Page 1 of 822
TEST BANK
Katzung's Basic and Clinical
Pharmacology, 16th Edition
by Todd W. Vanderah, Chapters 1 - 66
Katzung's Basic and Clinical Pharmacology
, Page 2 of 822
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
38. Thyroid & Antithyroid Drugs
Katzung's Basic and Clinical Pharmacology
, Page 3 of 822
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
Katzung's Basic and Clinical Pharmacology
, Page 4 of 822
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 toa
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 adisease.
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 categorywould
morphine be classified?
A) Schedule I
B) Schedule II
Katzung's Basic and Clinical Pharmacology
, Page 5 of 822
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 havelow
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
Katzung's Basic and Clinical Pharmacology
, Page 6 of 822
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 ofa 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 isthe 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 researchthem.
Katzung's Basic and Clinical Pharmacology
, Page 7 of 822
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, butthere
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 useof
the drug may be acceptable despite potential risks.
ANSWER: B
Katzung's Basic and Clinical Pharmacology
, Page 8 of 822
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 studieshave
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 bythe 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 originallybeen
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
Katzung's Basic and Clinical Pharmacology
, Page 9 of 822
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 NursingDrug 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 druginformation, they will not
contain nursing implications and teaching pointsand 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 containa
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
, Page 10 of 822
11 What aspect of pharmacology does a nurse study? (Select all that apply.)
.
A) Chemical pharmacology
B) Molecular pharmacology
C) Impact of drugs on the body
D) The bodys response to a drug
E) Adverse and anticipated drug effects
ANSWER: C, D, E
Feedback:
Nurses study pharmacology from a pharmacotherapeutic level, which includes
the effect of drugs on the body, the bodys response to drugs, and both
expected and unexpected drug effects. Chemical and molecular pharmacology
(Options A and B) are not included in nursing pharmacologycourses.
12 The nurse, providing patient teaching about home medication use to an older
. adult, explains that even when drugs are taken properly they can produce
negative or unexpected effects. What are these negative or unexpected
effects called?
A) Teratogenic effects
B) Toxic effects
C) Adverse effects
D) Therapeutic effects
ANSWER: C
Feedback:
Negative or unexpected effects are known as adverse or side effects.
Teratogenic effects are adverse effects on the fetus and not a likely concern
for an older adult. Toxic effects occur when medication is taken in larger than
recommended dosages caused by an increase in serum drug levels.
Therapeutic effects are the desired actions for which the medication is
prescribed.
Katzung's Basic and Clinical Pharmacology
