Exam 1- Chapters 1,2,3,4,5, & 7

The nurse is reviewing the four clinical phases of investigational drug studies. Place the four phases in the correct order of occurrence. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range.

C- Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. B- Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. D A-Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range. A- Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug

During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III? a. No prescription refills are permitted. b. Refills are allowed only by written prescription. c. The patient may have no more than five refills in a 6-month period. d. Written prescriptions expire in 12 months.

C. The patient may have no more than five refills in a 6-month period.

Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last. a. Enzymes in the liver transform the drug into an inactive metabolite. b. Drug metabolites are secreted through passive glomerular filtration into the renal tubules. c. A drug binds to the plasma protein albumin and circulates through the body. d. A drug moves from the intestinal lumen into the mesenteric blood system.

D. A drug moves from the intestinal lumen into the mesenteric blood system. C. A drug binds to the plasma protein albumin and circulates through the body. A. Enzymes in the liver transform the drug into an inactive metabolite. B. Drug metabolites are secreted through passive glomerular filtration into the renal tubules.

The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse wasr busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? a. "Right time" b. "Right dose" c. "Right route" d. "Right medication"

a. "Right time"

During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug's usefulness? a. A placebo b. FDA approval c. Informed consent d. Safety information

a. A placebo

A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody else making decisions for me. And I don't want to prolong my life." The patient is demonstrating which ethical term? a. Autonomy b. Beneficence c. Justice d. Veracity

a. Autonomy

The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Which term is used to identify this principle? a. Bioequivalent b. Synergistic c. Prodrugs d. Steady state

a. Bioequivalent

The nurse is administering medications. Examples of high-alert medications include: (Select all that apply.) a. Chemotherapeutic agents b. Antibiotics c. Opiates d. Antithrombotics e. potassium chloride for injection

a. Chemotherapeutic agents c. Opiates d. Antithrombotics e. potassium chloride for injection

When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs? a. Drugs with high potential for abuse that have accepted medical use b. Drugs with high potential for abuse that do not have accepted medical use c. Medically accepted drugs that may cause moderate physical or psychologic dependence d. Medically accepted drugs with limited potential for causing physical or psychologic dependence

a. Drugs with high potential for abuse that have accepted medical use

The nurse is trying to give a liquid medication to a 2.5 -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child? a. Give the medication with a spoonful of ice cream. b. Add the medication to the child's bottle. c. Tell the child you have candy for him. d. Add the medication to a cup of milk.

a. Give the medication with a spoonful of ice cream.

The patient is asking the nurse about current U.S. laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act of 1994, which statement is true? a. Medicinal herbs are viewed as dietary supplements. b. Herbal remedies are held to the same standards as drugs. c. Producers of herbal products must prove therapeutic efficacy. d. Herbal remedies are protected by patent laws.

a. Medicinal herbs are viewed as dietary supplements.

When evaluating polymorphism and medication administration, the nurse considers which factors? (Select all that apply.) a. Nutritional status b. Drug route c. Genetic factors d. Cultural beliefs e. Patient's age

a. Nutritional status c. Genetic factors d. Cultural beliefs e. Patient's age

For accurate medication administration to pediatric patients, the nurse must take into account which criteria? a. Organ maturity b. Renal output c. Body temperature d. Height

a. Organ maturity

A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? a. Palliative therapy b. Maintenance therapy c. Empiric therapy d. Supplemental therapy

a. Palliative therapy

The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? a. Parenteral drugs bypass the first-pass effect. b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. c. Absorption of parenteral drugs is faster when the stomach is empty. d. Parenteral drugs exert their effects while circulating in the bloodstream.

a. Parenteral drugs bypass the first-pass effect.

A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study? a. Phase I b. Phase II c. Phase III d. Phase IV

a. Phase I

Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension? a. Providing education on keeping a journal of blood pressure readings b. Setting goals and outcome criteria with the patient's input c. Recording a drug history regarding over-the-counter medications used at home d. Formulating nursing diagnoses regarding deficient knowledge related to the new treatment regimen

a. Providing education on keeping a journal of blood pressure readings

The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications? (Select all that apply.) a. Rectal ointment for hemorrhoids b. Eye drops for inflammation c. Sublingual tablet for chest pain d. Inhaled medication for asthma e. Intradermal injection for tuberculosis testing

a. Rectal ointment for hemorrhoids b. Eye drops for inflammation d. Inhaled medication for asthma

A patient tells the nurse that he has been using an herbal supplement that contains kava for several years to help him to relax in the evening. However, the nurse notes that he has a yellow tinge to his skin and sclera, and is concerned about liver toxicity. The nurse advises the patient to stop taking the kava and to see his health care provider for an examination. What else, if anything, should the nurse do at this time? a. Report this incident to MedWatch. b. Notify the state's pharmaceutical board. c. Contact the supplement manufacturer. d. No other action is needed.

a. Report this incident to MedWatch.

When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient's right to refuse. Which of these are additional rights? (Select all that apply.) a. Right drug b. Right route c. Right dose d. Right diagnosis e. Right time f. Right patient

a. Right drug b. Right route c. Right dose e. Right time f. Right patient

A patient shows the nurse an article in the newspaper about a new black box warning and states, "I take this drug! Is it safe for me to take now?" Which of these statements about black box warnings is true? (Select all that apply.) a. Serious adverse effects from the drug have been reported. b. The FDA is asking for a mandatory recall of this drug. c. Serious adverse effects have been reported with this drug, and the patient will not be able to take it again because the risks outweigh the benefits. d. It can still be prescribed as long as the prescriber and patient are aware of the potential risks. e. Pharmacies will no longer be able to dispense this drug to patients.

a. Serious adverse effects from the drug have been reported. d. It can still be prescribed as long as the prescriber and patient are aware of the potential risks.

A patient of Japanese descent says that members of her family often have "strong reactions" after taking certain medications, but her white friends have no problems with the same dosages of the same drugs. The nurse recognizes that, because of this trait, which statement applies? a. She may need lower dosages of the medications prescribed. b. She may need higher dosages of the medications prescribed. c. She should not receive these medications because of potential problems with metabolism. d. These situations vary greatly, and her accounts may not indicate a valid cause for concern

a. She may need lower dosages of the medications prescribed.

The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the-counter status in the United States are accurate? (Select all that apply.) a. The drug must be easy to use. b. The drug must have a low therapeutic index. c. The consumer must be able to monitor the drug's effectiveness. d. The drug must have a low potential for abuse. e. The drug must not have any interactions with other drugs.

a. The drug must be easy to use. c. The consumer must be able to monitor the drug's effectiveness. d. The drug must have a low potential for abuse.

Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.) a. The levels of microsomal enzymes are decreased. b. Fat content is increased because of decreased lean body mass. c. Fat content is decreased because of increased lean body mass. d. The number of intact nephrons is increased. e. The number of intact nephrons is decreased. f. Gastric pH is less acidic. g. Gastric pH is more acidic.

a. The levels of microsomal enzymes are decreased. b. Fat content is increased because of decreased lean body mass. e. The number of intact nephrons is decreased. f. Gastric pH is less acidic.

Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.) a. The levels of microsomal enzymes are decreased. b. Perfusion to the kidneys may be decreased and may result in reduced renal function. c. First-pass elimination is increased because of higher portal circulation. d. First-pass elimination is reduced because of the immaturity of the liver. e. Total body water content is much less than in adults. f. Gastric emptying is slowed because of slow or irregular peristalsis. g. Gastric emptying is more rapid because of increased peristaltic activity.

a. The levels of microsomal enzymes are decreased. b. Perfusion to the kidneys may be decreased and may result in reduced renal function. d. First-pass elimination is reduced because of the immaturity of the liver. f. Gastric emptying is slowed because of slow or irregular peristalsis.

An 86-year-old patient is being discharged to home on drug therapy for hyperthyroidism and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities? a. The patient and patient's daughter will state the proper way to take the drug. b. The nurse will provide teaching about the drug's adverse effects. c. The patient will state all the symptoms of toxicity of the drug. d. The patient will call the prescriber if adverse effects occur.

a. The patient and patient's daughter will state the proper way to take the drug.

The nurse is performing an admission assessment. Which findings reflect components of a cultural assessment? (Select all that apply.) a. The patient uses aspirin as needed for pain. b. The patient has a history of hypertension. c. The patient uses herbal tea to relax in the evenings. d. The patient does not speak English. e. The patient is allergic to shellfish. f. The patient does not eat pork products for religious reasons.

a. The patient uses aspirin as needed for pain. c. The patient uses herbal tea to relax in the evenings. d. The patient does not speak English. f. The patient does not eat pork products for religious reasons.

The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? a. Under the tongue b. On top of the tongue c. At the back of the throat d. In the space between the cheek and the gum

a. Under the tongue

The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.) a. Use of OTC drugs may delay treatment of serious ailments. b. Drug interactions with OTC medications are rare. c. OTC drugs may relieve symptoms without addressing the cause of the problem. d. OTC drugs are indicated for long-term treatment of conditions. e. Patients may misunderstand product labels and use the drugs improperly.

a. Use of OTC drugs may delay treatment of serious ailments. c. OTC drugs may relieve symptoms without addressing the cause of the problem. e. Patients may misunderstand product labels and use the drugs improperly.

The nurse is reviewing data collected from a medication history. Which of these data are considered objective data? (Select all that apply.) a. White blood cell count 22,000 mm3 b. Blood pressure 150/94 mm Hg c. Patient rates pain as an "8" on a 10-point scale d. Patient's wife reports that the patient has been very sleepy during the day e. Patient's weight is 68 kg

a. White blood cell count 22,000 mm3 b. Blood pressure 150/94 mm Hg e. Patient's weight is 68 kg

The nurse is reviewing interactions between drugs and herbal products. Which of these herbal products may interact with anticoagulants, resulting in altered bleeding? (Select all that apply.) a. chamomile b. ginkgo c. echinacea d. kava e. garlic

a. chamomile b. ginkgo e. garlic

A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statements? (Select all that apply.) a. "Take the tablet with 2 to 3 ounces of orange juice." b. "Be sure to drink 6 to 8 ounces of water with this tablet." c. "Avoid taking all other medications with any enteric-coated tablet." d. "Crush the tablet before swallowing if you have problems with swallowing." e. "Be sure to swallow the tablet whole without chewing it."

b. "Be sure to drink 6 to 8 ounces of water with this tablet." e. "Be sure to swallow the tablet whole without chewing it."

The nurse is performing medication reconciliation during a patient's admission assessment. Which question by the nurse reflects medication reconciliation? a. "Do you have any medication allergies?" b. "Do you have a list of all the medications, including over-the-counter, you are currently taking?" c. "Do you need to take anything to help you to sleep at night?" d. "What pharmacies do you use when you fill your prescriptions?"

b. "Do you have a list of all the medications, including over-the-counter, you are currently taking?"

Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.) a. Planning b. Evaluation c. Assessment d. Implementation e. Nursing Diagnoses

c. Assessment e. Nursing Diagnoses a. Planning d. Implementation b. Evaluation

The nurse is reviewing medication errors. Which situation is an example of a medication error? a. A patient refuses her morning medications. b. A patient receives a double dose of a medication because the nurse did not cut the pill in half. c. A patient develops hives after having started an IV antibiotic 24 hours earlier. d. A patient complains of severe pain still present 60 minutes after a pain medication was given.

b. A patient receives a double dose of a medication because the nurse did not cut the pill in half.

A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs? a. Digitalis b. Anticoagulants c. Sedatives d. Immunosuppressants

b. Anticoagulants

The nurse keeps in mind that which measures are used to reduce the risk of medication errors? (Select all that apply.) a. When questioning a drug order, keep in mind that the prescriber is correct. b. Avoid abbreviations and acronyms. c. Use two patient identifiers before giving medications. d. Always double-check the many drugs with sound-alike and look-alike names because of the high risk of error. e. If the drug route has not been specified, use the oral route.

b. Avoid abbreviations and acronyms. c. Use two patient identifiers before giving medications. d. Always double-check the many drugs with sound-alike and look-alike names because of the high risk of error.

The nurse is giving medications to a newly admitted patient who is to receive nothing by mouth (NPO status) and finds an order written as follows: "Digoxin, 250 mcg stat." Which action is appropriate? a. Give the medication immediately (stat) by mouth because the patient has no intravenous (IV) access at this time. b. Clarify the order with the prescriber before giving the drug. c. Ask the charge nurse what route the prescriber meant to use. d. Start an IV line, then give the medication IV so that it will work faster, because the patient's status is NPO at this time

b. Clarify the order with the prescriber before giving the drug.

During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time? a. Ask a colleague what the order says. b. Contact the prescriber to clarify the order. c. Wait until the prescriber makes rounds again to clarify the order. d. Ask the patient what medications he takes at home.

b. Contact the prescriber to clarify the order.

An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems? a. Constipation and anorexia b. Fatigue, leg cramps, and dehydration c. Daytime sedation and lethargy d. Edema, nausea, and blurred vision

b. Fatigue, leg cramps, and dehydration

An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction or effect? a. Allergic reaction b. Idiosyncratic reaction c. Mutagenic effect d. Synergistic effect

b. Idiosyncratic reaction

The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drug polymorphism? (Select all that apply.) a. The number of drugs ordered by the physician b. Inherited factors c. The patient's diet and nutritional status d. Different dosage forms of the same drug e. The patient's health beliefs and practices f. The patient's drug history g. The various available forms of a drug

b. Inherited factors c. The patient's diet and nutritional status e. The patient's health beliefs and practices

During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic? a. Acetaminophen (Tylenol) b. Insulin c. Antilipemic drugs d. Sedatives

b. Insulin

A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type of therapy? a. Palliative therapy b. Maintenance therapy c. Supportive therapy d. Supplemental therapy

b. Maintenance therapy

During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these? a. Medical negligence b. Nursing negligence c. Nonmaleficence d. Autonomy

b. Nursing negligence

A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best human needs statement for this situation? a. Physical activity b. Physical safety c. Freedom pain d. Interchange of gases

b. Physical safety

The nurse is reviewing facts about pharmacology for a review course. The term legend drug refers to which item? a. Over-the-counter drugs b. Prescription drugs c. Orphan drugs d. Older drugs

b. Prescription drugs

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.

The nurse will be injecting a drug into the fatty tissue of the patient's abdomen. Which route does this describe? a. Intradermal b. Subcutaneous c. Intramuscular d. Transdermal

b. Subcutaneous

The nurse is reviewing the drug history of a patient, and during the interview the patient asks, "Why are some drugs OTC and others are not?" The nurse keeps in mind that criteria for OTC status include: (Select all that apply.) a. The condition must be diagnosed by a health care provider. b. The benefits of correct usage of the drug outweigh the risks. c. The drug has limited interaction with other drugs. d. The drug is easy to use. e. The drug company sells OTC drugs at lower prices.

b. The benefits of correct usage of the drug outweigh the risks. c. The drug has limited interaction with other drugs. d. The drug is easy to use.

A patient is being counseled for possible participation in a clinical trial for a new medication. After the patient meets with the physician, the nurse is asked to obtain the patient's signature on the consent forms. The nurse knows that this "informed consent" indicates which of these? a. Once therapy has begun, the patient cannot withdraw from the clinical trial. b. The patient has been informed of all potential hazards and benefits of the therapy. c. The patient has received only the information that will help to make the clinical trial a success. d. No matter what happens, the patient will not be able to sue the researchers for damages.

b. The patient has been informed of all potential hazards and benefits of the therapy.

The nurse can prevent medication errors by following which principles? (Select all that apply.) a. Assess for allergies after giving medications. b. Use two patient identifiers before giving medications. c. Do not give a medication that another nurse has drawn up in a syringe. d. Minimize the use of verbal and telephone orders. e. Use trade names instead of generic names to avoid confusion.

b. Use two patient identifiers before giving medications. c. Do not give a medication that another nurse has drawn up in a syringe. d. Minimize the use of verbal and telephone orders.

Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as? a. Justice b. Veracity c. Beneficence d. Autonomy

b. Veracity

The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? (Select all that apply.) a. metformin (Glucophage) 1000 mg PO twice a day b. sitagliptin (Januvia) 50 mg daily c. simvastatin (Zocor) 20 mg PO every evening d. irbesartan (Avapro) 300 mg PO once a day e. docusate (Colace) as needed for constipation

b. sitagliptin (Januvia) 50 mg daily e. docusate (Colace) as needed for constipation

The nurse is reviewing definitions for a pharmacology review class. Which of these products would be categorized as "legend drugs?" (Select all that apply.) a. acetaminophen (Tylenol) b. warfarin (Coumadin) c. gingko biloba d. morphine sulfate e. diphenhydramine (Benadryl)

b. warfarin (Coumadin) d. morphine sulfate

When taking a patient's drug history, the nurse asks about use of OTC drugs. The patient responds by saying, "Oh, I frequently take aspirin for my headaches, but I didn't mention it because aspirin is nonprescription." What is the nurse's best response? a. "That's true; over-the-counter drugs are generally not harmful." b. "Aspirin is one of the safest drugs out there." c. "Although aspirin is over the counter, it's still important to know why you take it, how much you take, and how often." d. "We need you to be honest about the drugs you are taking. Are there any others that you haven't told us about?"

c. "Although aspirin is over the counter, it's still important to know why you take it, how much you take, and how often."

When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer? a. "The medication will cause fewer adverse effects when given intravenously." b. "The intravenous medication will have delayed absorption into the body's tissues." c. "The action of the medication will begin sooner when given intravenously." d. "There is a lower chance of allergic reactions when drugs are given intravenously."

c. "The action of the medication will begin sooner when given intravenously."

A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse? a. "Many people are allergic to penicillin." b. "This allergy is not of major concern because the drug is given so often." c. "What type of reaction did you have when you took penicillin?" d. "Drug allergies don't usually occur in older individuals due to built-up resistance to allergic reactions."

c. "What type of reaction did you have when you took penicillin?"

The nurse is compiling a drug history for a patient. Which questions from the nurse will obtain the most information from the patient? (Select all that apply.) a. "Do you use sleeping pills to get to sleep?" b. "Do you have a family history of heart disease?" c. "When you have pain, what do you do to relieve it?" d. "Did you have the mumps as a child?" e. "Tell me about what happened when you had the allergic reaction to penicillin." f. "What herbal products or over-the-counter medications do you use?"

c. "When you have pain, what do you do to relieve it?" e. "Tell me about what happened when you had the allergic reaction to penicillin." f. "What herbal products or over-the-counter medications do you use?"

An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medications he is taking at home. Which method is the best way to assess his home medications? a. Ask the patient what medications he takes at home. b. Ask the patient's wife what medications he takes at home. c. Ask the patient's wife to bring his medications to the hospital in their original containers. d. Contact the patient's pharmacy for a list of the patient's current medications.

c. Ask the patient's wife to bring his medications to the hospital in their original containers.

The medication order reads, "Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. What is the nurse's best action? a. Give the medication intravenously because the patient might vomit. b. Give the medication orally because the tablets are available in 4-mg doses. c. Contact the prescriber to clarify the route of the medication ordered. d. Hold the medication until the prescriber returns to make rounds.

c. Contact the prescriber to clarify the route of the medication ordered.

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 older adult 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

The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered? a. Digoxin .125 mg b. Digoxin .1250 mg c. Digoxin 0.125 mg d. Digoxin 0.1250 mg

c. Digoxin 0.125 mg

Which drugs would be affected by the first-pass effect? (Select all that apply.) a. Morphine given by IV push injection b. Sublingual nitroglycerin tablets c. Diphenhydramine (Benadryl) elixir d. Levothyroxine (Synthroid) tablets e. Transdermal nicotine patches f. Esomeprazole (Nexium) capsules g. Penicillin given by IV piggyback infusion

c. Diphenhydramine (Benadryl) elixir d. Levothyroxine (Synthroid) tablets f. Esomeprazole (Nexium) capsules

Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason? a. Decreased fetal surface area b. Increased placental surface area c. Enhanced blood flow to the fetus d. Increased amount of protein-bound drug in maternal circulation

c. Enhanced blood flow to the fetus

The nurse is reviewing dietary supplements and US Food and Drug Administration (FDA) requirements. Which of these actions are required by the FDA for manufacturers of dietary supplements? a. Follow FDA standards for quality control. b. Prove efficacy and safety of dietary supplements. c. Identify the active ingredients on the label. d. Obtain FDA approval before the products are marketed.

c. Identify the active ingredients on the label.

The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factors puts the neonatal patient at risk with regard to drug therapy? (Select all that apply.) a. Higher gastric pH b. Increased peristalsis in the GI tract c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding of medications

c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding of medications

A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements? a. It may increase the risk for bleeding if the patient is taking anticoagulants. b. It may increase the risk of toxicity of some psychotherapeutic drugs. c. It may reduce elimination of drugs that are excreted by the kidneys. d. Cranberry may increase the intensity and duration of effects of caffeine.

c. It may reduce elimination of drugs that are excreted by the kidneys.

The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in which phase of pharmacokinetics may occur in this patient? a. Absorption b. Distribution c. Metabolism d. Excretion

c. Metabolism

For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits? a. Hispanics b. Asian Americans c. Native Americans d. African Americans

c. Native Americans

The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child? a. Give the injection without any advanced preparation. b. Give the injection, and then explain the reason for the procedure afterward. c. Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present. d. Prepare the child in advance with details about the procedure without the parent or caregiver present.

c. Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.

When taking a telephone order for a medication, which action by the nurse is most appropriate? a. Verify the order with the charge nurse. b. Call back the prescriber to review the order. c. Repeat the order to the prescriber before hanging up the telephone. d. Ask the pharmacist to double-check the order.

c. Repeat the order to the prescriber before hanging up the telephone.

The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug? a. Laxatives b. Anticoagulants c. Sedatives d. Antidepressants

c. Sedatives

The patient wants to take the herb valerian to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs? a. Digitalis b. Anticoagulants c. Sedatives d. Immunosuppressants

c. Sedatives

The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity? a. The lungs are immature. b. The kidneys are small. c. The liver is not fully developed. d. Excretion of the drug occurs quickly.

c. The liver is not fully developed.

The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data? a. Blood pressure 158/96 mm Hg b. Weight 255 pounds c. The patient reports that he uses the herbal product ginkgo. d. The patient's laboratory work includes a complete blood count and urinalysis.

c. The patient reports that he uses the herbal product ginkgo.

When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? a. The patient's ability to swallow b. The patient's height c. The patient's last meal d. The patient's allergies

c. The patient's last meal

The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life? a. The time it takes for the drug to cause half of its therapeutic response b. The time it takes for one half of the original amount of a drug to reach the target cells c. The time it takes for one half of the original amount of a drug to be removed from the body d. The time it takes for one half of the original amount of a drug to be absorbed into the circulation

c. The time it takes for one half of the original amount of a drug to be removed from the body

When caring for an older adult Chinese patient, the nurse recognizes which of these cultural issues that may influence the care of this patient? a. Chest x-rays are seen as a break in the soul's integrity. b. Hospital diets are interpreted as being healing and healthful. c. The use of herbal products may be an important practice for this patient. d. Being hospitalized is a source of peace and socialization for this culture.

c. The use of herbal products may be an important practice for this patient.

A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can "avoid taking any drugs." Which statement by the nurse is correct? a. "Most herbal remedies are not harmful and are safe for use during pregnancy." b. "Please read each label carefully before use to check for cautionary warnings." c. "Keep in mind that products from different manufacturers are required to contain consistent amounts of the herbal products." d. "It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."

d. "It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."

When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response? a. "It's listed here on the medication sheet, so you should take it." b. "Go ahead and take it, and then I'll check with your doctor about it." c. "It wouldn't be listed here if it were not ordered for you!" d. "Let me check on the order first before you take it."

d. "Let me check on the order first before you take it."

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."

During the medication administration process, it is important that the nurse remembers which guideline? a. When in doubt about a drug, ask a colleague about it before giving the drug. b. Ask what the patient knows about the drug before giving it. c. When giving a new drug, be sure to read about it after giving it. d. If a patient expresses a concern about a drug, stop, listen, and investigate the concerns

d. If a patient expresses a concern about a drug, stop, listen, and investigate the concerns

The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient? a. "The over-the-counter drug has helped you, so you should continue to take it." b. "The over-the-counter dosage may not be strong enough. You should be taking prescription-strength for best effects." c. "For best results, you need to watch what you eat in addition to taking this drug." d. "Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider."

d. "Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider."

The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest? a. A capsule b. A tablet c. An enteric-coated tablet d. A powder

d. A powder

The nurse recognizes that it is not uncommon for an elderly patient to experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect? a. Delayed gastric emptying b. Increased gastric acidity c. Decreased intestinal absorption of medications d. Altered absorption of weakly acidic drugs

d. Altered absorption of weakly acidic drugs

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. Nonsteroidal antiinflammatory drugs (NSAIDs) b. Cardiac glycosides c. Anticoagulants d. Antihypertensives

d. Antihypertensives

The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis? a. Anxiety b. Anxiety related to new drug therapy c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars." d. Anxiety related to new drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars."

d. Anxiety related to new drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars."

The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. Which of these reflect the correct order of the steps of the nursing process? a. Assessment, planning, human needs statement, implementa-tion, evaluation b. Evaluation, assessment, human needs statement, planning, implementation c. Human needs statement, assessment, planning, implementa-tion, evaluation d. Assessment, human needs statement, planning, implementa-tion, evaluation

d. Assessment, human needs statement, planning, implementa-tion, evaluation

A patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the nurse, "I would like to try to live long enough to see my granddaughter graduate in 3 months, but after that I don't want any extra treatments." This patient is demonstrating which of these? a. Veracity b. Beneficence c. Maleficence d. Autonomy

d. Autonomy

The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category? a. Category X b. Category B c. Category C d. Category D

d. Category D

The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. What physical function does the nurse recognize as the most influential when deciding to use the intravenous route of drug administration? a. Altered biliary function b. Increased glomerular filtration c. Reduced liver metabolism d. Diminished circulation

d. Diminished circulation

The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate? a. Nursing diagnosis b. Planning c. Implementation d. Evaluation

d. Evaluation

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase? a. Absorption b. Distribution c. Metabolism d. Excretion

d. Excretion

When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations? a. West nomogram b. Clark rule c. Height-to-weight ratio d. Milligram per kilogram of body weight formula

d. Milligram per kilogram of body weight formula

If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? a. The student bears no legal responsibility when giving medications. b. The major legal responsibility lies with the health care institution at which the student is placed for clinical experience. c. The major legal responsibility for drug errors lies with the faculty members. d. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable.

d. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable.

When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction? a. Adverse effect b. Allergic reaction c. Idiosyncratic reaction d. Pharmacologic reaction

d. Pharmacologic reaction

A new drug has been approved for use, and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational drug studies? a. Phase I b. Phase II c. Phase III d. Phase IV

d. Phase IV

When educating patients about the safe use of herbal products, the nurse remembers to include which concept? a. Herbal and over-the-counter (OTC) products are approved by the FDA and under strict regulation. b. Herbal products are tested for safety by the FDA and the US Pharmacopeia. c. No adverse effects are associated with these products because they are natural and may be purchased without a prescription. d. Take the products with caution because labels may not contain reliable information

d. Take the products with caution because labels may not contain reliable information

When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction? a. The drug alters cell membrane permeability. b. The drug's effectiveness within the cell walls of the target tissue is enhanced. c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell.

d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell.

When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound? a. Renal excretion will be faster. b. The drug will be metabolized quickly. c. The duration of action of the medication will be shorter. d. The duration of action of the medication will be longer.

d. The duration of action of the medication will be longer.

A patient's medical record includes an order that reads as follows: "Atenolol 25 mg once daily at 0900." Which action by the nurse is correct? a. The nurse does not give the drug. b. The nurse gives the drug orally. c. The nurse gives the drug intravenously. d. The nurse contacts the prescriber to clarify the dosage route.

d. The nurse contacts the prescriber to clarify the dosage route.

The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects? a. The patient should be discouraged from using folk remedies and rituals. b. The nurse will expect the patient to value protective bracelets and "root workers" as healers. c. The nurse will remember that the balance among body, mind, and environment is important for this patient's health beliefs. d. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.

d. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.

A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these? a. The patient has been informed of the possible benefits of the new therapy. b. The patient will be informed of the details of the study as the research continues. c. The patient will receive the actual drug during the experiment. d. The patient has had the study's purpose, procedures, and the risks involved explained to him.

d. The patient has had the study's purpose, procedures, and the risks involved explained to him.

The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? a. The patient is experiencing multiple illnesses. b. The patient uses one medication for an illness several times per day. c. The patient uses over-the-counter drugs for an illness. d. The patient uses multiple medications simultaneously.

d. The patient uses multiple medications simultaneously.

The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? a. The patient will follow instructions. b. The patient will not experience complications. c. The patient will adhere to the new insulin treatment regimen. d. The patient will demonstrate correct blood glucose testing technique.

d. The patient will demonstrate correct blood glucose testing technique.

An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy? a. Drug therapy will be based on the patient's weight. b. Drug therapy will be based on the patient's age. c. The patient will receive the maximum dose that is expected to reduce the blood pressure. d. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.

d. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.

When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these? a. The time it takes for a drug to elicit a therapeutic response b. The amount of time needed to remove a drug from circulation c. The time it takes for a drug to achieve its maximum therapeutic response d. The time period at which a drug's concentration is sufficient to cause a therapeutic response

d. The time period at which a drug's concentration is sufficient to cause a therapeutic response

The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on the list. Which is a characteristic of Schedule C-I drugs? a. No refills are permitted. b. They may be obtained over-the-counter with a signature. c. They are available only by written prescription. d. They are used only with approved protocols.

d. They are used only with approved protocols.

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 which of these factors? 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%

The nurse is reviewing medication orders. Which digoxin dose is written correctly? a. digoxin .25 mg b. digoxin .250 mg c. digoxin 0.250 mg d. digoxin 0.25 mg

d. digoxin 0.25 mg