

You selected:

First-pass effect

Correct
Explanation:

The first-pass effect involves drugs that are absorbed from

the small intestine directly into the portal venous system,
which delivers the drug molecules to the liver. Once in
the... (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. 48.

Question 14:

What influences drug absorption?

(see full question)

You selected:

Route of administration

Correct
Explanation:

Drug absorption is influenced by the route of

administration. Some drugs are not taken with fluid, e.g.,

parenteral drugs, therefore Option A is incorrect. The route
of excretion d... (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. 43.

Question 15:
(see full question)

There are many enzyme systems in the body. What is

disrupted if a single step in any enzyme system is
blocked?

You selected:

Cell function

Correct
Explanation:

If a single step in one of the many enzyme systems is

blocked, normal cell function is disrupted. Therefore
Options A, B, and C are incorrect.... (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. 48-49.

Question 16:
(see full question)

A nurse would expect a drug to take the longest to be

absorbed if given by which route?

You selected:

Oral

Correct
Explanation:

Generally, drugs given by the oral route are absorbed more

slowly than those given parenterally. Generally,
parenterally administered drugs are absorbed more quickly
than oral drug... (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. 43.

Question 17:

You are caring for a patient who is receiving Gentamycin,

(see full question)

250 mg and Diflucan, 500 mg at the same time. As the

nurse you would know that if these two drugs competed
with each other for protein binding sites what would this
do?
You selected:

Alter the effectiveness of the drugs

Correct
Explanation:

Some drugs compete with each other for protein binding

sites, altering effectiveness or causing toxicity when the
two drugs are given together. Nothing in the scenario
would indica... (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. 45-46.

Question 18:

Most oral drugs are best taken on an empty stomach.

(see full question)

You selected:

False

Incorrect
Correct response:

True

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. 43, 44.

Question 19:

One function of metabolism is to:

(see full question)

You selected:

Increase the rate of metabolism for endogenous steroidal

hormones.

Incorrect
Correct response:

Convert fat-soluble drugs into water-soluble metabolites.

Explanation:

Most drugs are lipid soluble, which aids movement across

cell membranes; however, kidneys can only excrete watersoluble substances. Therefore, metabolism of the drug
includes conv... (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. 46-47.
Question 20:
(see full question)

A patient who is 6 feet tall and weighs 280 pounds will

require which of the following doses?

You selected:

Higher dose than a patient who weighs 180 pounds

Correct
Explanation:

In general, people heavier than average may need larger

doses, provided their renal, hepatic, and cardiovascular
functions are adequate.... (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. 47.

Question 10:

Which of the following is true of the hormone vasopressin?

Select all that apply:

(see full question)

You selected:

Vasopressin regulates the reabsorption of water from the

kidney.
Vasopressin is secreted when body fluids must be
conserved.

Correct
Explanation:

The following is true of the hormone vasopressin: is

secreted by the posterior pituitary gland, is secreted when
body fluids must be conserved, exhibits its greatest activity
on the renal tubular epithelium, regulates the reabsorption
of water from the kidney, and is used to treat diabetes
insipidus. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 50:
Drugs Affecting Pituitary, Thyroid, Parathyroid, and
Hypothalamic Function, p. 1087.

Question 12:
(see full question)

You selected:

A client who is on estrogen therapy calls the clinic and tells

the nurse that she is experiencing sudden, sharp chest
pain. The nurse tells the client to go to the emergency
department immediately, because the nurse suspects what
adverse reaction related to estrogen therapy?
Pulmonary embolism

Correct
Explanation:

Sudden, sharp chest pain that may or may not include

hemoptysis is a sign of pulmonary embolism. It may begin
as a deep vein thrombosis but the symptoms that the client
describes are related to the lungs. Breast tenderness and
skeletal pain do not indicate a visit to the emergency
department. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 52:
Drugs Affecting Womens Health and Sexuality, p. 1133.

Question 14:
(see full question)

Which of the following needs to be used in a child prior to

the closure of the bone epiphyses in order to exert its
effects? (Choose one)

You selected:

Somatropin

Correct
Explanation:

Somatropin needs to be used in a child prior to the closure

of the bone epiphyses in order to exert its effects. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 50:
Drugs Affecting Pituitary, Thyroid, Parathyroid, and
Hypothalamic Function, p. 1079.

Question 15:

A woman has been prescribed Climara, a transdermal

estradiol patch. Which of the following should she be
instructed regarding the administration?

(see full question)

You selected:
Correct

Avoid prolonged sun exposure at the patch site due to

increased plasma concentrations.

Explanation:

The total amount of drug absorbed and the resulting

plasma drug concentrations from transdermal estrogen can
increase during exposure to heat, so patients should be
advised to avoid prolonged sun exposure in the area of the
patch. The application of heat at the patch site will increase
effectiveness. The medication's exposure to sunlight will
not increase the risk of breast cancer. The medication's
exposure to cold will not change its effectiveness. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 52:
Drugs Affecting Women's Health and Sexuality, p. 1135.

Question 16:
(see full question)

A 31-year-old pregnant woman has been prescribed

administration of a tocolytic drug. During which period is a
tocolytic drug usually administered?

You selected:

Pre-term labor

Correct
Explanation:

Drugs used to prevent uterine contractions are called

tocolytics. They are useful in the management of pre-term
labor. These drugs will decrease uterine activity and
prolong the pregnancy to allow the fetus to develop more
fully, thereby increasing the chance of neonatal survival.
Oxytocic drugs are used antepartum (before birth of the
neonate) to induce uterine contractions and initiate or
augment labor. In the postpartum period and during the
second stage of normal labor, the tocolytics are not of any
importance. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 53,
Drugs Affecting Uterine Motility, p. 1162.

Question 17:

A patient you are caring for has both warfarin and

testosterone prescribed for separate disease processes.
You know that androgens may increase the effects of
warfarin by what method of action?

(see full question)

You selected:

Speeding up their metabolism

Incorrect
Correct response:

Slowing their metabolism

Explanation:

Androgens may increase effects of cyclosporine and

warfarin, apparently by slowing their metabolism and

increasing their concentrations in the blood. Therefore

Options C and D are incorrect. (less)
Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 51:
Drugs Affecting Men's Health and Sexuality, p. 1113.

Question 19:
(see full question)

The labor and delivery nurse administers ergonovine to a

patient after delievery of the placenta. The nurse does this:

You selected:

To prevent postpartum hemorrhage

Correct
Explanation:

Uterine stimulants increase the strength, duration, and

frequency of uterine contractions and decrease the
incidence of uterine bleeding. They are given after the
delivery of the placenta and are used to prevent
postpartum and postabortal hemorrhage caused by uterine
atony. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 53,
Drugs Affecting Uterine Motility, p. 1157.

Question 20:
(see full question)

You are caring for a client with cerebral edema caused by

trauma. Which of the following medications would you
anticipate being administered?

You selected:

Dexamethasone

Correct
Explanation:

Dexamethasone is considered the corticosteroid of choice

for cerebral edema associated with brain tumors,
craniotomy, or head injury because dexamethasone is
thought to penetrate the bloodbrain barrier more readily
and achieve higher concentrations in cerebrospinal fluids
and tissues. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 48:
Drugs Affecting Corticosteroid Levels, p. 1023.

Question 1:

A patient's medication regimen for treatment of anxiety has

been changed from a benzodiazepine to buspirone

(see full question)

(BuSpar). The patient asks the nurse what makes this

medication safer than the benzodiazepine he has taken.
What is the nurse's best response?
You selected:

It will not produce sedation like benzodiazepines.

Correct
Explanation:

Buspirone will not produce sedation. Compared with the

benzodiazepines, buspirone (BuSpar) lacks muscle
relaxant and anticonvulsant effects; does not cause
sedation or physical or psychological dependence; does
not increase the CNS depression of alcohol and other
drugs; and is not a controlled substance. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 232.

Question 3:

A 75 year old patient is brought to the emergency

department by his family. The family relates that the patient
is complaining of confusion, seizures and abnormal
perception of movement. When the nurse looks at the
medication that the family has brought to the ED the nurse
discovers that twice the number of tablets are missing from
the vial as the orders call for. What should the nurse
suspect is wrong with this patient?

(see full question)

You selected:

Benzodiapene toxicity

Correct
Explanation:

Common manifestations include increased anxiety,

psychomotor agitation, insomnia, irritability, headache,
tremor, and palpitations. Less common but more serious
manifestations include confusion, abnormal perception of
movement, depersonalization, psychosis, and seizures.
The scenario does not describe option B, C or D (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 227.

Flumazenil is the antidote for benzodiazepines and is used to reverse the sedation of
benzodiazepines used for diagnostic procedures. Temazepam would be used as a

hypnotic. Triazolam is a benzodiazepine used as a hypnotic. Promethazine is an

antihistamine with sedative effects. (less)

Question 6:
(see full question)

A patient undergoing treatment with barbiturates is

showing symptoms of barbiturate toxicity. Which of the
following interventions should the nurse perform?

You selected:

Provide respiratory assistance

Correct
Explanation:

The nurse must provide respiratory assistance to the

patient showing symptoms of barbiturate toxicity. Providing
assistance with movement, supportive care, and a safe
environment a... (more)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 235.

Question 8:
(see full question)

A nurse is caring for a 9-year-old patient and has received

an order for diazepam (Valium) 10 mg PO q.i.d. Which of
the following should be the nurse's initial action?

You selected:

Call the physician and question the order

Correct
Explanation:

The first action of the nurse would be to call the physician

and question the order. The normal dosage for a pediatric
patient is 1 to 2.5 mg PO t.i.d. or q.i.d. This would be an
unsafe dose for this patient. If the dosage was changed
and the correct amount administered, the nurse would
order the medication from the pharmacy if necessary and
determine what time to start the medication. She would
then wash her hands in preparation of administering the
medication. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 229.

Question 9:

A patient who suffers from GERD and diverticulosis has

(see full question)

just been admitted to a medical floor. The admitting

physician orders cimetadine and a sedative to calm the
patient. About what should the nurse be concerned?

You selected:

Increased sedative effect

Correct
Explanation:

An increased sedative effect may occur when a sedative is

given with cimetidine for gastric upset. The other options
do not play a role in providing the best care for the patient.
(less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 234.

REM deprivation can lead to serious psychological problems, including psychosis.

Question 17:
(see full question)

Which of the following is defined as a drug that induces

drowsiness? (Choose one)

You selected:

Sedative

Incorrect
Correct response:

Hypnotic

Explanation:

A hypnotic is defined as a drug that induces drowsiness.

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 232.

Question 18:
(see full question)

Which action would be least appropriate for the nurse to do

after administering an anxiolytic to a patient?

You selected:

Dim the lights

Incorrect
Correct response:

Having the patient walk to the bathroom

Explanation:

Having the patient walk to the bathroom would be

appropriate before administering the drug to reduce the
patient's risk for injury. Raising the side rails would be
appropriate after administering an anxiolytic. Placing the
call light within reach would be appropriate after
administering an anxiolytic. Dimming the lights would be
appropriate after administering an anxiolytic. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer

Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 227.

Question 19:
(see full question)

You selected:

Ms. Mole, a 65-year-old woman with a history of chronic

insomnia, is being seen in the physician office for follow-up
care. The physician has asked you to develop a plan of
care with Ms. Mole to improve her sleep. In addition to
drug therapy, what would you recommend as part of the
patient's plan of care?
Advise the patient to avoid food after 6:00 p.m.

Incorrect
Correct response:

Advise the patient to practice relaxation techniques.

Explanation:

In addition to the drug therapy, patients suffering from

chronic insomnia may also need to apply behavioral
techniques, such as relaxation therapy. Relaxation
techniques such as progressive relaxation and rhythmic
breathing allow the muscles to relax and the mind to stop
"racing," thereby allowing natural sleep to occur. Smoking
cigarettes before bedtime and taking long naps in the
afternoon are some of the behaviors associated with
chronic insomnia. It is not necessary to avoid all food in the
evening. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15:
Drugs Relieving Anxiety and Producing Sleep, p. 225.

Question 20:
(see full question)

A patient is admitted to a local health care facility for

chronic insomnia. The physician prescribes eszopiclone.
What should the nurse teach the patient when
administering eszopiclone?

You selected:

Avoid drinking alcohol

Correct
Explanation:

The nurse should instruct the patient to avoid alcohol

during the period of eszopiclone therapy as alcohol
interacts with eszopiclone to cause CNS depression.
Strenuous work, use of tobacco, and exposure to sunlight
do not cause any adverse reactions. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,

Drugs Relieving Anxiety and Promoting Sleep, p. 233.

Question 1:
(see full question)

You selected:

The daughter of an older adult client asks the nurse if her

father should be aware of any special precautions while
taking lorazepam (Ativan). What is the nurses best
response?
Monitor for increased signs of confusion or forgetfulness.

Correct
Explanation:

Recent studies link the chronic use of benzodiazepines by

those over 65 years of age to a greater chance of
developing dementia. Antianxiety drugs are not known to
cause kidney or liver damage but should be used
cautiously in elderly clients, and in clients with impaired
liver function or impaired kidney function. Antianxiety drugs
more likely can cause muscle relaxation than rigidity. A
symptom of withdrawal from antianxiety drugs is muscle
tension. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15:
Drugs Relieving Anxiety and Promoting Sleep, p. 227.

Question 2:

A patient suffers from generalized anxiety disorder. The

patient suffers an acute episode of anxiety. Buspirone
(BuSpar) is known to be superior to benzodiazepines. Why
is the administration of buspirone (BuSpar) not
recommended for this patient?

(see full question)

You selected:

It takes 24 weeks to work.

Correct
Explanation:

Buspirone (BuSpar) has a delayed onset of action for up to

24 weeks. Thus, buspirone is not useful for acute
episodes of anxiety and it may be difficult to persuade
some patients to take the drug long enough to be effective.
Buspirone (BuSpar) will not cause nausea and vomiting.
The administration of this medication orally has no effect
on the generalized anxiety disorder. Sexual dysfunction is
not an adverse effect of buspirone. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,

Drugs Relieving Anxiety and Promoting Sleep, p. 232.

Benzodiazepines are classified in pregnancy category X and their use is

contraindicated in pregnancy. (less)

Hydroxyzine (Vistaril) is administered in the preoperative stage to decrease anxiety,

nausea, and vomiting. Hydroxyzine (Vistaril) is not given preoperatively to decrease
oral secretions. Hydroxyzine (Vistaril) will not cause hypotension. Hydroxyzine (Vistaril)
will not cause confusion. (less)
Question 7:
(see full question)

You selected:

When monitoring a patient receiving

escitalopram for therapeutic effectiveness,
the nurse would keep in mind that full effect
may take up to how long?
2 weeks

Incorrect
Correct response:

4 weeks

Explanation:

It may take up to 4 weeks before the full

effect of a SSRI such as escitalopram is
noted.

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug

Therapy in Nursing, 4th ed., Philadelphia:
Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 16, Drugs Treating
Mood Disorders, p. 243.

Question 8:
(see full question)

A patient is receiving lithium carbonate for

treatment of bipolar disorder. Which of the
following statements should be included in
discharge education for this patient?

You selected:

"Do not drive while on this medication."

Incorrect
Correct response:

"Keep your scheduled appointments for

measurement of lithium levels."

Explanation:

Serum lithium concentrations should be

monitored frequently because they vary
widely among patients taking similar doses
and because of the narrow range between
therapeutic and toxic levels. (less)

Reference:

Question 12:

Aschenbrenner, D.S., & Venable, S.J. Drug

Therapy in Nursing, 4th ed., Philadelphia:
Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 16: Drugs Treating
Mood Disorders, pp. 266-268.

(see full question)

A patient arrives at the ER after attempting suicide by

taking an entire bottle of diazepam. Which of the following
drugs will the nurse most likely administer?

You selected:

Flumazenil (Romazicon)

Correct
Explanation:

Flumazenil is an antidote to benzodiazepine overdose and

to reverse the effects of benzodiazepines when used for
anesthesia. Phenobarbital, a barbiturate, would further
depress the body functions of this patient.
Dexmedetomidine is a new hypnotic drug used in ICU for
mechanically ventilated patients and ramelteon is also new
and used as a hypnotic. Side effects of this drug are
depression and suicidal ideation. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 228.

Question 15:
(see full question)

Terry, age 46, has a history of bipolar disorder and has

been taking lithium for the past 15 years. He recently
began showing signs of low thyroid function and changes
in his urinary output. Which adverse effect could be
affecting Terry's kidneys?

You selected:

Lithium causes a decrease in the levels of antidiuretic

hormones.

Incorrect
Correct response:

Lithium impairs the ability of the kidneys to concentrate

urine.

Explanation:

Long-term lithium therapy (exceeding 10 years) commonly

impairs the ability of the kidneys to concentrate urine,
although this effect is not associated with a reduced
glomerular filtration rate or with renal insufficiency. Low
thyroid function can also occur in patients receiving longterm lithium therapy. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer

Health/Lippincott Williams & Wilkins, 2012, Chapter 16:

Drugs Treating Mood Disorders, p. 266.
Question 17:
(see full question)

A nurse is caring for a patient who has been administered

a barbiturate. Which of the following are symptoms of
barbiturate toxicity that the nurse must monitor the patient
for?

You selected:

Restlessness

Incorrect
Correct response:

Hypotension

Explanation:

The nurse must monitor the patient for hypotension, which

is one of the symptoms of barbiturate toxicity.
Restlessness, euphoria, and confusion are withdrawal
symptoms seen in the use of sedatives and hypnotics.
(less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 15,
Drugs Relieving Anxiety and Promoting Sleep, p. 235.

Antidepressant therapy may be indicated if depressive symptoms persist at least 2

weeks, impair social relationships or work performance, and occur independently of life
events.

Question 3:
(see full question)

You selected:

The mother of a child newly diagnosed with resistant

epilepsy asks the nurse why two AEDs have been
prescribed for her daughter. What would be the nurse's
best answer?
Decreased risk of side effects

Incorrect
Correct response:

To minimize seizures in resistant epilepsy

Explanation:

When monotherapy is ineffective, a second, and

sometimes a third, drug may be added. It does not
decrease overall cost or reduce the risk of side effects or
increase movement of sodium ions into the cell. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18,
Drugs Treating Seizure Disorders, p. 313.

Question 3:
(see full question)

You selected:

The mother of a child newly diagnosed with resistant

epilepsy asks the nurse why two AEDs have been
prescribed for her daughter. What would be the nurse's
best answer?
Decreased risk of side effects

Incorrect
Correct response:

To minimize seizures in resistant epilepsy

Explanation:

When monotherapy is ineffective, a second, and

sometimes a third, drug may be added. It does not
decrease overall cost or reduce the risk of side effects or
increase movement of sodium ions into the cell. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18,
Drugs Treating Seizure Disorders, p. 313

Question 4:

A client tells the nurse he is going to stop taking his

medication because he is always having fine tremors and
slurred speech. These reactions are preventing him from
teaching art classes like he used to do. The nurse knows
that which of the following could help him?

(see full question)

You selected:

He could tell his doctor that the antipsychotics are not

working and he needs a larger dose, or another medication
added.
He could talk with his doctor and ask to have his
medication dosage decreased, or change his medication to
a second-generation antipsychotic.

Incorrect
Correct response:

He could talk with his doctor and ask to have his

medication dosage decreased, or change his medication to
a second-generation antipsychotic.

Explanation:

Fine tremors and slurred speech are common symptoms of

extrapyramidal syndrome. Symptoms may decrease if the
amount of the medication is decreased or if the client is
changed to a second-generation antipsychotic medication.
A large dose of medication or adding another firstgeneration antipsychotic medication would increase the
symptoms. Changing his profession may be necessary, but
getting on the correct drug and dosage is of primary
concern. Schizophrenia is not cured by the antipsychotic

medications. The symptoms are managed, so by stopping

the drug the client is at risk of showing all the symptoms of
schizophrenia. (less)
Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 17:
Drugs Treating Psychotic Disorders and Dementia, p. 286.

Question 4:

A client tells the nurse he is going to stop taking his

medication because he is always having fine tremors and
slurred speech. These reactions are preventing him from
teaching art classes like he used to do. The nurse knows
that which of the following could help him?

(see full question)

You selected:

He could tell his doctor that the antipsychotics are not

working and he needs a larger dose, or another medication
added.
He could talk with his doctor and ask to have his
medication dosage decreased, or change his medication to
a second-generation antipsychotic.

Incorrect
Correct response:

He could talk with his doctor and ask to have his

medication dosage decreased, or change his medication to
a second-generation antipsychotic.

Explanation:

Fine tremors and slurred speech are common symptoms of

extrapyramidal syndrome. Symptoms may decrease if the
amount of the medication is decreased or if the client is
changed to a second-generation antipsychotic medication.
A large dose of medication or adding another firstgeneration antipsychotic medication would increase the
symptoms. Changing his profession may be necessary, but
getting on the correct drug and dosage is of primary
concern. Schizophrenia is not cured by the antipsychotic
medications. The symptoms are managed, so by stopping
the drug the client is at risk of showing all the symptoms of
schizophrenia. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 17:
Drugs Treating Psychotic Disorders and Dementia, p. 286.

Question 7:
(see full question)

You selected:

A patient with advanced-stage Alzheimer's disease is seen

by a physician who prescribes a newer drug that is not a
cholinesterase inhibitor. This drug is a N-methyl-Dasparate (NMDA) receptor antagonist. This drug is better
known as which of the following?
aricept

Incorrect
Correct response:

namenda

Explanation:

Cholinesterase inhibitors are not used in late stage

Alzheimer's disease. A newer group of drugs, NMDA
receptor antagonists, is available. Namenda is thought to
work by decreasing the excitability of neurotransmission
caused by an excess of the amino acid glutamate in the
CNS. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 17,
Drugs Treating Psychotic Disorders and Dementia, p. 291.

Question 8:
(see full question)

Why does phenytoin increase the risk for neonatal

hemorrhage in the first 24 hours after birth?

You selected:

Phenytoin is highly protein bound.

Incorrect
Correct response:

Phenytoin is a competitive inhibitor of vitamin K.

Explanation:

Because phenytoin is a competitive inhibitor of vitamin K, it

increases the risk for neonatal hemorrhage in the first 24
hours after birth. The risk for neonatal hemorrhage is not
increased because phenytoin is highly protein bound,
reversibly binds to sodium channels while they are in the
inactive state, and selectively works at neurons that are
firing abnormally. The defect is characterized by low levels
of vitamin Kdependent clotting factors, prolonged
prothrombin times or partial thromboplastin times, or both.
(less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18:
Drugs Treating Seizure Disorders, p. 300.

A serum carbamazepine level of 14 mcg/mL is over the therapeutic range of 4 to 12

mcg/mL, necessitating a reduction in dosage. A serum carbamazepine level of 6

mcg/mL is within the th... (more)

Question 10:
(see full question)

You selected:

A patient has been administered donepezil HCL for

dementia. The patient has informed the nurse that she has
also been taking nonsteroidal anti-inflammatory drugs.
Which of the following interactions should the nurse
monitor for in this patient?
Decreased effectiveness of anticholinergics

Incorrect
Correct response:

Increased risk of GI bleeding

Explanation:

The interaction of nonsteroidal anti-inflammatory drugs

with cholinesterase inhibitors causes increased risk of GI
bleeding, which should be monitored for. Interaction of
anticholi... (more)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 17,
Drugs Treating Psychotic Disorders and Dementia, p. 290.

Question 12:
(see full question)

Gabapentin is frequently used to treat neuropathies.

Under which of the following conditions should the
first dose of the drug be given?

You selected:

In the morning with food

Incorrect
Correct response:

At bedtime

Explanation:

The initial dose of gabapentin should be given at

bedtime, because it can cause significant
somnolence and dizziness. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug

Therapy in Nursing, 4th ed., Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins, 2012,
Chapter 18: Drugs Treating Seizure Disorders, p.
313.

Question 12:
(see full question)

Gabapentin is frequently used to treat neuropathies.

Under which of the following conditions should the

first dose of the drug be given?

You selected:

In the morning with food

Incorrect
Correct response:

At bedtime

Explanation:

The initial dose of gabapentin should be given at

bedtime, because it can cause significant
somnolence and dizziness. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy

in Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter
18: Drugs Treating Seizure Disorders, p. 313.

Methsuximide is administered orally. Diazepam can be administered rectally. Diazepam

or phenobarbital may be administered intramuscularly. Diazepam, fosphenytoin,
phenytoin, valproic acid, and phenobarbital can be administered intravenously. (less)
Question 7:
(see full question)

You selected:

While taking the vital signs of a hospitalized client

admitted for seizure control due to epilepsy, the nurse
notices a bloody toothbrush on the clients bedside table
and scattered bruising over the clients extremities.
What is the nurses best action?
Document the findings and offer the client a soft-bristled
toothbrush.

Incorrect
Correct response:

Report the findings to the primary health care provider

immediately.

Explanation:

The client has a history of epilepsy and is likely taking

anticonvulsants. Hematologic changes when taking
anticonvulsants needs to be reported immediately to the
health care provider. Such changes include bleeding
gums and easy bruising. Abuse is not the likely cause of
the clients bruising given the history of epilepsy. Telling
the client to ask for assistance when ambulating and
offering a soft toothbrush are appropriate, but the health
care provider needs to be notified immediately about the
hematologic changes. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18:
Drugs Treating Seizure Disorders, p. 304.

Question 9:
(see full question)

Which of the following best reflects the action of

barbiturates when used to control seizures?

You selected:

Stimulation of the cerebral cortex

Incorrect
Correct response:

Inhibition of impulse conduction

Explanation:

Barbiturates inhibit impulse conduction in the ascending

reticular activating system. Barbiturates depress the
cerebral cortex. Barbiturates depress cerebellar
functioning. Barbiturates depress motor nerve output.
(less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18,
Drugs Treating Seizure Disorders, p. 314.

Question 7:

While taking the vital signs of a hospitalized client admitted

for seizure control due to epilepsy, the nurse notices a
bloody toothbrush on the clients bedside table and
scattered bruising over the clients extremities. What is the
nurses best action?

(see full question)

You selected:

Document the findings and offer the client a soft-bristled

toothbrush.

Incorrect
Correct response:

Report the findings to the primary health care provider

immediately.

Explanation:

The client has a history of epilepsy and is likely taking

anticonvulsants. Hematologic changes when taking
anticonvulsants needs to be reported immediately to the
health care provider. Such changes include bleeding gums
and easy bruising. Abuse is not the likely cause of the
clients bruising given the history of epilepsy. Telling the
client to ask for assistance when ambulating and offering a
soft toothbrush are appropriate, but the health care
provider needs to be notified immediately about the
hematologic changes. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in

Nursing, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2012, Chapter 18:
Drugs Treating Seizure Disorders, p. 304.

Question 9:
(see full question)

You selected:

Which of the following

best reflects the action
of barbiturates when
used to control
seizures?
Stimulation of the
cerebral cortex

Incorrect
Correct response:

Inhibition of impulse
conduction

Explanation:

Barbiturates inhibit
impulse conduction in
the ascending reticular
activating system.
Barbiturates depress
the cerebral cortex.
Barbiturates depress
cerebellar functioning.
Barbiturates depress
motor nerve output.
(less)

Reference:

Aschenbrenner, D.S., &

Venable, S.J. Drug
Therapy in Nursing,
4th ed., Philadelphia:
Wolters Kluwer
Health/Lippincott
Williams & Wilkins,
2012, Chapter 18,
Drugs Treating Seizure
Disorders, p. 314.

Question 11:

Which of the following

would the nurse include
as possible adverse
effects when teaching a
patient about
phenytoin?

(see full question)

You selected:

Liver toxicity

Correct
Explanation:

Liver toxicity is a
potential adverse effect
of phenytoin.

Constipation, not
diarrhea, is an adverse
effect of phenytion.
Bone marrow
suppression and
leukopenia would be
adverse effects of
phenytoin. Physical
dependence is an
adverse effect
associated with the use
of benzodiazepines.
(less)
Reference:

Aschenbrenner, D.S., &

Venable, S.J. Drug
Therapy in Nursing,
4th ed., Philadelphia:
Wolters Kluwer
Health/Lippincott
Williams & Wilkins,
2012, Chapter 18,
Drugs Treating Seizure
Disorders, p. 300.

Question 15:
(see full question)

Tonic-clonic seizures
and myoclonic seizures
are classified as what
type of seizures?
(Choose one)

You selected:

Partial seizures

Incorrect
Correct response:

Generalized seizures

Explanation:

Tonic-clonic seizures
and myoclonic seizures
are classified
generalized seizures.

Reference:

Aschenbrenner, D.S., &

Venable, S.J. Drug
Therapy in Nursing,
4th ed., Philadelphia:
Wolters Kluwer
Health/Lippincott
Williams & Wilkins,
2012, Chapter 18,
Drugs Treating Seizure

Disorders, p. 296.
Question 19:
(see full question)

Dilantin has several

side effects. When
teaching the patient
about these side
effects, which symptom
would indicate a lifethreatening condition
and should be reported
to the health care
provider immediately?

You selected:

Shortness of breath

Incorrect
Correct response:

Rash with itching

Explanation:

Shortness of breath,
alteration in taste, and
altered bowel function
are all side effects or
adverse reactions that
a patient may
experience when taking
Dilantin. If the patient
has a rash with itching,
this could indicate a
life-threatening adverse
reaction such as
Stevens-Johnson
syndrome. (less)

Reference:

Aschenbrenner, D.S., &

Venable, S.J. Drug
Therapy in Nursing,
4th ed., Philadelphia:
Wolters Kluwer
Health/Lippincott
Williams & Wilkins,
2012, Chapter 18:
Drugs Treating Seizure
Disorders, p. 307.

Question 20:
(see full question)

An 80-year-old patient has severe pain after a case of shingles.

The pain is noted along the shoulder and back. He states the pain
is so severe he cannot sleep. What is the primary medication that

will relieve this pain?

You selected:

Morphine sulfate (MS Contin)

Incorrect
Correct response: Gabapentin (Neurontin)
Explanation:

Gabapentin is the first oral medication approved by the FDA for

the management of postherpetic neuralgia. Meperidine will
provide pain relief but is not effective in postherpetic neuralgia.
Morphine sulfate will provide pain relief but is not effective in
postherpetic neuralgia. Naproxen sodium will decrease
inflammation but is not effective for postherpetic neuralgia. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing,

4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 18, Drugs Treating Seizure Disorders, p.
313.

Question 4:
(see full question)

After teaching a group of students about anti-seizure agents, the

instructor determines that the teaching was successful when the
students identify which agent as being administered
intravenously?

You selected:

Carbamazepine

Incorrect
Correct response: Fosphenytoin
Explanation:

Fosphenytoin is administered intravenously. Gabapentin is

administered orally. Felbamate is administered orally.
Carbamazepine is administered orally. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing,

4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 18, Drugs Treating Seizure Disorders, pp.
299, 306

Gabapentin is frequently used to treat neuropathies. Under which of the following

conditions should the first dose of the drug be given?
You selected:

In the morning with food

Incorrect
Correct response: At bedtime
Explanation:

The initial dose of gabapentin should be given at bedtime,

because it can cause significant somnolence and dizziness. (less)

Question 7:
(see full question)

Which of the following would be most important for the nurse to

monitor when administering valproic acid?

You selected:

Complete blood count

Incorrect

Correct response: Liver function studies

Explanation:

Valproic acid is associated with liver toxicity. It would be most

important to monitor the patient's liver function studies.... (more)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing,

4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 18, Drugs Treating Seizure Disorders, p.
307.

Question 6:
(see full question)

A patient has been started on dantrolene (Dantrium). What is the

most serious adverse effect on which the patient should be
instructed?

You selected:

Metabolic acidosis

Incorrect
Correct response: Fatal hepatitis
Explanation:

The most serious adverse effect of oral dantrolene is fatal

hepatitis. Metabolic acidosis, hypercarbia, and renal calculi are
not adverse effects of oral dantrolene. (less)

Reference:

Aschenbrenner, D.S., & Venable, S.J. Drug Therapy in Nursing,

4th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins, 2012, Chapter 20, Drugs Affecting Muscle Spasm and
Spasticity, p. 354.

Hypotension is the most significant adverse effect of tizanidine. Dark black urine,
excessive salivation, and eczema are not adverse effects of tizanidine. (less)