CHAPTER 3 - TOXIC EFFECTS OF DRUGS - PrepU Practice Questions
Atropine, which is used preoperatively, is considered which drug classification? -diuretic - cholinergic - benzodiazepine - anticholinergic
- anticholinergic p. 40 Rationale: Atropine, a drug used preoperatively to dry up secretions, is the prototype anticholinergic drug. Many cold remedies and antihistamines also cause anticholinergic effects. Atropine is not considered a cholinergic, benzodiazepine, or diuretic.
When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of: - hypersensitivity. - primary actions. - drug allergy. - secondary actions.
- secondary actions. p. 35 Rationale: Secondary actions are effects that are inevitable and undesired but not related to the desired pharmacologic effects. Nausea and diarrhea are examples of secondary actions due to an antibiotic's effect on the gastrointestinal tract. Primary actions are those associated with the therapeutic effect. Drug allergy involves the formation of antibodies to a particular drug. Hypersensitivity refers to an excessive response to either primary or secondary effects of a drug.
Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? (Choose all that apply.) - skeletal and limb abnormalities - central nervous system alterations - heart defects - birth at 40 weeks' gestation
- skeletal and limb abnormalities - central nervous system alterations - heart defects p. 41 Rationale: Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. Birth at 40 weeks' gestation is a normal pregnancy outcome.
An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? - Most reactions occurring with present-day therapy are less severe than before. - Many drugs are potentially harmless if used correctly. - Any effect results from the alteration of several chemical factors. - Drugs cause unexpected or unacceptable reactions despite screening and testing.
Drugs cause unexpected or unacceptable reactions despite screening and testing. p. 34 Rationale: All drugs are potentially dangerous. Even though chemicals are carefully screened and tested in animals and in people before they are released as drugs, drug products often cause unexpected or unacceptable reactions when they are administered. Drugs are chemicals, and the human body operates by a vast series of chemical reactions. Consequently, many effects can be seen when just one chemical factor is altered. Today's potent drugs can cause a great variety of reactions, many of which are more severe than ever seen before.
The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask? - "Do you ever check your blood pressure when you're at home?" - "Are you taking any herbal remedies or vitamin supplements?" - "Have you ever had any steroid injection to treat your arthritis?" - "Have you been taking aspirin on a regular basis?"
- "Have you been taking aspirin on a regular basis?" p. 40 Rationale: Aspirin is a relatively common cause of tinnitus and auditory nerve damage. As well, the fact that the client has an inflammatory disease makes it possible that the client is self-medicating with aspirin. Corticosteroids are not as commonly associated with tinnitus. Similarly, hypertension and hypotension do not normally cause this problem. Herbs and supplements have widely varying effects, but aspirin is a more likely cause due to the client's diagnosis and the wide availability and use of aspirin.
A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform? - Review the client's most recent potassium level. - Check the client's blood glucose level. - Check the client's urine output. - Assess the client's level of orientation
- Review the client's most recent potassium level. p. 39 Rationale: Hypokalemia is suggested by numbness and tingling in the extremities, muscle cramps, weakness, and irregular pulse. Fatigue, drowsiness, hunger, tremulousness, and cold clammy skin would suggest hypoglycemia. Renal injury would be manifested by elevated BUN and creatinine concentration, decreased hematocrit, and electrolyte imbalances, fatigue, malaise, decreased urine output and irritability. Neurologic dysfunction would most likely be manifested by confusion, delirium, insomnia, drowsiness, and changes in deep tendon reflexes.
Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects? - Cytotoxic reactions - Stomatitis - Teratogenicity - Blood dyscrasia
- Teratogenicity p. 41 Rationale: Teratogenicity is when drugs that reach the developing fetus or embryo cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. Stomatitis and blood dyscasia are examples of tissue and organ damage. Cytotoxic reaction is an example of an allergic reaction to a drug.
The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration? - protocols - adverse effects - route of administration - body system affected
- adverse effects p. 34 Rationale: Becoming familiar with classifications of medications helps the nurse to recognize possible adverse effects clients may experience, providing a basis for implementing appropriate nursing actions should undesirable effects occur. The route of administration, body system involved, and protocols are more important to know before medication administration.
A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client? - a smaller-than-normal dose of the general anesthetic - the same dose of the general anesthetic as another female of her age and medical history - no general anesthesia, because general anesthesia should not be given to a client with her history - a larger-than-normal dose of the general anesthetic
a larger-than-normal dose of the general anesthetic p. 29 Rationale: Drug tolerance occurs when the body becomes accustomed to a particular drug over time, so that larger doses must be given to produce the same effects. Tolerance may be acquired to the pharmacologic action of many drugs, especially opioid analgesics, alcohol, and other CNS depressants. Tolerance to pharmacologically related drugs is called cross-tolerance. For example, a person who regularly drinks large amounts of alcohol becomes able to ingest even larger amounts before becoming intoxicated; this is tolerance to alcohol. If the person is then given sedative-type drugs or a general anesthetic, larger-than-usual doses are required to produce a pharmacologic effect. This is cross-tolerance.
A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? - measures to alleviate any discomfort associated with adverse effects - the cost of the brand-name drug compared with the generic form - statistics related to phase III of testing for the prescribed drug - a list of pharmacies where the drug can be obtained
measures to alleviate any discomfort associated with adverse effects p. 34 Rationale: If clients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the client. However, a substitution may not be allowed, and the cost of a drug does not improve client safety. Most clients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with clients.
