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Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch – Test Bank
Sample Questions
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| 1. | Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism? | |
| A) | A 35-year-old woman with cervical cancer | |
| B) | A 41-year-old man with kidney stones | |
| C) | A 50-year-old man with cirrhosis of the liver | |
| D) | A 62-year-old woman in acute renal failure | |
Chapter 2- Drugs and the Body
| 2. | A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range? | |
| A) | 30 minutes | |
| B) | 1 hour | |
| C) | 2 hours | |
| D) | 3 hours | |
| 3. | A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of “dizzy spells and weakness.” While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what? | |
| A) | The impact of the placebo effect on the patient’s response. | |
| B) | The accumulative effect of the drug if it has been taken for many years. | |
| C) | The impact of the warmer environment on the patient’s physical status. | |
| D) | Problems with patient compliance with the drug regimen while on vacation. | |
| 4. | An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what? | |
| A) | Spending large amounts of money on medications | |
| B) | Allergic reactions to medications | |
| C) | Drug–drug interactions | |
| D) | Critical concentrations of medications in the body | |
| 5. | A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor’s best response? | |
| A) | A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site | |
| B) | A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions | |
| C) | A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site | |
| D) | A drug that reacts with receptor sites to block normal stimulation, producing no effect | |
| 6. | A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose? | |
| A) | Passive diffusion | |
| B) | Active transport | |
| C) | Glomerular filtration | |
| D) | First-pass effect | |
| 7. | A nurse is working as a member of a research team involved in exploring the unique response to drugs each individual displays based on genetic make-up. What is this area of study is called? | |
| A) | Pharmacotherapeutics | |
| B) | Pharmacodynamics | |
| C) | Pharmacoeconomics | |
| D) | Pharmacogenomics | |
| 8. | The nurse uses what term to describe the drug level required to have a therapeutic effect? | |
| A) | Critical concentration | |
| B) | Dynamic equilibrium | |
| C) | Selective toxicity | |
| D) | Active transport | |
| 9. | A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse’s priority action? | |
| A) | Wash her hands before handling the medications. | |
| B) | Consult a drug guide for compatibility. | |
| C) | Question the patient concerning drug allergies. | |
| D) | Identify the patient by checking the armband and asking the patient to state his name. | |
| 10. | The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs? | |
| A) | Perfusion of blood to the subcutaneous tissue | |
| B) | Integrity of the mucous membranes | |
| C) | Environmental temperature | |
| D) | Blood flow to the gastrointestinal tract | |
| 11. | The patient is taking a drug that affects the body by increasing cellular activity. Where does this drug work on the cell? | |
| A) | Receptor sites | |
| B) | Cell membrane | |
| C) | Golgi body | |
| D) | Endoplasmic reticulum | |
| 12. | Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes? (Select all that apply.) | |
| A) | Distribution to the active site | |
| B) | Biotransformation | |
| C) | Absorption from the muscle | |
| D) | Excretion | |
| E) | Interaction with other drugs | |
| 13. | A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective as possible, the nurse needs to consider what? | |
| A) | Pharmacotherapeutics | |
| B) | Pharmacokinetics | |
| C) | Pharmacoeconomics | |
| D) | Pharmacogenomics | |
| 14. | The nurse is explaining how medications work to a group of peers and explains that disruption of a single step in any enzyme system disrupts what? | |
| A) | Cell life | |
| B) | Cell membrane | |
| C) | Cell receptor sites | |
| D) | Cell function | |
| 15. | The processes involved in dynamic equilibrium are key elements in the nurse’s ability to determine what? | |
| A) | Dosage scheduling | |
| B) | Amount of solution for mixing parenteral drugs | |
| C) | Timing of other drugs the patient is taking | |
| D) | How long the patient has to take the drug | |
| 16. | What factor influences drug absorption? | |
| A) | Kidney function | |
| B) | Route of administration | |
| C) | Liver function | |
| D) | Cardiovascular function | |
| 17. | What does the lipid solubility of the drug influence? | |
| A) | Absorption of the drug | |
| B) | Metabolism of the drug | |
| C) | Excretion of the drug | |
| D) | Distribution of the drug | |
| 18. | The nursing students are learning about the half-life of drugs. A student asks the instructor to explain half-life. What is the instructor’s best response? | |
| A) | Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved. | |
| B) | Half-life is the amount of time it takes for the drug to be metabolized by the body. | |
| C) | Half-life is the amount of time it takes for half of the drug to reach peak level in the body. | |
| D) | Half-life of a drug is the time it takes for the drug to reach half its potential peak level in the body. | |
| 19. | The patient is taking a 2-mg dose of ropinerol XR. The drug has a half-life of 12 hours. How long will it be before only 0.25 mg of this drug remains in the patient’s system? | |
| A) | 24 hours | |
| B) | 36 hours | |
| C) | 48 hours | |
| D) | 60 hours | |
| 20. | The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient’s system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours? | |
| A) | 22 mcg | |
| B) | 16.5 mcg | |
| C) | 11 mcg | |
| D) | 5.5 mcg | |
| 21. | The patient is a 6-year-old child who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child’s body at the time of the next administration of the drug? | |
| A) | 62.5 mg | |
| B) | 46.875 mg | |
| C) | 31.25 mg | |
| D) | 15.625 mg | |
| 22. | A drug with a half-life of 4 hours is administered at a dosage of 100 mg. How much of the drug will be in the patient’s system 8 hours after administration? | |
| A) | 75 mg | |
| B) | 50 mg | |
| C) | 37.5 mg | |
| D) | 25 mg | |
| 23. | The nurse administers amoxicillin 500 mg. The half-life of this drug is approximately 1 hour. At what point would the drug level in the body be 62.5 mg if the drug was not administered again? | |
| A) | 1 hours after the original dose | |
| B) | 2 hours after the original dose | |
| C) | 3 hours after the original dose | |
| D) | 4 hours after the original dose | |
| 24. | The nurse is caring for a patient who is receiving gentamicin, 250 mg and fluconazole (Diflucan), 500 mg at the same time. The nurse knows that if these two drugs competed with each other for protein-binding sites, what would this do? | |
| A) | Make the patient gentamicin deficient | |
| B) | Make the patient fluconazole deficient | |
| C) | Counteract any positive benefit the drugs would have | |
| D) | Alter the effectiveness of both drugs | |
| 25. | The student nurse asks the instructor why a patient with a central nervous system infection is receiving antibiotics that will not cross the blood–brain barrier. What is the instructor’s most correct response? | |
| A) | A severe infection alters the blood–brain barrier to allow the drug to cross. | |
| B) | A medication that is water soluble is more likely to cross the blood-brain barrier. | |
| C) | Antibiotics are the exception to the blood–brain barrier and cross easily. | |
| D) | An infection that spreads outside the central nervous system helps drugs cross the barrier. | |
| 26. | The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process? | |
| A) | Distribution | |
| B) | First-pass effect | |
| C) | Reduced absorption | |
| D) | Gastrointestinal circulation | |
| 27. | What needs to happen to the protein–drug complex for the drugs to reach the cells where the drug can act? | |
| A) | The protein–drug complex must break itself into smaller pieces to enter the capillaries. | |
| B) | The binding site on the protein picks up a chemical to make it soluble in the serum. | |
| C) | The drug must break away from the protein-binding site and float freely. | |
| D) | The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues. | |
| 28. | The nurse is reviewing the results of the patient’s laboratory tests. What must the nurse keep in mind when reviewing these results related to medication administration? | |
| A) | The patient’s emotional response to the disease process | |
| B) | The timing of the last dose of medication relative to when blood was drawn | |
| C) | The possibility of a drug–laboratory test interaction | |
| D) | A change in the body’s responses or actions related to the drug | |
| 29. | A patient has come to the clinic and been diagnosed with Lyme disease. The physician has ordered oral tetracycline. What is important for the nurse to include in the teaching plan about tetracycline? (Select all that apply.) | |
| A) | Do not take the drug with anything high in sodium content to keep from producing a state of hypernatremia in the body. | |
| B) | Do not take the drug with foods or other drugs that contain calcium. | |
| C) | Do not take the drug at the same time you take an iron supplement or with foods that are high in iron content. | |
| D) | Avoid exposure to the sun when taking this drug as it can turn your skin purple. | |
| E) | Avoid eating bananas at the same time you take this drug as the potassium content of the tetracycline can produce hyperkalemia in the body. | |
| 30. | A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug–drug interaction. What is the nurse’s first and best means of avoiding this problem? | |
| A) | Consult a drug guide. | |
| B) | Call the pharmacist. | |
| C) | Contact the provider. | |
| D) | Ask another nurse. | |
| 31. | The nurse promotes optimal drug effectiveness by doing what? (Select all that apply.) | |
| A) | Incorporate basic history and physical assessment factors into the plan of care. | |
| B) | Evaluate the effectiveness of drugs after they have been administered. | |
| C) | Modify the drug regimen to modify adverse or intolerable effects. | |
| D) | Minimize the number of medications administered to patients. | |
| E) | Examine factors known to influence specific drugs if they are to be effective. | |
| 32. | The nurse administers a specific medication to an older adult patient every 4 hours. The patient has a history of chronic renal failure. Why would this patient be at risk for toxic drug levels? | |
| A) | Cumulative effect | |
| B) | First-pass effect | |
| C) | Drug interactions | |
| D) | Cross-tolerance effect | |
| 33. | The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient’s pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening? | |
| A) | Tolerance | |
| B) | Cumulation | |
| C) | Interactions | |
| D) | Addiction | |
| 34. | While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, “I have read all about this drug and it is such a wonder drug. I’m so lucky my doctor prescribed it because I just know it will treat my problem.” The nurse suspects this drug will be more effective than usual for this patient because of what effect? | |
| A) | Cumulative effect | |
| B) | First-pass effect | |
| C) | Placebo effect | |
| D) | Cross-tolerance effect | |
| 35. | The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what factors in this patient could extend the drug’s half-life? (Select all that apply.) | |
| A) | Gastrointestinal disease | |
| B) | Kidney disease | |
| C) | Liver disease | |
| D) | Cardiovascular disease | |
| E) | Route of administration | |
| 1. | A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient? | |
| A) | Noncompliance: Cost of the drug | |
| B) | Deficient knowledge: Unfamiliar with drug therapy | |
| C) | Risk for injury: Related to adverse effects of the drug | |
| D) | Ineffective health maintenance: Need for medication | |
Chapter 4- The Nursing Process in Drug
| 2. | What is the responsibility of the nurse related to the patient’s drug therapy? (Select all that apply.) | |
| A) | Teaching the patient how to cope with therapy to ensure the best outcome | |
| B) | Providing therapy as well as medications | |
| C) | Evaluating the effectiveness of therapy | |
| D) | Altering the drug regimen to optimize outcome | |
| E) | Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapy | |
| 3. | The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient? | |
| A) | The medication history of the patient’s mother and/or father | |
| B) | The name of the patient’s pharmacy | |
| C) | Insurance, financial support, and stability for the patient and his family | |
| D) | The last time the patient was hospitalized | |
| 4. | During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy? | |
| A) | Assessment | |
| B) | Nursing diagnosis | |
| C) | Interventions | |
| D) | Evaluation | |
| 5. | When the nurse reads in the drug handbook the section related to recommended dosage, it is important to remember that this suggested dosage is based on what? | |
| A) | A 40-year-old man | |
| B) | An average-sized adult | |
| C) | A 150-pound adult male | |
| D) | A healthy young adult | |
| 6. | A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose? | |
| A) | Surface area | |
| B) | Height | |
| C) | Birth date | |
| D) | Adult dosage | |
| 7. | You are evaluating the discharge teaching you have done with your patient concerning drug therapy. What statement from the patient would indicate that teaching had been effective? | |
| A) | “I have to take three pills each day and I can take them at the time that fits my schedule.” | |
| B) | “I should take the white pill in the morning because the doctor wants me to take it.” | |
| C) | “I will add the names and dosages of these new drugs to my medication list in my wallet.” | |
| D) | “I have prescriptions at different pharmacies. I shop around for the best price for each drug.” | |
| 8. | The nurse would expect to see an adjusted dosage in what patients? (Select all that apply.) | |
| A) | Young adult women | |
| B) | Middle-aged men | |
| C) | Infants | |
| D) | Neonates | |
| E) | Older adults | |
| 9. | When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies? | |
| A) | Patients starting on new drugs are usually not compliant with medical regimens. | |
| B) | Many drug-alternative therapy interactions can cause serious problems. | |
| C) | Natural products may be more effective and the prescribed drug may not be needed. | |
| D) | The cost of the drug and the alternative therapy may be too expensive for the patient to handle. | |
| 10. | The nurse is reviewing the patient’s medication orders and finds an order stating “amoxicillin 250 mg every 8 hours.” What would the nurse question regarding this order? | |
| A) | Dose | |
| B) | Route | |
| C) | Frequency of administration | |
| D) | Allowance for generic substitution | |
| 11. | The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would the nurse consider a priority to assess to develop the most effective plan of care related to medication administration? | |
| A) | Description of the patient’s living environment | |
| B) | Required lifestyle changes | |
| C) | Family members in the community | |
| D) | Compliance with therapy to reduce risk of skin breakdown | |
| 12. | Student nurses are learning to weigh patients and do vital signs. How does a correct weight impact administering medication? | |
| A) | Proper dosage calculation | |
| B) | Assessing changes in fluid balance | |
| C) | Assessing changes in nutritional status | |
| D) | Caloric needs | |
| 13. | Teaching the patient/caregiver about her or his medications is an important step in reducing the risk of medication errors. What is an important teaching point about medications? (Select all that apply.) | |
| A) | Speak up and ask questions. | |
| B) | Store medications in a warm humid place. | |
| C) | Adjust your medication according to how you feel. | |
| D) | Keep a list of your prescribed medications. | |
| E) | Take all medications together in the morning. | |
| 14. | A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) PO q4h. This over-the-counter pharmaceutical comes in bottles with plastic measuring caps. How much should the nurse teach the patient to take at home? | |
| A) | 1/2 tsp | |
| B) | 1 tsp | |
| C) | 2 tsp | |
| D) | 1 tbsp | |
| 15. | It is important for the nurse to evaluate the efficacy of what parameter when evaluating the drug therapy of a patient? | |
| A) | Appropriateness of drug dosages | |
| B) | Compliance | |
| C) | Caregivers’ knowledge level | |
| D) | Nursing interventions | |
| 16. | The nurse is conducting an admission assessment on a patient. When collecting data related to medications the nurse asks “What medications are you currently taking?” After collecting this information, what other questions should the nurse ask? (Select all that apply.) | |
| A) | “Do you take any medications?” | |
| B) | “What over-the-counter (OTC) medications do you take?” | |
| C) | “Do you take an herbs, vitamins, or supplements?” | |
| D) | “Do you take medications safely when you take them?” | |
| E) | “Why do you take this medication?” | |
| 17. | A 27-year-old man is admitted to the emergency department (ED) after a serious motorcycle accident. The patient has a head injury, abrasions covering the left side of his body, a broken left femur, and internal injuries that are not fully assessed at this time. He is transferred from the ED to the intensive care unit (ICU). The nurse who is going to care for this patient in the ICU knows that a priority responsibility in regard to drug therapy is what? | |
| A) | Support vital functions | |
| B) | Continue curative treatment | |
| C) | Institute life-saving treatment | |
| D) | Monitor patient’s response | |
| 18. | When assessing a patient before starting a drug regimen, why would the nurse consider it important to assess baseline kidney function? | |
| A) | To anticipate adverse effects of drugs | |
| B) | To determine patient’s baseline electrolyte levels | |
| C) | To determine patient’s ability to excrete the drug | |
| D) | To determine patient’s ability to metabolize the drug | |
| 19. | A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the knowledge that the aging process impacts drug therapy in what important way? | |
| A) | Blood volume decreases | |
| B) | Subcutaneous tissue increases | |
| C) | Total body water increases | |
| D) | Muscle mass increases | |
| 20. | The nurse is caring for a patient who takes several drugs. What patient would the nurse monitor most closely because of an increased risk for adverse effects of medications? | |
| A) | The school-aged child | |
| B) | The obese middle-aged man | |
| C) | The adolescent | |
| D) | The newborn infant | |
| 21. | Which statement best describes drug efficacy/toxicity in pediatric patients? | |
| A) | Drug requirements for infants have been extensively studied. | |
| B) | Drug dosage is altered by age and weight in children. | |
| C) | Children always need smaller doses of medication than adults. | |
| D) | Infants and children are not at risk for drug toxicity if the dosage is correct. | |
| 22. | A 7-year-old boy fell off a wood pile while playing. He has been admitted to the intensive care unit with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient? | |
| A) | Adverse effects may be decreased. | |
| B) | Therapeutic effects may be increased. | |
| C) | Pharmacodynamics may be altered. | |
| D) | Pharmacokinetics remain the same. | |
| 23. | After admitting a patient to the unit, the nurse is organizing times to administer ordered medications. What important consideration will guide the nurse’s timing of each medication? | |
| A) | Comfort | |
| B) | Ethnicity of patient | |
| C) | Gender | |
| D) | Age | |
| 24. | The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult? | |
| A) | Changes in the gastrointestinal (GI) system can reduce drug absorption. | |
| B) | In older adults, drugs enter into circulation more quickly. | |
| C) | In older adults, drugs are distributed to a smaller portion of the tissues. | |
| D) | In older adults, drugs have an increased action. | |
| 25. | In today’s health care environment there is often more contact between the patient and the nurse than between the patient and the physician. How does this increased patient contact impact drug therapy? | |
| A) | Choosing the best medication to treat the patient’s condition | |
| B) | Assessing the patient’s preferred communication strategies | |
| C) | Assessing the therapeutic success of the drug therapy | |
| D) | Reducing dosage quickly when adverse effects arise | |
| 26. | The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse’s first priority? | |
| A) | Administer medications ordered immediately. | |
| B) | Maintain the patient’s confidentiality. | |
| C) | Call the admitting physician immediately. | |
| D) | Provide teaching about chronic renal failure. | |
| 27. | It is often necessary to obtain baseline data prior to initiating many forms of drug therapy. These baseline data include what? (Select all that apply.) | |
| A) | Education level | |
| B) | Allergies | |
| C) | Drug use | |
| D) | Number of members in family | |
| E) | Father’s occupation | |
| 28. | A 32-year-old woman is admitted to the unit with a diagnosis of hypovolemia. The nurse is developing a care plan for this patient. What is an appropriate nursing diagnosis to help prevent medication errors? | |
| A) | Dysfunctional gastrointestinal motility | |
| B) | Ineffective self-health maintenance | |
| C) | Risk for injury | |
| D) | Deficient fluid volume | |
| 29. | The nurse applies the nursing process in medication therapy to ensure what? | |
| A) | That medications are given at the right time | |
| B) | That care is efficient and effective | |
| C) | That the right dose of the drug is given to the patient | |
| D) | That the right drug is given to the right patient at the right time | |
| 30. | A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient? | |
| A) | Deficient knowledge: monitoring temperature | |
| B) | Noncompliance | |
| C) | Risk for injury related to hypoxia | |
| D) | Non-adherence: overuse | |
| 31. | The nurse is reviewing the patient’s admission medication orders. What order would the nurse to question? | |
| A) | Digoxin .5 mg orally now–give one dose only | |
| B) | Lasix 20 mg. IV every 4 hours times 3 | |
| C) | Gentamicin 80 mg IV to infuse over 1 hour every 12 hours | |
| D) | Acetaminophen 650 mg PO every 4 hours as needed for pain | |
| 32. | The nursing instructor observes several nursing students administer medications to their assigned patients. The instructor would stop what student from administering the medication until the error was corrected? | |
| A) | The student checks the label on the medication against the administration record three times. | |
| B) | The student enters the patient’s room and asks the patient “Are you Mr. Jones?” | |
| C) | The student checks the drug’s brand name and generic name before taking it to the patient. | |
| D) | The student documents the medication upon exiting the patient’s room. | |
| 33. | The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the patient has an important medication due but it is supposed to be given orally. What is the nurse’s best action? | |
| A) | Give the medication with a small sip of water. | |
| B) | Give the medication via a different route. | |
| C) | Hold the medication and put a note on the front of the chart for the surgeon. | |
| D) | Call the ordering health care provider and clarify administration. | |
| 34. | The nurse admits an older adult patient to the emergency room with reports of shortness of breath on exertion and a productive cough. The nurse reviews the patient’s current medications and the patient says, “I take one pink pill every morning.” The nurse asks the name of the drug and the patient says she doesn’t know. The patient cannot supply the name of the drug or the purpose in taking it either. This happens with four other medications the patient says she takes. What is an appropriate nursing diagnosis for this patient? | |
| A) | Acute confusion | |
| B) | Risk-prone health behavior | |
| C) | Ineffective health maintenance | |
| D) | Noncompliance | |
| 35. | What action does the nurse take during the intervention state of the nursing process related to drug therapy? (Select all that apply.) | |
| A) | Administer the medication. | |
| B) | Determine medication effectiveness. | |
| C) | Document the medication. | |
| D) | Analyze the data collected. | |
| E) | Collect a nursing history. | |
| 1. | A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient? | |
| A) | Noncompliance: Cost of the drug | |
| B) | Deficient knowledge: Unfamiliar with drug therapy | |
| C) | Risk for injury: Related to adverse effects of the drug | |
| D) | Ineffective health maintenance: Need for medication | |
Chapter 4- The Nursing Process in Drug
| 2. | What is the responsibility of the nurse related to the patient’s drug therapy? (Select all that apply.) | |
| A) | Teaching the patient how to cope with therapy to ensure the best outcome | |
| B) | Providing therapy as well as medications | |
| C) | Evaluating the effectiveness of therapy | |
| D) | Altering the drug regimen to optimize outcome | |
| E) | Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapy | |
| 3. | The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient? | |
| A) | The medication history of the patient’s mother and/or father | |
| B) | The name of the patient’s pharmacy | |
| C) | Insurance, financial support, and stability for the patient and his family | |
| D) | The last time the patient was hospitalized | |
| 4. | During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy? | |
| A) | Assessment | |
| B) | Nursing diagnosis | |
| C) | Interventions | |
| D) | Evaluation | |
| 5. | When the nurse reads in the drug handbook the section related to recommended dosage, it is important to remember that this suggested dosage is based on what? | |
| A) | A 40-year-old man | |
| B) | An average-sized adult | |
| C) | A 150-pound adult male | |
| D) | A healthy young adult | |
| 6. | A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose? | |
| A) | Surface area | |
| B) | Height | |
| C) | Birth date | |
| D) | Adult dosage | |
| 7. | You are evaluating the discharge teaching you have done with your patient concerning drug therapy. What statement from the patient would indicate that teaching had been effective? | |
| A) | “I have to take three pills each day and I can take them at the time that fits my schedule.” | |
| B) | “I should take the white pill in the morning because the doctor wants me to take it.” | |
| C) | “I will add the names and dosages of these new drugs to my medication list in my wallet.” | |
| D) | “I have prescriptions at different pharmacies. I shop around for the best price for each drug.” | |
| 8. | The nurse would expect to see an adjusted dosage in what patients? (Select all that apply.) | |
| A) | Young adult women | |
| B) | Middle-aged men | |
| C) | Infants | |
| D) | Neonates | |
| E) | Older adults | |
| 9. | When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies? | |
| A) | Patients starting on new drugs are usually not compliant with medical regimens. | |
| B) | Many drug-alternative therapy interactions can cause serious problems. | |
| C) | Natural products may be more effective and the prescribed drug may not be needed. | |
| D) | The cost of the drug and the alternative therapy may be too expensive for the patient to handle. | |
| 10. | The nurse is reviewing the patient’s medication orders and finds an order stating “amoxicillin 250 mg every 8 hours.” What would the nurse question regarding this order? | |
| A) | Dose | |
| B) | Route | |
| C) | Frequency of administration | |
| D) | Allowance for generic substitution | |
| 11. | The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would the nurse consider a priority to assess to develop the most effective plan of care related to medication administration? | |
| A) | Description of the patient’s living environment | |
| B) | Required lifestyle changes | |
| C) | Family members in the community | |
| D) | Compliance with therapy to reduce risk of skin breakdown | |
| 12. | Student nurses are learning to weigh patients and do vital signs. How does a correct weight impact administering medication? | |
| A) | Proper dosage calculation | |
| B) | Assessing changes in fluid balance | |
| C) | Assessing changes in nutritional status | |
| D) | Caloric needs | |
| 13. | Teaching the patient/caregiver about her or his medications is an important step in reducing the risk of medication errors. What is an important teaching point about medications? (Select all that apply.) | |
| A) | Speak up and ask questions. | |
| B) | Store medications in a warm humid place. | |
| C) | Adjust your medication according to how you feel. | |
| D) | Keep a list of your prescribed medications. | |
| E) | Take all medications together in the morning. | |
| 14. | A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) PO q4h. This over-the-counter pharmaceutical comes in bottles with plastic measuring caps. How much should the nurse teach the patient to take at home? | |
| A) | 1/2 tsp | |
| B) | 1 tsp | |
| C) | 2 tsp | |
| D) | 1 tbsp | |
| 15. | It is important for the nurse to evaluate the efficacy of what parameter when evaluating the drug therapy of a patient? | |
| A) | Appropriateness of drug dosages | |
| B) | Compliance | |
| C) | Caregivers’ knowledge level | |
| D) | Nursing interventions | |
| 16. | The nurse is conducting an admission assessment on a patient. When collecting data related to medications the nurse asks “What medications are you currently taking?” After collecting this information, what other questions should the nurse ask? (Select all that apply.) | |
| A) | “Do you take any medications?” | |
| B) | “What over-the-counter (OTC) medications do you take?” | |
| C) | “Do you take an herbs, vitamins, or supplements?” | |
| D) | “Do you take medications safely when you take them?” | |
| E) | “Why do you take this medication?” | |
| 17. | A 27-year-old man is admitted to the emergency department (ED) after a serious motorcycle accident. The patient has a head injury, abrasions covering the left side of his body, a broken left femur, and internal injuries that are not fully assessed at this time. He is transferred from the ED to the intensive care unit (ICU). The nurse who is going to care for this patient in the ICU knows that a priority responsibility in regard to drug therapy is what? | |
| A) | Support vital functions | |
| B) | Continue curative treatment | |
| C) | Institute life-saving treatment | |
| D) | Monitor patient’s response | |
| 18. | When assessing a patient before starting a drug regimen, why would the nurse consider it important to assess baseline kidney function? | |
| A) | To anticipate adverse effects of drugs | |
| B) | To determine patient’s baseline electrolyte levels | |
| C) | To determine patient’s ability to excrete the drug | |
| D) | To determine patient’s ability to metabolize the drug | |
| 19. | A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the knowledge that the aging process impacts drug therapy in what important way? | |
| A) | Blood volume decreases | |
| B) | Subcutaneous tissue increases | |
| C) | Total body water increases | |
| D) | Muscle mass increases | |
| 20. | The nurse is caring for a patient who takes several drugs. What patient would the nurse monitor most closely because of an increased risk for adverse effects of medications? | |
| A) | The school-aged child | |
| B) | The obese middle-aged man | |
| C) | The adolescent | |
| D) | The newborn infant | |
| 21. | Which statement best describes drug efficacy/toxicity in pediatric patients? | |
| A) | Drug requirements for infants have been extensively studied. | |
| B) | Drug dosage is altered by age and weight in children. | |
| C) | Children always need smaller doses of medication than adults. | |
| D) | Infants and children are not at risk for drug toxicity if the dosage is correct. | |
| 22. | A 7-year-old boy fell off a wood pile while playing. He has been admitted to the intensive care unit with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient? | |
| A) | Adverse effects may be decreased. | |
| B) | Therapeutic effects may be increased. | |
| C) | Pharmacodynamics may be altered. | |
| D) | Pharmacokinetics remain the same. | |
| 23. | After admitting a patient to the unit, the nurse is organizing times to administer ordered medications. What important consideration will guide the nurse’s timing of each medication? | |
| A) | Comfort | |
| B) | Ethnicity of patient | |
| C) | Gender | |
| D) | Age | |
| 24. | The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult? | |
| A) | Changes in the gastrointestinal (GI) system can reduce drug absorption. | |
| B) | In older adults, drugs enter into circulation more quickly. | |
| C) | In older adults, drugs are distributed to a smaller portion of the tissues. | |
| D) | In older adults, drugs have an increased action. | |
| 25. | In today’s health care environment there is often more contact between the patient and the nurse than between the patient and the physician. How does this increased patient contact impact drug therapy? | |
| A) | Choosing the best medication to treat the patient’s condition | |
| B) | Assessing the patient’s preferred communication strategies | |
| C) | Assessing the therapeutic success of the drug therapy | |
| D) | Reducing dosage quickly when adverse effects arise | |
| 26. | The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse’s first priority? | |
| A) | Administer medications ordered immediately. | |
| B) | Maintain the patient’s confidentiality. | |
| C) | Call the admitting physician immediately. | |
| D) | Provide teaching about chronic renal failure. | |
| 27. | It is often necessary to obtain baseline data prior to initiating many forms of drug therapy. These baseline data include what? (Select all that apply.) | |
| A) | Education level | |
| B) | Allergies | |
| C) | Drug use | |
| D) | Number of members in family | |
| E) | Father’s occupation | |
| 28. | A 32-year-old woman is admitted to the unit with a diagnosis of hypovolemia. The nurse is developing a care plan for this patient. What is an appropriate nursing diagnosis to help prevent medication errors? | |
| A) | Dysfunctional gastrointestinal motility | |
| B) | Ineffective self-health maintenance | |
| C) | Risk for injury | |
| D) | Deficient fluid volume | |
| 29. | The nurse applies the nursing process in medication therapy to ensure what? | |
| A) | That medications are given at the right time | |
| B) | That care is efficient and effective | |
| C) | That the right dose of the drug is given to the patient | |
| D) | That the right drug is given to the right patient at the right time | |
| 30. | A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient? | |
| A) | Deficient knowledge: monitoring temperature | |
| B) | Noncompliance | |
| C) | Risk for injury related to hypoxia | |
| D) | Non-adherence: overuse | |
| 31. | The nurse is reviewing the patient’s admission medication orders. What order would the nurse to question? | |
| A) | Digoxin .5 mg orally now–give one dose only | |
| B) | Lasix 20 mg. IV every 4 hours times 3 | |
| C) | Gentamicin 80 mg IV to infuse over 1 hour every 12 hours | |
| D) | Acetaminophen 650 mg PO every 4 hours as needed for pain | |
| 32. | The nursing instructor observes several nursing students administer medications to their assigned patients. The instructor would stop what student from administering the medication until the error was corrected? | |
| A) | The student checks the label on the medication against the administration record three times. | |
| B) | The student enters the patient’s room and asks the patient “Are you Mr. Jones?” | |
| C) | The student checks the drug’s brand name and generic name before taking it to the patient. | |
| D) | The student documents the medication upon exiting the patient’s room. | |
| 33. | The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the patient has an important medication due but it is supposed to be given orally. What is the nurse’s best action? | |
| A) | Give the medication with a small sip of water. | |
| B) | Give the medication via a different route. | |
| C) | Hold the medication and put a note on the front of the chart for the surgeon. | |
| D) | Call the ordering health care provider and clarify administration. | |
| 34. | The nurse admits an older adult patient to the emergency room with reports of shortness of breath on exertion and a productive cough. The nurse reviews the patient’s current medications and the patient says, “I take one pink pill every morning.” The nurse asks the name of the drug and the patient says she doesn’t know. The patient cannot supply the name of the drug or the purpose in taking it either. This happens with four other medications the patient says she takes. What is an appropriate nursing diagnosis for this patient? | |
| A) | Acute confusion | |
| B) | Risk-prone health behavior | |
| C) | Ineffective health maintenance | |
| D) | Noncompliance | |
| 35. | What action does the nurse take during the intervention state of the nursing process related to drug therapy? (Select all that apply.) | |
| A) | Administer the medication. | |
| B) | Determine medication effectiveness. | |
| C) | Document the medication. | |
| D) | Analyze the data collected. | |
| E) | Collect a nursing history. | |
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