Deck 8: Individual Variation in Drug Responses

Question 1

A nurse is caring for a woman with breast cancer who is receiving tamoxifen. A review of this patient's chart reveals a deficiency of the CYP2D6 gene. The nurse will contact the provider to suggest:

A) a different medication.
B) an increased dose.
C) a reduced dose.
D) serum drug levels.

Answer 1

a different medication.

Question 2

A nurse is preparing to care for a patient who is receiving digoxin. When screening for potential adverse effects from this drug, the nurse will review which of this patient's laboratory results?

A) Albumin
B) Blood urea nitrogen (BUN) and creatinine
C) Hepatic enzymes
D) Serum electrolytes

Answer 2

Serum electrolytes

Question 3

A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the nurse recognize about this patient?

A) This patient exhibits a negative placebo effect with a reduced response to the drug.
B) This patient has developed a reaction known as tachyphylaxis because of repeated exposure to the drug.
C) This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect.
D) This patient produces higher than normal hepatic enzymes as a result of prolonged exposure to the drug.

Answer 3

This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect.

Question 4

A postoperative patient who is worried about pain control will be discharged several days after surgery. The nurse providing discharge teaching tells the patient that the prescribed Lortab is not as strong as the morphine the patient was given in the immediate postoperative period. Which response is the patient likely to experience?

A) A decreased likelihood of filling the prescription for the drug
B) A negative placebo effect when taking the medication
C) An increased compliance with the drug regimen
D) Optimistic, realistic expectations about the drug

Question 5

A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon?

A) Altered bioavailability of the drug
B) Patient compliance with the therapeutic regimen
C) Pharmacogenomic differences among individuals
D) Placebo effects enhancing expectations of drug efficacy

Question 6

A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:

A) drug receptor sites.
B) hypersensitivity potential.
C) metabolism of drugs.
D) psychosocial response.

Question 7

A nurse is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that:

A) drugs usually have more toxic effects in women.
B) most known drug effects are based on drug trials in men.
C) women have varying responses to drugs during menstrual cycles.
D) women metabolize drugs more slowly.

Question 8

Which groups of people are especially sensitive to medication effects?

A) Older adults
B) Caucasians
C) Infants
D) Minorities
E) Women

Question 9

The nurse is assessing a newly admitted older patient who has recently lost 15 lb. The nurse notes that the patient is taking warfarin (Coumadin). Which laboratory tests will the nurse discuss with this patient's provider?

A) Blood glucose and C-reactive protein
B) Complete blood count and hepatic function tests
C) Renal function tests and serum electrolytes
D) Serum albumin and coagulation studies

Question 10

The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers:

A) better establish a drug's therapeutic index.
B) determine whether a patient is a rapid or slow metabolizer of the drug.
C) identify racial characteristics that affect psychosocial variation in drug response.
D) produce a drug that is tailored to an individual patient's genetic makeup.