Exam 1 Answers

A nurse is conducting an assessment of a client who has recently had several changes made to the drug regimen. What assessment question most directly addresses the safety implications of the client's drug regimen?

"Do you take any herbal supplements or alternative medications?"

The nurse is teaching the parents of a school-aged child who is to receive medication therapy. What instructions should the nurse include?

"Tell your healthcare provider about all the medications your child is taking"

The nurse educates an older adult about the seven prescribed medications to prevent medication-related reactions and adverse effects. Which client statement indicates the need for further clarification? "I will use the same pharmacy to buy all my drugs, so the pharmacist can check for interactions." "I will ask my prescriber or pharmacist before taking any over-the-counter (OTC) drug or herbal." "The dietary supplement I used to take before admission to the hospital is alright to restart." "Reporting any listed adverse reactions to my prescriber right away is important."

"the dietary supplement I used to take before admission to the hospital is alright to restart"

Which client would a nurse expect to experience alterations in drug metabolism?

50 y/o man with cirrhosis of the liver

What client is most likely to have impaired drug metabolism

A client who has a diagnosis of hepatitis C

The nurse has administered a client's medication. What action should the nurse perform next?

Assess for drug effects

In today's health care environment, there is often more contact between the client and the nurse than between the client and the health care provider. What does this put the nurse in the best position to do?

Assess the therapeutic success of drug therapy

The client has a daily antihypertensive medication ordered. Taking the blood pressure prior to administration of the medication is which step of the nursing process?

Assessing

Which activity would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy? Compare the outcome expected with the actual client outcome. Reconsider core drug knowledge and core client variables. Ask questions to prepare an effective client education program. Establish a baseline for the client's treatment and care.

Compare the outcome expected with the actual client outcome.

A nurse is caring for a 49-year-old client with acute gout and arthritis. The nurse interviews the client and checks the medical records. Which additional assessment should the nurse consider before medication administration teaching?

Examining the client physically

Which agency evaluates drugs that have completed phase III?

Food and Drug Administration (FDA)

A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response?

Garlic

Which nonpharmacological measure has demonstrated some effect in treating nausea and vomiting in pregnant women?

Ginger

What are accurate regarding herbal remedies? (Select all that apply.) Clients often do not mention their use to health care providers. Ingredients are known to the consumer. Herbal remedies produce unexpected effects. Herbal remedies rarely cause toxicity. Herbal remedies can interact with prescription drugs.

Herbal remedies can interact with prescription drugs. Clients often do not mention their use to health care providers. Herbal remedies produce unexpected effects.

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?

Neurotoxicity

A method that describes the process of absorption, distribution, and elimination of a drug in the body is known as:

Pharmacokinetics

A client has informed the nurse that he has begun supplementing his medication regimen with a series of herbal remedies recommended by his sister-in-law. Which is the most important nursing intervention regarding the safe use of herbal supplements?

Research for potential interactions with medications

A nurse is assigned to care for a client in a health care facility. What is the nursing responsibility before administering a drug to the client?

Review the subjective and objective data

A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance?

Schedule II (C-II)

A client has been prescribed a selective serotonin reuptake inhibitor (SSRI) to treat depression. The regular use of which herbal supplement requires intervention by the nurse?

St. John's wort

With the increasing number of clients who go to their physician and request a drug they have seen advertised on television or in a magazine, a continuing challenge to health care providers to do what has emerged? Treat infections appropriately. Treat sicker clients. Prescribe cost effectively. Stay knowledgeable about drug therapy.

Stay knowledgable about drug therapy

In discussing the drug regimen with the client, what factors should be included? (Select all that apply.) Cut the tablet in half if the client does not have enough Call the health care provider only after two unexpected reactions occur Length of time before desired therapeutic effect will occur Steps to minimize adverse reactions Adverse reactions to expect

Steps to minimize adverse reactions Adverse reactions to expect Length of time before desired therapeutic effect will occur

When providing drug therapy to a client, what is a responsibility of the nurse?

Teach the client how to cope with the effects of the drug to ensure the best outcome

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity? visual disturbances yellowing of the skin a decrease in urine output ringing noise in the ears

a decrease in urine output

A client has been prescribed an oral drug that is known to have a high first-pass effect. Which measure has the potential to increase the amount of the free drug that is available to body cells?

administering the drug intravenously rather than orally

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?

adverse effects

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic reaction

An elderly postsurgical client has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which medication that the nurse will administer has the slowest absorption?

an oral antidepressant that the client has been taking for several years

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs). What subsequent assessment should the nurse prioritize? asking the client what the client's response is to taking NSAIDs asking if the client has tolerated narcotics and acetaminophen in the past assessing the client for signs and symptoms of inflammation assessing the client's pain tolerance and expectations for pain control

asking the client what the client's response is to taking NSAIDs

The nurse is administering a medication to a client who reports pain in the knees from arthritis. The nurse observes the name of the drug as p-isobutylhydratropic and recognizes that this refers to a:

chemical name

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate

A nurse is caring for a client who is receiving magnesium. The nurse would be alert for which finding? severe vasoconstriction depressed reflexes flaccid paralysis profuse sweating

depressed reflexes

The nurse's main rationale for applying the nursing process in medication therapy is to:

ensure that care is safe and effective

The nurse makes an effort to provide high-quality care to clients by obtaining and analyzing the best available scientific research. This activity demonstrates which important component?

evidence-based nursing

Clients who use garlic with co-administration of antidiabetic drugs may run into which serious problem?

hypoglycemia

The clinic nurse is assessing a client who reports taking ginseng recently. Which condition would the nurse take special care to check for in this client? hypoglycemia depression liver toxicity atherosclerosis

hypoglycemia

A 40-year-old client has become interested in alternative therapy as a means to maintain and enhance health. However, the client has developed hypertension and will be prescribed an antihypertensive agent. The nurse's health history reveals that the client eats a balanced diet, swims regularly, and occasionally takes an over-the-counter medication for allergies. A priority assessment for the nurse will be to determine:

if the client is taking herbal or botanical medications regularly

During assessment, a nurse asks a client about any chronic conditions that might have an impact on the client's prescribed drug therapy. What issue, if reported by the client, would alert the nurse to a possible problem? two episodes of pneumonia over the last 5 years kidney disease diagnosed 2 years ago nearsightedness for the past 10 years episode of gastroenteritis last month

kidney disease diagnosed 2 years ago

A client has told the nurse that the client began taking black cohosh, a herbal supplement, a few weeks ago. In addition to informing the care provider, the nurse should: learn as much about the herbal supplement as possible. ask the client to stop taking the supplement immediately. inform the client that the use of herbs and supplements is dangerous. suggest over-the-counter alternatives to the herbal supplement.

learn as much about the herbal supplement as possible

What is the most frequently used drug administration route in clinical practice?

oral

What factor accounts for the increased risk for drug interactions among clients aged 65 years and older? drugs more readily crossing the blood-brain barrier in older people physiologic changes affecting all pharmacokinetic processes increased drug-metabolizing enzymes in older people diminished immune response

physiologic changes affecting all pharmacokinetic processes

Plants and plant parts have been used as medicines since prehistoric times. Morphine (roxanol) is derived from which plant?

poppy

A nurse notes new drug orders for a client who is already getting several medications. Which is the most important consideration when preparing to administer the new drugs?

possible drug-drug interactions that may occur

The pharmacology instructor explains to the students that adverse effects can be extensions of: primary action of a drug. anaphylaxis. fourth level effects. anticholenergic responses to the drug.

primary action of a drug

A client with an extensive history of using herbal remedies asks the nurse if there is an herbal supplement for the diagnosis of BPH. Which supplement does the nurse provide information on for the treatment of BPH?

saw palmetto

When describing the characteristics of the client who comes into the health care system today, which would most likely apply? limited exposure to other sources of health information continued acceptance of the health care provider as omniscient eager acceptance of the medications selected for the client the use of a complex array of OTC and alternative therapies

the use of a complex array of OTC and alternative therapies

A nurse who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The nurse is documenting the generic, rather than proprietary or trade, names of the resident's current drugs because:

there is a potential for confusion and miscommunication if proprietary/trade names are used

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity

T/F St. John's wort is an herbal remedy with a large number of interactions with other drugs

true