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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.
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The patient is stating that he has a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
- A. A capsule
- B. A tablet
- C. A powder
- D. An enteric-coated tablet
Correct Answer: C
Rationale: Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order.
The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life?
- A. The time it takes for the drug to cause half of its therapeutic response
- B. The time it takes for one half of the original amount of a drug to reach the target cells
- C. The time it takes for one half of the original amount of a drug to be removed from the body
- D. The time it takes for one half of the original amount of a drug to be absorbed into the circulation
Correct Answer: C
Rationale: A drug's half-life is the time it takes for one half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed from the body. The other options are incorrect definitions of half-life.
Which drugs would be affected by the first-pass effect when administered?
- A. Morphine given by IV push injection
- B. Sublingual nitroglycerin tablet
- C. Diphenhydramine elixir
- D. Levotthroxine (Synthroid) tablet
- E. Transdermal nicotine patches
- F. Esomeparzole capsule
- G. Penicillin given by IV piggyback infusion
Correct Answer: C,D,F
Rationale: Orally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect, because they are metabolized in the liver after being absorbed into the portal circulation from the small intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal patches also enter the bloodstream without going directly to the liver, thus avoiding the first-pass effect.
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
- A. Pallative therapy
- B. Maintenance therapy
- C. Empirric therapy
- D. Supplmental therapy
Correct Answer: A
Rationale: The goal of palliative therapy is to make the patient as comfortable as possible. It is typically used in the end stages of illnesses when all attempts at curative therapy have failed. Maintenance therapy is used for the treatment of chronic illnesses such as hypertension. Empirric therapy is based on clinical probabilities and involves drug administration when a certain pathologic condition has an uncertain but high likelihood of occurrence based on the patient's initial presenting symptoms. Supplemental therapy (or replacement therapy) supplies the body with a substance needed to maintain normal function.
The patient is experiencing chest pain and needs to take a buccal form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
- A. Under the tongue
- B. On top of the tongue
- C. At the back of the throat
- D. In the space between the cheek and the gum
Correct Answer: D
Rationale: Drugs administered via the buccal route are placed in the space between the cheek and the gum. Drugs administered via the sublingual route are placed under the tongue. The other options are incorrect.