Nokea
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
- A. Absorption
- B. Distribution
- C. Metabolism
- D. Excretion
Correct Answer: D
Rationale: The kidneys are the organs that are most responsible for drug excretion. Renal function does not affect the absorption and distribution of a drug. Renal function may affect metabolism of drugs to a small extent.
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The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
- A. Parenteral drugs bypass the first-pass effect.
- B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
- C. Absorption of parenteral drugs is faster when the stomach is empty.
- D. Parenteral drugs exert their effects while circulating in the bloodstream.
Correct Answer: A
Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream.
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?
- A. Adverse effect
- B. Allergic reaction
- C. Idosyncratic reaction
- D. Pharmacologic reaction
Correct Answer: D
Rationale: A pharmacologic reaction is an extension of a drug's normal effects in the body. In this case, the antihypertensive drug lowered the patient's blood pressure levels too much. The other options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient's immune system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of a drug.
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction?
- A. The drug alters cell membrane permeability.
- B. The drug's effectiveness within the cell walls of the target tissue is enhanced.
- C. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor.
- D. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell.
Correct Answer: D
Rationale: With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells. As a result, the target cells are protected from the action of the enzymes. This results in a drug effect. The actions described in the other options do not occur with selective enzyme interactions.
A drug dose that delivers 10 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life.
Correct Answer: 5 mg
Rationale: A drug's half-life is the time required for one half of an administered dose of a drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%. Therefore, one half of 10 mg equals 5 mg.
The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe?
- A. Intradermal
- B. Subcutaneous
- C. Intramuscular
- D. Transdermal
Correct Answer: A
Rationale: Injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as intradermal injections. Injections into the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch.