Question 1

A nurse is caring for a patient who is taking multiple medications. To help ensure that adverse drug reactions are prevented or minimized, the nurse will do which of the following?

Accepted Answer

A)   Ask the patient about over-the-counter medications used.
B)   Contact the prescriber to request cytochrome P450 levels.
C)   Limit the patient's calcium intake.
D)   Obtain a thorough diet history.
E)   Request orders for PRN medications to treat any anticipated symptoms of drug interactions. A, B, D

Question 2

In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction?

Accepted Answer

A)   Naloxone [Narcan] blocking morphine sulfate's actions
B)   Antacids blocking the action of tetracycline [Sumycin]
C)   Propanolol [Inderal] blocking the effects of albuterol
D)   Cholestyramine blocking the actions of antihypertensive drugs A

Question 3

A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain that this drug may cause which effect on other drugs?

Accepted Answer

A)   Decreased absorption in the intestines
B)   Decreased elimination through the kidneys
C)   Increased brain exposure
D)   Increased fetal absorption B

Question 4

A child ingests a parent's aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for this patient knows that sodium bicarbonate is effective against the aspirin because it:

Accepted Answer

A)   accelerates its passage through the intestine.
B)   alters urinary pH to enhance renal excretion.
C)   induces CYP isoenzymes to increase drug metabolism.
D)   raises the pH of the interstitial fluid to facilitate passage out of the cells.

Question 5

A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require ____ doses of drug ____.

Accepted Answer

A)   lower; X
B)   lower; Y
C)   higher; X
D)   higher; Y

Question 6

The prescriber has ordered an antibiotic for a patient with a bacterial infection. The nurse provides patient education at discharge and instructs the patient to take the drug on an empty stomach. When should the patient take the drug?

Accepted Answer

A)   1 hour or more before a meal
B)   Only after an 8-hour fast
C)   Only after the patient has missed a meal
D)   At least 2 hours after a meal
E)   Shortly before a meal

Question 7

A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain. The last dose was 3 mg given 2 hours ago. The patient is asleep, and the nurse notes a heart rate of 86 beats/min and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?

Accepted Answer

A)   Diphenhydramine [Benadryl] to counter morphine side effects
B)   Morphine 4 mg for increased pain, as indicated by tachycardia
C)   Naloxone [Narcan] to block the effects of the morphine
D)   Nothing at this time, because the patient is resting comfortably

Question 8

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur?

Accepted Answer

A)   Binding of one or both agents will be reduced.
B)   Plasma levels of free drug will rise.
C)   Plasma levels of free drug will fall.
D)   The increase in free drug will intensify effects.
E)   The increase in bound drug will intensify effects.

Question 9

A nurse is teaching a patient about a prescription for a monoamine oxidase (MAO) inhibitor for depression. What will the nurse teach the patient to avoid while taking this drug?

Accepted Answer

A)   Alcoholic beverages
B)   Aged cheeses
C)   Brussels sprouts and cabbage
D)   Grapefruit juice

Question 10

A patient taking oral contraceptives thinks she may be pregnant. As part of this patient's history, what will the nurse ask the patient?

Accepted Answer

A)   "Do you drink grapefruit juice?"
B)   "Do you take seizure medication?"
C)   "Do you take your contraception with milk?"
D)   "Do you use laxatives regularly?"

Question 11

Which statement about food and drug interactions is true?

Accepted Answer

A)   Foods alter drug absorption and metabolism but not drug action.
B)   Medications are best absorbed on an empty stomach.
C)   Patient discomfort is the food and drug interaction of most concern.
D)   Some foods can inhibit CYP isoenzymes and alter drug metabolism.

Question 12

The nurse is teaching a patient about taking warfarin and asks if the patient takes aspirin. This assessment by the nurse reflects a knowledge of which type of drug interaction?

Accepted Answer

A)   Creation of unique effects
B)   Increased therapeutic effects
C)   Inhibitory effects
D)   Potentiative effects

Question 13

The nurse is providing multiple medications to a patient whose spouse brings grapefruit juice every morning. The nurse will be concerned about which classes of drugs?

Accepted Answer

A)   Calcium channel blockers
B)   Selective serotonin reuptake inhibitors
C)   Aminoglycosides
D)   Beta blockers
E)   Penicillins

Exam 6: Drug Interactions