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5. Which online drug reference makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up
and downloadable resource about medicines?
a. American Drug Index
b. American Hospital Formulary
c. DailyMed
d. Physicians’ Desk Reference (PDR)
ANS: C
DailyMed makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable
resource about medicines. The American Drug Index is not appropriate for patient use. The American Hospital Formulary is not
appropriate for patient use. The PDR is not appropriate for patient use.
6. Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
a. Federal Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. Controlled Substances Act (1970)
d. Kefauver Harris Drug Amendment (1962)
ANS: A
The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later
amendments and acts helped tighten FDA control and ensure drug safety. The Durham Humphrey Amendment defines the kinds of
drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner. The
Controlled Substances Act addresses only controlled substances and their categorization. The Kefauver Harris Drug Amendment
ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their
products before marketing them.
7. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification
does this drug fall?
a. I
b. II
c. III
d. IV
ANS: B
Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical
dependence. Schedule I drugs have high potential for abuse and no recognized medical use. Schedule III drugs have some potential
for abuse. Use may lead to low to moderate physical dependence or high psychological dependence. Schedule IV drugs have low
potential for abuse. Use may lead to limited physical or psychological dependence.
8. What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known
treatment?
a. List smallpox as a health orphan disease.
b. Omit the preclinical research phase.
c. Extend the clinical research phase.
d. Fast track the investigational drug.
ANS: D
Once the Investigational New Drug Application has been approved, the drug can receive highest priority within the agency, which
is called fast tracking. A smallpox outbreak would become a priority concern in the world. Orphan diseases are not researched in a
priority manner. Preclinical research is not omitted. Extending any phase of the research would mean a longer time to develop a
vaccine. The FDA must ensure that all phases of the preclinical and clinical research phase have been completed in a safe manner.
10. Which is the most authoritative reference for medications that are injected?
a. Physicians’ Desk Reference
b. Handbook on Injectable Drugs
c. DailyMed
d. Handbook of Nonprescription Drugs
ANS: B
The Handbook on Injectable Drugs is the most comprehensive reference available on the topic of compatibility of injectable drugs.
It is a collection of monographs for more than 300 injectable drugs that are listed alphabetically by generic name.
11. The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug’s classification?
a. Abuse potential for this drug is low.
b. Psychological dependency is likely.
c. There is a high potential for abuse.
d. This drug is not a controlled substance.
ANS: A
Lomotil, a Schedule V drug, has an abuse potential of limited physical or psychological dependence liability compared with drugs
in Schedule IV. Because abuse potential is low with a Schedule V drug, a prescription may not be required. Psychological
dependency is not likely with a Schedule V drug. Schedule V drugs are classified as controlled substances.
12. The nurse is transcribing new orders written for a patient with a substance abuse history. Choose the medication ordered that has
the greatest risk for abuse.
a. Lomotil
b. Diazepam
c. Phenobarbital
d. Lortab
ANS: D
Lortab is a Schedule III drug with a high potential for abuse but less so than drugs in Schedules I and II. Lomotil is a Schedule V
drug with a low potential for abuse compared with those in Schedule V. Diazepam is a Schedule IV drug with a low potential for
abuse compared with those in schedule III. Phenobarbital is a Schedule IV drug with a low potential for abuse compared with those
in Schedule III.
MULTIPLE RESPONSE
1. An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history
from the patient and her daughter, the nurse discovers that neither has a list of the patient’s current medications or prescriptions. All
the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy.
Which resource(s) would be appropriate to use in determining the medication names and doses? (Select all that apply.)
a. Martindale—The Complete Drug Reference
b. Physicians’ Desk Reference, Section 4
c. Senior citizens’ center
d. Patient’s home pharmacy
ANS: B, D
The Physicians’ Desk Reference, Section 4, has full color images of commonly dispensed tablets and capsules. The patient’s
pharmacy would have an accurate account of all the medications the client is currently taking. Martindale—The Complete Drug
Reference has written information on medications and would not be an appropriate resource. The senior citizens’ center is not
likely to have specific patient medication information.
3. When categorizing, the nurse is aware that which drug(s) would be considered Schedule II? (Select all that apply.)
a. Marijuana
b. Percodan
c. Amphetamines
d. Fiorinal
e. Flurazepam
ANS: B, C
Schedule II drugs have a high potential for abuse, they are currently accepted in the United States, and use may lead to severe
psychological or physical dependence. Percodan and amphetamines are considered Schedule II drugs. Marijuana is a Schedule I
drug. Fiorinal is a Schedule III drug. Flurazepam is a Schedule IV drug.
The countess, naturally, has the best of the argument, and shames
the king. In this pleasant light is she presented by both chronicler
and poet, and the lady, chiefly to honor whom the Order of the Garter
was constructed upon the basis of the Order of the Blue Thong, was
worthy of all the distinctive homage that could be rendered to her by
knight or king.
Richard II., so fond of parade and pleasure, so refined and
intellectual, so affable at first, so despotic and absolute at last, till he
was superseded and then slain, is among the most melancholy of
knights and sovereigns. He was not heroic, for he was easily
elevated and easily depressed. He turned deadly pale on hearing, in
Ireland, of the landing of Henry Bolingbroke in England, and that the
Archbishop of Canterbury had preached in favor of the usurper. He
was eminently courageous, sang a roundelay as well as any
minstrel, and often made the roundelays he sung. He looked little
like a knight indeed when he traversed part of Wales to Conway,
disguised as a Franciscan friar; or flying from castle to castle, having
sorry lodging and little food. It was in the dress and cowl of a monk
that the once chivalrous Richard surrendered himself to his cousin.
In the army of that cousin, sent to take Richard and his few faithful
knights and squires who refused to detach his device from their
coats, was “Sir Henry Percy” (the Hotspur of Shakespeare), “whom
they held to be the best knight in England.”
It was by persuasion of Hotspur’s father that Richard left Conway for
Flint, where he was made prisoner, and afterward conveyed to
Chester, the English knights of the opposite faction behaving to him
with most unchivalric rudeness. The unsceptred monarch was first
taken to Pickering, one of the most beautiful spots in England,
defaced by scenes of the greatest crimes, of which place knights and
nobles were the masters. Thence he passed on to Leeds and
Knaresborough Castle, where the king’s chamber is still pointed out
to visiters. Finally, he was carried to “bloody Pomfret”—“fatal and
ominous to noble peers.” Never, it is said, did man look less like a
knight than the unhappy king, when he appeared before the
drawbridge of Pontefract Castle. Majestic still he was in feature, but
the majesty was depressed by such profound melancholy, that few
could look upon the weeping king without themselves shedding
tears. If the picture of him at this juncture might be metrically given in
outline, the following sketch might feebly render it:—
A man of wo he seems,
Whom Sadness deep hath long marked for her own.
Hath such a form as that indulged in dreams
Upon a throne?
In Edward’s time then, the collar may have constituted the difference
between squire and knight. But it was not the only one. If there was a
difference at their necks, there was also a distinction at their heels.
The knight always wore golden spurs: he was the Eques Auratus.
The squire could wear spurs of no more costly metal than silver, and
“White-spurs,” accordingly, was the generic term for an esquire. It
was probably in allusion to this that the country squire mentioned by
Jonson, displayed his silver spurs among his side-board plate. To
return to Henry VIII.; let me add that he exhibited something of what
was considered a knightly attribute, compassion for the lowly, when
he suggested that due sleeping-time should be allowed to laborers
during the summer.
Edward VI. was simply a youth of much promise. His father was
unwilling to create him a knight before he knew how to wield arms;
and if he gained this knowledge early, he was never called to put it in
practice. There was more of the chivalrous character in his over-
abused half-sister, Mary, and also in Elizabeth; but then queens can
not of course be considered as knights: Elizabeth, however, had
much of the spirit, and she was surrounded by knightly men and
served with a knightly devotion. There was, I may observe, one
species of knights in her time, who were known as “knights of the
road.” The 39th of Elizabeth, especially and curiously points to them
in an act to relieve the hundred of Beynhurst from the statute of Hue
and Cry (where there was no voluntary default) on account of the
penalties to which that hundred was subject from the numerous
robberies committed in Maidenhead Thicket. Mavor, in his account of
Berkshire, says that “The vicar of Henley who served the curé of
Maidenhead, was allowed about the same time an advance of salary
as some compensation for the danger of passing the thicket.” The
vicar, like the knights of the road, at least, had purer air than the
clergy and chivalry who kept house in the capital. “In London,” says
Euphues, “are all things (as the fame goeth) that may either please
the sight, or dislike the smell; either fill the eye with delight, or fill the
nose with infection.”
Refreshment under such circumstances was doubly needed; and the
popular gratitude was due to that most serviceable of knights, Sir
Thomas Gresham, who introduced the orange as an article of trade,
and who was consequently painted by Antonio More with an orange
in his hand. The old Utrecht artist just named, was knighted by
Charles V. who paid him poorly—some six hundred ducats for three
pictures, but added knighthood, which cost the emperor nothing, and
was esteemed of great value by the painter.
One would imagine that under Mary and Elizabeth, knighthood had
become extinguished, were we to judge by an anonymous volume
which was published in Mary’s reign, and republished in that of
Elizabeth. The great names of that period are proof to the contrary,
but there may have been exceptions. Let us then look into the
volume of this unknown writer who bewails the degeneracy of his
times, and lays down what he entitles the “Institution of a
Gentleman.”