Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57)

Preview (31 of 296 Pages)

100%

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 1 preview image

Loading page ...

Chapter 01: The Nursing Process and Drug TherapyLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.The nurse is developing a human needs statement for a patient who has a new diagnosis ofheart failure. Identification of human needs statements occur with which of these activities?a.Collection of patient datab.Administering interventionsc.Deciding on patient outcomesd.Documenting the patient‘s behaviorANS:AIdentification of human needs occurs with the collection of patient data.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: Human Needs StatementMSC: NCLEX: Safe and Effective Care Environment: Management of Care2.The patient is to receive oral guaifenesin twice a day. Today, the nurse was busy and gave themedication 2 hours after the scheduled dose was due. What type of problem does thisrepresent?a.―Right time‖b.―Right dose‖c.―Right route‖d.―Right medication‖ANS:A―Right time‖ is correct because the medication was given more than 30 minutes after thescheduled dose was due. ―Dose‖is incorrect because the dose is not related to the time themedication administration is scheduled. ―Route‖ is incorrect because the route is not affected.―Medication‖ is incorrect because the medication ordered will not change.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control3.The nurse has been monitoring the patient‘s progress on a new drug regimen since the firstdose and documenting the patient‘s therapeutic response to the medication. Which phase ofthe nursing process do these actions illustrate?a.Human needs statementb.Planningc.Implementationd.EvaluationANS:DMonitoring the patient‘s progress, including the patient‘s response to the medication, is part ofthe evaluation phase. Planning, implementation, and human needs statement are not illustratedby this example.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: Evaluation

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 2 preview image

Loading page ...

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 3 preview image

Loading page ...

MSC: NCLEX: Safe and Effective Care Environment: Management of Care4.The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.Which statement best illustrates an outcome criterion for this patient?a.The patient will follow instructions.b.The patient will not experience complications.c.The patient will adhere to the new insulin treatment regimen.d.The patient will demonstrate correct blood glucose testing technique.ANS:D―Demonstrating correct blood glucose testing technique‖ is a specific and measurableoutcome criterion. ―Following instructions‖ and ―not experiencing complications‖ are notspecific criteria. ―Adhering to new regimen‖ would be difficult to measure.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: PlanningMSC: NCLEX: Safe and Effective Care Environment: Management of Care5.Which activity best reflects the implementation phase of the nursing process for the patientwho is newly diagnosed with hypertension?a.Providing education on keeping a journal of blood pressure readingsb.Setting goals and outcome criteria with the patient‘s inputc.Recording a drug history regarding over-the-counter medications used at homed.Formulating human needs statements regarding deficient knowledge related to thenew treatment regimenANS:AEducation is an intervention that occurs during the implementation phase. Setting goals andoutcomes reflects the planning phase. Recording a drug history reflects the assessment phase.Formulating human needs statements reflects analysis of data as part of planning.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care6.The medication order reads, ―Give ondansetron 4 mg, 30 minutes before beginningchemotherapy to prevent nausea.‖ The nurse notes that the route is missing from the order.What is the nurse‘s best action?a.Give the medication intravenously because the patient might vomit.b.Give the medication orally because the tablets are available in 4-mg doses.c.Contact the prescriber to clarify the route of the medication ordered.d.Hold the medication until the prescriber returns to make rounds.ANS:CA complete medication order includes the route of administration. If a medication order doesnot include the route, the nurse must ask the prescriber to clarify it. The intravenous and oralroutes are not interchangeable. Holding the medication until the prescriber returns wouldmean that the patient would not receive a needed medication.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 4 preview image

Loading page ...

7.When the nurse considers the timing of a drug dose, which factor is appropriate to considerwhen deciding when to give a drug?a.The patient‘s ability to swallowb.The patient‘s heightc.The patient‘s last meald.The patient‘s allergiesANS:CThe nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that maybe affected by the timing of the last meal. The patient‘s ability to swallow, height, andallergies are not factors to consider regarding the timing of the drug‘s administration.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Management of Care8.The nurse is performing an assessment of a newly admitted patient. Which is an example ofsubjective data?a.Weight 155 poundsb.Pulse 72 beats/minutec.The patient reports that he uses the herbal product ginkgod.The patient‘s complete blood count resultsANS:CSubjective data include information shared through the spoken word by any reliable source,such as the patient. Objective data may be defined as any information gathered through thesenses or that which is seen, heard, felt, or smelled. A patient‘s pulse,weight, and laboratorytests are all examples of objective data.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Management of CareMULTIPLE RESPONSE1.When giving medications, the nurse will follow the rights of medication administration. Therights include the right documentation, the right reason, the right response, and the patient‘sright to refuse. Which of these are additional rights? (Select all that apply.)a.Right drugb.Right routec.Right dosed.Right diagnosise.Right timef.Right patientANS:A, B, C, E, FAdditional rights of medication administration must always include the right drug, right dose,right time, right route, and right patient. The right diagnosis is incorrect.DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: Implementation

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 5 preview image

Loading page ...

MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection ControlOTHER1.Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 asthe last phase.a. Planningb. Evaluationc. Assessmentd. Implementatione. Human needs statementANS:C, E, A, D, BThe nursing process is an ongoing process that begins with assessing and continues withhuman needs statement, planning, implementing, and evaluating.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: GeneralMSC: NCLEX: Safe and Effective Care Environment: Management of CareChapter 02: Pharmacologic PrinciplesLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.The patient is receiving two different drugs. At current dosages and dosage forms, both drugshave the same concentration of the active ingredient. Which term is used to identify thisprinciple?a.Bioequivalentb.Synergisticc.Prodrugsd.Steady stateANS:ATwo drugs absorbed into the circulation in the same amount (in specific dosage forms) havethe same bioavailability; thus, they are bioequivalent. A drug‘s steady state is the physiologicstate in which the amount of drug removed via elimination is equal to the amount of drugabsorbed from each dose. The termsynergisticrefers to two drugs, given together, with aresulting effect that is greater than the sum of the effects of each drug given alone. A prodrugis an inactive drug dosage form that is converted to an active metabolite by variousbiochemical reactions once it is inside the body.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies2.When given an intravenous medication, the patient says to the nurse, ―I usually take pills.Why does this medication have to be given in the arm?‖ What is the nurse‘s best answer?

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 6 preview image

Loading page ...

a.―The medication will cause fewer adverse effects when given intravenously.‖b.―The intravenous medication will have delayed absorption into the body‘s tissues.‖c.―The action of the medication will begin sooner when given intravenously.‖d.―There is a lower chance of allergic reactions when drugs are given intravenously.‖ANS:CAn intravenous (IV) injection provides the fastest route of absorption. The IV route does notaffect the number of adverse effects, nor does it cause delayed tissue absorption (it results infaster absorption). The IV route does not affect the number of allergic reactions.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies3.The nurse is administering parenteral drugs. Which statement is true regarding parenteraldrugs?a.Parenteral drugs bypass the first-pass effect.b.Absorption of parenteral drugs is affected by reduced blood flow to the stomach.c.Absorption of parenteral drugs is faster when the stomach is empty.d.Parenteral drugs exert their effects while circulating in the bloodstream.ANS:ADrugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to thestomach and the presence of food in the stomach apply to enteral drugs (taken orally), not toparenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulationbefore they can exert their effects; they do not exert their effects while circulating in thebloodstream.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies4.When monitoring the patient receiving an intravenous infusion to reduce blood pressure, thenurse notes that the patient‘s blood pressure is extremely low, and the patient is lethargic anddifficult to awaken. This would be classified as which type of adverse drug reaction?a.Adverse effectb.Allergic reactionc.Idiosyncratic reactiond.Pharmacologic reactionANS:DA pharmacologic reaction is an extension of a drug‘s normal effects in the body. In this case,the antihypertensive drug lowered the patient‘s blood pressure levels too much. The otheroptions do not describe a pharmacologic reaction. An adverse effect is a predictable,well-known adverse drug reaction that results in minor or no changes in patient management.An allergic reaction (also known as ahypersensitivity reaction) involves the patient‘s immunesystem. An idiosyncratic reaction is unexpected and is defined as a genetically determinedabnormal response to normal dosages of a drug.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 7 preview image

Loading page ...

5.The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Whichsentence defines a drug‘s half-life?a.The time it takes for the drug to cause half of its therapeutic responseb.The time it takes for one half of the original amount of a drug to reach the targetcellsc.The time it takes for one half of the original amount of a drug to be removed fromthe bodyd.The time it takes for one half of the original amount of a drug to be absorbed intothe circulationANS:CA drug‘s half-life is the time it takes for one half of the original amount of a drug to beremoved from the body. It is a measure of the rate at which drugs are removed from the body.The other options are incorrect definitions of half-life.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies6.When administering drugs, the nurse remembers that the duration of action of a drug isdefined as which of these?a.The time it takes for a drug to elicit a therapeutic responseb.The amount of time needed to remove a drug from circulationc.The time it takes for a drug to achieve its maximum therapeutic responsed.The time period at which a drug‘s concentration is sufficient to cause a therapeuticresponseANS:DDuration of action is the time during which drug‘s concentration is sufficient to elicit atherapeutic response. The other options do not define duration of action. A drug‘s onset ofaction is the time it takes for the drug to elicit a therapeutic response. A drug‘s peak effect isthe time it takes for the drug to reach its maximum therapeutic response. Elimination is thelength of time it takes to remove a drug from circulation.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies7.When reviewing the mechanism of action of a specific drug, the nurse reads that the drugworks by selective enzyme interaction. Which of these processes describes selective enzymeinteraction?a.The drug alters cell membrane permeability.b.The drug‘s effectiveness within the cell walls of the target tissue is enhanced.c.The drug is attracted to a receptor on the cell wall, preventing an enzyme frombinding to that receptor.d.The drug binds to an enzyme molecule and inhibits or enhances the enzyme‘saction with the normal target cell.ANS:DWith selective enzyme interaction, the drug attracts the enzymes to bind with the drug insteadof allowing the enzymes to bind with their normal target cells. As a result, the target cells areprotected from the action of the enzymes. This results in a drug effect. The actions describedin the other options do not occur with selective enzyme interactions.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 8 preview image

Loading page ...

DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies8.When administering a new medication to a patient, the nurse reads that it is highly proteinbound. Assuming that the patient‘s albumin levels are normal, the nurse would expect whichresult, as compared to a medication, that is not highly protein bound?a.Renal excretion will be faster.b.The drug will be metabolized quickly.c.The duration of action of the medication will be shorter.d.The duration of action of the medication will be longer.ANS:DDrugs that are bound to plasma proteins are characterized by longer duration of action. Proteinbinding does not make renal excretion faster, does not speed up drug metabolism, and doesnot cause the duration of action to be shorter.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: PlanningMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies9.The patient is experiencing chest pain and needs to take a buccal form of nitroglycerin. Wheredoes the nurse instruct the patient to place the tablet?a.Under the tongueb.On top of the tonguec.At the back of the throatd.In the space between the cheek and the gumANS:DDrugs administered via the buccal route are placed in the space between the cheek and thegum. Drugs administered via the sublingual route are placed under the tongue. The otheroptions are incorrect.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies10.The nurse is administering medications to the patient who is in renal failure resulting fromend-stage renal disease. The nurse is aware that patients with kidney failure would most likelyhave problems with which pharmacokinetic phase?a.Absorptionb.Distributionc.Metabolismd.ExcretionANS:DThe kidneys are the organs that are most responsible for drug excretion. Renal function doesnot affect the absorption and distribution of a drug. Renal function may affect metabolism ofdrugs to a small extent.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 9 preview image

Loading page ...

11.A patient who has advanced cancer is receiving opioid medications around the clock to keephim comfortable as he nears the end of his life. Which term best describes this type oftherapy?a.Palliative therapyb.Maintenance therapyc.Empiric therapyd.Supplemental therapyANS:AThe goal of palliative therapy is to make the patient as comfortable as possible. It is typicallyused in the end stages of illnesses when all attempts at curative therapy have failed.Maintenance therapy is used for the treatment of chronic illnesses such as hypertension.Empiric therapy is based on clinical probabilities and involves drug administration when acertain pathologic condition has an uncertain but high likelihood of occurrence based on thepatient‘s initial presenting symptoms. Supplemental therapy (or replacement therapy) suppliesthe body with a substance needed to maintain normal function.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies12.The patient is stating that he has a headache and asks the nurse which over-the-countermedication form would work the fastest to help reduce the pain. Which medication form willthe nurse suggest?a.A capsuleb.A tabletc.A powderd.An enteric-coated tabletANS:COf the types of oral medications listed, the powder form would be absorbed the fastest, thushaving a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would beabsorbed next, in that order.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies13.The nurse will be injecting a drug into the superficial skin layers immediately underneath theepidermal layer of skin. Which route does this describe?a.Intradermalb.Subcutaneousc.Intramusculard.TransdermalANS:A

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 10 preview image

Loading page ...

Injections under the more superficial skin layers immediately underneath the epidermal layerof skin and into the dermal layer are known asintradermalinjections. Injections into the fattysubcutaneous tissue under the dermal layer of skin are referred to assubcutaneousinjections.Injections into the muscle beneath the subcutaneous fatty tissue are referred to asintramuscularinjections. Transdermal drugs are applied to the skin via an adhesive patch.DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesMULTIPLE RESPONSE1.Which drugs would be affected by the first-pass effect when administered? (Select all thatapply.)a.Morphine given by IV push injectionb.Sublingual nitroglycerin tabletc.Diphenhydramine elixird.Levothyroxine (Synthroid) tablete.Transdermal nicotine patchesf.Esomeprazole capsuleg.Penicillin given by IV piggyback infusionANS:C, D, FOrally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect, becausethey are metabolized in the liver after being absorbed into the portal circulation from the smallintestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and donot go directly to the liver. Sublingual tablets and transdermal patches also enter thebloodstream without going directly to the liver, thus avoiding the first-pass effect.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesCOMPLETION1.A drug dose that delivers 10 mg has a half-life of 5 hours. Identify how much drug willremain in the body after one half-life. _______ANS:5 mgA drug‘s half-life is the time required for one half of an administered dose of a drug to beeliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%.Therefore, one half of 10 mg equals 5 mg.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesChapter 03: Lifespan ConsiderationsLilley: Pharmacology and the Nursing Process, 10th Edition

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 11 preview image

Loading page ...

MULTIPLE CHOICE1.Drug transfer to the fetus is more likely during the last trimester of pregnancy for whichreason?a.Decreased fetal surface areab.Increased placental surface areac.Enhanced blood flow to the fetusd.Increased amount of protein-bound drug in maternal circulationANS:CDrug transfer to the fetus is more likely during the last trimester of pregnancy as a result ofenhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area,not decreased, is a factor that affects drug transfer to the fetus. The placenta‘s surface areadoes not increase during this time. Drug transfer is increased because of an increased amountof free drug, not protein-bound drug, in the mother‘s circulation.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Health Promotion and Maintenance2.The nurse is monitoring a patient who is in the 26th week of pregnancy and has developedgestational diabetes and pneumonia. She is given medications that pose a possible fetal risk,but the potential benefits may warrant the use of the medications in her situation. The nurserecognizes that these medications are in which U.S. Food and Drug Administration pregnancysafety category?a.Category Ab.Category Bc.Category Cd.Category DANS:DPregnancy category D fits the description given. Category A indicates no risk to the humanfetus; Category B indicates no risk to animal fetus; information for humans is not available.Category C indicates adverse effects reported in animal fetus; information for humans is notavailable.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control3.When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nursenotes that which type of dosage calculation is used most commonlyin pediatric calculations?a.West nomogramb.Clark rulec.Height-to-weight ratiod.Milligram per kilogram of body weight formulaANS:DThe milligram per kilogram formula, based on body weight, is the most common method ofcalculating doses for pediatric patients. Height-to-weight ratio is not used. The other optionsare available methods but are not the most commonly used.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 12 preview image

Loading page ...

DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: ImplementationMSC: NCLEX: Health Promotion and Maintenance4.The nurse is assessing a newly admitted 83-year-old patient and determines that the patient isexperiencing polypharmacy. Which statement most accurately illustrates polypharmacy?a.The patient is experiencing multiple illnesses.b.The patient uses one medication for an illness several times per day.c.The patient uses over-the-counter drugs for an illness.d.The patient uses multiple medications simultaneously.ANS:DPolypharmacy usually occurs when a patient has several illnesses and takes medications foreach of them, possibly prescribed by different specialists who may be unaware of othertreatments the patient is undergoing. The other options are incorrect. Polypharmacy addressesthe medications taken, not just the illnesses. Polypharmacy means the patient is taking severaldifferent medications, not just one, and can include prescription drugs, over-the-countermedications, and herbal products.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies5.The nurse is aware that confusion, forgetfulness, and increased risk for falls are commonresponses in an elderly patient who is taking which type of drug?a.Laxativesb.Anticoagulantsc.Sedativesd.AntidepressantsANS:CSedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy,forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, andantidepressants may cause adverse effects in the elderly, but not the ones specified in thequestion.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control6.For accurate medication administration to pediatric patients, the nurse must consider which ofthese factors?a.Organ maturityb.Renal outputc.Body temperatured.HeightANS:ATo administer medications to pediatric patients accurately, one must take into account organmaturity, body surface area, age, and weight. The other options are incorrect; renal output andbody temperature are not considerations, and height alone is not sufficient.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 13 preview image

Loading page ...

DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Health Promotion and Maintenance7.The nurse recognizes that an elderly patient may experience a reduction in the stomach‘sability to produce hydrochloric acid. This change may result in which effect?a.Delayed gastric emptyingb.Increased gastric acidityc.Decreased gastrointestinal motilityd.Altered absorption of some drugsANS:DReduction in the stomach‘s ability to produce hydrochloric acid is an aging-related changethat results in a decrease in gastric acidity and may alter the absorption of some drugs. Theother options are not results of reduced hydrochloric acid production.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Health Promotion and Maintenance8.The nurse is administering drugs to neonates and will consider which factor may contributethe most to drug toxicity?a.The lungs are immature.b.The kidneys are small.c.The liver is not fully developed.d.Excretion of the drug occurs quickly.ANS:CA neonate‘s liver is not fully developed and cannot detoxify many drugs. The other optionsare incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renalexcretion is slow, not fast, because of organ immaturity, but this is not the factor thatcontributes the most to drug toxicity.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: Planning dosage has been double-checked and updatedMSC: NCLEX: Health Promotion and Maintenance9.An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and hercaregiver should be told to watch for which problems?a.Constipation and anorexiab.Fatigue, leg cramps, and dehydrationc.Daytime sedation and lethargyd.Edema, nausea, and blurred visionANS:BElectrolyte imbalance, leg cramps, fatigue, and dehydration are common complications whenthiazide diuretics are given to elderly patients. The other options do not describecomplications that occur when these drugs are given to the elderly.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: PlanningMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 14 preview image

Loading page ...

10.An elderly patient with a new diagnosis of hypertension will be receiving a new prescriptionfor an antihypertensive drug. The nurse expects which type of dosing to occur with this drugtherapy?a.Drug therapy will be based on the patient‘s weight.b.Drug therapy will be based on the patient‘s age.c.The patient will receive the maximum dose that is expected to reduce the bloodpressure.d.The patient will receive the lowest possible dose at first, and then the dose will beincreased as needed.ANS:DAs a general rule, dosing for elderly patients should follow the admonition, ―Start low, and goslow,‖ which means to start with the lowestpossible dose (often less than an average adultdose) and increase the dose slowly, if needed, based on patient response. The other responsesare incorrect.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: PlanningMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies11.The nurse is trying to give a liquid medication to a 2 1/2-year-old child and notes that themedication has a strong taste. Which technique is the best way for the nurse to give themedication to this child?a.Give the medication with a spoonful of ice cream.b.Add the medication to the child‘s bottle.c.Tell the child you have candy for him.d.Add the medication to a cup of milk.ANS:AIce cream or another nonessential food disguises the taste of the medication. The other optionsare incorrect. If the child does not drink the entire contents of the bottle, medication is wastedand the full dose is not administered. Using the wordcandywith drugs may lead to the childthinking that drugs are actually candy. If the medication is mixed with a cup of milk, the childmay not drink the entire cup of milk, and the distasteful drug may cause the child to refusemilk in the future.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies12.The nurse is preparing to give an injection to a 4-year-old child. Which intervention is ageappropriate for this child?a.Give the injection without any advanced preparation.b.Give the injection, and then explain the reason for the procedure afterward.c.Offer a brief, concrete explanation of the procedure at the patient‘s level andwiththe parent or caregiver present.d.Prepare the child in advance with details about the procedure without the parent orcaregiver present.ANS:C

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 15 preview image

Loading page ...

For a 4-year-old child, offering a brief, concrete explanation about a procedure justbeforehand, with the parent or caregiver present, is appropriate. The other options areincorrect for any age group.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Psychosocial IntegrityMULTIPLE RESPONSE1.Which statements are true regarding pediatric patients and pharmacokinetics? (Select all thatapply.)a.The levels of microsomal enzymes are decreased.b.Perfusion to the kidneys may be decreased and may result in reduced renalfunction.c.First-pass elimination is increased because of higher portal circulation.d.First-pass elimination is reduced because of the immaturity of the liver.e.Total body water content is much less than in adults.f.Gastric emptying is slowed because of slow or irregular peristalsis.g.Gastric emptying is more rapid because of increased peristaltic activity.ANS:A, B, D, FIn children, first-pass elimination by the liver is reduced because of the immaturity of theliver, and microsomal enzymes are decreased. In addition, gastric emptying is reducedbecause of slow or irregular peristalsis. Perfusion to the kidneys may be decreased, resultingin reduced renal function. The other options are incorrect. In addition, remember that totalbody water content is greater in children than in adults.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Health Promotion and Maintenance2.Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)a.The levels of microsomal enzymes are decreased.b.Fat content is increased because of decreased lean body mass.c.Fat content is decreased because of increased lean body mass.d.The number of intact nephrons is increased.e.The number of intact nephrons is decreased.f.Gastric pH is less acidic.g.Gastric pH is more acidic.ANS:A, B, E, FIn the elderly, levels of microsomal enzymes are decreased because the aging liver is less ableto produce them; fat content is increased because of decreased lean body mass; the number ofintact nephrons is decreased as the result of aging; and gastric pH is less acidic because of agradual reduction of the production of hydrochloric acid. The other options are incorrectstatements.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Health Promotion and MaintenanceCOMPLETION

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 16 preview image

Loading page ...

1.A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses.The child weighs 55 pounds. The medication, once reconstituted, is available as an oralsuspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose._______ANS:25 mL per doseConvert pounds to kilograms: 55 pounds = 25 kg. 25 kg50 mg/kg/day = 1250 mg/day. Toget the amount per dose, divide 1250 by 2, which equals 625 mg/dose. To calculate themilliliters: 125 mg:5 mL:: 625 mg:xmL. (125x) = (5625); 125x= 3125;x= 25 mL/dose.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesChapter 04: Cultural, Legal, and Ethical ConsiderationsLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.During the development of a new drug, which would be included in the study by theresearcher to prevent any bias or unrealistic expectations of the new drug‘s usefulness?a.A placebob.FDA approvalc.Informed consentd.Safety informationANS:ATo prevent bias that may occur as a result of unrealistic expectations of an investigational newdrug, a placebo is incorporated into the study. The other options are incorrect. FDA approval,if given, does not occur until after phase III. Informed consent is required in all drug studies.Safety information is not determined until the study is under way.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control2.A member of an investigational drug study team is working with healthy volunteers whoseparticipation will help to determine the optimal dosage range and pharmacokinetics of thedrug. The team member is participating in what type of study?a.Phase Ib.Phase IIc.Phase IIId.Phase IVANS:APhase I studies involve small numbers of healthy volunteers to determine optimal dosagerange and the pharmacokinetics of the drug. The other phases progressively involvevolunteers who have the disease or ailment that the drug is designed to diagnose or treat.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 17 preview image

Loading page ...

DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies3.During discharge patient teaching, the nurse reviews prescriptions with a patient. Whichstatement is correct about refills for an analgesic that is classified as Schedule C-III?a.No prescription refills are permitted.b.Refills are allowed only by written prescription.c.The patient may have no more than five refills in a 6-month period.d.Written prescriptions expire in 12 months.ANS:CSchedule C-III medications may be refilled no more than five times in a 6-month period. Thepatient should be informed of this regulation. No prescription refills are permitted forSchedule C-II drugs. Requiring refills by written prescription only applies to Schedule C-IIdrugs. Schedule C-III prescriptions (written or oral) expire in 6 months.DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies4.A patient has been selected as a potential recipient of an experimental drug for multiplesclerosis. The nurse knows that when informed consent has been obtained, it indicates whichof these?a.The patient has been informed that he or she will need to stay in the study until itends.b.The patient will be informed of the details of the study as the research continues.c.The patient will receive the actual drug during the experiment.d.The patient has had the study‘s purpose, procedures, and possible benefits as wellas risks involved explained to him.ANS:DInformed consent involves the careful explanation of the purpose of the study, the proceduresto be used, and the risks involved. The other options do not describe informed consent.Participation in studies is voluntary and patients have the right to end participation at anytime.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care5.For which cultural group must the health care provider respect the value placed on preservingharmony with nature and the belief that disease is a result of ill spirits?a.Hispanicsb.Asian Americansc.Native Americansd.African AmericansANS:CSome Native Americans believe in preserving harmony with nature and that disease is a resultof ill spirits. The groups listed in the other options do not typically reflect these practices.DIF:Cognitive Level: Remembering (Knowledge)

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 18 preview image

Loading page ...

TOP:Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity6.The nurse is assessing an elderly Hispanic woman who is being treated for hypertension.During the assessment, what is important for the nurse to remember about cultural aspects?a.The patient should be discouraged from using folk remedies and rituals.b.The nurse will expect the patient to value protective bracelets and ―root doctors‖ ashealers.c.The nurse will remember that the balance among body, mind, and environment isimportant for this patient‘s health beliefs.d.The nurse‘s assessment needs to include gathering information regarding religiouspractices and beliefs regarding medication, treatment, and healing.ANS:DAll beliefs need to be considered clearly so as to prevent a conflict from arising between thegoals of nursing and health care and the dictates of a patient‘s cultural background. Assessingreligious practices and beliefs is part of a thorough cultural assessment. The other options areincorrect. The nurse should not ignore a patient‘s cultural practices. The concept of balanceamong body, mind, and environment and the valuing of protective bracelets and root doctorsreflect beliefs or practices that usually do not apply to the Hispanic cultural group.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity7.When reviewing the various schedules of controlled drugs, the nurse knows that whichdescription correctly describes Schedule II drugs?a.Drugs with high potential for abuse that have accepted medical useb.Drugs with high potential for abuse that do not have accepted medical usec.Medically accepted drugs that may cause moderate physical or psychologicdependenced.Medically accepted drugs with limited potential for causing physical orpsychologic dependenceANS:ASchedule II drugs are those with high potential for abuse but that have accepted medical use.Drugs that have high potential for abuse but do not have accepted medical use are Schedule Idrugs. Medically accepted drugs that have moderate physical or high psychologic dependencepotential are Schedule III drugs. Medically accepted drugs with limited potential for causingphysical or psychologic dependence are Schedule IV and V drugs.DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies8.The nurse is reviewing facts about pharmacology for a review course. The termlegend drugrefers to which item?a.Over-the-counter drugsb.Prescription drugsc.Orphan drugsd.Older drugsANS:B

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 19 preview image

Loading page ...

The termlegend drugrefers to prescription drugs, which were differentiated fromover-the-counter drugs by the 1951 Durham-Humphrey Amendment. Orphan drugs are drugsthat are developed for rare diseases. The other options are not examples of legend drugs.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies9.Nurses have the ethical responsibility of doing or actively promoting good. What is thisprinciple known as?a.Justiceb.Veracityc.Beneficenced.AutonomyANS:CVeracityis defined as the duty to tell the truth.Justiceis the ethical principle of being fair orequal in one‘s actions.Beneficenceis the ethical principle of doing or actively promotinggood.Autonomyis self-determination, or the ability to make one‘s own decisions.DIF:Cognitive Level: Remembering (Knowledge)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Reduction of Risk Potential10.A patient is undergoing major surgery and asks the nurse about a living will. He states, ―Idon‘t want anybody else making decisions for me. And Idon‘t want to prolong my life.‖ Thepatient is demonstrating which ethical term?a.Autonomyb.Beneficencec.Justiced.VeracityANS:AAutonomyincludes self-determination, or the ability to act on one‘s own, including makingone‘s own decisions about health care.Veracityis defined as the duty to tell the truth.Justiceis the ethical principle of being fair or equal in one‘s actions.Beneficenceis the ethicalprinciple of doing or actively promoting good.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: GeneralMSC: NCLEX: Physiological Integrity: Reduction of Risk Potential11.The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not onthe list. Which is a characteristic of Schedule C-I drugs?a.No refills are permitted.b.They may be obtained over-the-counter with a signature.c.They are available only by written prescription.d.They are used only with approved protocols.ANS:DSchedule C-I drugs are used only with approved protocols. Schedule C-II drugs are availableonly by written prescription, and refills are not permitted. Being available over-the-counterwith a signature may be true of Schedule C-V drugs in certain states.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: General

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 20 preview image

Loading page ...

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies12.During a busy night shift, a new nurse administered an unfamiliar medication withoutchecking it in a drug handbook. Later that day, the patient had a severe reaction because hehas renal problems, which was a contraindication to that drug. The nurse may be liable forwhich of these?a.Medical negligenceb.Nursing negligencec.Nonmaleficenced.AutonomyANS:BNegligenceis the failure to act in a reasonable and prudent manner or failure of the nurse togive the care that a reasonably prudent (cautious) nurse would render or use under similarcircumstances. Nurses are expected to assess patients thoroughly before medications aregiven, and to be familiar with medications they are administering (see Box 4-2). In this case,nursing negligence applies to nurses, not medical negligence.Nonmaleficenceis defined asthe duty to do no harm;autonomyis defined as the right to make one‘s own decisions, orself-determination.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection ControlMULTIPLE RESPONSE1.The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drugpolymorphism? (Select all that apply.)a.The number of drugs ordered by the physicianb.Inherited factorsc.The patient‘s diet and nutritional statusd.Different dosage forms of the same druge.The patient‘s cultural practicesf.The patient‘s drug historyg.The various available forms of a drugANS:B, C, EInherited factors, diet and nutritional status, and cultural practices are some of the factors thatcontribute to drug polymorphism. The other options are not factors that contribute to drugpolymorphism.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies2.The nurse is performing an admission assessment. Which findings reflect components of acultural assessment? (Select all that apply.)a.The patient uses aspirin as needed for pain.b.The patient has a history of hypertension.c.The patient uses herbal tea to relax in the evenings.d.The patient does not speak English.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 21 preview image

Loading page ...

e.The patient is allergic to shellfish.f.The patient does not eat pork products because of religious beliefs.ANS:A, C, D, FThe past use of medicines, use of herbal treatments, languages spoken, and religious practicesand beliefs are components of a cultural assessment. The other options reflect components ofa general medication assessment or health history.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Psychosocial IntegrityChapter 05: Medication Errors: Preventing and RespondingLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.The nurse is reviewing medication errors. Which situation is an example of a medicationerror?a.A patient refuses her morning medications.b.A patient receives a double dose of a medication because the nurse did not cut thepill in half.c.A patient develops hives after having started an IV antibiotic 24 hours earlier.d.A patient complains of severe pain still present 60 minutes after a pain medicationwas given.ANS:BA medication error is defined as apreventableadverse drug event that involves inappropriatemedication use by a patient or health care provider. The other options are not preventable. Thepatient‘s refusing to take medications and complaining of pain after a medication is given arepatient behaviors, and the development of hives is a possible allergic reaction.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care2.The nurse is reviewing a list of verbal medication orders. Which is the proper notation of thedose of the drug ordered?a.Levothyroxine .75 mgb.Levothyroxine .750 mgc.Levothyroxine 0.75 mgd.Levothyroxine 0.750 mgANS:CLevothyroxine 0.75 mg illustrates the correct notation with a leading zero before the decimalpoint. Omitting the leading zero may cause the order to be misread, resulting in a large drugoverdose. Levothyroxine .75 mg and Levothyroxine .750 mg do not have the leading zerobefore the decimal point. Levothyroxine 0.750 mg has trailing zero, which also is incorrect.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Management of Care

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 22 preview image

Loading page ...

3.When given a scheduled morning medication, the patient states, ―I haven‘t seen that pillbefore. Are you sure it‘s correct?‖ The nurse checks the medication administration record andverifies that it is listed. Which is the nurse‘s best response?a.―It‘s listed here on the medication sheet, so you should take it.‖b.―Go ahead and take it, and then I‘ll check with your doctor about it.‖c.―It wouldn‘t be listed here if it were not ordered for you!‖d.―Let me check on the order first before you take it.‖ANS:DWhen giving medications, the nurse should always listen to and honor any concerns or doubtsexpressed by the patient. If the patient doubts an order, the nurse should check the writtenorder and/or check with the prescriber. The other options illustrate that the nurse is notlistening to the patient‘s concerns.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: PlanningMSC: NCLEX: Safe and Effective Care Environment: Management of Care4.During a period of time when the computerized medication order system was down, theprescriber wrote admission orders, and the nurse is transcribing them. The nurse is havingdifficulty transcribing one order because of the prescriber‘s handwriting. Which is the bestaction for the nurse to take at this time?a.Ask a colleague what the order says.b.Contact the prescriber to clarify the order.c.Wait until the prescriber makes rounds again to clarify the order.d.Ask the patient what medications he takes at home.ANS:BIf a prescriber writes an order that is illegible, the nurse should contact the prescriber forclarification. Asking a colleague is not useful because the colleague did not write the order.Waiting for the prescriber to return is incorrect because it would delay implementation of theorder. Asking the patient about medications is incorrect because this question will not clarifythe current order written by the prescriber.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care5.When taking a telephone order for a medication, which action by the nurse is mostappropriate?a.Verify the order with the charge nurse.b.Call back the prescriber to review the order.c.Repeat the order to the prescriber before hanging up the telephone.d.Ask the pharmacist to double-check the order.ANS:CFor telephone or verbal orders, repeat the order back to the prescriber before hanging up thetelephone. The other options are incorrect.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 23 preview image

Loading page ...

6.During morning medication administration, the nurse discovered an error on the electronicMAR before the medication was given. Which action by the nurse is appropriate for this―near-miss‖?a.Correct the MAR error but say nothing because nothing happened.b.Notify the pharmacy about the error they almost caused.c.Report the near-miss using the facility‘s recommended protocol, and correct theerror on the MAR.d.Report the near-miss to the next shift before the next dose is due.ANS:CIf a ―near-miss‖ occurs, report using the health care facility‘s policies and procedures forreporting, regardless of whether an error occurred. The other responses are not appropriateactions.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care7.When reviewing pediatric medication administration, the nurse recognizes that which type ofmedication error is most common with children?a.Oral medication administration errorsb.Wrong route errorsc.Incorrect dosage form errorsd.Dosing errorsANS:DThe most common medication errors in pediatrics are dosing errors. The other responses arepossible, but are not the most common medication errors in pediatrics.DIF:Cognitive Level: Understanding (Comprehension)TOP:Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Safety and Infection ControlMULTIPLE RESPONSE1.The nurse can prevent medication errors by following which principles? (Select all thatapply.)a.Assess for allergies after giving medications.b.Use two patient identifiers before giving medications.c.Always following the rights of medication administration.d.Minimize the use of verbal and telephone orders.e.Use trade names instead of generic names to avoid confusion.ANS:B, C, DMeasures that prevent medication errors include using two patient identifiers, minimizing theuse of verbal and telephone orders, and always following the rights of medicationadministration. Assessment for allergies should be donebeforemedications are given. Genericnames should be used to avoid the many sound-alike trade names of medications.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: Implementation

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 24 preview image

Loading page ...

MSC: NCLEX: Physiological Integrity: Reduction of Risk PotentialCOMPLETION1.Levothyroxine is available in 88-mcg tablet form. Convert this dose to milligram strength. (donot round)ANS:0.088 mgOne mg equals 1000 mcg. To convert 88 mcg to mg, divide 88 by 1000 to equal 0.088 mg, ormove the decimal point to theleftthree spaces. Do not forget to include the leading zero infront of the decimal point.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies2.Digoxin is available in 0.25-mg tablet form. Convert this dose to microgram strength. (do notround)ANS:250 mcgOne mg equals 1000 mcg. To convert 0.25 mg to mcg, multiply by 1000 to equal 250 mcg, ormove the decimal point to therightthree spaces.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesChapter 06: Patient Education and Drug TherapyLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinusinfection. Which of these outcomes reflect the affective domain of learning?a.The patient will take the prescribed antibiotic for the full 14 days of theprescription.b.The patient will demonstrate correct nasal spray self-administration.c.The patient will list signs and symptoms that need to be reported immediately ifthey occur.d.The patient will list measures to take to reduce allergy triggers at home.ANS:A

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 25 preview image

Loading page ...

The affective domain is the most intangible component of the learning process. Affectivebehavior is conduct that expresses feelings, needs, beliefs, values, and opinions. Adhering tothe prescribed medication regimen is an example of the affective domain. Demonstratingnasal spray self-administration reflects the psychomotor domain; listing signs and symptomsor measures to take both reflect the cognitive domain.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process:PlanningMSC: NCLEX: Safe and Effective Care Environment: Management of Care2.The nurse is developing a care plan for a patient who will be self-administering ametered-dose inhaler. Which statement reflects a measurable outcome?a.The patient will know about self-administration of a metered-dose inhaler.b.The patient will understand the principles of self-administration of a metered-doseinhaler.c.The patient will demonstrate the proper technique of self-administering ametered-dose inhaler.d.The patient will comprehend the proper technique of self-administering ametered-dose inhaler.ANS: CThe worddemonstrateis a measurable verb, and measurable terms should be used whendeveloping goals and outcome criteria statements. The other options are incorrect because thetermsknow,understand,andcomprehendare not measurable terms.DIF:Cognitive Level: Applying (Application)TOP:Nursing Process:PlanningMSC: NCLEX: Safe and Effective Care Environment: Management of Care3.During a nursing assessment, which question by the nurse allows for greater clarification andadditional discussion with the patient?a.―Are you allergic to iodine?‖b.―What type of reaction did you have to penicillin?‖c.―Have you had a reaction to this drug?‖

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 26 preview image

Loading page ...

d.―Are you taking this medication with meals?‖ANS: BAsking ―What type of reaction did you have?‖ is an open-ended question that will encouragegreater clarification and additional discussion with the patient. The other options are examplesof closed-ended questions, which prompt only a ―yes‖ or ―no‖ answer and provide limitedinformation.DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Management of Care4.The nurse is setting up a teaching session with an 85-year-old patient who will be going homeon anticoagulant therapy. Which educational strategy would reflect consideration of theage-related changes that may exist with this patient?a.Show a video about anticoagulation therapy.b.Present all the information in one session just before discharge.c.Give the patient pamphlets about the medications to read at home.d.Develop large-print handouts that reflect the verbal information presented.ANS: DDeveloping large-print handouts addresses altered perception in two ways. First, by usingvisual aids to reinforce verbal instructions, one addresses the possibility of decreased ability tohear high-frequency sounds. By developing the handouts in large print, one addresses thepossibility of decreased visual acuity. Showing a video does not allow discussion of theinformation; furthermore, the text and print may be small and difficult to read and understand.Presenting all the information in one session before discharge also does not allow fordiscussion, and the patient may not be able to hear or see the information sufficiently. Becauseof the possibility of decreased short-term memory and slowed cognitive function, simplygiving pamphlets to read without other teaching strategies may not be appropriate.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 27 preview image

Loading page ...

DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance5.When the nurse teaches a skill such as self-injection of insulin to the patient, what is the bestway to set up the teaching/learning session?a.Provide written pamphlets for instruction.b.Show a video, and allow the patient to practice as needed on his own.c.Verbally explain the procedure, and provide written handouts for reinforcement.d.After demonstrating the procedure, allow the patient to do several returndemonstrations.ANS: DReturn demonstration allows the nurse to evaluate the patient‘s newly learned skills. Thetechniques in the other options are incorrect because those suggestions do not allow forevaluation of the patient‘s technique.DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care6.A patient with a new prescription for a diuretic has just reviewed with the nurse how toinclude more potassium in her diet. This reflects learning in which domain?a.Cognitiveb.Affectivec.Physicald.PsychomotorANS: A

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 28 preview image

Loading page ...

The cognitive domain refers to problem-solving abilities and may involve recall andknowledge of facts. The affective domain refers to values and beliefs. The termphysicaldoesnot refer to one of the learning domains. The psychomotor domain involves behaviors such aslearning how to perform a procedure.DIF:Cognitive Level: Understanding (Comprehension)TOP: Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care7.During an admission assessment, the nurse discovers that the patient does not speak English.Which is considered the ideal resource for translation?a.A family member of the patientb.A close family friend of the patientc.A translator who does not know the patientd.Prewritten note cards with both English and the patient‘s languageANS: CThe nurse should communicate with the patient in the patient‘s native language if at allpossible. If the nurse is not able to speak the patient‘s native language, a translator should bemade available so as to prevent communication problems, minimize errors, and help boost thepatient‘s level of trust and understanding of the nurse. In practice, this translator may beanother nurse or health care professional, a nonprofessional member of the health care team,or a layperson, family member, adult friend, or religious leader or associate. However, it isbest to avoid family members as translators, if possible, because of issues with bias,misinterpretation, and potential confidentiality issues.DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Safe and Effective Care Environment: Management of Care8.A 60-year-old patient is on several new medications and expresses worry that she will forgetto take her pills. Which action by the nurse would be most helpful in this situation?

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 29 preview image

Loading page ...

a.Teaching effective coping strategiesb.Asking the patient‘s prescriber to reduce the number of drugs prescribedc.Assuring the patient that she will not forget once she is accustomed to the routined.Assisting the patient with obtaining and learning to use a calendar or pill containerANS: DCalendars, pill containers, or diaries may be helpful to patients who may forget to takeprescribed drugs as scheduled. The nurse must ensure that the patient knows how to use thesereminder tools. Teaching coping strategies is a helpful suggestion but will not help withremembering to take medications. Asking the prescriber to reduce the number of drugs thatare prescribed is not an appropriate action by the nurse. Assuring the patient that she will notforget is false reassurance by the nurse and inappropriate when education is needed.DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Reduction of Risk PotentialMULTIPLE RESPONSE1.Which are appropriate considerations when the nurse is assessing the learning needs of apatient? (Select all that apply.)a.Cultural backgroundb.Family historyc.Level of educationd.Readiness to learne.Health beliefsANS: A, C, D, EFamily history is not a part of what the nurse considers when assessing learning needs. Theother options are appropriate to consider when the nurse is assessing learning needs.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 30 preview image

Loading page ...

DIF:Cognitive Level: Understanding (Comprehension)TOP: Nursing Process: AssessmentMSC: NCLEX: Safe and Effective Care Environment: Management of Care2.The nurse is teaching an older patient about the use of an incentive spirometer after surgery.Which of these age-related changes are appropriate for the nurse to consider when teachingolder patients? (Select all that apply.)a.Decreased sense of touchb.Increased conduction of soundc.Decreased cognitive functiond.Decreased short-term memorye.Increased ability to concentrateANS: A, C, DAge-related changes in older adults that may affect learning include a decreased sense oftouch, decreased cognitive function, and decreased short-term memory. Sound conduction andability to concentrate are also decreased. Refer to Table 6-1.DIF:Cognitive Level: Analyzing (Analysis)TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial IntegrityCOMPLETION1.A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mgstrength. Identify how many tablets will the patient receive. _______ANS:3 tablets1 tablet:2.5 mg::xtablet:7.5 mg. (17.5) = (2.5x); 7.5 = 2.5x;x= 3; therefore 7.5 mg = 3tablets.

Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57) - Page 31 preview image

Loading page ...

DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral TherapiesChapter 07: Over-the-Counter Drugs and Herbal and Dietary SupplementsLilley: Pharmacology and the Nursing Process, 10th EditionMULTIPLE CHOICE1.A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go―natural‖ with her pregnancy. She shows the nurse a list of herbal remedies that she wants tobuy so that she can ―avoid taking any drugs.‖ Which statement by the nurse is correct?a.―Most herbal remedies are not harmful and are safe for use during pregnancy.‖b.―Please read each label carefully before use to check for cautionary warnings.‖c.―Keep in mind that products from different manufacturers are required to containconsistentamounts of the herbal products.‖d.―It‘s important to remember that herbal remedies do not have proven safety ratingsfor pregnant women.‖ANS: DThe fact that a drug is an herbal or a dietary supplement does not mean that it can be safelyadministered to children, infants, or pregnant or lactating women. Many herbal products havenotbeen tested for safety during pregnancy. Simply reading the labels may not provideenough information for use during pregnancy. Last, manufacturers of herbal products are notrequired to guarantee the reliability of the contents.DIF:Cognitive Level: Applying (Application)TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance2.The nurse is giving a lecture about current U.S. laws and regulations of herbal products.According to the United States Dietary Supplement and Health Education Act of 1994, whichstatement is true?

Preview Mode

This document has 296 pages. Sign in to access the full document!

Report

Study Now!

Document Details

Related Documents

Laboratory 8 Muscle Soreness Lab Manual

Case Diana

Identifying a Local Healthcare Economic Issue

Dashboard Metrics Evaluation 1 Dashboard Metrics E

NRP 563 DQ 2

NRP 563 DQ 7

Clinical Supervision Report Week 2

NU 185 Exam 5 Final

NURS FPX 4010 Assessment 3

Strategies for Difficult Venipuncture

Company

Explore

Study Tools