Drug Sources, Forms, and Names

Every question here, with the answer

1. A client has difficulty swallowing and asks the nurse to crush an enteric-coated tablet and mix it with applesauce. What is the nurse’s best response?

   1. Crush the tablet because enteral medications are intended for the GI tract.
   2. Hold all enteral medications because dysphagia requires parenteral administration.
   3. Do not crush the tablet; verify with the pharmacist or prescriber before changing how it is taken.
   4. Open or crush the medication only if the client agrees to take it immediately.

   Answer: Do not crush the tablet; verify with the pharmacist or prescriber before changing how it is taken.

   Enteric-coated and time-release preparations should not be crushed or chewed because doing so can change how quickly the drug is absorbed. The section also notes that opening some formulations can cause an overdose or a subtherapeutic dose, so the nurse should ask before attempting this.

2. A client is nauseated, vomiting, and needs a medication delivered quickly. Which route would the nurse expect the provider to prescribe?

   1. Parenteral injection
   2. Oral tablet
   3. Enteric-coated tablet
   4. Lozenge

   Answer: Parenteral injection

   The parenteral route is often used when rapid drug delivery is needed and is helpful when the client has nausea or vomiting. Oral tablets, enteric-coated tablets, and lozenges are enteral forms that must go through the GI tract, which is not helpful when vomiting is present.

3. The nurse is obtaining a medication history from a client. Which items should the nurse specifically ask the client to list? Select all that apply.

   1. Herbal products
   2. Only medications covered by insurance
   3. Over-the-counter pain or fever reducers
   4. Dietary supplements
   5. Only medications prescribed by a health care provider

   Answer: Herbal products, Over-the-counter pain or fever reducers, Dietary supplements

   The section emphasizes that OTC drugs, dietary supplements, herbals, and supplements must be included because they can interact with other therapies. Asking only about prescriptions or insurance-covered drugs could miss important safety risks.

4. A client reports alternating Advil and Motrin because “they are different brands, so they must be different drugs.” What teaching should the nurse provide?

   1. The chemical name is the name the client should use to prevent medication errors.
   2. Brand names are always safer than generic names.
   3. Advil and Motrin are different brand names for the same generic drug, ibuprofen.
   4. A drug can have many generic names but only one brand name.

   Answer: Advil and Motrin are different brand names for the same generic drug, ibuprofen.

   The section explains that the generic name remains the same even when different companies sell the drug under different brand names. Teaching the client to recognize the generic name helps prevent taking duplicate products.

5. A nurse reviews a prescription for a controlled substance and notices the prescriber’s DEA number is missing. What is the nurse’s priority action?

   1. Replace the missing DEA number with the prescriber’s phone number.
   2. Process the prescription because the client’s name and dose are present.
   3. Ask the client to provide the DEA number.
   4. Clarify the prescription because a DEA number is required for controlled substances.

   Answer: Clarify the prescription because a DEA number is required for controlled substances.

   The section lists the DEA number as required information for controlled substances. The nurse should not process the prescription as complete or substitute other information for the missing DEA number.

6. A client asks why a biosimilar medication is not simply called a generic version of a biologic. Which statements by the nurse are accurate? Select all that apply.

   1. Generic medications usually require the same research and development protocols as the original company’s drug.
   2. Biosimilar drugs have larger and more complex molecular structures than generic drugs.
   3. A generic drug manufacturer must demonstrate bioequivalence to the brand-name drug.
   4. A biosimilar manufacturer must demonstrate that the drug is similar to the biologic reference drug.
   5. Biosimilars are considered bioequivalent because their manufacturing processes are simple.

   Answer: Biosimilar drugs have larger and more complex molecular structures than generic drugs., A generic drug manufacturer must demonstrate bioequivalence to the brand-name drug., A biosimilar manufacturer must demonstrate that the drug is similar to the biologic reference drug.

   Generics and biosimilars are evaluated differently: generics must show bioequivalence, while biosimilars must show similarity to the reference biologic. Biosimilars are also larger, more complex molecules made from living organisms, so they are not considered the same as generic drugs.