General Principles CH 1 + 2

The prescription order for a patient reads: "acetaminophen two tablets PO, every 6 hours as needed for fever." What does the nurse ask the prescriber to clarify? 1. The drug dose 2. The drug route 3. The drug name 4. The drug duration

1

Which is a characteristic of highly protein-bound drugs? 1. increased risk of drug-drug interaction 2. provide a short duration of action 3. must be administered with 8oz of water 4. decreased effect in pt w/low albumin level

1

The nurse administers intravenous atropine to a patient with a cardiac dysrhythmia. What would be the bioavailability of atropine in this patient?

100%

The nurse needs to be aware that which factors will affect the absorption of orally administered medications? Select all that apply. 1. time of day 2. pH of the stomach 3. form of drug preparation 4. presence of food in the stomach 5. patient position upon intake of med

1,2,3,4

Drugs exert their actions on the body by performing which actions? Select all that apply. 1. Interacting with receptors 2. Altering metabolic chemical processes 3 Making the cell perform a new function 4. Inhibiting the action of a specific enzyme

1,2,4

A patient with end-stage renal disease is admitted to the hospital with a complication and is in need of drug therapy. Which pharmacokinetic phase is affected by a compromised renal system? 1.Excretion 2. Absorption 3. Distribution 4.Metabolism

1.

When a drug should circumvent first-pass metabolism in the liver, what are the recommended routes of administering that drug? Select all that apply. 1. oral 2. intranasal 3. intraocular 4. transdermal 5. injection into the portal vein

2,3,4

A patient is known to have glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse ensures that drugs causing idiosyncratic reactions are not administered to the patient. What types of cells are destroyed as a result of an idiosyncratic reaction in such patients? 1. Platelets 2. Mucosal cells 3. Red blood cells 4. White blood cells

3

The nurse should check a medication how many times before administering it?

3 times

A patient reports decreased sensation in the left arm and a persistent headache that prevents sleep. The nurse observes that the patient's right eyelid is drooping. The patient's blood pressure is 140/80 mm Hg. The report from the computed tomography (CT) scan of the brain reveals a right middle cerebral artery hemorrhage. Which assessment information is classified as subjective data? 1. Increased blood pressure 2. Drooping of the right eyelid 3.Decreased sensation in the left arm 4.Results of CT scan showing hemorrhage

3.

A patient who is a lactating mother presents with complaints of fever, vomiting, and diarrhea. The nurse understands that some medications may not be safe for the patient because she is breastfeeding. What term is used to define this condition? 1. allergy 2. drug interaction 3. contraindication 4. idosyncratic reaction

3.

The nurse administers drug therapy to a patient and monitors the drug concentration in the blood. After a few hours, the concentration of the drug is maintained at a uniform level. What state has the drug reached? 1. First pass 2. Peak level 3. Steady state 4. Onset of action

3.

A patient who has been prescribed an antibiotic capsule to treat pharyngitis is reluctant to swallow the capsule. How should the nurse advise the patient to take the medication? 1. Crush the capsule. 2. Chew the granules in the capsule. 3. Dissolve the granules in a beverage. 4. Open the capsule and sprinkle the granules on soft food.

4

The nurse has been instructed to give a medication to a patient three times daily at 1000, 1400, and 1800 hours. The nurse dispenses the first dose at 1200 instead of 1000. What should the nurse do next? 1. Give the rest of the doses as ordered at 1400 and 1800. 2. Give the medication twice daily for that day at 1200 and 1800. 3. Skip the first dose and give the other two doses at 1400 and 1800. 4. Change the subsequent dose schedule after contacting the provider

4

The nurse is administering medications to a newly admitted elderly patient. What should the nurse do before administering the medications? 1 Ask whether the patient is allergic to any medications. 2. Ask for the patient's name and confirm with the person visiting the patient. 3.Ask for the patient's age and confirm with the person visiting with the patient 4.Check the patient's identification band against the medication profile and medication order.

4

What is the appropriate nursing action once a medication error has occurred? 1. Document the suspected reason for the error. 2. Document that the patient's family was notified. 3. Summarize the conversations of those involved. 4. Document the facts associated with the medication error.

4

A nurse has been asked to administer an oral drug that is available in various formulations. Which formulation of the drug will have the fastest onset of action? 1. elixir 2. powder 3. suspension 4. oral soluble wafer

4.

A nurse is educating a patient who is prescribed warfarin. The nurse advises the patient to avoid taking aspirin and explains that taking both drugs together may cause excessive bleeding. What is this phenomenon called?

Additive effect

When reviewing a patient's medical records, the nurse finds that the patient had developed an idiosyncratic reaction to aspirin. What should the nurse infer? a. The therapeutic index of the drug may have been high. b. The patient may have taken an excess dose of the drug. c. The patient may have taken the drug with grapefruit juice. d. The patient may have a deficiency of drug-metabolizing enzymes.

D

A patient has taken a drug orally. If the drug has a high first-pass effect, which statement about the drug is appropriate?

Formation of inactive metabolites is high in the liver.

When assigned to a maternity unit, what technique should be used to identify the mother and child for safe administration of medication?

Make certain the identification bracelets on the mother and baby have the same numbers.

A patient asks the nurse why a lower dose of intravenous pain medication is being given than the previous oral dose. What knowledge will the nurse draw on to respond to the patient?

Medications given intravenously are not affected by the first-pass effect.

Which enzyme is responsible for the metabolism of drugs in the liver during first-pass metabolism?

P450 enzymes

A nurse is reviewing information about a drug. The drug is absorbed in the mouth, and after 12 hours, traces of the drug are found in urine and cerebrospinal fluid. What is the study of this process called?

Pharmacokinetics

A patient is newly diagnosed with diabetes, and oral drug therapy is prescribed. The nurse explains a possible drug reaction resulting in very low blood glucose levels that can cause light-headedness and profuse sweating. What term would best describe such a reaction to the drug?

Pharmacologic reaction

An elderly patient has refused to take his prescribed antihypertensive tablet and is adamant that the tablet is worsening his condition. What should the nurse do?

Respect the patient's right to refuse and notify the health care provider.

An experienced nurse is discussing the rights of medication administration with nursing students. The nurse teaches that completion of which "right" is essential as proof of completion of all other rights?

Right documentation

A pregnant patient is diagnosed with strep throat. She is prescribed a course of oral antibiotics. What kind of effects on the fetus might result from administering antibiotic medication to women who are pregnant?

Teratogenic effects

When reviewing a patient's medical records, the nurse finds that the patient had developed an idiosyncratic reaction to aspirin. What should the nurse infer?

The patient may have a deficiency of drug-metabolizing enzymes.

The nurse is assessing a patient who reports abdominal pain. What subjective data should the nurse document?

The patient reports abdominal pain since yesterday.

What term means the ratio between a drug's therapeutic effects and toxic effects?

Therapeutic index

Drug half-life is defined as the amount of time required for 50% of a drug to do what?

be eliminated by the body

A prescription is written "Diltiazem 30 mg orally three times daily at 0700, 1300, and 1900." The trainee nurse misreads the prescription and administers the drug at 1000. What is the best nursing action before administration of the next dose of medication?

consult the health care provider

Pharmacokinetics involves the study of which factor?

distribution rates among body compartments

A patient presents with a severe cough and cold. The primary health care provider prescribes antibiotics and then prescribes blood work. What kind of therapy has the patient been prescribed?

empiric

A patient has a wound infection. A swab of the wound is sent for culture and, pending culture results, the primary health care provider starts an intravenous antibiotic. Which type of therapy has been prescribed for this patient?

empiric therapy

A patient will receive a drug that requires slow absorption in the body in a high (basic) pH environment. What form of the drug should be prescribed?

enteric-coated tablet

After undergoing the first dose of a new antihypertensive medication, a patient complains of hives with severe itching. The nurse explains to the patient that this is caused by an allergic reaction to the drug. What body system triggers an allergic reaction?

immune system

To achieve the most rapid onset of action, the primary health care provider will prescribe the medication to be administered by which route?

intravenously

A patient is prescribed an oral antidiabetic drug. Which type of therapy has been prescribed?

maintenance therapy

What is an alternate term for biotransformation of a drug?

metabolism

A patient has symptoms of an upper respiratory infection. The primary health care provider prescribes an antibiotic drug that causes the destruction of bacterial cell walls. Which mechanism of action does the drug use?

nonselective interaction

A drug given by which route is altered by the first-pass effect?

oral

physiochemical properties of drugs and how they influence the body

pharmacodynamics

A nurse is teaching a group of nursing students about various drugs such as insulin and their natural sources. What is the other main source of natural insulin besides humans?

pigs

The nurse will administer a drug to a patient via the oral route. What condition interferes with the optimum therapeutic effect of a drug given by this route?

resection of the small intestine

A health care provider writes a prescription for "gentamicin 100 mg every 8 hours." What information is missing from the prescription?

route

A patient diagnosed with coronary artery disease is scheduled for coronary artery bypass graft surgery. Which prophylactic therapy should the nurse expect to initiate before the scheduled surgery?

start preoperative antibiotics

A patient presents to the emergency department with acute angina-like chest pain. The nurse is instructed to administer nitroglycerin to the patient. Which route of administration would be ideal for this patient 1. oral 2. rectal 3. sublingual 4. subcutaneous

sublingual

A primary health care provider prescribes a combination therapy of hydrochlorothiazide and lisinopril for enhanced effects in the treatment of hypertension. Which effect describes this type of enhanced therapeutic action of drugs? 1. adverse effect 2. additive effect 3. antagonist effect 4. synergistic effect

synergistic effect

A patient who has type 2 diabetes has poorly controlled blood glucose. The patient is currently taking oral medications, but they are increasingly ineffective. What term is attributed to such a condition?

tolerance