PHA1142 Pharmacology and Medication Administration

Free preview · Original latest version

Sample questions from PHA1142 Pharmacology and Medication Administration

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A medication is administered orally to a client with reduced hepatic blood flow. Which pharmacokinetic process is most likely to be altered first?

   • A.Absorption from the small intestine
   • B.Receptor binding
   • C.First-pass metabolism
   • D.Renal excretion

   Rationale: Reduced hepatic blood flow can decrease first-pass metabolism, increasing the fraction of an oral dose that reaches systemic circulation. Absorption occurs primarily in the gastrointestinal tract, while renal excretion and receptor binding are different processes. Consider hepatic function when evaluating medications that undergo extensive first-pass metabolism.

2. 2.A nurse is preparing to administer an oral medication to a client with dysphagia. Which actions support safe medication administration? Select all that apply.

   • A.Check whether the medication is extended-release or enteric-coated before altering it.
   • B.Document administration before giving the medication.
   • C.Assess the client's ability to swallow and follow the prescribed diet consistency.
   • D.Verify the client's identity using two approved identifiers.
   • E.Crush every tablet and mix it with applesauce.

   Rationale: Using two identifiers helps ensure the medication is given to the correct client. Extended-release and enteric-coated medications generally should not be crushed, so the formulation must be checked first. Assess swallowing ability and diet consistency to reduce aspiration risk. Crushing every tablet can alter drug release or make administration unsafe. Document after administration, not before, to maintain an accurate record.

3. 3.A client with chronic kidney disease is prescribed a medication that is primarily excreted unchanged by the kidneys. Which pharmacokinetic change is most likely?

   • A.Reduced plasma protein binding for every medication
   • B.Increased absorption from the stomach
   • C.Increased first-pass metabolism
   • D.Reduced clearance and prolonged drug half-life

   Rationale: Reduced renal function can decrease clearance of a renally excreted medication and prolong its half-life, allowing accumulation. First-pass metabolism is a hepatic process, and kidney disease does not necessarily increase gastrointestinal absorption. Plasma protein binding varies by drug and is not uniformly reduced in kidney disease.

4. 4.A client's creatinine clearance has decreased since a renally cleared medication was started. Which medication plan should the nurse anticipate?

   • A.Taking each dose with grapefruit juice
   • B.A lower dose or longer interval, as prescribed
   • C.Stopping all medications that are taken orally
   • D.A higher dose at shorter intervals

   Answer and rationale are in the full material.

5. 5.An older adult asks how to take a newly prescribed oral medication safely at home. Which guidance is appropriate? Select all that apply.

   • A.Store medications in their original labeled containers unless instructed otherwise.
   • B.Take a missed dose together with the next dose in every case.
   • C.Ask the pharmacist before splitting or crushing a tablet.
   • D.Use a medication organizer if it is appropriate and the regimen is understood.
   • E.Keep an up-to-date list of prescription drugs, over-the-counter drugs, and supplements.

   Answer and rationale are in the full material.