Pharmacology Chapter 3

11. The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have a increased protein in circulation. b fat composition lower than 0.001%. c more muscular body composition. d water composition of approximately 75%.

d water composition of approximately 75%.

7. A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the appropriate response for this patient? a. "You should not take any medication while breastfeeding." b. "Only certain medications pass to infants while breastfeeding." c. "I will leave the doctor a message to return your call." d. "Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

d. "Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

16. The nurse is preparing to give an oral dose of acetaminophen (Tylenol) to a child who weighs 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose?

180mg

10. The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk with regard to drug therapy? a Immature renal system b Hyperperistalsis in the GI tract c Irregular temperature regulation d Smaller circulatory capacity

a Immature renal system

3. Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse can expect the prescriber to perform which action to minimize the risk of toxicity? a. Decrease the amount of drug given b. Increase the amount of drug given c. Shorten the time interval between doses d. Administer the medication intravenously

a. Decrease the amount of drug given

8. A nurse working with elderly patients is concerned about the number of medications each patient is taking. Which will the nurse assess as the highest priority for the patients related to polypharmacy? a. Drug interactions b. Cost of medications c. Schedule of medications d. Nonadherence to drug regimen

a. Drug interactions

2. When teaching a pregnant mother about the effects of medication on the fetus, the nurse recognizes that the greatest harm from maternally ingested medications occurs during which time period? a. First trimester b. Second trimester c. Third trimester d. Birthing process

a. First trimester

15. The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply.) a Explain to the child in advance about the injection. b Provide a brief, concrete explanation about the injection. c Encourage participation in the procedure. d Make use of magical thinking. e Provide comfort measures after the injection.

b Provide a brief, concrete explanation about the injection. d Make use of magical thinking. e Provide comfort measures after the injection.

4. The physiologic changes that normally occur in the older adult have which implication for drug response in this patient? a. Drug metabolism is faster. b. Drug half-life is lengthened. c. Drug elimination is faster. d. Protein binding is more efficient.

b. Drug half-life is lengthened.

9. Which actions will the nurse perform to ensure the medication dose for a pediatric patient is correct? (Select all that apply.) a. Use the patient's weight in pounds. b. Use a current drug reference to determine usual dosage per 24 hours. c. Determine the dose parameters by multiplying the weight by the minimum and maximum daily doses of the drug (the safe range). d. Determine the total amount of the drug to administer per dose and per day. e. Compare the drug dosage prescribed with the calculated safe range. f. If the drug dosage prescribed varies from recommended reference range, notify the provider.

b. Use a current drug reference to determine usual dosage per 24 hours. c. Determine the dose parameters by multiplying the weight by the minimum and maximum daily doses of the drug (the safe range). d. Determine the total amount of the drug to administer per dose and per day. e. Compare the drug dosage prescribed with the calculated safe range. f. If the drug dosage prescribed varies from recommended reference range, notify the provider.

12. While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the elderly patient because of which alterations in pharmacokinetics? a Increased renal excretion of protein-bound drugs b More alkaline gastric pH, resulting in more adverse effects c Decreased blood flow to the liver, resulting in altered metabolism d Less adipose tissue to store fat-soluble drugs

c Decreased blood flow to the liver, resulting in altered metabolism

6. The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor? a. Maternal blood type b. Fetal sex c. Drug properties d. Diet of the mother

c. Drug properties

5. The nurse is admitting an 82-year-old patient for treatment of heart failure. During assessment of the patient's history, the nurse notes a subjective complaint of chronic constipation. Of the prescribed medications the patient was taking prior to admission, which would the nurse suspect might contribute to this gastrointestinal complaint? a. naproxen (Aleve), a nonsteroidal antiinflammatory drug b. warfarin sodium (Coumadin), an anticoagulant c. verapamil (Calan), a calcium channel-blocking drug d. spironolactone (Aldactone), a potassium-sparing diuretic

c. verapamil (Calan), a calcium channel-blocking drug

14. A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct? a "This drug causes problems in the human fetus, so you should not take this medication." b "This drug may cause problems in the human fetus, but nothing has been proven in clinical trials. It is best not to take this medication." c "This drug has not caused problems in animals, but no testing has been done in humans. It is probably safe to take." d "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it."

d "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it."

13. When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? a NSAIDs b Cardiac glycosides c Anticoagulants d Antihypertensives

d Antihypertensives

1. When calculating pediatric dosages, what will the nurse take into consideration? a. Utilization of drug reference recommendations based on mg/kg of body weight is the preferred method. b. Calculated doses based on body weight need to be increased by 10% due to immature renal and hepatic function. c. Dosage calculation according to body weight is the most accurate method because it takes into account differences in maturational development. d. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

d. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.