Free Chapter 4

Holland/Adams/Brice, Core Concepts in Pharmacology 4th Edition Test Bank
Chapter 4

Question 1

Type: MCSA

A nurse educator is teaching pharmacokinetics to the pharmacology class. What statement, made by a student, would show the class understands this term?

“Pharmacokinetics is what the body does to a drug.”

“Pharmacokinetics is how drugs activate specific receptors.”

“Pharmacokinetics is what a drug does to the body.”

“Pharmacokinetics is the efficacy of a drug.”

Correct Answer: 1

Rationale 1: Pharmacokinetics describes how the body absorbs, distributes, metabolizes, and excretes drugs.

Rationale 2: Pharmacokinetics is how drugs activate specific receptors is incorrect because drug–receptor interactions describe, in part, what effects a drug has on the body, and thus are considered part of pharmacodynamics.

Rationale 3: Pharmacokinetics is what a drug does to the body is incorrect because pharmacodynamics is the term that describes what effects a drug has on the body.

Rationale 4: Pharmacokinetics is the efficacy of a drug is incorrect because efficacy is a pharmacodynamic concept.

Global Rationale: Pharmacokinetics describes how the body absorbs, distributes, metabolizes, and excretes drugs. Pharmacokinetics is how drugs activate specific receptors is incorrect because drug—receptor interactions describe, in part, what effects a drug has on the body, and thus are considered part of pharmacodynamics. Pharmacokinetics is what a drug does to the body is incorrect because pharmacodynamics is the term that describes what effects a drug has on the body. Pharmacokinetics is the efficacy of a drug is incorrect because efficacy is a pharmacodynamic concept.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-1 Identify the four major processes of pharmacokinetics.

Question 2

Type: MCSA

What is the first step in drug transport?

Metabolism

Distribution

Excretion

Absorption

Correct Answer: 4

Rationale 1: Metabolism is the third step in drug transport.

Rationale 2: Distribution is the second step in drug transport.

Rationale 3: Excretion is the fourth step in drug transport.

Rationale 4: Absorption is the first step in drug transport.

Global Rationale: Absorption is the first step in drug transport. Distribution is the second step in drug transport. Metabolism is the third step in drug transport. Excretion is the fourth step in drug transport.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-1 Identify the four major processes of pharmacokinetics.

Question 3

Type: MCSA

The nurse educator is describing the process by which drugs are transported after they have been absorbed or administered directly into the bloodstream. Which response by the student indicates understanding of the process?

This process is metabolism.

This process is administration.

This process is excretion.

This process is distribution.

Correct Answer: 4

Rationale 1: Metabolism is the total of all chemical reactions in the body.

Rationale 2: Administration is giving medication to the client.

Rationale 3: Excretion is the process to remove medication from the body.

Rationale 4: Distribution is the process by which drugs are transported after they have been absorbed or administered directly into the bloodstream.

Global Rationale: Distribution is the process by which drugs are transported after they have been absorbed or administered directly into the bloodstream. Metabolism is the total of all chemical reactions in the body. Administration is giving medication to the client. Excretion is the process to remove medication from the body.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-1 Excretion is the process to remove medication from the body.

Question 4

Type: MCSA

A client asks the nurse how medication is excreted from the body. Which response by the nurse is most appropriate?

The lungs are the main organ of excretion.

The kidney is the main organ of excretion.

The colon is the main organ of excretion.

The liver is the main organ of excretion.

Correct Answer: 2

Rationale 1: The main organ of excretion is the kidney.

Rationale 2: The kidney is the main organ of excretion.

Rationale 3: The main organ of excretion is the kidney.

Rationale 4: The main organ of excretion is the kidney.

Global Rationale: The main organ of excretion is the kidney. The lungs, colon and liver all play a role in the excretion of medications, but none are the main organ of excretion.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-1 Excretion is the process to remove medication from the body.

Question 5

Type: MCSA

Which action will slow the absorption of a drug?

Taking medication earlier than prescribed

Taking medication with food

Taking medication with water

Taking medication as prescribed

Correct Answer: 2

Rationale 1: The presence of food in the GI tract slows the absorption of medication. Taking a medication earlier than prescribed can lead to a higher-than-prescribed level of drug in the body.

Rationale 2: The presence of food in the GI tract slows the absorption of medication.

Rationale 3: The presence of food, not water, in the GI tract slows the absorption of medication.

Rationale 4: Following the instructions of the prescriber can prevent slow absorption of a drug.

Global Rationale: The presence of food in the GI tract slows the absorption of medication. Taking a medication earlier than prescribed can lead to a higher-than-prescribed level of drug in the body. The presence of food, not water, in the GI tract slows the absorption of medication. Following the instructions of the prescriber can prevent slow absorption of a drug.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-2 Discuss the factors affecting drug absorption.

Question 6

Type: MCSA

What occurs when a medication binds to a plasma protein?

The drug is working at its full potential.

The drug is in the process of being excreted by the body.

The drug is unable to reach its target cells.

The drug has reached its target cells.

Correct Answer: 3

Rationale 1: The drug is held by the plasma protein, and unable to reach its target cells.

Rationale 2: The drug is held by the plasma protein, and unable to reach its target cells.

Rationale 3: When the drug binds to a plasma protein, it is unable to reach its target cells.

Rationale 4: The drug is held by the plasma protein, and unable to reach its target cells.

Global Rationale: When the drug binds to a plasma protein, it is unable to reach its target cells. The other options are not true statements of what occurs when the drug binds to plasma.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-3 Describe how plasma proteins affect drug distribution.

Question 7

Type: MCSA

A client takes two medications at the same time. Why might the action of one drug be intensified when this occurs?

Neither drug will bind to any plasma protein receptors, and the effect of the more potent drug will be intensified.

A client must never take two medications at the same time.

The drugs bind together, and the effect of the more potent drug is intensified.

Both drugs compete for the plasma protein receptors, and one drug will displace the other.

Correct Answer: 3

Rationale 1: When the drug binds to a plasma protein, it is unable to reach its target cells, which will cause the drug to be less effective.

Rationale 2: Clients can take two medications at the same time as long as it is not contraindicated.

Rationale 3: The drugs bind together, and the effect of the more potent drug is intensified.

Rationale 4: The drugs bind together, and the effect of the more potent drug is intensified.

Global Rationale: When drugs bind together, and the effect of the more potent drug is intensified. When the drug binds to a plasma protein, it is unable to reach its target cells which will cause the drug to be less effective.  Clients can take two medications at the same time as long as it is not contraindicated.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-3 Describe how plasma proteins affect drug distribution.

Question 8

Type: MCSA

Which organ contains anatomical barriers that limit some drugs from gaining access?

Kidney

Liver

Brain

Heart

Correct Answer: 3

Rationale 1: There is no anatomical barrier to limit some drugs from gaining access.

Rationale 2: There is no anatomical barrier to limit some drugs from gaining access.

Rationale 3: The brain, testes, and placenta all have barriers that restrict the movement of some drugs from the bloodstream into those organs.

Rationale 4: There is no anatomical barrier to limit some drugs from gaining access.

Global Rationale: The brain, testes, and placenta all have barriers that restrict the movement of some drugs from the bloodstream into those organs. The kidneys, liver, and heart have no anatomical barriers to limit some drugs from gaining access.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-4 Explain the significance of the blood-brain barrier, blood-placental barrier, and blood-testicular barrier to drug therapy.

Question 9

Type: MCSA

What is not a barrier to distribution of medications?

Blood–brain barrier

Blood–testicular barrier

Blood–placental barrier

Blood–lung barrier

Correct Answer: 4

Rationale 1: This is a barrier to the distribution of medications.

Rationale 2: This is a barrier to the distribution of medications.

Rationale 3: This is a barrier to the distribution of medications.

Rationale 4: There is no blood–lung barrier.

Global Rationale: There is no blood—lung barrier for the distribution of medication. This is a barrier to the distribution of medications between the blood-brain barrier, the blood-testicular barrier, and the blood-placental barrier.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-4 Explain the significance of the blood-brain barrier, blood-placental barrier, and blood-testicular barrier to drug therapy.

Question 10

Type: MCMA

First-pass effect can result in a large fraction of an administered drug’s being metabolically deactivated. Which client factors will decrease the magnitude of the first-pass effect?

(Select all that apply.)

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Elderly client

Hepatic disease

Gall bladder disease

Renal disease

Parental medication administration

Correct Answer: 1, 2

Rationale 1: Elderly clients have reduced enzyme activity; thus first-pass effect is reduced in this population as well.

Rationale 2: Liver enzymes are the major metabolic pathway for deactivation of most drugs, and clients with liver disease have decreased amounts of liver enzymes. First-pass effect will be diminished in these clients.

Rationale 3: The gall bladder is not involved in first-pass effect.

Rationale 4: The kidneys are not involved in first-pass effect.

Rationale 5: Medications given parenterally are not affected by the first-pass effect.

Global Rationale: Elderly clients have reduced enzyme activity; thus first-pass effect is reduced in this population. Liver enzymes are the major metabolic pathway for deactivation of most drugs, and clients with liver disease have decreased amounts of liver enzymes. First-pass effect will be diminished in these clients. The gall bladder is not involved in first-pass effect. The kidneys are not involved in first-pass effect. Medications given parenterally are not affected by the first-pass effect.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-5 Explain the importance of the first-pass effect.

Question 11

Type: MCMA

Drug metabolism can be affected by which factors?

(Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Kidney disease

Age

Liver disease

Genetics

Kidney disease

Correct Answer: 1, 2, 3, 4

Rationale 1: Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism.

Rationale 2: Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism.

Rationale 3: Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism.

Rationale 4: Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism.

Rationale 5: Kidney disease affects the excretion of drugs, not the metabolism of drugs.

Global Rationale: Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism. Kidney disease affects the excretion of drugs, not the metabolism of drugs.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-6 Describe how metabolic enzymes differ in younger and in older patients, and explain the significance of this difference to the success of drug therapy.

Question 12

Type: MCSA

The nurse wants to discuss the biotransformation reaction to a student. What is the best explanation by the nurse?

Biotransformation converts drugs from one form to another that can result in increased or decreased activity.

Biotransformation is the final step in excretion of a drug from the body.

Biotransformation does not change the effect of a drug.

Biotransformation is the process of absorption.

Correct Answer: 1

Rationale 1: A biotransformation reaction converts drugs from one form to another that can result in increased or decreased activity.

Rationale 2: Biotransformation is not the final step of excretion of a drug from the body.

Rationale 3: Biotransformation does not change the effect of a drug.

Rationale 4: Biotransformation is not the process of absorption.

Global Rationale: A biotransformation reaction converts drugs from one form to another that can result in increased or decreased activity. Biotransformation is the final step in excretion of a drug from the body; does not change the effect of a drug; is not the process of absorption.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-7 Explain how intermediate products of drug metabolism may produce more intense responses than the original drug.

Question 13

Type: MCSA

A student nurse asks the charge nurse the definition of a prodrug. What is the best response by the charge nurse?

A prodrug is a name brand drug.

A prodrug is not absorbed by the body.

A prodrug is the first drug developed in a drug class.

A prodrug requires metabolism to make it active.

Correct Answer: 4

Rationale 1: Is a name brand drug is incorrect. A prodrug requires metabolism to make it active. In these cases, as the drug is broken down by chemical reactions of metabolism, the products formed by the breakdown produce a more intense response than does the original drug.

Rationale 2: Is not absorbed by the body is incorrect. A prodrug requires metabolism to make it active. In these cases, as the drug is broken down by chemical reactions of metabolism, the products formed by the breakdown produce a more intense response than does the original drug.

Rationale 3: Is the first drug developed in a drug class is incorrect. This would be a prototype drug.

Rationale 4: In these cases, as the drug is broken down by chemical reactions of metabolism, the products formed by the breakdown produce a more intense response than does the original drug.

Global Rationale: A prodrug requires metabolism to make it active. In these cases, as the drug is broken down by chemical reactions of metabolism, the products formed by the breakdown produce a more intense response than does the original drug. A prodrug is not necessarily a brand name drug. A prodrug is absorbed by the body. A prototype drug, not a prodrug, is the first drug developed in a drug class.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-7 Explain how intermediate products of drug metabolism may produce more intense responses than the original drug.

Question 14

Type: MCMA

A nurse is conducting an inservice for students regarding drug excretion. Which responses by the students indicate an understanding of drug excretion?

(Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Breast milk

Urine

Gastric juice

Feces

Lungs

Correct Answer: 1, 2, 4, 5

Rationale 1: Because some drugs are excreted into breast milk, nursing mothers should check with their health care providers before taking any drugs or supplements.

Rationale 2: Urine is the major route of excretion for most drugs.

Rationale 3: Gastric juice is incorrect because it is not a route of excretion for drugs.

Rationale 4: Some drugs are excreted into the bile and are ultimately lost from the body in the feces.

Rationale 5: Some drugs are excreted by the lungs through expiration.

Global Rationale: Drugs can be excreted through breast milk, urine, feces, and the lungs. Gastric juice is incorrect because it is not a route of excretion for drugs.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-8 Identify the major processes by which drugs are eliminated from the body.

Question 15

Type: MCMA

The nurse is educating a client regarding the effects of kidney damage and medications. Which statements by the nurse are appropriate regarding this topic?

(Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Kidney damage can significantly shorten drug action.

Kidney damage does not cause adverse reactions.

Kidney damage is a common cause of adverse reactions.

Kidney damage can significantly prolong drug action.

Kidney damage decreases the metabolism of drugs.

Correct Answer: 3, 4

Rationale 1: Kidney damage can significantly prolong drug action, not shorten drug action.

Rationale 2: Kidney damage can significantly prolong drug action, and is a common cause of adverse reactions.

Rationale 3: Kidney damage can significantly prolong drug action, and is a common cause of adverse reactions.

Rationale 4: Kidney damage can significantly prolong drug action, and is a common cause of adverse reactions.

Rationale 5: Kidney damage does not affect drug metabolism. Liver damage affects drug metabolism.

Global Rationale: Kidney damage can significantly prolong drug action, and is a common cause of adverse reactions. Kidney damage does not affect drug metabolism. Liver damage affects drug metabolism.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-8 Identify the major processes by which drugs are eliminated from the body.

Question 16

Type: MCSA

Which method of drug excretion excretes most drugs in their original, unmetabolized form?

Exhalation

Defecation

Sweating

Urination

Correct Answer: 1

Rationale 1: In contrast to other methods of excretion, the lungs excrete most drugs in their original unmetabolized form, via exhalation.

Rationale 2: Defecation excretes most drugs in a metabolized form.

Rationale 3: Sweating excretes most drugs in a metabolized form.

Rationale 4: Urination excretes most drugs in a metabolized form.

Global Rationale: In contrast to other methods of excretion, the lungs excrete most drugs in their original unmetabolized form, via exhalation. Defecation, sweating, and urination excrete most drugs in a metabolized form.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-8 Identify the major processes by which drugs are eliminated from the body.

Question 17

Type: MCSA

The nurse educator is planning to teach a group of pharmacology students about enterohepatic recirculation. What should the educator include in the presentation?

Enterohepatic recirculation involves the kidneys.

Enterohepatic recirculation results in prolonged drug action.

Enterohepatic recirculation results in a decreased drug action.

Enterohepatic recirculation does not affect drug action.

Correct Answer: 2

Rationale 1: Involves the kidneys is incorrect because enterohepatic recirculation involves the liver.

Rationale 2: Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action.

Rationale 3: Results in decreased drug action is incorrect because recirculating drugs are then metabolized by the liver and excreted by the kidneys. The fraction of drug that is not recirculated continues on its way to the feces. Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action.

Rationale 4: Does not affect drug action is incorrect because recirculating drugs are then metabolized by the liver and excreted by the kidneys. The fraction of drug that is not recirculated continues on its way to the feces. Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action.

Global Rationale: Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action. Involves the kidneys is incorrect because enterohepatic recirculation involves the liver. Results in decreased drug action is incorrect because recirculating drugs are then metabolized by the liver and excreted by the kidneys. The fraction of drug that is not recirculated continues on its way to the feces. Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action. Does not affect drug action is incorrect because recirculating drugs are then metabolized by the liver and excreted by the kidneys. The fraction of drug that is not recirculated continues on its way to the feces. Elimination of drugs through bile can continue for several weeks after therapy has stopped, and results in prolonged drug action.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-9 Explain the importance of enterohepatic recirculation to drug therapy.

Question 18

Type: MCSA

What is an indicator of how long a drug will produce its effect in the body?

Potency

Bioavailability

Half-life (t1/2)

Efficacy

Correct Answer: 3

Rationale 1: Potency refers to what dose of drug must be administered to achieve a certain level of response.

Rationale 2: Bioavailability is an index of what fraction of administered drug is absorbed and available to act in the body.

Rationale 3: Half-life is the time it takes the body to remove one-half of the drug from the circulation, and thus is a measure of how long the drug effect will last in the body.

Rationale 4: Efficacy refers to the magnitude of the response to a given dose of drug.

Global Rationale: Half-life is the time it takes the body to remove one-half of the drug from the circulation, and thus is a measure of how long the drug effect will last in the body. Potency refers to what dose of drug must be administered to achieve a certain level of response. Bioavailability is an index of what fraction of administered drug is absorbed and available to act in the body. Efficacy refers to the magnitude of the response to a given dose of drug.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-10 Explain how rate of elimination and plasma half-life (t1/2) are related to the duration of drug action.

Question 19

Type: MCSA

What is the correct term for the length of time for a drug concentration to decrease by half?

Half-time

Metabolism

Half-life

Distribution

Correct Answer: 3

Rationale 1: The length of time for a drug concentration to decrease by half is its half-life.

Rationale 2: The length of time for a drug concentration to decrease by half is its half-life.

Rationale 3: The length of time for a drug concentration to decrease by half is its half-life.

Rationale 4: The length of time for a drug concentration to decrease by half is its half-life.

Global Rationale: The length of time for a drug concentration to decrease by half is its half-life. Half-time, metabolism and distribution have different definitions.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-10 Explain how rate of elimination and plasma half-life (t1/2) are related to the duration of drug action.

Question 20

Type: MCSA

What phrase best describes pharmacodynamics?

The potency of a drug

What the body does to a drug

How a drug exerts its effects

The efficacy of a drug

Correct Answer: 3

Rationale 1: The potency of a drug is incorrect because how a drug exerts its effects is pharmacodynamics.

Rationale 2: What the body does to a drug is incorrect because this is the definition of pharmacokinetics.

Rationale 3: How a drug exerts its effects is pharmacodynamics.

Rationale 4: The efficacy of a drug is incorrect because how a drug exerts its effects is pharmacodynamics.

Global Rationale: How a drug exerts its effects is pharmacodynamics. The potency of a drug is incorrect because how a drug exerts its effects is pharmacodynamics. What the body does to a drug is incorrect because this is the definition of pharmacokinetics. The efficacy of a drug is incorrect because how a drug exerts its effects is pharmacodynamics.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-11 Discuss how successful pharmacotherapy depends on principles of pharmacodynamics.

Question 21

Type: MCSA

Which definition describes a receptor?

A cell component to which a drug binds in a dose-dependent manner

Present only in the drug’s target tissue

Required to drug action

Analogous to the “key” in the lock-and-key model of drug–receptor interaction

Correct Answer: 1

Rationale 1: A cell component to which a drug binds in a dose-dependent manner is a receptor.

Rationale 2: Present only in the drug’s target tissue is incorrect because receptors are present not only in the drug’s target tissue, but in many other tissues in the body. It often is drug effects at sites other than the target tissue that result in side effects.

Rationale 3: Required to drug action is incorrect because although most drugs act via receptor-mediated mechanisms, some drugs do not act at specific receptors.

Rationale 4: Analogous to the “key” in the lock-and-key model of drug–receptor interaction is incorrect because a receptor is analogous to the “lock” in the lock-and-key model of drug–receptor interaction.

Global Rationale: A cell component to which a drug binds in a dose-dependent manner is a receptor. Present only in the drug’s target tissue is incorrect because receptors are present not only in the drug’s target tissue, but in many other tissues in the body. It often is drug effects at sites other than the target tissue that result in side effects. Analogous to the “key” in the lock-and-key model of drugreceptor interaction is incorrect because a receptor is analogous to the “lock” in the lock-and-key model of drug—receptor interaction.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-12 Explain the significance of the receptor theory.

Question 22

Type: MCSA

What is the action of a drug antagonist?

It facilitates cell action.

It does not bind with receptors.

It blocks the actions of an agonist.

It has no therapeutic benefit.

Correct Answer: 3

Rationale 1: Agonists facilitate drug action; antagonists block the effects of agonists.

Rationale 2: Many therapeutically useful drugs act by blocking receptors (e.g., beta-adrenergic blockers, antihistamines).

Rationale 3: Blocks the actions of an agonist is the definition of an antagonist.

Rationale 4: Many therapeutically useful drugs act by blocking receptors (e.g., beta-adrenergic blockers, antihistamines).

Global Rationale: Blocks the actions of an agonist is the definition of an antagonist. An agonist facilitates drug action. Many therapeutically useful drugs act by blocking receptors (e.g., beta-adrenergic blockers, antihistamines); therefore, not biding with receptors and it has no therapeutic effect are both incorrect.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4-13 Describe how “blockers” of drug action work.

Question 23

Type: MCSA

Drug A produces a certain therapeutic effect at a dose of 5 mg/kg. Drug B produces the same magnitude of effect at a dose of 0.1 mg/kg. How would the nurse describe the action of Drug A when compared to Drug B?

Drug A is more efficacious.

Drug A is less efficacious.

Drug A is more potent.

Drug A is less potent.

Correct Answer: 4

Rationale 1: Efficacy is a concept that refers to the magnitude of the maximal response to a drug.

Rationale 2: Efficacy is a concept that refers to the magnitude of the maximal response to a drug.

Rationale 3: It takes a higher dose of drug A to produce the same effect as drug B; therefore, drug A is less potent than drug B.

Rationale 4: It takes a higher dose of drug A to produce the same effect as drug B; therefore, drug A is less potent than drug B.

Global Rationale: It takes a higher dose of drug A to produce the same effect as drug B; therefore, drug A is less potent than drug B. Efficacy is a concept that refers to the magnitude of the maximal response to a drug.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-14 Compare and contrast the therapeutic terms potency and efficacy.

Question 24

Type: MCSA

Codeine has a greater maximal ability to suppress cough when compared with dextromethorphan. What is the most appropriate description of codeine when compared to dextromethorphan?

Codeine is more efficacious.

Codeine is less potent.

Codeine is more potent.

Codeine is less efficacious.

Correct Answer: A

Rationale 1: Codeine has a greater maximal effect than dextromethorphan; it is more efficacious than is dextromethorphan.

Rationale 2: Less potent is incorrect because potency refers to the dosage of drug required to produce a certain magnitude of response, whereas efficacy is the magnitude of the maximum response to a drug.

Rationale 3: More potent is incorrect because potency refers to the dosage of drug required to produce a certain magnitude of response, whereas efficacy is the magnitude of the maximum response to a drug.

Rationale 4: Less efficacious is incorrect; because codeine has a greater maximal effect than does dextromethorphan, it is more efficacious than is dextromethorphan.

Global Rationale: Codeine has a greater maximal effect than dextromethorphan; it is more efficacious than is dextromethorphan. Less potent is incorrect because potency refers to the dosage of drug required to produce a certain magnitude of response, whereas efficacy is the magnitude of the maximum response to a drug. More potent is incorrect because potency refers to the dosage of drug required to produce a certain magnitude of response, whereas efficacy is the magnitude of the maximum response to a drug. Less efficacious is incorrect; because codeine has a greater maximal effect than does dextromethorphan, it is more efficacious than is dextromethorphan.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4-14 Compare and contrast the therapeutic terms potency and efficacy.

Holland/Adams/Brice, Core Concepts in Pharmacology, 4th edition