final pharm
A nurse is preparing to administer a topical medication. What is the priority nursing intervention?
Assess the patient's skin where the medication will be applied.
The physician orders enteric-coated aspirin, 300 mg every day, for the patient with a nasogastric tube. What is the priority action by the nurse?
Withhold the medication and contact the physician.
A nurse teaches a client that the newly prescribed medication has a very high risk of causing fetal abnormalities and that reliable measures to prevent pregnancy are essential while taking the medication. The nurse has described a medication that falls into which category?
X
At a dose of 10 mg, drug X lowers total cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 65 mg/dL is achieved at 40 mg. At a dose of 5 mg, drug Y lowers cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 55 mg/dL is achieved at 10 mg. What can be concluded about the efficacy and potency of these two drugs?
Y is more potent, and drug X has a higher efficacy.
A client returns to the clinic for follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which statement?
"I've been taking my medication on an empty stomach like the prescription label said to." "I take my medication first thing in the morning, just like you said." "I switched all my medications to one pharmacy like you suggested."
A client tells a nurse that he is on many medications and asks how they all get to the right places. What are the best responses by the nurse?
"It depends on how much protein you have in your body." "It depends on whether they are fat based or water based." "It depends on the amount of blood flow to your body tissues."
A nurse is preparing to administer medications to a client. The nurse understands that which substance has the lowest rate of crossing renal tubular membranes and would therefore be excreted in the urine?
Ionized drugs
5) The nurse administers narcotics to a surgical patient. Which statement represents the nurse's best understanding as it relates to the potency of different narcotics?
Morphine is more potent than codeine; a lesser dose will be required.
A nurse is teaching a group of nursing students about the preclinical research stage of drug development. The nurse understands that the students understand the teaching by which of the following student responses?
Most drugs do not proceed past the preclinical stage because they are found to be too toxic or just ineffective. The preclinical stage of research involves extensive testing on animals in the laboratory to determine if the drug will cause harm to humans. Preclinical research results are always inconclusive.
A client looks up the drug they are taking in a drug guide. The client asks a nurse why the healthcare provider prescribed a medication that has a lethal dose measure. What is the best response by the nurse?
"It is a value determined during research, which helps to determine the safe dose to give."
The student nurse has been reading about the Human Genome Project and asks the nursing instructor how this will impact future pharmacological therapies. What is the best response by the instructor?
"It will help to individualize drug therapy for people in a more effective way."
A patient is receiving a sustained-release capsule for his cardiac condition. The patient tells the nurse there is no way he can swallow such a large pill. What is the best response by the nurse?
"Let me contact your physician to see if a change can be made."
The order is for a pain medication to be given intravenous (IV) q 3-4 hours prn. Which statement, by the nurse, correctly teaches the client about this medication order?
"Let me know when you are having pain."
A client says, "This morning's nurse told me that my pain medication is a scheduled drug. Aren't all drugs given on a schedule?" How should the nurse respond?
""Scheduled medications have a significant potential for abuse
A nurse teaches a student nurse about the pharmacological classification of drugs. The nurse evaluates that learning has occurred when the student makes which response?
"A calcium channel blocker blocks heart calcium channels."
A nurse is teaching a class for clients about over-the-counter (OTC) medications. The nurse determines that education has been effective when the clients make which of the below statements?
"After reading all the directions on the label, I will call the healthcare provider's office if they are not clear."
A student nurse asks a nursing instructor why anatomy and physiology as well as microbiology are required courses when the student only wants to learn about pharmacology. What is the best response by the instructor?
"An understanding of those subjects is essential to understand pharmacology."
The nurse assesses the client with diabetes mellitus prior to administering medications. Which questions are important to ask the client?
"Are you allergic to any medications?" "Are you taking any herbal or over-the-counter (OTC) medications?" "Will you please tell me about the kind of diet you follow?" "What other medications are you currently taking?"
A client has been taking paroxetine (Paxil) for a year and tells a nurse it is no longer working. What is the best response by the nurse?
"Are you taking name brand Paxil or the generic version paroxetine?"
The nurse follows the nursing process when conducting medication education about insulin. What will the nurse ask the client to evaluate the client's knowledge of insulin? "Can you tell me four points you remember about how to take your insulin?" 3) The healthcare provider has prescribed a nitroglycerine (Nitrodur) patch for the client. The nurse understands that which of the following is the best outcome for this client as it relates to use of the medication? Client will demonstrate correct application of the patch prior to discharge. Answer: 4 4) The client is receiving albuterol (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this medication? Monitor the client for relief of bronchospasms. Answer: 1 5) The client is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The client's outcome is "Client will state a key point about antibiotic treatment for cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been met? "I need to take all the pills even if my leg looks better." Answer: 3 6) The healthcare provider has prescribed quetiapine (Seroquel) for the client with chronic auditory hallucinations. The client has stopped taking the medication. The nurse incorrectly uses the diagnosis of "noncompliance." In which situation would this diagnosis be appropriate? The client made an informed decision not to take the medication. Answer: 2 7) The nurse is preparing for medication administration to a group of clients. What is the best overall outcome for the clients? Clients will receive the best therapeutic outcome from the medications. Answer: 2 8) The nurse is managing care for several clients at a diabetic treatment center. The nurse understands that which of the following is the priority nursing intervention? To return the client to an optimum level of wellness while limiting adverse effects related to the client's medical diagnosis Answer: 2 9) What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission? Client teaching Answer: 2 10) The Joint Commission documented that client education was deficient on several medical- surgical units of a local hospital. A nursing committee was formed to address this problem. What is the best intervention to improve client education? Discussing medications each time they are administered to clients Answer: 3 11) The nurse has several educational pamphlets for the client about medications the client is receiving. Prior to giving the client these pamphlets, what is the most important assessment by the nurse? Assess the client's reading level. Answer: 3 Explanation: 12) The nurse is reviewing the steps of the nursing process with a student. The nurse is aware that it is most important to be accurate in which portion of the nursing process?Assessment 13) The nurse is assessing a newly admitted client's current medication. Which of the following is an example of objective data? The nurse checks the prescription bottles the client has brought to the hospital. Answer: 2 14) The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of medication? Kidney and liver function tests Answer: 2 15) The nurse is reviewing the steps of the nursing process with a student. The nurse knows that the student understands the teaching when the student correctly lists which of the following as the correct order of the nursing process? Assessment, establish nursing diagnosis, planning, interventions, evaluation Answer: 3 18) Which statement about the nursing process is accurate? Obtaining the outcomes is essential for goal attainment. Answer: 3 19) Which nursing intervention would take priority following administration of a new medication? Monitoring the client's respiratory status Answer: 2 20) A client with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication administration? Determining that goals were not met 3 days following medication administration Answer: 2 21) A nurse is assessing a client recently admitted to the unit. The nurse understands that which assessment identifies the collection of objective data? The client has a wound measured at 5 cm in length. Answer: 3 22) When teaching the client about a new medication, the nurse should include which information? Adverse effects that can be expected Which adverse effect to report to the healthcare provider The drug's therapeutic action Answer: 1, 2, 3 23) A nurse is preparing care for a newly admitted client with diabetes. Which information would be critical for the nurse to assess? Medical history Current lab results Medication allergies Use of dietary supplements Answer: 1, 2, 3, 4 24) A nurse has admitted a new client to the unit. Which concepts should the nurse use when developing a nursing diagnosis? Include the client in the identification of needs. Consider the client's response to the current health problem. Answer: 3, 4
"Can you tell me four points you remember about how to take your insulin?"
A client with advanced heart disease says, "I read about a new drug that was just released. Do you think my doctor could get it for me?" What should the nurse include in discussion with the client?
"Decisions on using drugs are based on many different variables." "We certainly can talk to your physician about the drug."
A client says to the nurse, "My wife and I take the same drug, but we have different side effects. Are we doing something wrong?" What is the best response by the nurse?
"Differences such as your sex can result in different side effects."
A client is receiving a very expensive medication. The client asks the nurse why the medicine is so expensive. What is the best response by the nurse?
"Drug companies must recoup the cost of developing and producing the drug."
A student nurse is taking a pharmacology course and studying about the Food and Drug Administration (FDA). Which statement indicates the student understands how the FDA has decreased the amount of time involved in bringing a new drug to the market?
"Drug manufacturers are required to pay yearly user fees, which allow the Food and Drug Administration (FDA) to hire more employees to increase its efficiency."
A nurse is reviewing key events in the history of pharmacology with a student nurse. Which student comment indicates an understanding?
"Early researchers used themselves as test subjects."
The client and his wife receive the same medication for hypertension. The client's wife asks the nurse why she is receiving a higher amount of the medication. What is the best response by the nurse?
"Everyone is unique and responds differently to medications."
A student nurse asks a nursing instructor how to remember all of the antibiotic drugs since there are so many. What is the best response by the nursing instructor?
"Focus on a representative drug from each class."
During assessment, the patient mentions that he recently "sent off to a company for pharmacogenomic testing." What nursing responses are indicated?
"Have you changed your medications any?" "Have you talked with your physician about the results?"
During the admission assessment, a client tells a nurse, - - "Sure I smoke a little weed (marijuana) to manage my stress. Doesn't everyone?" What is the nurse's best response?
"How often do you smoke marijuana, and how much each time?"
A client has skin lesions that have not responded to prescription drugs. He tells the nurse he has heard about some research going on with a new drug and asks why he can't take it. What is the best response by the nurse?
"I know it is frustrating, but the Food and Drug Administration (FDA) approval process is in place to ensure that drugs are safe."
A nurse provides medication education to a client with terminal cancer. The physician has ordered morphine, a Schedule II drug, for the client. The nurse determines that learning has occurred when the client makes which statement?
"I need to see my doctor before my prescription runs out so I can get a refill."
The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor?
"It could be that all of the receptors for the drug are occupied." "It may mean that the drug has brought 100% relief to the patient."
A client asks a nurse how medications are distributed within the body. What among the below would be the nurse's response?
"Medications that are lipid-soluble are more completely distributed."
A nurse is reviewing key events in the history of pharmacology with a student nurse. Which student comment from below indicates a need for further teaching?
"Modern pharmacology began in the early 1600s."
A nurse has finished teaching a client's husband how to administer drugs and enteral feeding through a gastrostomy tube. The nurse knows the husband understands the teaching when he makes which statements?
"My wife has a gastrostomy tube instead of a nasogastric tube because she will have the tube for a long time." "I will need to use liquid medications. If any of the medications are in pill form, I will use the pill crusher to crush them and mix them with water before putting them in the tube." "This medication says it is enteric coated. I'm not supposed to crush this kind of medication. I will need to ask the physician to substitute another medication that is liquid or can be crushed." "I have to be very careful to flush the tube after I put medication in it. If I don't, the tube could get clogged."
A client has a long history of hypertension. The healthcare provider orders an antihypertensive drug that has just come on the market. The nurse teaches the patient that this drug works more effectively than his prior drug and has fewer side effects. The patient asks how this can be. What is the best response by the nurse?
"Newer drugs are altered to affect your cells' receptors in a different way." "Research into receptors helps 'fine-tune' drugs to be more effective."
A nursing mother asks a nurse if it is all right to take St. John's wort for mild depression. What is the best response by the nurse?
"No, it could be excreted in your milk and affect the baby."
A client is receiving methadone (which is a Schedule II drug). The client says to the nurse,"A pharmacist told me the pharmacy must register with the Drug Enforcement Administration (DEA) to give me this drug; will DEA agents be snooping around my house?" What is the best response by the nurse?
"No, the Drug Enforcement Administration (DEA) restricts drugs that have a high potential for abuse."
A nurse is teaching a group of nurses about the differences between pharmacology and therapeutics. The nurse determines that learning has occurred when which statements are made?
"Pharmacology is the study of medicines." "Therapeutics relates to drug use to treat suffering." "Pharmacology is the study of drugs to prevent disease."
Prior to administering a newly prescribed antibiotic, a nurse asks a client if any other drugs have been taken today. The patient responds, "Why do you need to know?" Which of the below indicate nursing responses?
"Some drugs block the action of others." "Some drugs increase the activity of other drugs."
A nurse is concerned that a client has not been taking the prescribed antihypertensive medication because the patient's blood pressure remains elevated. What is the best therapeutic response by the nurse?
"Taking medication can be difficult for some people. What are some of your concerns about the medication?"
The educator has reviewed the phases of graded dose-response with the nursing staff. Which statement made by a nurse indicates an understanding of phase 2 of the response?
"The client's response is based on the amount of drug given."
A client says to a nurse, "Why do you need to know the names of all the over-the-counter supplements I take? They aren't drugs." Which of the nurse's responses are appropriate?
"The healthcare provider needs to know everything you are taking." "It is true that supplements are not considered drugs; however, some of these products can cause adverse effects with prescribed drugs."
A client at 14-weeks gestation is seen in the clinic with a sprained ankle. The healthcare provider prescribes a mild analgesic, rest, compression, and application of an ice bag. The client is very concerned about taking the prescribed medication, telling the nurse, "I don't want to hurt my baby." How should the nurse respond?
"The most dangerous time for birth defects is probably in the first semester and you are past that now." "This is a category A drug, so there is very little risk to your baby."
A client with hypertension is taking a potent antihypertensive without results. The client is concerned when the healthcare provider orders a new drug. What is the nurse's response?
"The new drug has greater efficacy, so it will help reduce your blood pressure." "Efficacy in treating your hypertension is more important than potency."
A nurse is teaching a medication class for parents of children with attention-deficit hyperactivity disorder (ADHD) who are receiving stimulant medications. The nurse has reviewed reasons why the medications are restricted. The nurse determines that learning has occurred when the parents make which responses?
"The use of these medications is restricted because they have the potential for abuse." "The use of these medications is restricted because this is the current law."
A client has a prescription for an intravenous medication for nausea. The client asks the nurse how it will help his nausea since it is given in his vein. What is the best therapeutic response by the nurse?
"This will work much faster for your nausea."
A client is receiving lithium (Eskalith) and asks the nurse why their blood has to be drawn so often. What is the best response by the nurse?
"To be sure you have the correct amount of medication in your system."
A nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement?
"We need to be careful about taking the medication with certain foods."
The patient receives antibiotics for a serious infection. The patient asks the nurse, "Why don't you just give me more of that drug to cure this infection faster?" What is the best response by the nurse?
"You are at a maximum dose; taking more will not help."
A client says to a nurse, "My healthcare provider said my drug is a controlled substance; am I considered an addict?" What is the best response by the nurse?
"You are not an addict; the Drug Enforcement Administration (DEA) restricts the use of drugs with a high potential for abuse."
A client prescribed a loading dose to be followed by a lower maintenance dose asks the nurse why the maintenance dose is lower. Which response should the nurse provide the client?
"You had a larger dose initially so that the medication would work more quickly."
A client comes to the emergency department with a myocardial infarction. The client's husband tells the nurse that his wife has been taking calcium carbonate (Tums) for years for what she thought was indigestion. What is the best response by the nurse?
"Your wife was self-diagnosing, which is generally not a good idea."
A client will receive a liter of fluid intravenously to treat dehydration. The client says, "I don't understand the metric system, how much is that?" What is the best response by the nurse?
1 quart
A pediatric client has been receiving 5 mL of liquid antibiotic three times each day. The nurse providing discharge instructions would teach the parents to administer which amount for each dose?
1 teaspoon
At the end of the shift, a client reports drinking 4 cups of water during the day. The client also has an IV running at 125 mL/hour for the 12 hours. How many mL's of total intake should the nurse document?
2460 mL
A nurse is providing preconception teaching to a group of women who wish to become pregnant. The nurse informs the group that which classifications of medications have shown no confirmed risk for fetal abnormalities if taken while pregnant?
A, B
A client asks a nurse how many Americans take at least one prescription drug per year. What is the nurse's best response?
50
A nurse is caring for the following clients. The nurse should assess for nonadherence with prescribed medications in which clients?
A 70-year-old male patient with hypertension who has a prescription for a diuretic and is complaining that his medication is keeping him up all night An 18-year-old male with a prescription for an acne medication that must be taken 4 times a day
A nurse is teaching a client the importance of taking the medication as prescribed. Client teaching is guided by the nurse's knowledge of which principles of pharmacokinetics?
A drug may be exposed to several physiological processes while en route to target cells. Liver enzymes may chemically change the drug. Excretion organs such as kidneys and intestines must be healthy enough to eliminate the drug. Many processes to which drugs are exposed are destructive, thereby helping facilitate the drug's movement throughout the body.
A nurse is preparing to administer oral medication to a client. What is the primary nursing assessment of the client prior to receiving this medication?
Ability to swallow
The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding by the student nurses?
About 50% of patients will not experience any effect from the drug.
A nursing student asks a nurse what the categories of pharmacokinetics are. What is the nurse's best response?
Absorption
A nurse is administering aspirin to a client. Aspirin is ionized as it enters the small intestine. The nurse understands which of the following is correct regarding absorption of aspirin in the small intestine.
Absorption is decreased.
A client asks a nurse why a large dose of a drug was administered first followed by a lower dose of the same drug later. What is the nurse's best response?
Achieve a therapeutic dose more quickly
A healthcare provider prescribes aspirin to a client complaining of a severe headache. Which action by the nurse will result in the fastest relief of the client's headache?
Administer the aspirin on an empty stomach.
The nurse is reviewing the role of diffusion in the distribution of medications with a nursing student. The nurse understands that drugs that can be distributed by simple diffusion include those with which of the below characteristics?
Alcohol Urea
The nurse is reviewing prescription refill request messages. The nurse understands that a prescription for which of the following drugs can be sent to the pharmacy by telephone?
An anabolic steroid
A student nurse asks a nurse about a drug that has been prescribed to decrease the effects of an endogenous chemical. The nurse understands this drug is placed in which category?
An antagonist
A pharmaceutical representative comes to the physician's office and says his company's pharmaceutical laboratory is marketing a drug that does not need approval by the Food and Drug Administration (FDA). What is the best response by the nurse?
Any pharmaceutical laboratory must obtain approval from the Food and Drug Administration (FDA) before marketing a drug.
The nurse plans to administer heparin by drawing the heparin up in an appropriate syringe, donning gloves, prepping the patient's abdominal area, inserting the needle, aspirating for blood, and injecting the medication. Which statement best describes the nurse's plan? A student nurse is administering heparin subcutaneously (SQ) to a client. The nurse should intervene if the student nurse does which of the following?
Aspirate for blood
A nurse is preparing to administer a client's medications. Which of the following is most important to assess first?
Assess the patient's medical history.
A drug is withdrawn from a client who has been taking it routinely for many years. The client has developed muscle tremors. How will the nurse document this event?
Assessment finding associated with physical dependence on a drug
A nurse is participating in the New Drug Review step for a new therapeutic agent. Which activities will the nurse most likely perform during this phase of the drug approval process?
Attend meetings to finalize the brand name for the drug. Check on the results of animal testing.
A nurse is observing a student nurse prepare to administer an intradermal medication. Which observation by the nurse indicates the student nurse understands the correct procedure to administer intradermal medications.
Avoid sites with excess body hair.
A nurse is preparing to teach pharmacology concepts to a group of students. The nurse should include which of the following?
Biosimilar drugs don't require the same clinical testing as the comparable biologic drug.
The nurse is participating in the clinical trial of a new medication for the treatment of hypertension. To assess the effectiveness of the medication, which assessments would the nurse perform to help determine whether the average dose is effective for the patient?
Blood pressure Heart rate Laboratory values
A nurse is caring for a client with meningitis who is receiving a water-soluble drug. The client asks the nurse why the healthcare provider changed the prescription to a lipid-soluble drug. What is the best response by the nurse?
Lipid-soluble drugs are more effective in treating the client's illness.
A nurse is administering a medication to a group of volunteers and is assessing for the development of adverse effects. The nurse is working in which phase of the development of this drug?
Clinical Phase I Trials
A client with chronic back pain informs the nurse he has been receiving therapeutic touch in addition to his medications. What is the nurse's best classification of this client's treatment?
Complementary therapy
A client asks a nurse why a prescribed medication is very expensive. What is the best response by the nurse?
Contact the healthcare provider to ask if a generic drug may be substituted.
Twenty minutes after receiving a dose of antibiotic, the client develops a red, itchy rash. What should the nurse do first?
Contact the prescriber and relay this assessment information.
A nurse is developing a time line of drug regulations and standards. The nurse should list which of the following events as the first drug regulation and/or standard?
Development of the U.S. Pharmacopoeia
A nurse administers a drug to a client. Following ingestion, the drug crosses a membrane from an area of higher concentration to an area of lower concentration. The nurse understands that this is an example of which of the following?
Diffusion
Drug X has a median lethal dose of 30 mg and a median effective dose of 10. Drug Y has a therapeutic index of 4, while drug Z has a therapeutic index of 3. Which statement is accurate based on this information?
Drug Y is the safest of the three.
Which information is essential for the nurse to collect when reviewing a client's medication list?
Drug names Dosage being taken Frequency of administration
A nurse is explaining the benefits of using a prototype approach to learn pharmacology to a nursing student. The nurse understands that studying the prototype drug makes it possible to predict certain characteristics of drugs in the same class. Which response by the nursing student below indicates the need for further teaching?
Duration of action
A client is 3 days postop, and the physician orders an oral pain medication. The client asks the nurse if it wouldn't be better to get the medication in the intravenous (IV) line. What is the best response by the nurse?
Pills are safer than intravenous (IV) medications."
The nurse reads that a newly discovered drug is a functional antagonist for some commonly administered medications. The nurse interprets this information as indicating the new drug could have which actions?
Enhances drug excretion Speeds drug metabolism
The nurse is reviewing the medication administration record for a group of clients and recognizes that which agents have nonspecific cellular responses?
Ethyl alcohol General anesthetics Osmotic diuretics
A nurse is reviewing excretion of medications with a student nurse. The nurse understands that the student nurse understands the teaching when the student nurse states that medications can be excreted by which route(s)?
Fecal Glandular Pulmonary Renal
Which factor is used to help predict the safety of the dose of drug for a client?
Frequency distribution curve
A nurse is documenting a client's list of current medications. Which substances would be categorized as complementary and alternative medicine?
Garlic Vitamin C Zinc
While in the hospital, a pediatric patient has been receiving amoxicillin 10 mL orally bid, pc. The client will be going home on this medication. What should the nurse include when teaching parents about this medication?
Give 2 teaspoons by mouth, twice a day, after meals.
A nurse suspects a client has had an allergic reaction to a recently prescribed antibiotic. The nurse is responsible for providing emergency treatment and for reporting this suspected reaction to which persons?
Healthcare provider Hospital pharmacist Hospital risk management
A nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics?
How drugs move from the site of administration to circulating fluids How drugs are converted to a form that is easily removed from the body How drugs are transported throughout the body How drugs are removed from the body
A nurse is employed by the Food and Drug Administration (FDA) and is involved in clinical investigation. The nurse's primary role in this phase of the FDA review and approval is to perform tests on which of the following?
Human clients
The patient is scheduled to receive a medication that is an enzyme inducer of the P450 system. What best describes the effect of this medication on the patient?
In time, the patient will experience a reduced effect from this medication.
A client has an adverse reaction to a drug following a change in dietary habits. The nurse understands that which change would most likely be the cause?
Increased intake of grapefruit juice
When administering a standard or median effective dose to a client, the nurse explains that this amount of drug will have which effect?
It will be effective in half of the population.
A nurse is reviewing drug safety with a student nurse. The nurse explains that the median lethal dose of drugs is often determined in laboratory preclinical trials because of which factors?
It would be unethical to determine these values in human subjects. The safety of the medication must be determined prior to clinical trials.
A student nurse has completed an initial pharmacology course and tells a nurse that it was difficult. What is the best response by the nurse?
Learning is gradual and continuous; we never completely master all areas of pharmacology."
A nurse understands that chemical names are assigned for each drug. What are the major reasons that nursing usually does not use the chemical name of the drugs?
They are usually not brief or easy to remember. They are often difficult to pronounce.
A nursing student asks a nurse which organ is the most responsible for the first-pass effect. What is the nurse's best response?
Liver
A nurse is observing a student nurse administer an intramuscular injection in the deltoid muscle. The nurse should intervene if the student nurse does which of the following?
Locates the site by putting the heal of the hand on the greater trochanter. Plans to administer 2 mL in a single injection. Inserts the needle at a 45-degree angle with the skin.
A nurse understands that a particular agent causes a reduction in blood pressure by blocking receptor sites. The nurse recognizes that this is an example of which drug information?
Mechanism of action
A client says, "I don't understand why so much money is spent on trying to find a cure for cancer. I have epilepsy and wish more money went into epilepsy drugs." What should the nurse consider prior to responding?
More people are affected by cancer than by epilepsy. Drugs that are effective in treating epilepsy exist.
A nurse explains to a student nurse that pharmacogenetics is a relatively new area within pharmacology. Which statement best describes the potential of this new area?
To customize drugs and prevent idiosyncratic responses
A student nurse asks an advanced practice nurse (APRN) about the role of APRNs in prescribing medications. Which of the following is the best response by the nurse?
Nurse practitioners are an example of an advanced practice nurse.
A nurse administers medications by various routes of delivery. The nurse recognizes which route of administration requires higher dosages of drugs to achieve a therapeutic effect?
Oral route
A nurse is reviewing enzymatic activity that changes a medication to a less active form with a nursing student. The nurse knows the teaching is effective if the nursing student responds that which of the following is an example of this concept?
Pharmacokinetics
A nurse is preparing to administer a buccal medication. The nurse should do which of the following?
Place the medication between the cheek and gum.
A nurse is teaching a student nurse about the stages of drug approval. A drug manufacturer that is studying the effects of a drug on laboratory animals would be in which phase of the new drug development timeline?
Preclinical Investigation
A nursing student asks a nursing instructor whether there are any tips that will make learning pharmacology easier. The instructor gives an example of the anticoagulant heparin. The instructor indicates that knowing heparin and comparing other drugs to it will facilitate learning the many anticoagulants. Which approach is the instructor using?
Prototype drug approach
A nurse administers an oral preparation of liquid acetaminophen 650 mg as ordered. Afterward, the client indicates they have been receiving acetaminophen 650 mg in pill form. Which statement is accurate in regards to the five rights?
The nurse did not violate the five rights.
A nurse is providing medication education to a client with hypertension. The nurse teaches the client that the healthcare provider ordered a diuretic to decrease the amount of fluid in the client's body. Which statement best describes the nurse's instruction?
The nurse explained the drug's mechanism of action.
A nurse is caring for a client who has been involved in a motor vehicle accident. The healthcare provider has written orders for a transdermal patch for pain. The nurse knows which of the following?
The transdermal patch should not be applied to areas of abrasion. Transdermal medications completely bypass digestive enzymes. The actual dose received by the patient from this pain patch may vary.
The patient is having chest pain. The physician orders sublingual nitroglycerine STAT. The nurse obtains the medication from the pharmacy and administers it to the patient 30 minutes later. Which statement best describes the nurse's action?
The medication should have been administered within a 5-minute time frame.
A nurse administers a vaccine to a client. What is the nurse's best understanding as it relates to the manufacture of a vaccine?
The vaccine is naturally produced in animal cells or microorganisms.
1) A nurse is preparing to administer several medications for a client. The nurse is responsible for understanding which of the following regarding medication administration?
Reason the medication was prescribed Route of administration How the medication is supplied by the pharmacy Name of the medication
A student nurse asks a nursing instructor about which type of classification system is being used when drugs are grouped together because they help treat a particular disease or condition? What is the nursing instructor's best response?
Therapeutic
A nursing instructor plans to teach a group of nursing students about graded-dose response curves. The instructor understands that they are most useful to determine what?
Response intensity within an individual
A nurse is teaching a group of nursing students about the role of the U.S. Food and Drug Administration (FDA). The nurse plans to include which of the following?
Responsible for improving the health of Americans. Ensures the availability of effective drugs. Takes action against any supplement that is deemed to be unsafe. Facilitates the availability of safe drugs.
During evaluation, the nurse, client, and healthcare provider determine that the goals of antibiotic therapy have not been met. What actions are indicated?
Review the dosage of the medication. Consider checking serum drug levels. Consider prolonging therapy. Consider using a different antibiotic.
A client asks a nurse why he experiences a metallic taste after taking certain medications. The nurse explains that some medications are secreted by glandular activity. The nurse would identify which substances as examples of this excretion?
Saliva Sweat Breast milk
A charge nurse is observing a nurse administer an intradermal injection. Which of the following demonstrates that the nurse is using the correct technique?
Slowly injects the medication to form a small wheal or bleb.
A client comes to the emergency department following an overdose of aspirin, which is an acidic drug. The nurse should anticipate administering which of the following?
Sodium bicarbonate to alter the client's serum pH
A nursing instructor is reviewing how medications are secreted with a nursing student. Which statement is accurate regarding medications that end up being secreted in bile?
Some medications are excreted in the feces while others can be recirculated to the liver many times.
A client is receiving a brand name drug and wants to change to the generic form because it is less expensive. What is the best outcome for this client?
State two ways a brand name drug differs from a generic name drug.
A patient at a community health center has been prescribed oral medications and tells the nurse that medications were administered intravenously when they were in the hospital. The nurse discusses the advantages and disadvantages of oral medications, based on which of the following?
Tablets that are scored may be crushed for easier swallowing. A major disadvantage of oral medications is that the patient must be conscious and able to swallow.
A student nurse asks a nurse what the generic name of a drug means. Which of the following is true regarding the generic name of a drug?
There is only one name for each medication.
An older client is admitted with gastrointestinal bleeding. The client says to the nurse, "I don't understand this. All I did was take ibuprofen (Advil) for my arthritis." What is the nurse's best response?
Teach the client about the side effects of ibuprofen (Advil).
A student nurse asks a nurse why some medications get approved by the Federal Drug Administration (FDA) faster. What is the nurse's best response?
The FDA collects a user fee from pharmaceutical companies and uses it to hire more employees to speed up the process.
A client who has received an oral medication for treatment of hives asks the nurse, "How long will it be before my skin clears and quits itching?" Which concepts should the nurse consider when formulating a response?
The amount of time between administration and the drug taking effect is known as onset of action. Duration of action is the amount of time a drug is effective.
A client who is terminally ill reports hearing about a drug that is in preclinical investigation. The client asks the nurse if the drug will be available to the public soon. What should the nurse consider when formulating an answer to this question?
The average length of preclinical investigation is 18 months.
he nurse is conducting medication education about the difference between potency and efficacy to a group of patients. The nurse correctly determines that learning has occurred when the patients make which response?
The best drug for us is the one with the greatest efficacy."
A client is admitted to the hospital in chronic renal failure and several drugs are prescribed. What best describes the nurse's assessment of this client?
The client may have drug toxicity from all the drugs.
When reading about a drug, the nurse learns it has a median toxic dose of 50 mg. The client has been receiving 60 mg of the drug. What analysis does the nurse make?
The client will be at greater risk of adverse effects.
The patient is malnourished and has a low serum albumin. A nurse is caring for a client with a low serum albumin level. The healthcare provider has ordered aspirin, which is a highly protein-bound drug. Which evaluation by the nurse best describes the effect this will have on the client?
The client will be at risk of experiencing toxic effects of the drug.
A nurse is developing a care plan for a client. Which client outcome statements are correctly formatted?
The client will identify two adverse effects of enoxaprarin (Lovenox) prior to self- administering the drug. The client will verbalize the storage requirements for NPH insulin prior to discharge.
While reading a medication package insert, a nurse notes the information contained within the "black box." What is the significance of this information to the nurse?
The drug can cause "special problems." It identifies extreme adverse drug reactions.
A client is receiving a drug that is excreted in the bile. What will the best nursing assessment of the effect of this drug on the patient include?
The effect of the drug will be a prolonged action.
Which assessment finding reflects a therapeutic range for a medication?
The indication for administration was achieved without serious side effects.
A parent of an adolescent receiving methylphenidate (Concerta) for ADHD asks why she needs a new prescription each month. What is the best response by the nurse?
The law does not allow us to give you refills on this medication."
A nurse incorrectly administered an oral medication intravenously. What is the best analysis of the nurse's action?
The medication cannot be retrieved.
A healthcare provider orders Lasix (furosemide) for a client. The hospital formulary substitutes the generic equivalent of the brand name drug, and the nurse administers the generic drug. Which of the statements best represent the nurse's action?
The nurse used good judgment in administering the drug. The nurse was correct; hospital policies allow for this.
The patient was receiving haloperidol (Haldol), a dopamine antagonist. The psychiatrist changed the order to aripiprazole (Abilify), a partial dopamine antagonist. Which statement best describes the effect of the change of medication on the patient?
The patient experiences fewer side effects.
The home health nurse notes that the elderly patient doubled up on his pain medication, even though the prescribed dose was at a therapeutic level. The patient says, "If one pill is good, two pills are better." Which statement best describes the result of the patient's action?
The patient is more likely to exhibit side effects from the additional dose.
A client admitted to the hospital tells the nurse they are very nervous about getting all their medications while they are in the hospital because their healthcare provider has them on a very "strict" schedule. The nurse understands that which of the following describes the principles about how medication dosing schedules are determined?
The physical and biological characteristics of a drug may determine dosing schedule. Specific times may improve effectiveness and decrease risk of adverse effects. Some drugs must be taken a certain time prior to an event or immediately after an event. Dosing may be set for the convenience of patient and nurse.
A nurse is preparing medications prior to administration. To promote client safety, the nurse uses the "rights" of drug administration. What do these "rights" include?
The right medication 2. The right time of delivery 3. The right dose 4. The right route of administration
Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?
The student is able to identify the patients who will need to have serum blood levels monitored.
A client has been chosen to participate in the clinical trial of a medication to treat chemotherapy-induced nausea. When the nurse takes the informed consent form to the bedside, the client says, "I am glad there is finally a medication to cure my cancer." How should the nurse respond?
What questions do you have about this medication?" "Has anyone explained the research trial to you?"
A nurse is teaching a client about their medications. The client is worried about "getting addicted" to their medications. The nurse explains that which of the following drugs has the highest risk for dependence?
heroin
