Pharacological Principles Quiz (Week 1)

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Which drugs would be affected by the first-pass effect when administered? ( Select all that apply.)

a. Levothyroxine (Synthroid) tablet
b. Morphine given by IV push injection
c. Sublingual nitroglyverin tablets
d. Penicillin given by IV piggyback infusion
e. Diphenhydramine (Benadryl) elixirs
f. Esomeprazole (Nexium) capsules
g. Transdermal nicotine patches

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f. Esomeprazole (Nexium) capsules
a. Levothyroxine (Synthroid) tablets
e. Diphenhydramine (Benadryl) elixirs

Explanation: 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

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Terms in this set (10)

A swab of a wound infection is sent for culture and, pending culture results, the health care provider starts an intravenous antibiotic. Which type of therapy has been prescribed for this patient?

a. Prophylactic
b. Maintenance
c. Palliative
d. Empiric

d. Empiric

Explanation: Empiric therapy involves drug administration based on the patient's symptoms when there is a high likelihood oof a certain pathologic condition. Palliative therapy is used to relieve patients of specific symptoms, pain, and stress related to a terminal illness. Prophylactic therapy is administered to prevent illness or to prevent complications during a planned event. Maintenance therapy is used in chronic illnesses to prevent progression of the disease; however, it may not eradicate the problem.

The nurse can prevent medication errors by following which principles? ( Select all that apply.)

a. Use two patient identifiers before giving medications.
b. Always following the rights of medication administration.
c. Minimize the use of verbal and telephone orders.

- Use two patient identifiers before giving medications.
- Always following the rights of medication administration.
- Minimize the use of verbal and telephone orders.

Explanation: Measures that prevent medication errors include using two patient identifiers, minimizing the use of verbal and telephone orders, and always following the rights of medication administration. Assessment for allergies should be done before medications are given. Generic names should be used to avoid the many sound-alike trade names of medications.

The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?

a. Category A
b. Category X
c. Category D
d. Category E

c. Category D

Explanation: Pregnancy category D fits the description given. Category B indicates no risk to animal fetus; information for humans is not available. Category C indicates adverse effects reported in animal fetus; information for humans is not available. Category X consists of drugs that should not be used in pregnant women because of reports of fetal abnormalities and positive evidence of fetal risk in humans.

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?

- Excretion

Explanation: 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.