Pharmacology Unit 1 Review

The emergency department nurse is admitting a young adult client who denies the use of prescription or over-the-counter medications, but who admits to using cocaine and ecstasy. How should the nurse best follow up this assessment finding?

Assess the frequency of use and document the findings.

The breakdown of oral drugs in the liver immediately after absorption is known as which of the following?

First-pass effect

After a class on pharmacokinetics, the nursing students can correctly choose which site for the metabolism of most drugs?

Liver

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

The nurse is transcribing physician orders for a client with pneumonia who has been admitted to the hospital. Why should the physician order the medications using the generic name instead of a brand name?

Numerous brand names may exist for the same drug, so the generic drug should be ordered

The nurse is working in a community outreach clinic. What should the nurse teach a client about over-the-counter medications?

OTC medications are not risk free.

A client has brought in a magazine advertisement for a medication and has asked the nurse to arrange a prescription for it. When addressing the client's request, what is the nurse's best action?

Provide factual, understandable information that meets the client's learning needs.

A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?

Question the prescriber concerning the ordered drug

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.

Mental dysfunction in an older adult may seem like a normal part of aging, but it can result from disease or another cause. What should the ER staff do first for a presenting older adult with a mental dysfunction such as extreme confusion?

Review the drugs being taken.

Since 1962, newly developed medications have been extensively tested before being marketed for general use. Which step must the pharmaceutical companies prioritize when beginning the testing?

Test the drugs with animals

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion

The client's blood urea nitrogen level and creatinine clearance rate

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 larger-than-normal dose of the general anesthetic

The nurse administers a medication to the client that induces the secondary action of hypoglycemia. What organ will be most acutely affected by inadequate circulating glucose?

brain

A client reports that taking St. John's wort. When reviewing the client's medication history, what would be a cause of concern?

digoxin

A 38-year-old client is obese and has abscesses around the inner thigh muscles. The client is receiving IV antibiotics, but no improvement has been seen. The client questions the nurse about the most likely cause for the drug therapy failure. The nurse explains that the

distribution of the drug to the area of the abscesses is impaired.

A new drug has been created by altering DNA. What process has been utilized to create this drug?

genetic engineering

When administering a drug, the nurse understands that a drug administered by which route would be absorbed most rapidly?

intravenous

Which phase of drug development is associated with continual evaluation of the drug?

phase IV study

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 might occur

How is pharmacodynamics best defined?

the action that the drug has on body cells

A nurse is assessing a pregnant client who admits to having a cocaine addiction. Which condition of the baby after birth should the nurse explain and prepare the client for?

Addiction to drugs

Which is an example of a black box warning by the Food and Drug Administration (FDA)?

Difficulty breathing and maintaining an airway

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys

Excretion is likely to take place slowly.

A 70-year-old with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse's admission assessment, the nurse realizes that the client has been taking ginkgo biloba supplements in addition to prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this client's care?

Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy

A client, admitted for the treatment of a fracture, has a history of heavy alcohol use. What event should suggest the implementation of pharmacologic treatment for alcohol withdrawal?

Signs/symptoms of withdrawal are noted.

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?

Stay knowledgeable about drug therapy.

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

Preoperative atropine belongs to what classification of drugs?

anticholinergic

What unique characteristic is present in lipid soluble drugs?

can cross the blood-brain barrier

A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?

chlordiazepoxide

A nurse administers a prescribed loading dose of digoxin based on the understanding that doing so will result in:

critical concentration being reached more quickly.

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

decreased glomerular filtration rate

What is included in FDA approval of a drug for OTC availability?

evaluation of evidence that the consumer can use the drug safely, using information on the product label

The mentoring nurse is orienting a new graduate RN to the geriatric floor. What assessment technique will the new graduate nurse perform to identify an age-related physiological change associated with medication metabolism?

external palpation of the liver

An older adult client has been prescribed meperidine hydrochloride for pain management. According to Beers criteria, what assessment should the nurse conduct regularly to best assure the safety of this client?

orientation to person, place, and time

What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?

pharmacotherapeutics

A client has been diagnosed with cardiovascular disorder. The client is age 68; suffers from intermittent joint pain and is under drug therapy; eats meat, salads, and fruits; prefers alternative herb medications along with drug therapy; sometimes smokes; he lives alone and is looked after by a caregiver. Which item of information has the greatest implication for planning his drug therapy?

prefers alternative herb medications

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

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:

secondary actions.

When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?

sedation

A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that the client has been prescribed. What topic should the nurse address?

the effect of the drug on the client's body

A nurse is caring for a 92-year-old who is taking multiple drugs and displaying increased cognitive impairment and memory loss. The initial action of the nurse would be to:

try to distinguish between normal signs of aging and the adverse drug effects.

A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. The client has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the client's drug therapy?

vascular impairment

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"Do you remember what happened the last time you received penicillin?"

A gerontological nurse is conducting a medication assessment of a new client on a subacute medicine unit. Which of the client's statements should signal to the nurse a need for education?

"I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

A client diagnosed with diabetes mellitus has been started on insulin therapy to control glucose levels. The client does not want to take any medications that come from an animal source. What is the best response by the nurse?

"Many forms of insulin, such as genetically engineered, do not use animal products."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

A client is receiving 250 mg of a drug that has a half-life of 8 hours. How much drug would remain after 24 hours?

31.25 mg

A client asks a nurse about using the Internet to obtain drugs at a cheaper price. The nurse should recommend the client access what site for additional information regarding this practice?

Food and Drug Administration

A nurse is reading a journal article about seasonal allergies and comes across the name of the drug loratadine. The nurse determines this drug name as which type?

Generic

A client is admitted to the emergency department after having taken several barbiturates and drinking a pint of vodka. What is important for the nurse to continuously monitor for this client?

Monitor for respiratory depression.

The nurse is assessing a client's response to sleeping pills and notes continued restlessness and inability to sleep. After an increased dose leads to sleep, which factor should the nurse investigate first?

Is the client now tolerant to the drug?

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin

A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics?

absorption

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

What drug category indicates fetal risk where the risk outweighs any potential benefit?

category X

A client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of

first-pass effect.

A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for

hypertension.

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug can cause:

hypoglycemia.

A nurse is preparing to administer a prescribed drug to a client who has liver disease. The nurse expects a reduction in dosage based on the understanding that what might be altered?

metabolism

In the past 20 years, the marketing power for prescription drugs has grown. Because of this, the health care provider must be aware of:

what clients are seeing about these drugs.