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TEST BANK
Katzung's Basic and Clinical
Pharmacology, 16th Edition
by Todd W. Vanderah, Chapters 1 - 66
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Table of Contents
1. Introduction: The Nature of Drugs & Drug Development & Regulation
2. Drug Receptors & Pharmacodynamics
3. Pharmacokinetics & Pharmacodynamics: Rational Dosing & the Time Course of Drug Action
4. Drug Biotransformation
5. Pharmacogenomics
6. Introduction to Autonomic Pharmacology
7. Cholinoceptor-Activating & Cholinesterase-Inhibiting Drugs
8. Cholinoceptor-Blocking Drugs
9. Adrenoceptor Agonists & Sympathomimetic Drugs
10. Adrenoceptor Antagonist Drugs
11. Antihypertensive Agents
12. Vasodilators & the Treatment of Angina Pectoris
13. Drugs Used in Heart Failure
14. Agents Used in Cardiac Arrhythmias
15. Diuretic Agents
16. Histamine, Serotonin, & the Ergot Alkaloids
17. Vasoactive Peptides
18. The Eicosanoids: Prostaglandins, Thromboxanes, Leukotrienes, & Related Compounds
19. Nitric Oxide
20. Drugs Used in Asthma
21. Introduction to the Pharmacology of CNS Drugs
22. Sedative-Hypnotic Drugs
23. The Alcohols
24. Antiseizure Drugs
25. General Anesthetics
26. Local Anesthetics
27. Skeletal Muscle Relaxants
28. Pharmacologic Management of Parkinsonism & Other Movement Disorders
29. Antipsychotic Agents & Lithium
30. Antidepressant Agents
31. Opioid Agonists & Antagonists
32. Drugs of Abuse
33. Agents Used in Cytopenias; Hematopoietic Growth Factors
34. Drugs Used in Disorders of Coagulation
35. Agents Used in Dyslipidemia
36. Nonsteroidal Anti-Inflammatory Drugs, Disease-Modifying Antirheumatic Drugs, Nonopioid Analgesics, &
Drugs Used in Gout
37. Hypothalamic & Pituitary Hormones
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38. Thyroid & Antithyroid Drugs
39. Adrenocorticosteroids & Adrenocortical Antagonists
40. The Gonadal Hormones & Inhibitors
41. Pancreatic Hormones & Antidiabetic Drugs
42. Agents That Affect Bone Mineral Homeostasis
43. Beta-Lactam & Other Cell Wall- & Membrane-Active Antibiotics
44. Tetracyclines, Macrolides, Clindamycin, Chloramphenicol, Streptogramins, & Oxazolidinones
45. Aminoglycosides & Spectinomycin
46. Sulfonamides, Trimethoprim, & Quinolones
47. Antimycobacterial Drugs
48. Antifungal Agents
49. Antiviral Agents
50. Miscellaneous Antimicrobial Agents; Disinfectants, Antiseptics, & Sterilants
51. Clinical Use of Antimicrobial Agents
52. Antiprotozoal Drugs
53. Clinical Pharmacology of the Antihelminthic Drugs
54. Cancer Chemotherapy
55. Immunopharmacology
56. Introduction to Toxicology: Occupational & Environmental
57. Heavy Metal Intoxication & Chelators
58. Management of the Poisoned Patient
59. Special Aspects of Perinatal & Pediatric Pharmacology
60. Special Aspects of Geriatric Pharmacology
61. Dermatologic Pharmacology
62. Drugs Used in the Treatment of Gastrointestinal Diseases
63. Therapeutic & Toxic Potential of Over-the-Counter Agents
64. Dietary Supplements & Herbal Medications
65. Rational Prescribing & Prescription Writing
66. Important Drug Interactions & Their Mechanisms
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Chapter 1. Introduction: The Nature of Drugs & Drug Development & Regulation
1. A nurse working in radiology administers iodine to a patient who is having a
computed tomography (CT) scan. The nurse working on the oncology unit
administers chemotherapy to patients who have cancer. At the Public Health
Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to
a 14-month-old child as a routine immunization. Which branch of
pharmacology best describes the actions of all three nurses?
A) Pharmacoeconomics
B) Pharmacotherapeutics
C) Pharmacodynamics
D) Pharmacokinetics
ANSWER: B
Feedback:
Pharmacology is the study of the biologic effects of chemicals. Nurses are
involved with clinical pharmacology or pharmacotherapeutics, which is a
branch of pharmacology that deals with the uses of drugs to treat, prevent,
and diagnose disease. The radiology nurse is administering a drug to help
diagnose a disease. The oncology nurse is administering a drug to help treat a
disease. Pharmacoeconomics includes any costs involved in drug therapy.
Pharmacodynamics involves how a drug affects the body and
pharmacokinetics is how the body acts on the body.
2. A physician has ordered intramuscular (IM) injections of morphine, a
narcotic, every 4 hours as needed for pain in a motor vehicle accident victim.
The nurse is aware this drug has a high abuse potential. Under what category
would morphine be classified?
A) Schedule I
B) Schedule II
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C) Schedule III
D) Schedule IV
ANSWER: B
Feedback:
Narcotics with a high abuse potential are classified as Schedule II drugs
because of severe dependence liability. Schedule I drugs have high abuse
potential and no accepted medical use. Schedule III drugs have a lesser
abuse potential than II and an accepted medical use. Schedule IV drugs have
low abuse potential and limited dependence liability.
3. When involved in phase III drug evaluation studies, what responsibilities
would the nurse have?
A) Working with animals who are given experimental drugs
B) Choosing appropriate patients to be involved in the drug study
C) Monitoring and observing patients closely for adverse effects
D) Conducting research to determine effectiveness of the drug
ANSWER: C
Feedback:
Phase III studies involve use of a drug in a vast clinical population in which
patients are asked to record any symptoms they experience while taking the
drugs. Nurses may be responsible for helping collect and analyze the
information to be shared with the Food and Drug Administration (FDA) but
would not conduct research independently because nurses do not prescribe
medications. Use of animals in drug testing is done in the preclinical trials.
Select patients who are involved in phase II studies to participate in studies
where the participants have the disease the drug is intended to treat. These
patients are monitored closely for drug action and adverse effects. Phase I
studies involve healthy human volunteers who are usually paid for their
participation. Nurses may observe for adverse effects and toxicity.
4. What concept is considered when generic drugs are substituted for brand
name drugs?
A) Bioavailability
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B) Critical concentration
C) Distribution
D) Half-life
ANSWER: A
Feedback:
Bioavailability is the portion of a dose of a drug that reaches the systemic
circulation and is available to act on body cells. Binders used in a generic
drug may not be the same as those used in the brand name drug. Therefore,
the way the body breaks down and uses the drug may differ, which may
eliminate a generic drug substitution. Critical concentration is the amount of
a drug that is needed to cause a therapeutic effect and should not differ
between generic and brand name medications. Distribution is the phase of
pharmacokinetics, which involves the movement of a drug to the bodys
tissues and is the same in generic and brand name drugs. A drugs half-life is
the time it takes for the amount of drug to decrease to half the peak level,
which should not change when substituting a generic medication.
5. A nurse is assessing the patients home medication use. After listening to the
patient list current medications, the nurse asks what priority question?
A) Do you take any generic medications?
B) Are any of these medications orphan drugs?
C) Are these medications safe to take during pregnancy?
D) Do you take any over-the-counter medications?
ANSWER: D
Feedback:
It is important for the nurse to specifically question use of over-the-counter
medications because patients may not consider them important. The patient
is unlikely to know the meaning of orphan drugs unless they too are health
care providers. Safety during pregnancy, use of a generic medication, or
classification of orphan drugs are things the patient would be unable to
answer but could be found in reference books if the nurse wishes to research
them.
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6. After completing a course on pharmacology for nurses, what will the nurse
know?
A) Everything necessary for safe and effective medication administration
B) Current pharmacologic therapy; the nurse will not require ongoing
education for 5 years.
C) General drug information; the nurse can consult a drug guide for specific
drug information.
D) The drug actions that are associated with each classification of
medication
ANSWER: C
Feedback:
After completing a pharmacology course nurses will have general drug
information needed for safe and effective medication administration but will
need to consult a drug guide for specific drug information before
administering any medication. Pharmacology is constantly changing, with
new drugs entering the market and new uses for existing drugs identified.
Continuing education in pharmacology is essential to safe practice. Nurses
tend to become familiar with the medications they administer most often, but
there will always be a need to research new drugs and also those the nurse is
not familiar with because no nurse knows all medications.
7. A nurse is instructing a pregnant patient concerning the potential risk to her
fetus from a Pregnancy Category B drug. What would the nurse inform the
patient?
A) Adequate studies in pregnant women have demonstrated there is no risk
to the fetus.
B) Animal studies have not demonstrated a risk to the fetus, but there have
been no adequate studies in pregnant women.
C) Animal studies have shown an adverse effect on the fetus, but there are
no adequate studies in pregnant women.
D) There is evidence of human fetal risk, but the potential benefits from use
of the drug may be acceptable despite potential risks.
ANSWER: B
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Feedback:
Category B indicates that animal studies have not demonstrated a risk to the
fetus. However, there have not been adequate studies in pregnant women to
demonstrate risk to a fetus during the first trimester of pregnancy and no
evidence of risk in later trimesters. Category A indicates that adequate
studies in pregnant women have not demonstrated a risk to the fetus in the
first trimester or in later trimesters. Category C indicates that animal studies
have shown an adverse effect on the fetus, but no adequate studies in
humans. Category D reveals evidence of human fetal risk, but the potential
benefits from the use of the drugs in pregnant women may outweigh
potential risks.
8. Discharge planning for patients leaving the hospital should include
instructions on the use of over-the-counter (OTC) drugs. Which comment by
the patient would demonstrate a good understanding of OTC drugs?
A) OTC drugs are safe and do not cause adverse effects if taken properly.
B) OTC drugs have been around for years and have not been tested by the
Food and Drug Administration (FDA).
C) OTC drugs are different from any drugs available by prescription and
cost less.
D) OTC drugs could cause serious harm if not taken according to directions.
ANSWER: D
Feedback:
It is important to follow package directions because OTCs are medications
that can cause serious harm if not taken properly. OTCs are drugs that have
been determined to be safe when taken as directed; however, all drugs can
produce adverse effects even when taken properly. They may have originally
been prescription drugs that were tested by the FDA or they may have been
grandfathered in when the FDA laws changed. OTC education should
always be included as a part of the hospital discharge instructions.
9. What would be the best source of drug information for a nurse?
A) Drug Facts and Comparisons
B) A nurses drug guide
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C) A drug package insert
D) The Physicians Drug Reference (PDR)
ANSWER: B
Feedback:
A nurses drug guide provides nursing implications and patient teaching
points that are most useful to nurses in addition to need-to-know drug
information in a very user friendly organizational style.Lippincotts Nursing
Drug Guide (LNDG) has drug monographs organized alphabetically and
includes nursing implications and patient teaching points. Numerous other
drug handbooks are also on the market and readily available for nurses to
use. Although other drug reference books such as Drug Facts and
Comparisons, PDR, and drug package inserts can all provide essential drug
information, they will not contain nursing implications and teaching points
and can be more difficult to use than nurses drug guides.
10 The nurse is preparing to administer a medication from a multidose bottle.
. The label is torn and soiled but the name of the medication is still readable.
What is the nurses priority action?
A) Discard the entire bottle and contents and obtain a new bottle.
B) Find the drug information and create a new label for the bottle.
C) Ask another nurse to verify the contents of the bottle.
D) Administer the medication if the name of the drug can be clearly read.
ANSWER: A
Feedback:
When the drug label is soiled obscuring some information the safest action
by the nurse is to discard the bottle and contents because drug labels contain
a great deal of important information, far more than just the name of the
drug. Concentration of the drug, expiration date, administration directions,
and precautions may be missing from the label and so put the patient at risk.
Looking up drug information in a drug handbook or consulting with another
nurse will not supply the expiration date or concentration of medication. Be
safe and discard the bottle and its contents.
Katzung's Basic and Clinical Pharmacology
