Lehne’s Test Bank for Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants 2nd Edition Rosenthal

Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants 2nd Edition Rosenthal Test Bank

Chapter 4: Pharmacokinetics, Pharmacodynamics, and Drug Interactions 

Test Bank 

Multiple Choice

21. The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of

morphine sulfate. The nurse understands that the naloxone is effective because of which

action?

a. Countering the effects of morphine sulfate by agonist actions

b. Increasing the excretion of morphine sulfate by altering serum pH

c. Preventing activation of opioid receptors through antagonist actions

d. Regulating the sensitivity of opioid receptors by neurochemical alterations

ANS: C

Naloxone acts by blocking the action of opioids at opioid receptors. An opioid agonist would

increase the effects of morphine. Naloxone does not affect serum pH or excretion of opioids.

Naloxone does not alter the sensitivity of opioid receptors.DIF: Cognitive Level: AnalysisREF: p.

31TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic

Integrity: Pharmacologic and Parenteral Therapies 

22. A patient is taking drug X and receives a new prescription for drug Y, which is listed as an

inducing agent. The nurse caring for this patient understands that this patient may require doses

of drug .

a. lower; X

b. lower; Y

c. higher; X

d. higher; Y 

ANS: C

An inducing agent stimulates the synthesis of CYP isoenzymes, which may increase the

metabolism of other drugs as much as two- to threefold, thereby lowering the level of those drugs

in the body and requiring higher doses to maintain drug effectiveness.DIF: Cognitive Level:

ApplicationREF: p. 36TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category:

Physiologic Integrity: Pharmacologic and Parenteral Therapies 

23. The nurse is preparing to administer penicillin G intramuscularly to a child. The child’s parents

ask why the drug cannot be given in an oral liquid form. What is the nurse’s reply?

a. “This drug causes severe gastric upset if given orally.”

b. “This drug has a narrow therapeutic range, and the dose must be tightly controlled.”

c. “This drug is absorbed much too quickly in an oral form.”

d. “This drug would be inactivated by enzymes in the stomach.”

ANS: D

Penicillin G is inactivated by digestive enzymes in the stomach and cannot be given orally. It does

not have a narrow therapeutic range.DIF: Cognitive Level: ApplicationREF: p. 20TOP: Nursing

Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:

Pharmacologic and Parenteral Therapies

24. Which statement about food and drug interactions is true?

a. Foods alter drug absorption and metabolism but not drug action.

b. Medications are best absorbed on an empty stomach.

c. Patient discomfort is the food and drug interaction of most concern.

d. Some foods can inhibit CYP isoenzymes and alter drug metabolism.

ANS: D

Grapefruit juice inhibits CYP3A4, which lowers the metabolism of some drugs, leading to toxic

effects of drugs affected by these isoenzymes. Foods can alter all pharmacokinetic and

pharmacodynamic processes. Not all medications are absorbed better on an empty stomach; some

require certain foods to enhance absorption. Patient comfort is a concern, but it is not as important

as more severe and possibly life-threatening food and drug interactions.DIF: Cognitive Level: