Chapter 1. History of Pharmacology

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	While caring for a client who is taking furosemide (Lasix), the nurse recognizes dietary teaching has been effective if the patient includes which of the following foods in his daily menus?
A.	Broccoli and kiwi	
B.	Oranges and sweet potatoes	
C.	Kale and cucumbers	
D.	Bananas and melon	

____	2.	A client newly diagnosed with diabetes tells the nurse, “I can’t take any insulin made from pigs or cows.” Which of the following responses by the nurse is best?
A.	“Most insulin comes from animal sources, but I’m sure alternative options are available.”	
B.	“Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available.”	
C.	“Most insulin is synthetic now to help reduce the risk of disease transmission.”	
D.	“The animals aren’t hurt in the production of medications, so you don’t need to worry.”	

____	3.	While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients?
A.	A 48-year-old Caucasian male diagnosed with atrial fibrillation	
B.	A 55-year-old African American female diagnosed with hypertension	
C.	A 63-year-old Caucasian female diagnosed with sick sinus syndrome	
D.	A 64-year-old African American male diagnosed with heart failure	

____	4.	While caring for a patient scheduled for knee replacement surgery, the nurse provides cefazolin (Ancef) as ordered 30 minutes pre-operatively. The nurse knows that teaching has been effective by which of the following client statements?
A.	“The antibiotic is given as a prophylactic to help reduce the risk of infection after surgery.”	
B.	“This is a palliative medication to help ease the pain from surgery.”	
C.	“This medication will replace vitamins and minerals that may be lost due to bleeding during surgery.”	
D.	“This medication will help the surgeon identify areas of bone destruction due to arthritis.”	

____	5.	While caring for a patient with a history of hypothyroidism, the nurse expects which of the following medications to be included in the patient’s medication list?
A.	Levothyroxine sodium (Synthroid)	
B.	Estrogen (Estradiol)	
C.	Iodine 131	
D.	Carbimazole (Methimazole)	

____	6.	The nurse is receiving a shift-to-shift report on a medical unit and is informed that a 55-year-old patient with a history of vomiting is scheduled for a diagnostic radiograph of the upper gastrointestinal tract. Which of the following statements would the nurse include in the client’s teaching?
A.	“You will need to drink a large amount of prep to clear out your system before the test.”	
B.	“It is important that you be given a prophylactic medication to prevent aspiration during the test.”	
C.	“You will be asked to drink a barium contrast about 30 minutes before the test to help highlight any digestive problems.”	
D.	“You will be given a sedative to help make you sleepy during the testing procedure.”	

____	7.	A student nurse is providing care for a 29-year-old patient with advanced cervical cancer who was recently admitted with metastatic disease. While reviewing the patient’s medication list, the student would categorize which of the following medications as palliative in nature?
A.	Cisplatin (Platinol) 50 mg IV weekly to start day 8	
B.	Sorafenib (Nexavar) 200 mg orally twice daily for 7 days	
C.	Ondansetron (Zofran) 4 mg IV prior to chemotherapy	
D.	Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain	

____	8.	A woman experiencing menopausal symptoms asks the nurse about conjugated estrogen (Premarin). Which of the following statements by the individual indicates an understanding of the medication’s origin?
A.	“I’m against animal cruelty, so I don’t want to take anything made from animal flesh.”	
B.	“I was told the medication is actually derived from the urine of pregnant horses.”	
C.	“Because I’m Jewish, I can’t take the medication since it comes from pigs.”	
D.	“I think harvesting medicines from cows seems rather odd.”	

____	9.	The nurse working in a diagnostic center is responsible for verifying client allergies prior to testing. A 47-year-old woman reports being allergic to iodine, and thus is unable to have which test?
A.	Computerized axial tomography (CAT) scan	
B.	Magnetic resonance imaging (MRI)	
C.	Colonoscopy	
D.	Thyroid scan	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	1.	While working with patients in home care, a nurse becomes interested in additional ways to support patient healing and comfort. Which of the following is recognized as an alternative therapy? (Select all that apply.)
A.	Acupuncture	
B.	Aromatherapy	
C.	Therapeutic touch	
D.	Stem cell treatment	
E.	Vegetarianism	
F.	Acupressure	

Chapter 1. History of Pharmacology
Answer Section

MULTIPLE CHOICE

	1.	ANS:	B	PTS:	1	DIF:	Moderate	TOP:	Therapeutic Classification: Diuretic
KEY:	Application	MSC:	NCLEX Category: Basic Care and Comfort	
NOT:	See Minerals (p. 7): Diuretic drugs such as furosemide (Lasix) cause the body to lose excess water through the kidneys, and potassium, a vital mineral is also excreted with the water. Potassium is contained in sweet potatoes, bananas, and oranges.

	2.	ANS:	C	PTS:	1	DIF:	Moderate	
TOP:	Therapeutic Classification: Anti-diabetic medication	KEY:	Analysis
MSC:	NCLEX Category: Pharmacological Therapies	
NOT:	See Synthetic Medications (p. 8): Insulin can be obtained from pigs or cows, but a synthetic source is most commonly used. This change occurred because of concern over the possible transmission of diseases from animals to humans. Synthetic medications are usually more inexpensive because they are mass produced.

	3.	ANS:	D	PTS:	1	DIF:	Moderate	
TOP:	Therapeutic Classification: Combination drug (diuretic/nitrate)	
KEY:	Analysis	MSC:	NCLEX Category: Pharmacologic and Parenteral Therapy
NOT:	See Synthetic medications (p. 8). BiDil is a combination of two generic drugs and is used to treat African American patients with heart failure.	

	4.	ANS:	A	PTS:	1	DIF:	Easy	
TOP:	Therapeutic Classification: Antibiotics		KEY:	Analysis
MSC:	NCLEX Category: Pharmacological Therapies	
NOT:	See Categorizing Medications (p. 8): Prophylactic medications are given to prevent problems such as antibiotics given before surgery to prevent infection. Example of cefazolin is listed in Table 1.2.

	5.	ANS:	A
Difficulty Level: Easy

PTS:	1	DIF:	Easy	TOP:	Therapeutic Classification: Replacement hormones
KEY:	Knowledge	MSC:	NCLEX Category: Pharmacological Therapies
NOT:	See Categorizing Medications (p. 9): Replacement drugs are given to replace missing substances. Levothyroxine sodium (Synthroid) is a drug that replaces missing thyroid hormone. Estrogen may be given to women once they enter menopause. Iodine 131 is a radioactive medication used to help diagnose thyroid abnormalities. Carbimazole is used to inhibit the production of thyroid hormone to treat hyperthyroidism.

	6.	ANS:	C	PTS:	1	DIF:	Moderate	
TOP:	Therapeutic Classification: Diagnostic contrast	KEY:	Analysis
MSC:	NCLEX Category: Reduction of Risk Potential	
NOT:	See Categorizing Medications (p. 8): Some drugs help diagnose a disease such as barium that patients swallow to help highlight digestive problems on radiograph.

	7.	ANS:	D	PTS:	1	DIF:	Moderate	
TOP:	Therapeutic Classification: Narcotics		KEY:	Analysis
MSC:	NCLEX Category: Pharmacological Therapies	
NOT:	See Categorizing Medications (p. 8): Palliative drugs, such as pain relievers, do not cure disease, but they make patients more comfortable. Morphine is listed as an example in Table 1.2. Cisplatin is an antineoplastic agent and sorafenib is a biologic agent; both are designed to treat the cancer (destructive medications), while ondansetron is given in a prophylactic measure to prevent nausea and vomiting related to the chemotherapy.

	8.	ANS:	B	PTS:	1	DIF:	Moderate	
TOP:	Therapeutic Classification: Hormonal therapy	KEY:	Analysis
MSC:	NCLEX Category: Pharmacological Therapies	
NOT:	See Sources of Drugs (p. 6): Cows and pigs are good sources of hormone replacements, but conjugated estrogen (Premarin) comes from a pregnant mare’s urine.	

	9.	ANS:	D	PTS:	1	DIF:	Moderate	TOP:	Therapeutic Classification: NA
KEY:	Application	MSC:	NCLEX Category: Pharmacological Therapies
NOT:	See Toxins (p. 7): Radioactive iodine in small doses can help pinpoint problems in a patient’s thyroid. Because the client is allergic to iodine, she should not have this test.	

MULTIPLE RESPONSE

	1.	ANS:	A, B, D, F	PTS:	1	DIF:	Easy	TOP:	Therapeutic Classification: NA
KEY:	Knowledge	MSC:	NCLEX Category: Basic Care and Comfort	
NOT:	See Pharmacology in the 21st century (p. 5): Alternative therapies now seem to have a place in the healing of patients. For example, aromatherapy involves the use of fragrant oils in baths; acupressure originates from an ancient Chinese art. Along similar lines is acupuncture; therapeutic touch involves the use of hand movements to stimulate circulation and healing. Stem cell research is considered mainstream medical treatment. Dietary manipulation may promote health but is not a recognized alternative therapy.