Chapter 02: Basic Principles of Drug Action and Drug Interactions Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th Edition MULTIPLE CHOICE 1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority action? a. Notify physician of allergic reaction. b. Notify physician of idiosyncratic reaction. c. Notify physician of potential teratogenicity. d. Notify physician of potential tolerance. ANS: A An allergic reaction is indicative of hypersensitivity and manifests with hives and/or urticaria, which are easily identified. An idiosyncratic reaction occurs when something unusual or abnormal happens when a drug is first administered. A teratogenic reaction refers to the occurrence of birth defects related to administration of the drug. Tolerance refers to the body’s requirement for increasing dosages to achieve the same effects that a lower dose once did. DIF: Cognitive Level: Application REF: p. 17 OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Clinical Judgment | Safety 2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after administration, the nurse finds the patient agitated and stating that “everyone is out to get me.” What is the term for this unu NsualRreaIctioGn? B.C M a. Desired action b. Adverse effect c. Idiosyncratic reaction d. Allergic reaction ANS: C U S N T O Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is first administered. Patients typically exhibit an overresponsiveness to a medication related to diminished metabolism. These reactions are believed to be related to genetic enzyme deficiencies. Desired actions are expected responses to a medication. Adverse effects are reactions that occur in another system of the body; they are usually predictable. Allergic reactions appear after repeated medication dosages. DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Evaluation CON: Patient Education | Clinical Judgment | Caregiving | Safety | Sensory Perception 3. Which is the best description of when drug interactions occur? a. On administration of toxic dosages of a drug b. On an increase in the pharmacodynamics of bound drugs c. On the alteration of the effect of one drug by another drug d. On increase of drug excretion ANS: C
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