Module 7 Pharmacology

Which interpretation of a patch test is correct if the nurse finds an induration of 2 to 3mm with erythema? (1+) 2+ (3+) (4+)

2+ Rationale If there is 2 to 3-mm wheal with flare, the nurse records the finding as (2+). If there is no wheal with a 3-mm flare, the correct reading is (1+). For a 3- to 5-mm wheal with flare, the correct reading is (3+) If the wheal is larger than 5 mm, the correct reading is 44

7. A pregnant woman asked a nurse at the obstetrician's clinic how she could determine which drug was safe to take during pregnancy. What would be an appropriate response by the nurse? 1. "Because there are few studies done to determine the safe use of drugs during pregnancy, it is okay to keep taking what was previously prescribed by your physician." 2. "Because there are few studies done to determine the safe use of drugs during pregnancy, it is advisable to ask your physician or pharmacist regarding taking prescription and over-the-counter drugs." 3. "You are not to take any drugs during pregnancy." 4. "It would be fine to take over-the-counter drugs, since they never cause any issues."

2. "Because there are few studies done to determine the safe use of drugs during pregnancy, it is advisable to ask your physician or pharmacist regarding taking prescription and over-the-counter drugs."

8. The nurse was teaching a patient how to use an inhaler prescribed for asthma. The nurse knows that further teaching is needed after the patient made which statement? 1. "I will hold my breath for 10 seconds before breathing out." 2. "I will take a slow deep breath and let it out quickly." 3. "I will check the number on the dose counter window to see how many more puffs I have left." 4. "I will notify my physician if I notice that I am coughing a lot more than usual."

2. "I will take a slow deep breath and let it out quickly."

6. While discussing with a mother the importance of administering furosemide orally to an infant with a cardiac abnormality, the nurse would recognize the need for further explanation if the mother makes which statement? 1. "I know that my baby needs this drug every day at approximately the same time." 2. "My baby will have no problem taking this tablet." 3. "I will check to make sure that the furosemide is working by monitoring the number of wet diapers." 4. "I understand that my baby will continue to grow even while taking this drug."

2. "My baby will have no problem taking this tablet."

8. A nurse was teaching a patient from Canada the names of her medications and reviewed the differences between Canadian names. Which statement indicates the patient understands the instructions? 1. "The proper name of the medication is the same as the brand name in Canada." 2. "The proper name of the medication is the same as the generic name in Canada." 3. "The chemical name is the one used the most when buying medications in Canada." 4. "The chemical names and the brand names are the only names used in Canada."

2. "The proper name of the medication is the same as the generic name in Canada."

5. A patient asked the nurse for an example of an appropriate source for drug information on the Internet. What would be an appropriate response by the nurse? 1. "The Internet is not an appropriate place to look up any drug information; you need to ask your physician or pharmacist." 2. "There are several reliable sites for drug information that are from official sources, for example, DailyMed." 3. "The Internet is reliable for any drug information that you search for." 4. "The only acceptable drug information sources are the package inserts."

2. "There are several reliable sites for drug information that are from official sources, for example, DailyMed."

4. Fentanyl patches do not usually achieve a sufficient blood level for pain control until how many hours after their initial application? 1. 6 hours 2. 12 hours 3. 18 hours 4. 24 hours

2. 12 hours

4. A nurse is having difficulty reading a physician's order for a medication. The nurse knows that the physician is very busy and does not like to be called. What does the nurse do next? 1. Calls a pharmacist to interpret the order 2. Calls the physician to have the order clarified 3. Consults the unit manager to help interpret the order 4. Asks the unit secretary to interpret the physician's handwriting

2. Calls the physician to have the order clarified

6. List in order what steps the nurse takes when preparing and administering a patient's morning medications. 1. Document the administration of the medications. 2. Check the order to verify the medication is correct. 3. Obtain the medications for administration from the medication room. 4. Identify the patient using two patient identifiers before administration. 5. Triple-check that the correct medication was prepared.

2. Check the order to verify the medication is correct. 3. Obtain the medications for administration from the medication room. 5. Triple-check that the correct medication was prepared. 4. Identify the patient using two patient identifiers before administration. 1. Document the administration of the medications.

4. When an antihypertensive drug causes a drop in blood pressure to the normal range, what is this effect called? 1. Antagonistic effect 2. Desired effect 3. Side effect 4. Additive effect

2. Desired effect

10. Drugs known to bind to an enzyme that cause the metabolism of the drug to be increased are called what? 1. Enzyme inhibitors 2. Enzyme inducers 3. Enzyme enhancers 4. Enzyme metabolizers

2. Enzyme inducers

2. What are the benefits of using CPOE technology for healthcare providers? (Select all that apply.) 1. It verifies the patient has received appropriate patient education. 2. It checks for potential drug interactions. 3. It checks associated laboratory values. 4. It checks for the appropriateness of the drug dosages. 5. It frees pharmacists from filling orders.

2. It checks for potential drug interactions. 3. It checks associated laboratory values. 4. It checks for the appropriateness of the drug dosages.

7. Why is it important not to crush medications that are considered long acting? 1. Medications that are crushed are harder to swallow, making it harder to activate the effect. 2. Medications that are crushed release the drug immediately, inactivating the long-acting effect and potentially causing an overdose. 3. Medications that are crushed will not be absorbed properly, inactivating the long-acting effect. 4. Medications that are crushed will become powder and lose all the effectiveness of the drug.

2. Medications that are crushed release the drug immediately, inactivating the long-acting effect and potentially causing an overdose.

9. A patient was discussing with the nurse the idea that in the future we will be able to determine which drug will be effective depending upon a person's genetic makeup. Which term does this refer to? 1. Polymorphisms 2. Pharmacogenetics 3. Genome coding 4. Pharmacokinetics

2. Pharmacogenetics

3. The nurse preparing the narcotic hydromorphone (Dilaudid) needs to get assistance from another licensed healthcare provider when what occurs? 1. The patient takes all the medication and then becomes nauseated and vomits the drug. 2. The medication is delivered in a dose that is more than the amount ordered. 3. The patient states that the drug will not work and refuses to take it. 4. The medication ordered is locked in the narcotic drawer.

2. The medication is delivered in a dose that is more than the amount ordered.

1. What are the legal responsibilities for correctly preparing and administering medications to patients? (Select all that apply.) 1. The nurse must ensure that the patient fully understands all the effects of the medication. 2. The nurse must understand the patient's diagnosis and symptoms correlating to the medication. 3. The nurse must assess the patient for adverse effects of the medication. 4. The nurse must be accurate in calculating and preparing medications. 5. The nurse must administer all medication orders without question.

2. The nurse must understand the patient's diagnosis and symptoms correlating to the medication. 3. The nurse must assess the patient for adverse effects of the medication. 4. The nurse must be accurate in calculating and preparing medications.

2. When performing a patch test for allergens, the nurse knows what is important? (Select all that apply.) 1. To know what allergen is causing the symptoms 2. To recognize when a wheal has formed 3. To cleanse the area for testing with alcohol before applying the patches 4. To have emergency equipment available in case of an anaphylactic response 5. To ask the patient if he or she has taken any antihistamines or antiinflammatory agents

2. To recognize when a wheal has formed 3. To cleanse the area for testing with alcohol before applying the patches 4. To have emergency equipment available in case of an anaphylactic response 5. To ask the patient if he or she has taken any antihistamines or antiinflammatory agents

3. What is the portion of a drug that is pharmacologically active called? 1. Protein-bound drug 2. Unbound drug 3. Drug tolerance level 4. Incompatibility factor

2. Unbound drug

8. A patient complains to his nurse about heartburn. The nurse notes in the medication profile that an antacid has been ordered PRN. What will the nurse need to do next? 1. Give the antacid immediately. 2. Verify the last time that the drug was given and determine whether it is appropriate to give the dose now. 3. Inform the patient that the next scheduled medications will be given in a few hours and that the drug will be given at that time. 4. Call the physician and ask if the antacid can be given.

2. Verify the last time that the drug was given and determine whether it is appropriate to give the dose now.

8. The nurse was aspirating the patient's NG tube to check the contents. What can the nurse expect for results if the contents are gastric fluid? 1. pH of 8, clear colored 2. pH of 3, green with sediment 3. pH of 7, yellow-colored 4. pH of 4, off-white colored

2. pH of 3, green with sediment

1. A patient has received a prescription from his primary care provider for the drug metoprolol (Lopressor). He asks the nurse why there are two names for the same drug. The nurse responds with which statements(s)? (Select all that apply.) 1. "One of the names is the brand name of the drug, and the other is the generic name." 2. "When drugs are discovered, all drugs are given a detailed chemical name and a simple generic name. If the company that discovered the drug brings it to the marketplace for sale, the manufacturer will give it a distinctive brand name. 3. "Lopressor is the generic name, and metoprolol is the brand name." 4. "The two names are used to determine whether the drug is a Schedule III or a Schedule IV drug." 5. "Generally, the generic form of the drug is less expensive."

1. "One of the names is the brand name of the drug, and the other is the generic name." 2. "When drugs are discovered, all drugs are given a detailed chemical name and a simple generic name. If the company that discovered the drug brings it to the marketplace for sale, the manufacturer will give it a distinctive brand name. 5. "Generally, the generic form of the drug is less expensive."

8. An expecting mother asks the nurse if it would be okay for her to take some cold medicine. What would be an appropriate response by the nurse? 1. "There are not a lot of studies done with regard to how safe medications are to take during pregnancy." 2. "I am sure it is safe to take, no problem." 3. "I believe the cold medication is contraindicated for pregnant women." 4. "Animal studies have revealed no evidence of harm to the fetus using these drugs."

1. "There are not a lot of studies done with regard to how safe medications are to take during pregnancy."

4. Which nursing action(s) would be essential when monitoring drug therapy in the geriatric patient? (Select all that apply.) 1. Monitoring renal and liver function 2. Monitoring for drug interactions 3. Completing a thorough drug history, including over-the-counter and alternative therapies 4. Inquiring about the ability to pay for medications 5. Educating the patient and caregivers about all drugs and potential complications

1. Monitoring renal and liver function 2. Monitoring for drug interactions 3. Completing a thorough drug history, including over-the-counter and alternative therapies 5. Educating the patient and caregivers about all drugs and potential complications

6. The nurse knows which of these factors are the differences between prescription and nonprescription drugs? (Select all that apply.) 1. Nonprescription drugs are available over-the-counter. 2. Prescription drugs are those drugs that may be prescribed by dentists, pharmacists, nurse practitioners, and physicians. 3. Recreational drugs are available by prescription only. 4. Over-the-counter drugs are available at a pharmacy or health section of grocery stores. 5. Prescription drugs have been approved for use by the FDA.

1. Nonprescription drugs are available over-the-counter. 2. Prescription drugs are those drugs that may be prescribed by dentists, pharmacists, nurse practitioners, and physicians. 4. Over-the-counter drugs are available at a pharmacy or health section of grocery stores. 5. Prescription drugs have been approved for use by the FDA.

5. A patient is to receive a medication via the buccal route. Which action does the nurse plan to implement? 1. Place the medication inside the pouch between the patient's lower molar and the cheek. 2. Crush the medication before administration. 3. Offer the patient a glass of water or juice after administration. 4. Use sterile technique to administer the medication.

1. Place the medication inside the pouch between the patient's lower molar and the cheek.

3. Which of the following nursing principles apply to administering guaifenesin syrup to a 5-year-old? (Select all that apply.) 1. The correct amount of liquid should be measured in a medicine cup by reading the meniscus at eye level. 2. Hold the bottle containing the liquid so the label is covered with the palm of the hand. 3. Use a syringe that compares closely to the volume to be measured. 4. The expiration date does not need to be checked on liquids. 5. A syringe can be used when giving an infant medications.

1. The correct amount of liquid should be measured in a medicine cup by reading the meniscus at eye level. 3. Use a syringe that compares closely to the volume to be measured. 5. A syringe can be used when giving an infant medications.

Which stage of new drug development involves giving the medication to large numbers of individuals with the disorder that the medication intends to treat? 1 Developmental stage-phase 2 Developmental stage phase 3 Developmental stage-phase Postmarketing surveillance stage

3 Developmental stage-phase Rationale Phase 3 of drug development includes larger patient populations to ensure the statistical significance of the results. Studies in this phase also provide additional information on proper dosing and safety. Phase 1 studies are done to determine an experimental drug's pharmacologic properties, safe dosage range, the potential for toxicity at a certain dosage, and safe routes of administration. The study population consists of either normal volunteers or the intended treatment population, such as those patients who have failed standard treatments of certain cancers or dysrhythmias. Phase 2 studies usually require 20 to 100 subjects, who are treated for 4 to 6 weeks. Studies in this phase are done to determine the success rate of a drug for its intended use. After the manufacturer decides to market the medication, there is an ongoing review of the adverse effects of the new drug and periodic inspections of the manufacturing facilities and products.

After how many days should a fentanyl patch be replaced?

3 days

1. A patient who has been asked to participate in a study asks the nurse what the term placebo means. What would be an appropriate response by the nurse? 1. "The word placebo refers to the type of abnormal response that may occur when taking medications." 2. "That term means the body has built up a resistance to a drug and that more of the drug is needed to get the same response." 3. "The term placebo refers to a dosage form that has no active ingredients; these are frequently used in studies to determine the effect of a new medication." 4. "The word placebo comes from Latin and means 'I will harm.' "

3. "The term placebo refers to a dosage form that has no active ingredients; these are frequently used in studies to determine the effect of a new medication."

3. When nitroglycerin ointment is prescribed, how long is the typical recommended drug-free period? 1. 3 to 4 hours off every 24 hours 2. 5 to 10 hours off every 24 hours 3. 10 to 12 hours off every 24 hours 4. 12 to 14 hours off every 24 hours

3. 10 to 12 hours off every 24 hours

6. When a patient has taken a drug and a rash appears along with severe itching, what is this reaction called? 1. Idiosyncratic reaction 2. Antagonistic effect 3. Allergic reaction 4. Displacement effect

3. Allergic reaction

2. With regard to the administration of oral medications, put the following actions that the nurse takes in chronological order. 1. Give the patient water to drink. 2. Identify the patient. 3. Check all aspects of the medication order. 4. Sit the patient upright. 5. Document the administration.

3. Check all aspects of the medication order. 2. Identify the patient. 4. Sit the patient upright. 1. Give the patient water to drink. 5. Document the administration.

3. When drugs are circulating in the bloodstream and reach the sites of action, what is this process known as? 1. Absorption 2. Metabolism 3. Distribution 4. Excretion

3. Distribution

8. A person who has an increased metabolic rate (e.g., hyperthyroidism) generally requires what type of dosage? 1. Normal dosage 2. Lower-than-normal dosage 3. Higher-than-normal dosage 4. A dosage that is based on his or her thyroid function levels

3. Higher-than-normal dosage

1. The prescriber has changed the route of the patient's medication from an intravenous route to an oral route. What effect (in general) does the change in the route have on the drug dosage and the absorption time? 1. Decreased dosage and increased absorption time 2. Increased dosage and increased absorption time 3. Increased dosage and decreased absorption time 4. Decreased dosage and decreased absorption time

3. Increased dosage and decreased absorption time

6. When administering a rectal suppository, the patient needs to be in which position? 1. Semi-Fowler's 2. Lithotomy 3. Left side-lying 4. Right side-lying

3. Left side-lying

9. When administering vaginal medications, the nurse knows the patient needs to be in which position? 1. Sims position 2. Trendelenburg position 3. Lithotomy position 4. Prone position

3. Lithotomy position

7. A nurse is preparing to administer eardrops to a 5-year-old child. What is the proper technique to use for this patient? 1. Pull the earlobe downward and back. 2. Pull the earlobe forward and up. 3. Pull the earlobe upward and back. 4. Pull the earlobe downward and straight.

3. Pull the earlobe upward and back.

9. A patient refuses an essential heart medication that has been prescribed. What does the nurse do next? 1. Calls the physician 2. Reports it to the head nurse 3. Seeks patient reasons 4. Documents refusal on the MAR

3. Seeks patient reasons

10. Why is it important for nurses to know about drug actions and current developments in drug therapy? 1. Patients who are hospitalized need drug monitoring. 2. Drug actions detail how effective the drug will be for everyone. 3. The elderly population has a greater likelihood of polypharmacy. 4. Prescription medication use decreases as a person ages.

3. The elderly population has a greater likelihood of polypharmacy.

6. A patient is ordered to have eyedrops administered daily to both eyes. Into which part of the eye are eyedrops instilled? 1. The sclera 2. The outer canthus 3. The lower conjunctival sac 4. The opening of the lacrimal duct

3. The lower conjunctival sac

What is the minimal number of hours before travel that a scopolamine transdermal patch should be placed?

4 Hours

1. The nurse was teaching a patient how to apply the prescribed powder under a skinfold for a yeast infection. The nurse knows that further teaching is needed after the patient made which statement? 1. "I know that I need to wash the area first and dry it thoroughly before I apply this powder." 2. "I will need to watch for any changes in my rash and notify my physician if it gets worse." 3. "I should shake the container first before I apply this powder." 4. "I can sprinkle this powder all over to prevent the infection from spreading."

4. "I can sprinkle this powder all over to prevent the infection from spreading."

2. A patient takes 50 mg of a drug that has a half-life of 12 hours. What percentage of the dose remains in the body 36 hours after the drug is administered? 1. 50 mg (100%) 2. 25 mg (50%) 3. 12.5 mg (25%) 4. 6.25 mg (12.5%)

4. 6.25 mg (12.5%)

3. The nurse giving a drug to a patient for the effect it will have on the cardiovascular system understands that which method is used to classify the drug? 1. Therapeutic use 2. Physiologic action 3. Clinical indication 4. Body system

4. Body system

4. The nurse is to administer several medications to the patient via an NG tube. What is the nurse's first action? 1. Add the medication to the tube feeding being given. 2. Crush all tablets and capsules before administration. 3. Administer all of the medications mixed together. 4. Check for the placement of the tube.

4. Check for the placement of the tube.

2. Antacids, antibiotics, antihypertensives, diuretics, and laxatives are examples of drugs that are classified by which method? 1. Nonprescription status 2. Body system 3. Chemical action 4. Clinical indication

4. Clinical indication

7. When a patient who was prescribed warfarin and valproic acid begins experiencing an increased effect of warfarin, what is this known as? 1. Synergistic effect 2. Antagonistic effect 3. Idiosyncratic effect 4. Displacement effect

4. Displacement effect

2. What is the reason it is important to understand the difference between drug dependence and drug accumulation? 1. Drug accumulation can be detected more easily than drug dependence. 2. Drug accumulation may result in drug toxicity, and drug dependence can result in cell mutation. 3. Drug dependence can be prevented, and drug accumulation is inevitable. 4. Drug dependence can be the result of taking addictive substances for a prolonged time, and drug accumulation can result in drug overdose.

4. Drug dependence can be the result of taking addictive substances for a prolonged time, and drug accumulation can result in drug overdose.

7. What process is used to eliminate medication errors in the healthcare environment as patients transition from one clinical setting to another? 1. Case management 2. Transcription 3. Verification 4. Medication reconciliation

4. Medication reconciliation

5. When administering an intermittent enteral feeding to an adult patient, the nurse finds that the residual aspirate obtained is "coffee-ground" in color. What does the nurse do? 1. Administers the next scheduled feeding 2. Stops feeding the patient for 30 minutes 3. Reinstills the aspirate and starts a new feeding 4. Notifies the healthcare provider

4. Notifies the healthcare provider

7. During which stage of the process of new drug development does testing on humans start? 1. The preclinical research and development stage 2. The postmarketing surveillance stage 3. The post clinical research and development stage 4. The clinical research and development stage

4. The clinical research and development stage

For how many hours is an applied patch left in place when allergy testing?

48

Which nursing action would be a priority for a patient on multidrug therapy who reports a new symptom? O Perform a functional health assessment O Determine changes in the physiology and nutrition. O Assess the pharmacokinetic factors associated with drug therapy. O Determine whether it is induced by the medicine that the patient is taking

O Determine whether it is induced by the medicine that the patient is taking Rational When a patient develops a new symptom, it is important to determine whether the drug prescribed has caused the development of the new symptom. This would help decide if the drug must be discontinued or the dose of the drug has to be adjusted. A functional health assessment would help to know the patient's ability to self-medicate. The changes in physiology and nutrition of the patient and pharmacokinetic factors associated with drug therapy should be assessed to determine the changes related to aging of the patient.

Which reference would the healthcare provider use to provide effective care to a pregnant patient who has been exposed to a teratogen? O American Drug Index O Lactmed Database O Drug Facts and Comparisons O Developmental and Reproductive Toxicology Database

O Developmental and Reproductive Toxicology Database Rationale Referring to the Developmental and Reproductive Toxicology Database, which contains teratology and other aspects of reproductive toxicology, would benefit the primary healthcare provider in providing effective care to this patient. The American Drug Index is useful for comparing the brand names and generic names of drugs and checking strengths and dosage forms. The LactMed Database contains information on drugs that a breastfeeding mother may be exposed to. Drug Facts and Comparisons are useful to compare similar products, brand names, manufacturers, cost indices, and available dosage forms,

Which is a pharmacy-only nonprescription drug according to the Canadian Food and Drugs Act and Regulations? O Insulin O Loperamide O Pseudoephedrine O Diphenhydramine

O Diphenhydramine

Which statement is true regarding Schedule V drugs according to the Controlled Substances Act? O The drug has high potential for drug abuse. O The drug is not accepted for medical use in the United States. O Methylphenidate belongs to Schedule V. O Diphenoxylate and atropine (Lomotil) belong to Schedule V

O Diphenoxylate and atropine (Lomotil) belong to Schedule V Rationale Diphenoxylate and atropine are listed under Schedule V according to the Controlled Substances Act. Schedule V drugs have a low potential for abuse, and a prescription may not be needed, they are currently accepted for medical use in the United States. Methylphenidate is a Schedule Il drugs

Which action by the primary healthcare provider is the most beneficial for a patient taking a seasonal allergy medication after allergy season? O Discontinuing the drug O Reducing the dose of the drug O Prescribing the drug for lifetime O Changing the drug after months

O Discontinuing the drug

A nurse ordered Mucomyst for the nursing unit over the telephone, but Mucinex was delivered instead, so the nurse avoids giving the drug to the patient. Which medication error was prevented O Prescribing O Dispensing O Menitering O Transcriptor

O Dispensing Rationale When the wrong drug or wrong dose is sent to the nursing unit, a dispensing error may occur. The nurse can avoid administering the drug to the patient to avoid dispensing error. Mucomyst as a sound-alike medication for Mucinex may have been confused while ordering over the telephone Prescribing errors occur when the incorrect dose is prescribed for a patient. Monitoring errors may occur because of suboptimal monitoring or suboptimal patient education Transcription errors may occur as a resultat omission ol orders or unapproved abbreviations

The interference of one drug with the action of another drug indicates an antagonistic effect. When an opiate analgesic is prescribed for pain and the patient refuses it when the nurse attempts to administer the injection, which nursing action is best Select all that apply. O Provide the patient with oral medication O Dispose of the drug to avoid legal use or abuse O Have another licensed nurse witness discarding of the drug O Notify the physician that the medications no longer required. O Record in a medication order that the drug has not been given to the patient

O Dispose of the drug to avoid legal use or abuse O Have another licensed nurse witness discarding of the drug Rationale Unused narcotics should be disposed of to reduce the danger of unintentional use or overdose. They should be disposed of under the witness of a second qualified nurse. Therefore the drug should be disposed of under the supervision of a registered nurse. It depends on the condition of the patient whether to suggest an alternate dosage for the prescriber will specify the right route of administration. The physician will decide to continue or stop the medication, the nurse should not decide, The nurse should not record a medication order until after the drug is administered.

Which stage of pharmacokinetics is altered when 90% of the medication is displaced from its binding sites by a counter medication? O Excretion O Absorption O Distribution O Metabolism

O Distribution Rationale A drug interaction because of a change in distribution usually occurs when the medication is displaced from its binding sites by a counter medication. Drug interaction because of change in excretion occurs in the kidney tubules by changing the pH to alkaline, which enhances or inhibits the excretion. Changes in gastric pH and insoluble complex formation occur because of medications, which lead to absorption-related drug interaction. A drug interaction because of a change in metabolism occurs either by enzyme induction or inhibition.

Which process describes the transport of a drug from systemic circulation to the target site? O Excretion O Absorption O Distribution O Metabolism

O Distribution Rationale Distribution refers to the transport of a drug from the circulating body fluids to the site of action. Excretion is defined as the elimination of a drug or its metabolites. The transfer of a drug from the site of administration to the systemic circulation is called absorption. Inactivation of the drug by enzymes produced from organs such as the liver, gastrointestinal tract, and lungs is called metabolism

The Durham Humphrey Amendment serves which function? O Provision of incentives for sponsors to develop products for rare diseases O Division of medicines into prescription and nonprescription drugs based on safety O Protection of the public from foreseeable risks of the manufacture and sale of drugs O Provision of greater control and surveillance of the distribution of investigational drugs

O Division of medicines into prescription and nonprescription drugs based on safety Rationale Aspirin with codeine is a Schedule III drug, these drugs have a high potential for psychological dependence because of their high potential for abuse. Schedule lill drugs require a prescription that expires in 6 months. Aspirin with codeine has a low physical dependence,

Which phrase describes tablets? O Small, cylindrical, gelatin containers holding dry powder O Dispersions of small droplets of water-in-oil or of oil-in-water O Flat disks containing medicinal agents in a hard sugar candy base O Dried powdered drugs that have been compressed into small disks

O Dried powdered drugs that have been compressed into small disks Rationale Dried powdered drugs that have been compressed into small disks are called tablets. Small, cylindrical, gelatin containers holding dry powder are called capsules. Dispersions of small droplets of water-in-oil or of oil-in- water are called emulsions. Flat disks containing medicinal agents in a hard sugar candy base are called lozenges.

Which governmental body was organized to conduct research in the area of dangerous drugs, drug abuse, and enforcement of the Controlled Substances Act? O US Food and Drug Administration (FDA) O Drug Enforcement Administration (DEA) O Federal Bureau of Investigation (FB) O Central Intelligence Agency (CIA)

O Drug Enforcement Administration (DEA)

What information does the nurse include in the teaching plan about the parenteral route drug administration? O Drugs pass through the gastrointestinal tract O Drugalisorption decreases the area of injection is cooled O Drugs administered by the subcutaneous route get absorbed quickly. O Drugs administered through the intravenous route get absorbed slowly

O Drug absorption decreases the area of injection is cooled Rationale Cooling of the skin causes vasoconstriction, thereby hindering blood flow. Therefore cooling of the injection site affects drug delivery, which results in decreased drug absorption Drugs administered through the parenteral route directly enter the systemic circulation and do not pass through the gastrointestinal tract. The subcutaneous route of drug administration is associated with slow absorption as a result of poor blood flow when compared with other routes of drug administration, such as the intramuscular route. Drugs administered intravenously are absorbed rapidly because the drug directly enters the bloodstream

What change may occur in pharmacokinetics when an obese patient receives a highly lipid-bound medication O Drug distribution will be more rapid. O Drug absorption will be impaired. O Drug metabolism will be incomplete O Drug elimination will be slowed.

O Drug elimination will be slowed. Rationale Lipid-soluble drugs have an affinity for adipose tissue (fat), where they tend to accumulate. Because of the relatively low blood circulation in adipose tissue, lipid-soluble drugs tend to linger in the body. Thus excretion of a highly lipid-soluble drug will be slower in an obese person. Distribution is determined by circulation of body fluids. Absorption of a drug varies, depending on route of administration and local conditions. Liver functioning affects drug metabolism. Obesity does not have a direct effect on the metabolism of a drug

Which description best defines a medication? O Chemical substance that requires a prescription by a health professional O Drug used for a therapeutic effect to prevent and treat disease O Pharmacologic preparation used to reverse disease O Plant, animal, or mineral substance that prevents disease

O Drug used for a therapeutic effect to prevent and treat disease

A 66-year-old patient is considered to be in which life stage? O Adult O older adult O Elderly O Aged

O Elderly Rationale Age 65 to 74 years is considered elderly. The adult age range is 19 to 54 years. The older adult age range is 55 to 64 years. The aged age range is 75 to 84 years:

Which dose form consists of dispersions of small droplets of water-in-oil or of oil-in-water? O Elixirs O Syrups O Emulsions O Suspensions

O Emulsions Rationale Emulsions are dispersions of small droplets of water-in-oil or of oil-in-water. Elixirs are clear liquids that contain drugs that have been dissolved in alcohol and water. Syrups are medicinal agents that have been dissolved in a concentrated solution of sucrose and water. Suspensions are liquid dose forms that contain solid, insoluble drug particles dispersed in a liquid base.

Which reaction can cause an increase in urine pH in a patient taking acetazolamide quinidine? O Chemical incompatibility between two drugs O Interference in the action of one drug by the other one O Inhibition of meteibolism of one drug by the other one O Enhancement in the pharmacologic action of one drug by the other one

O Enhancement in the pharmacologic action of one drug by the other one Rationale The pharmacologic action of quinidine is enhanced when coadministered with acetazolamide. The alkaline urine produced by acetazolamide causes quinidine to be reabsorbed in the rena tubules, which potentially increases the physiologic and toxic effects of quinidine, Chemical incompatibility occurs when one drug is incompatible with another drug, thereby causing deterioration when used concomitantly An antagonistic effect occurs when one drug interferes with the action of another. Interference occurs when the metabolism of one drug is inhibited by another

Which statement by a nursing student indicates the need for additional training administering intermittent tube feeding? O Ensure that bowel sounds are absent O "Check that the tube is properly placed in the stomach O "Aspirate residual before each feeding O "Monitor blood glucose testing during the enteral feeding initiation

O Ensure that bowel sounds are absent Rationale When administering enteral nutrition via an intermittent tube feeding, the nurse should ensure that the bowel sounds are present. The nurse should notify the primary healthcare provider before proceeding with the process if bowel sounds are absent. The nurse should ensure that the tube is properly placed in the stomach before administering enteral feeding. When administering intermittent tube feedings, the nurse should ensure that the residual volume is monitored before each feeding: During the administration of intermittent feedings through the jejunostomy tube, the primary healthcare provider may order blood glucose testing.

For which conditions is serum drug monitoring routinely performed to prevent toxicities and ensure appropriate therapeutic levels? Select all that apply. O Epilepsy O Stroke O Heart failure O Gastric ulcers O Infections

O Epilepsy O Stroke O Heart failure O Infections Rationale Therapeutic drug monitoring is routine for conditions such as epilepsy (e.g., phenytoin, carbamazepine valproic acid, phenobarbital), stroke (eg, warfarin), heart failure (eg, digoxin), and antimicrobial therapy (c.g. gentamicin, tobramycin, vancomycin) to prevent toxicities and to ensure that dosages are adequate to provide appropriate therapeutic levels. Medications given for gastric ulcers do not require routine serum drug monitoring to prevent toxicities and ensure appropriate therapeutic levels

Which antibiotic can cause an increase in serum theophylline levels? O Rifampin O Ampicillin O Erythromycin O Gentamicin

O Erythromycin Rationale Erythromycin inhibits metabolism and results in increased serum levels of theophylline; therefore the doses should be reduced to avoid toxicity. Rifampin causes an increased incidence of menstrual abnormalities when coadministered with Ortho-Novum. Ampicillin inhibits metabolism when coadministered with probenecid. Gentamicin when given with pancuronium increases neuromuscular blockade, prolonging return to normal respirations and recovery time.

Which statements are true regarding drug interactions? Select all that apply. O Antacids enhance the dissolution of ketoconazole tablets O Erythromycin inhibits the metabolism of theophylline O Caffeine Inhibits the actions of antihistamine medications O aluminum-containing antacids inhibit the absorption of tetracycline. O Probenecid increases the antibacterial activity of ampicillin

O Erythromycin inhibits the metabolism of theophyline O Aluminum-containing antacids inhibit the absorption of telracydine. O Probenecid increases the antibacterial activity of ampicillin Rationale Erythromycin inhibits the metabolism of theophylline because it binds to certain metabolising enzymes, the dose of theophylline must be reduced on the basis of theophylline serum levels and to prevent toxicity. Aluminium-containing antacids inhibit the absorption of tetracycline, because alumınium sats form an insoluble chemical complex with tetracyd ne. This interaction can be managed by separating the administration of tetracycline and antacids by 3 to 4 hours. Probenecid blocks the real excretion of ampicillin, thus prolonging the antibacterial activity of ampicillin Antacids inhibit the dissolution of ketoconazole tablets by increasing gastric ph. Caffeine provides stimulant effects when antihistamines cause depressant effect, but it does not inhibit the actions of the antihistamine

When would the nurse change the equipment used for administering enteral feeding via continuous tube feeding? O Every 30 minutes O Every 60 minutes O Every 8 hours O Every 24 hours

O Every 24 hours Rationale The nurse should change the equipment that is used for administering enteral feeding via continuous tube feeding every 24 hours. The nurse should ask the patient to remain in a semi-Fowler's position for 30 to 60 minutes when administering enteral feeding via intermittent tube feeding to prevent gastric reflux. The nurse should fill a disposable feeding container with enough of the prescribed formula for an 8-hour period when administering enteral feeding via continuous tube feeding

Which pharmacokinetic process is altered when quinidine is coadministered with acetazolamide? O Excretion O Absorption O Distribution O Metabolism

O Excretion Rationale Changes in excretion may occur when acetazolamide is coadministered with quinidine. The alkaline urine produced by acetazolamide increases the physiologic and toxic effects of quinidine. A combination of quinidine and acetazolamide does not cause absorption, distribution, or metabolic changes

Which type of medication may require normal saline solution for proper administration? O Ear Drops O Eye Drops O Vaginal medications O Nitroglycerin ointment

O Eye Drops Rationale Administration of eyedrops may require the use of normal saline solution to remove exudates. Other equipment required for application of eyedrops includes a dropper, tissues, and a sterile eye dressing. The administration of cardrops requires a dropper, the medication administration record and the medication profile Administration of vaginal medications requires a water-soluble lubricant, a ********** with tubing and nozzle, douche solution, the medication administration record, and the medication profile. The administration of nitroglycerin ointment requires applicator paper, non allergenic adhesive tape, the medication administration record, and the medication profile.

Which course of action would the nurse take to remove the residual formula from a gastrostomy tube? O Clamp or plug the gastrostomy tube. O Flush the tube with 50 to 60 mL of water. O Hang the feeding bag on an intravenous (IV) pole. O Place the patient in a semi-Fowler's position for 30 to 60 minutes

O Flush the tube with 50 to 60 mL of water. Rationale The nurse should flush the gastrostomy tube with 50 to 60 mL of water after the feeding bag is empty. This helps remove any residual formula from the tube. Clamping or plugging the gastrostomy tube does not remove residual formula after the feeding. The nurse should hang the bag on an IV pole to infuse the feeding by gravity. After the feeding, the patient should be placed in a semi-Fowler's position to enable normal digestion and prevent gastric reflux.

Which medications when given in combination with warfarin can cause heavy bleeding for a period of time after the medication is discontinued? Select all that apply. O Furosemide O Gentamicin O Tobramycin O Antacids O Valproic acid

O Furosemide O Valproic acid Rationale Furosemide and valproic acid will increase the free plasma drug concentration of warfarin, thereby leading to prolonged anticoagulant effect and bleeding Warfarin does not interact with gentamicin and tobramycin. Antacids have a negligible interaction with warfarin, and the combination can be safely used in the patient.

Women may experience more problems than men when taking aspirin because of decrease in which factor? O Gastric emptying O Amount of alcohol dehydrogenase O Gastric acidity O Levels of hepatic enzymes

O Gastric emptying

Which factors affect the gastrointestinal (GI) absorption of medicines? Select all that apply. O Gastric pH O Gastric emptying time O Blood flow of the mucous lining of the stomach and intestines O Enzyme activity O Drug distribution

O Gastric pH O Gastric emptying time O Blood flow of the mucous lining of the stomach and intestines O Enzyme activity

Which pH would the nurse expect from a nasogastric tube aspirate in a patient who is not receiving histamine-2 (H) blockers? O Intestinal pH greater than 6 O Gastric pH between 1 and 6 O Gastric pH between 1 and 4 O Intestinal pH between 8 and 9

O Gastric pH between 1 and 4 Rationale If the patient is not receiving H z blockers, the nurse will expect the gastric pH to be between I and 4. If the patient is receiving H, blockers, the nurse will expect the intestinal pH to be greater than or equal to 6 and the gastric pH to be between 1 and 6. The intestinal pH of patients who are not taking histamine-2 antagonists will ideally be 6 or 7

Which source of information is used to record pain assessment? O Graphic record O Physician order form O Other diagnostic reports O Medication administration record

O Graphic record Rationale Pain assessment is recorded in the graphical record as a fifth vital sign. The physician's order form contains the procedures and treatments ordered by the physician. Other diagnostic forms contain the reports of surgery, electroencephalography, electrocardiography, and pulmonary function tests. The medication administration record is the record of time of medication administration and the person who administered it.

Which aspect of a medication explains why one medication may be taken once per day and another is taken every 8 hours? O Toxicity O Half-life O Protein binding O Therapeutic range

O Half-life Rationale The half-life of a drug is determined by an individual's ability to metabolize and excrete a particular drug. Drugs with long half-lives need to be administered only once daily, whereas drugs with short half-lives need to be administered more often to maintain therapeutic activity. One medication may be more or less toxic than another; however, there is no way to know based on the information provided. Protein binding affects drug activity; the bound drug is pharmacologically inactive, and the unbound drug is active. Frequency of administration does not reflect extent of protein binding. Therapeutic range refers to the range of plasma drug levels between the minimum effective concentration and the toxic concentration. No conclusion regarding the therapeutic range is possible based on the Information provided

The patient reports severe back pain and comments that morphine sulfate (Avinza) therapy provided no relief. Medication error may be likely, due to which cause? Select all that apply. O High alert medications O Similarly sounding names O Wrong administration time O Overdose of the medication O Improper route of administration

O High alert medications O Similarly sounding names Rationale Morphine sulfate (Avinza) is a high-alert medication, so medication error due to high-alert medication may occur in the patient. Some medications may sound similar but are used for different purposes. In this instance, because the patient has severe pain in her back, which is a symptom of osteoporosis, she might have been prescribed Evista (Raloxifene), which is used to treat osteoporosis in postmenopausal women. Because of similar-sounding names drugs, Evista may have been confused with Avinza, which is used for relieving the pain. The patient does not mention incorrect administration time, therefore it is unlikely that the persistent pain is a result of improper administration time. The patient does not report overdose of the medication; therefore the persistent pain is unlikely a result of overdose. Avinza is taken through the oral route as prescribed, so there is no chance of error because of route of administration

Which information does the nurse include when teaching a patient about a Schedule II drug? Select all that apply. O High potential for abuse O Prescriptions expire in 6 months O Currently accepted for use in the United States O No refills, requires a new prescription each time O Abuse may lead to low or moderate dependence

O High potential for abuse O Currently accepted for use in the United States O No refills, requires a new prescription each time Rationale Schedule Il drugs have a high potential for abuse and are currently accepted for use in the United States. They require a new prescription each time without refills. Schedule III, IV and V prescriptions expire in 6 months Schedule Ill drugs may lead to low or moderate dependence.

Which drug interaction may produce a positive outcome? O Ampicillin and gentamicin O Tetracycline and antacid O Hydrocodone and acetaminophen O Norethindrone and ethinyl estradiol and rifampin

O Hydrocodone and acetaminophen Rationale Hydrocodone and acetaminophen are both analgesics, and the medications produce additive effects when taken in combination. Ampicillin is chemically incompatible and inactivates gentamicin activity. Antacids containing aluminum inhibit the activity of tetracycline. Rifampin induces the metabolic enzymes of norethindrone and ethinyl estradiol, leading to menstrual abnormalities and failure of conception control

Which type of dressing is appropriate to use on a clean, unilateral partial-thickness burn with no exudate, infection, or cellulitis? O Hydrogel O Hydrocolloid O Calcium alginate O Nonadherent gauze

O Hydrogel Rationale Hydrogel dressings can be used on partial-thickness and full-thickness wounds and on skin that has been damaged by burns. A calcium alginate dressing is ideal for wounds with exudates. Hydrocolloid dressings are applied to minor injuries to provide a protective barrier, they are not ideal for burn cases. Nonadherent gauze dressings are preferred for use on ulcer and infection cases,

Which equipment should be available when a patch test is performed? O Perlite O Tongue blade O Applicator paper OHypoallergenic tape

O Hypoallergenic tape Rationale Hypoallergenic tape is needed to perform patch testing Other required equipment includes alcohol 1x 1 inch gauze pads, droppers, mineral or olive oil, water, dippers, and a record for charting data, A penlights needed to administer nasal spray. A tongue blade is used during the application of creams or ointments. Applicator paper is used during the administration of nitroglycerin ointment.

Which schedule drugs have a very high potential for abuse? O I O II O IV O v

O I Rationale Schedule I drugs such as lysergic acid diethylamide (LSD), hashish, peyote, and heroin have a very high potential for abuse. Schedule Ill drugs have a high potential for abuse but less than Schedule Schedule IV drugs have a lower potential for drug abuse than Schedule III drugs. Schedule V drugs have a low potential for abuse

Which statement by a nurse indicates effective teaching about medication instructions that should be provided to patients at the time of discharge? Select all that apply. O I will ask the patient to take medications on time O I will instruct the patient to monitor the response to drugs." O "I will explain to the patients about taking the prescribed medications in proper manner. O I will instruct the patient to report to the primary healthcare provider If a dose is missed! O I will instruct the patient that if he or she misses a dose to double the dose next time it is due

O I will ask the patient to take medications on time! O I will instruct the patient to monitor the response to drugs." O "I will explain to the patients about taking the prescribed medications in proper manner.

What step should the nurse follow to prevent the drug from causing irritation when administering a solid-form medication? O Crush the medication with a tablet crush ng device O Place the medication at the back of the patient's tongue O Provide a small amount of water before administering the medication O Instruct the patient to drink a full glass of fluid after administering the medication

O Instruct the patient to drink a full glass of fluid after administering the medication Rationale The nurse should instruct the patient to drink a full glass of fluid after administering a solid-form medication. This action helps dilute the drug and diminish the risk of irritation. If the patient has difficulty swallowing medications the nurse may crush them using a tablet-crushing device. Placing the medication at the back of the patient's tongue does not help prevent irritation. The nurse may provide a small amount of water to the patient before administering the medication to master the tongue and make it easier to swallow the drug

Which step would the nurse take to ensure that a rectal suppository melts and is absorbed? O Place the patient in a sitting position on the bedpan or toilet. O Apply water-soluble lubricant to the tip of the rectal suppository. O Use petroleum jelly or mineral oil to lubricate the tip of the rectal suppository O Instruct the patient to remain in a side lying position for 20 minutes after inserting the suppository

O Instruct the patient to remain in a side lying position for 20 minutes after inserting the suppository Rationale After inserting the suppository, the nurse should instruct the patient to remain in a side-lying position for 15 to 20 minutes to allow the medication to melt and be absorbed. After administering an enema, the nurse should assist the patient to a sitting position and the bedpan or toilet, Water-soluble lubricant is applied to the tip of a rectal suppository to enable easy insertion This does not help in drug absorption. Petroleum Jelly or mineral oil should not be used to lubricate a suppository because these substances might decrease the absorption of the medication

which aspect of a medication explains why one medication may be taken once per day and another is taken every 8 hours? Toxicity Half-life Protein binding Therapeutic range

Half-life

Which statement by a student indicates effective teaching on documentation of nursing actions and patient observations? Select all that apply. O I will record the drug action O I will record the drug refusals. O "I will record the health teaching performed." O "I will record the medication before administering O "I will record in the nurse notes that an incident report completed upon medication error

I will record the drug action I will record the drug refusals. "i will record the health teaching performed."

Which statements by a nursing student about general principles of administering liquid-form oral medications to adults needs correction? Select all that apply. O " The medication can be mixed in oral fluids that may be at the patient's bedside." O "Liquid medications should not be diluted unless specified." O "Refrain from leaving medications at the patient's bedside." O Instruct the patient to drink a full glass of fluid after taking the medication O Provide a little water to the patient before giving the medication

O " The medication can be mixed in oral fluids that may be at the patient's bedside." O Instruct the patient to drink a full glass of fluid after taking the medication O Provide a little water to the patient before giving the medication

Which statement by a nursing student indicates a need for further instruction regarding the technique for instillation of eyedrops? O Medication should be instilled by approaching the eye from below O The lower conjunctival sac should be exposed by applying gentle traction O "Any exudate should be cleaned starting from the outer canthus wiping inward O "The patient should be positioned so that his or her face is directed toward the ceiling O Before instilling eye drops, the nurse should remove any exudate from the eyelid and eyelashes with sterile

O "Any exudate should be cleaned starting from the outer canthus wiping inward

Which response from the nurse is appropriate to give a patient who asks why a timed- released table has been ordered? O it prevents the drug from imitating the stomach lining O " allows a higher blood level of drip to be achieved. O "It increases the therapeutic index of the drug O "It decreases the required frequency of administration

O "It decreases the required frequency of administration Rationale Timed-release preparations provide a gradual but continuous release of a drug because different parts of the preparation dissolve at different rates. The advantage of this delivery system is that it reduces the number of doses administered per day. Enteric coated tablets, not timed-release tablets are designed to prevent the drug from irritating the stomach lining. The blood level of the drug and the therapeutic index of the drug are Irrelevant to the question.

Which instructions are important to give on how to properly administer rectal suppositories? Select all that apply. O "Always use the index finger to insert rectal suppositories." O"Place the patient in a sitting position after administering the medication O "Lubricate the tip of the rectal suppository before inserting it in the patient." O "Refrain from using petroleum jelly or mineral oil to lubricate the tip of the rectal suppository O "Instruct the patient to remain in a side-lying position for 15 minutes after administering the medication."

O "Lubricate the tip of the rectal suppository before inserting it in the patient." O "Refrain from using petroleum jelly or mineral oil to lubricate the tip of the rectal suppository O "Instruct the patient to remain in a side-lying position for 15 minutes after administering the medication." The nurse should lubricate the tip of the rectal suppository to ensure easy insertion. Petroleum jelly or mineral oil should not be used as lubricants because they may decrease the medication's absorption rate. The patient should remain in a side-lying position for 15 to 20 minutes to aid in the melting and absorption of the medication. The nurse may use the index finger for inserting rectal suppositories in adults. However, the fourth finger should be used for infants. The nurse should assist the patient to a sitting position after administering a disposable enema.

Which information given by a nurse is correct about administering tablets? Select all that apply. O Some correction was not selected O "Keep the medication in front of the tongue O "Refrain from keeping medications at the bedside O "Have the patient drinks a full glass of fluid when swallowing the medication O "Drink a full glass of fluid before swallowing the medication! O "Keep the head of the patient forward when he or she swallowing the medication

O "Refrain from keeping medications at the bedside O "Have the patient drinks full glass of fluid when swallowing the medication O "Keep the head of the patient forward when he or she swallowing the medication Rationale When administering solid forms of medications, the nurse may be ordered to keep certain medications by the bedside, but the nurse should ideally refrain from doing so. The nurse should encourage the patient to drink a full glass of fluid when swallowing tablets to ensure that the medication reaches the stomach and that it is diluted to decrease irritation. The nurse should assist the patient to keep his or her head forward to ensure that the tablet is swallowed easily. The tablet should be kept at the back of the tongue.

Which nonprescription sale of codeine phosphate preparation is liable for punishment according to the Controlled Drugs and Substances Act? O 7 mg of codeine phosphate per solid dosage unit unit O 10 mg of codeine phosphate per solid dosage O 15 mg of codeine phosphate per 30 mL of liquid preparation O 18 mg of codeine phosphate per 30 mL of liquid preparation

O 10 mg of codeine phosphate per solid dosage Rationale According to the Controlled Drugs and Substances Act, a nonprescription sale of codeine phosphate should not exceed the equivalent of 8 mg of codeine phosphate per solid dosage unit; therefore 10 mg cannot be sold without a prescription. A nonprescription sale of codeine phosphate should not exceed the equivalent of 20 mg per 30 mL of a liquid preparation.

Which number is the gastric pH of a full-term newborn after 24 hours? O 4 O 5 O 6 O 7

O 4 Rationale The gastric pH of a full-term newborn after 24 hours is 4 (2 to 4). The gastric pH of a 1-year-old-child, when the stomach is full, is 5. The gastric pH of premature infants ranges from 6 to 8.

Which equipment would the nurse gather to administer enteral feedings through a jejunostomy tube? Select all that apply. O l-mL syringe O 50 mL of water O pH indicator tape O 60-mL. catheter tip syringe O Blood glucose testing materials

O 50 mL of water O pH indicator tape O 60-mL. catheter tip syringe Rationale The nurse will need 50 mL of water, a pH indicator tape, and a 60-ml catheter tip syringe to administer enteral feedings through a jejunostomy tube Al-mL syringe is used to administer enteral feedings to infants with a nasogastric tube Blood glucose testing materials are used only when blood glucose levels have been ordered

Which number is the pH in the stomach of a premature infant? O 2 O 3 O 5 O 6

O 6 Rationale A premature infant has immature acid-secreting cells in the stomach; therefore they have a high gastric pH ranging from 6 to 8. At 1 year of age, a child's stomach pH becomes approximately the same as an adult in response to acid-secreting cells. On an empty stomach, the pH of an l-year-old child is nearly 1 to 2 and when the stomach is full it is approximately

Which statement about drug names is correct? O A drug may have multiple proprietary names. O Drugs are listed by their chemical names in the US Pharmacopeia. O The generic name is a trademarked name O The official name must be used on all prescriptions,

O A drug may have multiple proprietary names.

Which information would the nurse include in patient teaching regarding the use of nitroglycerin transdermal patches for the prevention of angina attacks? Select all that apply. O Continue to replace the disk every 10 to 14 hours." O A new patch is required if the disk becomes partially loosened O The disk will be placed at the same site at a regular schedule. O Take sublingual nitroglycerin as prescribed by healthcare provider O "Avoid touching the exposed side of the patch while applying it

O A new patch is required if the disk becomes partially loosened O Take sublingual nitroglycerin as prescribed by a healthcare provider O "Avoid touching the exposed side of the patch while applying it

Which pharmacokinetics process is affected when antacids are coadministered with ketoconazole? O Excretion O Absorption O Distribution O Metabolism

O Absorption Changes in absorption may occur when ketoconazole and antacids are used concomitantly. Antacids inhibit the dissolution of ketoconazole tablets by increasing gastric pH. Changes in excretion may occur when acetazolamide is coadministered with quinidine. Changes in distribution may occur when warfarin is coadministered with furosemide. Changes in metabolism may occur when erythromycin and theophylline are used concomitantly

Which process describes the transport of medication from its site of entry to the circulating fluids of the body? O Liberation O Absorption O Metabolism O Distribution

O Absorption Rationale Absorption involves the transport of medication from its site of entry to the circulating fluids of the body for distribution around the body. Liberation involves the dissolving of the active medication in the gastrointestinal fluid so that the drug can be transported across the stomach or intestinal lining. Metabolism is the process by which the body inactivates medications into minor metabolites. Distribution is the process where the medication is transported throughout the body and lymphatic system

Which pharmacokinetic process is affected when a patient in shock receives an intramuscular antibiotic? O Excretion O Absorption O Distribution O Dissolution

O Absorption Rationale When an antibiotic is administered intramuscularly to a patient in shock, the rate of absorption of the drug decreases because of reduced peripheral vascular circulation. A slow rate of excretion of drugs may occur in patients with kidney failure. In patients with nephrotic syndrome or malnutrition, the distribution of drugs is affected by serum protein level, which helps in drug distribution. Changes in dissolution and rate of absorption of drugs can be seen in patients who are vomiting because of the short retention e of the drug in the stomach

Which drug possesses a high risk for abuse according to the Controlled Substance Drug Schedules? O Diazepam (Valium) O Diphenoxylate and atropine (Lomotil) O Guaifenesin and codeine (Robitussin AC) O Acetaminophen and hydrocodone (Norco)

O Acetaminophen and hydrocodone (Norco) Rationale Acetaminophen and hydrocodone (Norco) is listed under Schedule III of the Controlled Substances Act because of a high potential for abuse Diazepam (Valium) is listed under Schedule IV because it has a low potential for abuse compared with Schedule Il drugs. The combination of diphenoxylate and atropine (Lomotil) and guaifenesin and codeine (Robitussin AC) are classified as Schedule V drugs, which have low potential for abuse

Which step would the nurse take to administer a liquid aerosol O Have the patient assume the supine position O Activate the nebulizer until fine mist starts flowing: O Request the patient to take short breaths after applying the nebulizer mask. O Have the patient stand to assess the effectiveness of the intervention

O Activate the nebulizer until fine mist starts flowing Rationale The nurse should activate the nebulizer with compressed oxygen or air until a fine mist is flowing. To administer a liquid aerosol, the nurse should have the patient assume a sitting position to allow maximum lung expansion. The supine position is required after the application of vaginal medication. After placing a nebulizer mask on the patient's mouth, the nurse should ask the patient to breathe normally. The nurse should assess the effectiveness of the intervention while the patient is in the same sitting position

Which type of medication error occurs when a patient takes a prescribed medication then takes that same medicine again an hour later? O Dispensing O Monitoring O Prescription O Administration

O Administration Rationale An administration error may occur due to administration of an incorrect dose of a medication. A patient taking a medicine repeatedly indicates an extra dose of the medicine. The extra dose may have led to adverse effects suct as nausea and stomach upset. Dispensing errots may occur due to an incorrect formulation or dosage form. Monitoring errors may occur as a result of suboptimal monitoring, assessment of drug response or revision of regimen, or patient education. Prescription errors may occur due to suboptimal drug therapy decisions.

Which statement is true of administration of nitroglycerin ointment, but not true when applying a nitroglycerin transdermal patch? O There must be a drug-free period between doses. O The ointment can be applied anywhere on the body. O Application site rotation is required. O Administration should be every 3 to 4 hours and at bedtime.

O Administration should be every 3 to 4 hours and at bedtime. Rationale In regulated dose, nitroglycerin ointment is applied every 3 to 4 hours and at bedtime, whereas a nitroglycerin transdermal patch is applied once daily. Both nitroglycerin ointment and a nitroglycerin transdermal patch require a drug-free period for effectiveness. Both forms must be placed on any area without hair with continuous rotation of the site is required

During the new drug development process, at which time is an investigational new drug application submitted to the Food and Drug Administration (FDA)? O After the preclinical phase of drug development O During phase 1 O Before phase 2 O Before phase 3

O After the preclinical phase of drug development Rationale An investigational new drug application is submitted to the FDA after the preclinical phase of drug development to begin the clinical phase of drug development

Which source of drug information would the nurse refer to while educating the nursing student about comparing drug brand names with generic names? O American Drug Index O Pharmaceutical Codex O Compendium of Pharmaceuticals and Specialties (CPS) O USP Dictionary of United States Adopted Names (USAN) and International Drug Names

O American Drug Index

Which class of drugs would be given at higher than normal doses in an infant? O Phenothiazines O Benzodiazepines O Calcium channel blockers O Aminoglycoside antibiotics

O Aminoglycoside antibiotics Rationale Infants have a larger volume of distribution for water-soluble medications and thus require a higher dose on a milligram-per-kilogram basis than an adult. Aminoglycoside antibiotics are water-soluble drugs. Phenothiazines, benzodiazepines, and calcium channel blockers should be prescribed in smaller dosages to a low-birth-weight infant because the infant has less fat content to bind with the drug, which may lead to toxicity.

Which class of drugs is categorized as water-soluble? O Phenothiazines O Antidepressants O Aminoglycosides O Calcium channel blockers

O Aminoglycosides Rationale Aminoglycosides are the class of antibiotics that are considered water-soluble drugs. Phenothiazines, antidepressants, and calcium channel blockers are highly fat-soluble drugs.

Which drugs have the highest potential for abuse? Select all that apply. O Amphetamine (Evekeo) O Acetaminophen (Tylenol) O Aspirin and oxycodone (Percodan) O Aspirin, butalbital, and caffeine (Fiorinal) O Hydrocodone and acetaminophen (Lortab)

O Amphetamine (Evekeo) O Aspirin and oxycodone (Percodan) Rationale Amphetamine, aspirin and oxycodone are Schedule II drugs they have a high potential for abuse and may lead to severe psychological or physical dependence. Acetaminophen, aspirin, butalbital, caffeine, hydrocodone, and acetaminophen also have a high potential for drug abuse, but it is less than that of Schedule Il drugs.

Which category of drugs falls under Schedule III according to the Canadian Controlled Drugs and Substances Act, 1972 O Opioids O Cannabis O Amphetamines O Sedative hypnotic agents

O Amphetamines

Which drug's absorption is increased in older patients? O Phenytoin O Ampicillin O Phenobarbital O Acetaminophen

O Ampicillin Rationale Ampicillin is destroyed by gastric acid. It is more readily absorbed by older patients because of age-related loss of acid-secreting cells, which results in higher gastric pH. Because of this, the serum concentration of the drug increases, which may cause toxicity. Phenytoin, phenobarbital, and acetaminophen require an acidic environment for absorption. Therefore these drugs are poorly absorbed by older patients, which reduces the serum concentration of these drugs

Which effect can occur in a patient who takes tetracycline and an antacid? O Additive effect O Allergic reaction O Antagonistic effect O Idiosyncratic reaction

O Antagonistic effect Rationale Antacids interfere with the absorption of tetracycline, thereby decreasing its effect. The effect of one drug inhibiting the action of another is called the antagonistic effect. The increased effect produced by the use of two or more drugs is called an additive effect. An allergic reaction is an immune response developed because of the presence of an antigen. Idiosyncratic reaction occurs when a drug is administered for the first time.

Which class of drugs is classified on the basis of physiologic action? O Antacids O Laxatives O Anticholinergics O Antihypertensives

O Anticholinergics Rationale Anticholinergics are classified on the basis of their chemical or physiologic action: Antacids, laxatives, and antihypertensives are classified on the basis of their therapeutic use

Which statement is true for administration of ophthalmic ointment but not true for administration of ophthalmic drops? O Application is over the conjunctival sac. O Exudate should be removed before installation. O The patient to be in a supine position facing upward, O Application is in a strip fashion, from the inner canthus to the outer canthus

O Application is in a strip fashion, from the inner canthus to the outer canthus Rationale Ophthalmic ointment is applied in a strip fashion from the inner to the outer canthus. Ophthalmic drops are instilled by exposing the lower conjunctival sac by applying gentle traction to the lower lid at the bony rim of the orbit. Both ophthalmic ointment and ophthalmic drops require precleansing of exudates. Both types of medication are applied over the conjunctival sac by having the patient assume a supine position facing upward.

Which supplies would the nurse make available when administering a nitroglycerin ointment? O Penlight O Tongue blade O Applicator paper O Hypoallergenic tape

O Applicator paper Rationale Applicator paper is used to apply nitroglycerin ointment. Other equipment required includes dean gloves, nitroglycerin ointment, the medication administration report, and a medication profile. A penlight is needed to administer nasal spray, A tongue blade is used to apply cream or ointments. Hypoallergenic tape is used to perform patch testing.

When a patient in pain requests pain medication, which action to address the patient's request is a priority O Consult the healthcare provider immediately O Give morphine sulfate to the patient immediately O Ask the patient to wait for the time of administration of the drag. O Check the chart for any prior administration of the drug and then give the drug if appropriate

O Check the chart for any prior administration of the drug and then give the drug if appropriate Rationale The patient's chart should first be checked before administering as-needed (PRN) medications to ensure that Someone else has not administered the drug, After that, the nurse should check the time to see if it is appropriate to give the medication to the patient and then administer the medication to the patient. Giving the medication immediately without checking before hard could lead to toxicity or severe adverse effects: Consulting the healthcare provider may not be required in this situation. Asking the patient to wait for some time may not help the patient in this situation and may make the patient angry because of severe pain.

Which mechanism of drug-drug interaction is observed when ampicillin and gentamicin are administered in the same syringe or solution? O Chemical incompatibility between two medications O Inhibition of the metabolism of the first medication by the second one O Displacement of the first medication from protein-binding sites by the second one O The combined effect of two medications is greater than the sum of the individual effect

O Chemical incompatibility between two medications Rationale Ampicillin is chemically incompatible with gentamicin. When these medications are mixed in the same syringe or solution, both drugs deteriorate Inhibition of metabolism of the first medication by the second one indicates interference and may occur when probenecid and ampicillin are coadministered. Displacement of warfarin from protein-binding sites may occur when valproic acid is used concomitantly A synergistic effect occurs when the combined effect of two medications is greater than the sum of the individual effect this may occur when aspirin and codeine are coadministered

Which site is ideal for the placement of a transdermal patch? O Back O Arms O Chest O Thighs

O Chest Rationale Any site without hair is considered ideal for the application of transdermal patches. The chest can be an ideal site for placing a transdermal patch because it has minimal hair. The back, arms, and thighs tend to be hairier than the chest; hence these are not common sites for the placement of a transdermal patch

Which drug has reduced absorption in an infant? O Ampicillin O Phenytoin O Ibuprofen O Chloramphenicol palmitate

O Chloramphenicol palmitate Rationale An infant cannot metabolize palmitic acid from chloramphenicol palmitate, therefore absorption is reduced. Ibuprofen, a nonsteroidal antiinflammatory drug has the potential to cause gastric ulcers, increasing the extended contact time with the stomach lining. Phenytoin is poorly absorbed and results in a low serum concentration of blood. Ampicillin is readily absorbed in older adults because of high gastric pH and results in high serum concentration

a new medication order written at 8 AM by the physician reads Demerol 75 mg stat. Which action does the nurse take? O Administers the medication right away O Gives the medication with the 9 AM meds O Clarifies the order with the physician O Verifies the dose of the drug with the pharmacist

O Clarifies the order with the physician Rationale The medication should not be administered because the order is incomplete; it does not specify the route of administration. The order should be clarified with the physician before administration. The medication should not be administered right away. The medication would not be administered with the 9 AM medications because it is a stat or give immediate order. The pharmacist would be consulted about the dose only in special circumstances, such as if information about the standard dosage ranges for the ordered drug were not available

Which transdermal medication system is applied once every 7 days? O Fentany O Clonidine O Scopolamine O Nitroglycerin

O Clonidine Clonidine transdermal systems are applied once every 7 days. Fentanyl patches are changed every 3 days. Scopolamine is applied at least 4 hours before travel. A nitroglycerin transdermal patch is applied once a

A patient taking insulin (Humulin R) has an elevated blood glucose level and has run out of insulin. Which action by the nurse is correct according to the Canadian Food and Drugs Act and Regulations? O Instructing the patient to immediately take an herbal hypoglycemic product along with food O Checking the patient's blood sugar levels every 10 minutes until he or she can take insulin O Instructing the patient to reduce intake of fiber until the primary healthcare provider can be consulted O Collaborating with the pharmacist to issue insulin to the patient immediately

O Collaborating with the pharmacist to issue insulin to the patient immediately Rationale According to the Food and Drugs Act and Regulations, Schedule Il drugs such as insulin can be obtained directly from a pharmacist. Therefore the licensed practical nurse should collaborate with the pharmacist to Issue insulin immediately to ensure the patient's safety. Herbal products do not ensure the patient's safety. There is no need to check blood sugar levels every 10 minutes, in fact, doing so may increase the patient's discomfort. Reducing fiber intake would not normalize the patient's blood glucose levels.

Which property is characteristic of a cream? O Comes as a nongreasy base O Isa dear preparation O Used to absorb excess moisture O Has an astringent action

O Comes as a nongreasy base Rationale The cream has a nongreasy base, whereas an ointment has an oily base. Because of this property, creams are easily removed with water, whereas ointments adhere better to the skin and are not easily removed with water. Creams are not clear, they are typically white in color Creams can be used to hydrate the skin, not absorb excess moisture. Lotions, not creams, have astringent actions

Which procedural step would be done first when administering an enteral feeding through a gastrostomy tube? O Release the clamp on the tube. O Confirm the placement of the tube O Attach a 60-ml catheter tip syringe to the tube. O Aspirate residual material by withdrawing the plunger.

O Confirm the placement of the tube Rationale The nurse should initiate the feeding only after verifying the placement of the gastrostomy. The nurse should then initiate the feed by attaching a 60-ml catheter tip syringe to the tube, releasing the clamp, and then aspirating the residual material by drawing back the plunger slowly.

Which information about pregnancy-related issues is required to be on drug labels per the Food and Drug Administration (FDA) rules? Select all that apply. O Contraception O Pregnancy testing O Infertility O Risks when taking while breastfeeding O Dietary requirements

O Contraception O Pregnancy testing O Infertility O Risks when taking while breastfeeding Rationale In 2015, the FDA instituted new rules for drug labels that replace the lettered categories with new categories on pregnancy, lactation, and reproductive potential. In addition to including information that summarizes the risks of using a drug during pregnancy and lactation, the labeling must include relevant information about contraception, pregnancy testing, and infertility to inform the healthcare provider prescribing drugs for females and males of reproductive potential and for the consumer). Dietary requirements are not required to be on drug labels for pregnancy based on the FDA labeling ruling.

Which formulation is a semisolid emulsion with a nongreasy base? O Cream O Lotion O Dressing O Ointment

O Cream Rationale A cream is a semisolid emulsion that contains medicinal agents for external application Creams have a nongreasy base and can be removed with water. Lotions are aqueous (water-based) preparations that contain suspended materials. A dressing is a covering or ligature that is used to cover and protect a wound Ointments are semisolid preparations of medicinal substances in an oily base such as lanolin or petrolatum

Which statements describe the advantages of drug dispensing systems? Select all that apply. O Credit is given to the patient for unused medication O Time taken for preparing drugs for administrations reduced O Misappropriation is drastically reduced by the dispensing system. O Dosage calculations are managed by controlled dispensing system O Counting drugs from multidose packets managed by dispensing systems.

O Credit is given to the patient for unused medication O Counting drugs from multidose packets managed by dispensing systems. Rationale Because cach dose is individually packaged by using a unit-dose distribution system, credit is given to the patient for unused medications. It is still the nurses' responsibility to calculate dosages and check drugs, as sometimes errors might occur. The dispensing systems reduce the time taken to prepare drugs for administration Also, misappropriations are reduced by dispensing systems. The dispensing systeris count drugs from multidose packets

Which drug interferes with the metabolism of a nursing infant? O Aspirin O Alprazolam O Cytarabine O Amphetamine

O Cytarabine Rationale Cytarabine interferes with the metabolism of nursing infants. Aspirin, alprazolam, and amphetamines have an effect on nursing infants but are not metabolic in nature.

Which online source of drug information provides a database for new package inserts? O DailyMed O Drug interaction Facts O Physicians' Desk Reference (PDR) O Martindale: The Complete Drug Reference

O DailyMed Rationale DailyMed is an online source of information that provides a database for new package inserts and is searchable by any characteristic of a drug Drug Interaction Facts, Physicians Desk Reference (PDR), and Martindale: The Complete Drug Reference are offline sources of drug information

Which online source of drug information provides a database for new package inserts? O DailyMed O Drug Interaction Facts O Physicians' Desk Reference (PDR) O Martindale: The Complete Drug Reference

O DailyMed Rationale DailyMed is an online source of information that provides a database for new package inserts and is searchable by any characteristic of a drug. Drug Interaction Facts, Physicians' Desk Reference (PDR), and Martindale: The Complete Drug Reference are offline sources of drug information.

Which physiologic change in a patient with renal failure requires a reduced initial dose of phenytoin? O Decreased globulin levels O Decreased albumin levels O Decreased creatinine levels O Decreased blood urea nitrogen

O Decreased albumin levels Rationale In disease conditions such as renal failure, the initial doses of highly protein- bound drugs such as phenytoin should be reduced initially and increased slowly if albumin levels are decreased Globulin levels are increased when albumin levels are decreased. Creatinine levels and blood urea nitrogen are used to assess renal function. These may be decreased in older adults because of decreased renal function

Which alterations can cause diarrhea in a 56-year-old on drug therapy? Select all that apply. O High gastric pH O Slow intestinal transit time O slow gastric emptying time O Decreased intestinal blood flow O Decreased gastrointestinal motility

O Decreased intestinal blood flow O Decreased gastrointestinal motility Rationale In older adults, intestinal blood flow and gastrointestinal motility are decreased. These factors alter the absorption of drugs and cause constipation or diarrhea, depending on the drug used. High gastric pH results in high serum concentration of drugs such as penicillins, Slow intestinal transit time is seen in premature and full-term newborn is Slow gastric emptying time not only increases the absorption of the drug, but it can also cause toxicity because of extended contact time in the stomach

Which action should the nurse take for a patient taking furosemide and warfarin? O Discontinuing furosemide O Discontinuing warfarin O Decreasing the dose of furosemide O Decreasing the dose of warfarin

O Decreasing the dose of warfarin Rationale Furosemide displaces warfarin from the protein binding sites, which will cause an increased concentration of warfarin and may lead to hemorrhage However, coadministration of bath drugs is possible by reducing the dose of warfarin Discontinuing and decreasing furosemide can be avoided because the dose of warfarin can be adjusted to facilitate concomitant administration. Discontinuing warfarin can be avoided because the dosage can be adjusted

Which factor associated with aging increases the risk for gastric irritation from nonsteroidal antiinflammatory drugs (NSAIDS) in older adults? O Decreased splanchnic blood flow O Delayed gastric emptying O Prolonged secretion of gastric acid O Loss of cells from the gastric plexus

O Delayed gastric emptying Rationale Premature infants and geriatric patients have a slower gastric emptying time, partly because of their reduced acid secretion. A slower gastric emptying time may allow the drug to stay in contact with the absorptive tissue longer, thereby allowing for increased absorption with a higher serum concentration. There is also the potential for toxicity caused by extended contact time and with NSAIDs increased potential for gastric ulcers. Decreased splanchnic blood flow has no effect on gastric irritation from NSAIDs. Secretion of gastric acid is decreased, not Increased or prolonged, and the pH of the gastric acid is increased in older adults. Loss of cells from the gastric plexus is not a factor associated with gastric irritation from NSAIDS

Which is the best description of a toxic reaction to a drug? O Psychological craving O Physiologic dependence O Deleterious adverse effect O Individual unexpected effect

O Deleterious adverse effect Rationale A toxic reaction is one that is capable of causing injury or death. A deleterious adverse effect is one having a harmful or injurious effect, so it is the best description. Examples of toxic reactions to drugs include kidney and liver damage. A psychological craving and physiologic dependence to a drug are not considered toxic reactions. An idiosyncratic reaction is an unpredictable effect occurring in an individual

Which change can be observed in a patient who is receiving acetazolamide and quinidine? O Elevated urinary pH levels O Elevated gastric pH levels O Increased effects of quinidine O Increased levels of unbound quinidine in the urine

OIncreased effects of quinidine Rationale The administration of acetazolamide causes a change in excretion by increasing the pH of the urine, making it more alkaline. When the two drugs (acetazolamide and quinidine) are administered together, the Increased pH of the urine caused by acetazolamide causes quinidine to be reabsorbed in the renal tubules, increasing its physiologic effects and potential for toxicity. The administration of acetazolamide and quinidine does not cause acidic urinary levels or increased gastric pH, nor does it affect the unbound levels of quinidine in the urine

Which formulation is a semisolid preparation with an oily base?

Ointment

A patients medical history reveals Pneumocystis jiroveci pneumonia. Which medications are beneficial for the patient according to the Orphan Drug Act? Select all that apply Pentamidine Atovaquone Leustatin Zidovudine Thalidomine

Pentamidine Atovaquone

Which drug when given with warfarin can precipitate blood clots? O Cimetidine O Amiodarone O Chloramphenicol O Phenytonin

Phenytonin Rationale Phenytoin stimulates the production of enzymes required for metabolism. Therefore if phenytoin and warfarin are administered concomitantly, warfarin may get eliminated, thereby increasing the risk for blood clots in the patient. Cimetidine, amiodarone, and chloramphenicol slow the metabolism of other drugs

Which types of medication error have occurred when a patient who has received suboptimal patient education takes a drug that is not prescribed and develops an allergy and intolerance Select all that apply. O Dispensing O Prescribing O Monitoring O Transcription O Administration

Prescribing Monitoring Rationale A prescribing medication error happens when there is a suboptimal drug therapy or an unauthorized drug is administered, which can lead to allergy and intolerance. A monitoring error happens when there is a suboptimal assessment of drug response or revision of a regimen and when there is suboptimal patient education A dispensing medication error occurs when the patient is administered the wrong formulation. A transcription error occurs due to unapproved abbreviations and illegible handwriting, An administration error occurs due to incorrect administration technique and wrong administration time.

Which action does the nurse take when a patient suddenly stops taking his or her prescribed heart medication? O Convince the patient that it is in his or her best interest to take the medication. O Record the medication as refused and continue with the care of the patient. O Record the patient's refusal of the medication in the nurse's notes and notify the prescriber. O Provide patient teaching concerning how the drug alleviates heart symptoms.

Record the patient's refusal of the medication in the nurse's notes and notify the prescriber. Rationale Because this is a heart medication, the prescriber should be notified because the patient may experience changes in his or her condition. The nurse should determine why the patient refuses the medication but should be sensitive to reasons. In cases where there may be adverse effects if the patient does net take the medication, the nurse should document the patient's refusal of the medication and notify the prescriber Patient teaching should already have been performed by this point.

Which statement is true regarding the classification system of drugs in the United States? O The generic name is followed by the symbol O The first letter of the generic name is capitalized, O The first letter of the brand name is not capitalized. O The brand names are deliberately made easier to pronounce.

The brand names are deliberately made easier to pronounce.

A patient reports taking an antacid routinely. The patient's reference to the drug in this way characterizes which method of drug classification? Therapeutic use Body system Chemical action Physiologic action

Therapeutic use.

Which principle of pharmacokinetics must the nurse keep in mind when administering medication to an infant?

There is an increased risk of toxicity with use of topical agents.

For which reason would a patient who takes a sedative-hypnotic medication be instructed to avoid drinking alcohol? To prevent CNS depression To prevent neuromuscular blockade To increase the metabolism of medication To prevent the absorption of the medication

To prevent CNS depression

Which medication can increase bleeding in a patient taking warfarin? O Probenecid O Valproic acid O Acetaminophen O Hydrocodone

Valproic acid Rationale Valproic acid and warfarin compete with each other for protein binding, thereby causing displacement of warfarin by valproic acid. An unbounded form of warfarin may increase its anticoagulant effect and cause bleeding. Probenecid has no known interaction with warfarin. Acetaminophen and warfarin also have no known interactions. Hydrocodone has no known interactions with warfarin,

Which statements are limitations of administering medication through the oral route? Select all that apply. O Insulin and gentamicin are destroyed by digestive fluids. O Absorption is the slowest and least dependable. O The digestive system enzymes are bypassed O Teeth can be damaged or discolored by enteral medications. O Medication cannot be administered orally to patients who are likely to aspirate or are unconscious.

O Insulin and gentamicin are destroyed by digestive fluids. O Absorption is the slowest and least dependable. O Teeth can be damaged or discolored by enteral medications. O Medication cannot be administered orally to patients who are likely to aspirate or are unconscious. Rationale Insulin and gentamicin are destroyed by digestive fluids and should not be administered orally. The oral route of administration has the slowest and least dependable rate of absorption, Oral medications are not administered to patients who are likely to aspirate or are unconscious. Enteral medications route, including oral medications, should not be used if the drug may harm or discolor the teeth. Administering drugs via the rectal route bypasses the digestive enzymes present in the gastrointestinal environment. The advantages of oral medications are that they are safe, convenient, and comparatively cheap. In addition, dose forms are readily available,

Which drug interaction may occur in a patient taking both pancuronium and aminoglycoside? O Interference O Incompatibility O Synergistic effect O Antagonistic effect

O Interference Rationale The increased activity of one drug because of the inhibition of metabolism or excretion by another drug is called interference. The interaction between aminoglycoside antibiotics and neuromuscular blocking agents such as pancuronium causes serious consequences because antibiotics increase the neuromuscular blockade, which indicates interference. Incompatibility occurs when one drug is incompatible with another drug resulting in the deterioration of the drugs when they are mixed in the same syringe or solution. A synergistic effect occurs when the combined effect of two drugs is greater than the sum of the individual effect of the drug.

Which fluid aspirated from a nasogastric tube is yellow in color? O Gastric O Pleural O Intestinal O Tracheobronchial

O Intestinal Rationale Intestinal fluid is yellow-colored. Gastric fluid is off-white or green with sediment. Pleural fluid is clear or straw-colored. Tracheobronchial fluid is off-white or tan.

Which statement best describes a lotion? O It has a greasy base O It contains suspended material O applied by rubbing on the skin O It consists of self-adhesive and nonadhesive films.

O It contains suspended material Rationale A lotion is an account preparation that contains suspended materials: it is commonly used as a soothing agent to protect the skin and to relieve rashes and itching. An ointment is a semisolid formulation with an oily base that cannot be easily removed. A lotion is applied by firmly getting it on the skin, not by rubbing it on the skin. Dressings may have self-adhesive or nonadhesive transparent Films

Which statement is true of percutaneous drug administration? O It is the application of medicine to the skin or mucous membranes for absorption O System adverse effects are increased when drugs are green percutaneous O Use of the percutaneous route does not require frequent reapplication O Topical applications have a long duration of action.

O It is the application of medicine to the skin or mucous membranes for absorption Rationale The percutaneous route uses the skin or mucous membranes as administration sites. By localizing the application, there is reduced incidence of systemic side effects using percutaneous administration Percutaneous administration requires frequent reapplication because it has a short duration. Topical applications have a short duration of action

Which statement is true related to vaginal douching? O recommended during pregnancy. O It is an effective method of birth control, O It is essential for normal female hygiene. O It is used for vaginal infection and discharge

O It is used for vaginal infection and discharge Rationale A vaginal douche may be used to irrigate the vagina during vaginal infection and discharge. Douches are not recommended during pregnancy They Are not an effective method of birth control nor are they a part of normal feminine hygiene.

Which statement is true about the floor or ward system with regard to medication administration in the hospital? O It Reduces medication errors. O It diminishes the drug deterioration. O It minimizes the return of medications O It requires infrequent total drug inventories.

O It minimizes the return of medications Rationale The floor or ward system is used in the hospital where there is no direct charge to the patient for medications; this system helps minimize the return of medications. There could be an increase in drug deterioration by unnoticed passing of expiration dates. Medication errors may increase in this system because of the large array of stock medication from which to choose for a patient's medication order. With this system, there will be a need for larger stocks and frequent total drug inventories.

Which statement is true about the floor or ward system with regard to medication administration in the hospital? O It reduces medication errors O It diminishes the drug deterioration. O It minimizes the return of medications. O It requires infrequent total drug inventories.

O It minimizes the return of medications. Rationale The floor or ward system is used in the hospitals where there is no direct charge to the patient for medications, this system helps minimize the return of medications. There could be an increase in drug deterioration by unnoticed passing of expiration dates. Medication errors may increase in this system because of the large array of stock medication from which to choose for a patient's medication order. With this system, there will be a need for larger stocks and frequent total drug inventories.

why is the oral route preferred for medications? Select all that apply. O Its relatively economical O Most medications are readily available in oral dose forms. O The rate of absorption is dependable. O It is convenient. O is safe

O Its relatively economical O Most medications are readily available in oral dose forms. O It is convenient. O is safe

Which dressing would the nurse apply on a patient peripheral wound that is oozing clear. thin, pale yellow exudate? O Telfa O Kaltostat O DUODERM O Tegaderm

O Kaltostat Rationale The exudate is rich in protein and cells and promotes wound healing in such cases, to achieve moisture balance in a wound, the nurse should use an alginate dressing such as Kaltostat (a calcium alginate dressing Telfa is a nonadherent gauze dressing. DuoDERM is a hydrocolloid dressing that is used on damaged skin. Tegaderm is a self-adhesive transparent film that acts second skin

Which record is used to store pertinent information? O Kardex O Patient education O Unscheduled medication O Medication administration

O Kardex Rationale The Kardex record is used for storing pertinent information such as the patient's name, diagnosis, allergies, treatments, and the nursing care plan. The patient education record is used to document the health-related teaching provided to the patient, the family member, or the caretaker. The unscheduled medication record is also known as the PRN record. It records the dose, the reason for administering the as-needed (PRN) medication, and the patient's response to the given drug. A medication administration record is used to store information regarding the pain medication received by a patient.

Which factor is the reason for administering a higher dose of a water-soluble drug on milligram-per-kilogram (mg/kg) basis to an infant? O Lean body mass O High-fat content O Larger volume of distribution O Low percentage of total body water

O Larger volume of distribution Rationale Infants have a larger volume of distribution for water-soluble drugs compared with an older child or an adult. Therefore they require higher doses on an mg/kg basis. Body mass becomes decreased, fat content increases, and total body water content becomes low with aging. These features are not seen in infants and are

If a nasogastric (NG) tube is in the stomach, at which level does the nurse expect the aspirate to be? O Less than 3 O 4 to 5 O 6 to 7 O Greater than 7

O Less than 3 Rationale If an NG tube is correctly placed in the stomach, the stomach pH would measure less than 3. A pH reading of 4 to 5 is acidic but is usually not a low enough reading for stomach contents unless the patient is receiving histamine-2 antagonists, which would affect the aspirated fluid pH. Intestinal pH is typically 6 to 7 Respiratory pH is typically greater than 7

Which process involves dissolving active medication in gastrointestinal fluid for its transport across the stomach or intestinal lining? O Liberation O Absorption O Metabolism O Distribution

O Liberation Liberation occurs when the active medication is dissolved in the gastrointestinal fluid so it can be transported through the stomach or intestinal lining. Absorption is the process in which a drug is transferred from its site of ent the body to the circulating fluids of the body. Metabolism is the process in which the body inactivates medications into minor metabolites. Distribution is the process in which a medication is transported throughout the body and lymphatic system

Which areas of a patient's body are affected first after a drug overdose? Select all that apply. O Fat O Skin O Liver O Brain O Muscles

O Liver O Brain Rationale Organs with a rich blood supply (such as the liver and the brain) receive drugs rapidly these organs will be most affected by a drug overdose. Fat, skin, and muscles have less extensive blood supply and will be affected by a drug overdose later.

Which medication is included in Schedule of the United States Controlled Substance Drug Schedules? O Codeine O Flurazepam O Methadone O Lysergic acid diethylamide

O Lysergic acid diethylamide Rationale in the US Controlled Substance Drug Schedules, Schedule I drugs have the highest potential for abuse. Lysergic acid diethylamide is a hallucinatory agent that has a very high potential for abuse and is therefore included in Schedule I. Codeine is included in Schedule ill because it has a moderate potential for physical dependence Flurazepam 15 included in Schedule IV because it has a limited potential for physical dependence Methadone is included in Schedule It because it has a high potential for abuse

Which equipment would the nurse gather to administer medication through a nasogastric (NG) tube to an adult patient? Select all that apply. O I-ml syringe O Measuring container O Small incontinence pad O Water-soluble lubricant O Two 60-ml catheter tip syringes

O Measuring container O Small incontinence pad O Two 60-ml catheter tip syringes Rationale The nurse should gather a measuring container, a small incontinence pad, and two 60-ml catheter tip syringes to administer medication through an NG tube to an adult patient. A l-mL syringe is used to administer medication through an NG tube to a young child. Water-soluble lubricant is used to administer a rectal suppository

Which change in the pharmacokinetic stages may cause an idiosyncratic reaction? O Excretion O Absorption O Distribution O Metabolism

O Metabolism Rationale Changes in metabolism may cause an idiosyncratic reaction. This type of reaction is generally the result of a patient's inability to metabolize a drug because of a genetic deficiency of certain enzymes. Changes in excretion occur because of drug interactions in the kidney tubules when the pH is changed. Changes in absorption may occur as a result of drug interactions, resulting in inhibiting or inducing the enzymes that metabolize the drug. Changes in distribution occur as a result of drug interactions that affect the binding of a drug at the inactive site

Which stage pharmacokinetics may be altered in a patient who has abnormal hepatic enzymes? O Absorption O Distribution O Metabolism O Excretion

O Metabolism Rationale Metabolism is the process whereby the body inactivates drugs. Hepatic enzyme systems are the primary site for the metabolism or biotransformation of drugs in the body. If levels of hepatic enzymes are high, drug metabolism may occur more rapidly than normal. Conversely, if hepatic enzyme activity is low, drug metabolism is slowed and there is a risk for drug accumulation, Absorption is not affected by the level of hepatic enzymes Distribution of drug is affected by blood flow, not by the level of hepatic enzymes. The kidneys are the primary area of drug excretion. Hepatic enzymes are not directly involved in drug excretion

Which medication is most likely responsible for a breast-fed infant's metabolic problems? O Phenobarbital O Amitriptyline O Diazepam O Methotrexate

O Methotrexate Rationale Chemotherapeutic agents such as cyclophosphamide and methotrexate may interfere with the metabolism of a nursing infant when taken by the breastfeeding mother. Anticonvulsants, antidtpressants, and antianxiety drugs also have significant adverse effects on nursing infants but are not specifically metabolism related.

Which scale is used on a medicine cup? O Centimeter O Millimeter O Metric O Kilogram

O Metric Rationale The metric scale is labeled on a medicine cup. The centimeter and millimeter are not scales but units of measurement. A kilogram is a unit of measurement to measure weight.

Which nursing action may lead to complications from administering medications via a nasogastric (NG) tube? O Flushing 30 mL of water to clear the tubing O Drawing up 60 mL of tepid water in the catheter-tip syringe O Mixing the medications to administer them with the second syringe O Disconnecting the NG tube from the suction device and pinching the tubing

O Mixing the medications to administer them with the second syringe Rationale The nurse should have administered the medications one at a time because mixing the medications together can clog the tube. The nurse should flush 30 mL of water to clear the tubing. The nurse should draw up 60 ml of tepid water in the catheter-tip syringe for flushing. The nurse should also disconnect the NG tube from the suction device and pinch the tubing to prevent any back flow of liquid.

Which steps are essential when administering medications via a nasogastric (NG) tube? Select all that apply. O Use of a tablet crusher to crush enteric-coated tablets O Mixing the powder in the capsule with approximately 10 to 15 ml of water. O Flushing the tube using 30 mL of water before and after the medication is administered O Placing the patient in the Sims' position and check the location of the NG tube before administering medication O when administering more than one medication at a time, flushing the line using 5 to 10 mL of water between each medication

O Mixing the powder in the capsule with approximately 10 to 15 ml of water. O Flushing the tube using 30 mL of water before and after the medication is administered O when administering more than one medication at a time, flushing the line using 5 to 10 mL of water between each medication

Which actions would be the immediate nursing interventions for a pediatric patient who receives penicillin intravenously? Select all that apply O Secret Wichte O Assess for nausea O Monitor respiration O Monitor perspiration O Measure blood pressure O Assess for laryngeal edema

O Monitor respiration O Monitor perspiration O Measure blood pressure Rationale Allergic reactions can occur rapidly in children as a result of intravenous administration of drugs such as penicillin. Intense anxiety, weakness, sweating, and shortness of breath may be the first symptoms of allergy. Monitoring respiration and perspiration should be the immediate nursing interventions in this patient Hypotension shock, dysrhythmia, respiratory congestion, laryngeal edema, nausea, and defecation are the other symptoms. These symptoms may not be seen immediately in the patient

Which nursing actions are best suited when initiating the drug therapy for an elderly patient diagnosed with hypertension? Select all that apply. O Monitoring for renal function O Inquiring about the patient's socioeconomic status O Educating the patient about potential complications O Inquiring about over the counter and alternative therapies O Increasing the dosage rapidly to assess for the therapeutic effect.

O Monitoring for renal function O Inquiring about the patient's socioeconomic status O Educating the patient about potential complications Rationale Low socioeconomic status can be a barrier for therapy, so it may be necessary for referral to social services The patient should know about the purpose of the drug and complications that can occur if the drug is discontinued. The primary healthcare provider should be informed if the patient is experiencing any symptoms because of the drug Inquiring about over the counter and alternative therapies would help in preventing serious drug interactions Renal function is assessed by the physician, not the nurse, only to plan the dosage of a drug to be administered, and renal function is monitored when a patient is being monitored during the drug therapy. The dose of the drug should not be increased rapidly stead it should be increased gradually to assess the therapeutic effect and to determine any adverse effects

Which drug information is contained in the American Hospital Formulary Service Information? O Monographs that describe al drugs in a therapeutic class O Over the counter medications that can be purchased in the United States O Evidence based information about herbal medicines and combination products O Monographs about virtually every single-entity drug available in the United States

O Monographs about virtually every single-entity drug available in the United States

Which drug information is contained in the American Hospital Formulary Service Drug Information O Monographs that describe all drugs in a therapeutic class O Over-the-counter medications that can be purchased in the United States O Evidence-based information about herbal medicines and combination products O Monographs about virtually every single-entity drug available in the United States

O Monographs about virtually every single-entity drug available in the United States Rationale The American Hospital Formulary Service Drug Information contains monographs about virtually every single-entity drug available in the United States. Monographs describing all drugs in a therapeutic class are described in Drug Facts and Comparisons. The Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care is a comprehensive text of over-the-counter medications that can be purchased in the United States The Natural Medicines Comprehensive Database contains evidence-based information about herbal medicines and combination products

Which symptoms confirm a diagnosis of angina in a female patient? Select all that apply. O Nausea O Indigestion O Upper back pain O Left-sided chest pain O Left-sided chest pressure

O Nausea O Indigestion O Upper back pain

Which condition can cause inadequate drug distribution in the blood? O Shock O Kidney failure O Hypothyroidism O Nephrotic syndrome

O Nephrotic syndrome Rationale The amount of serum protein levels in the blood is reduced in patients with nephrotic syndrome. This can lead to inadequate drug distribution in the blood. In shock, a drug is absorbed slowly through the intramuscular or subcutaneous route because of reduced peripheral vascular circulation. Drugs are excreted at a slower rate in a patient with kidney failure. In hypothyroidism, the drug absorption is slow because of lower-than-average metabolic rate.

Which drug is categorized as "unscheduled" according to Canadian drug legislation? O Loperamide O Nicotine patch O Diphenhydramine O Pseudoephedrine

O Nicotine patch

Which records are used when a medication is administered during a medical emergency? Select all that apply. O Nurses notes O Progress notes O Nursing care plan O Medication administration record

O Nurses notes O Medication administration record Rationale Nurses' notes are the records of ongoing assessments, diagnosis, and nursing interventions ordered by the primary healthcare provider. The medication administration record has all of the data regarding administration of the medication, date, and time. The flow sheets are quick references to compare data and are condensed sources of information. The progress notes contain the observations of a patient health status, but the interventions are not noted in them. The nursing care plan is an initial data and order collection of a plan of interventions determined for a patient

A 63-year-old patient is considered to be in which life stage? O Adult O Older adult O Elderly O Aged

O Older adult Rationale The older adult age range is 5 to 64 years. The adult age range is 19 to 54 years. The elderly age range is 65 to 74 years. The aged age range is 75 to 84 years

Which is an example of a transcription-based medication error? O Omission of orders O Incorrect dose for diagnosis O Extra dose is given or missed dose O Suboptimal drug therapy decisions

O Omission of orders Rationale The omission of orders is an example of a transcription error. Incorrect dose for diagnosis is an example of a prescribing error. An extra dose is given or a missed dose is an example of an administration error. A suboptimal drug therapy decision is an example of prescribing error,

When initiating drug therapy in elderly adults, at which range is prescribed medications typically started? O One-fourth to one third O One-eighth to one-fourth O One-third to one-half O One-half to three-fourths

O One-third to one-half Rationale Start at one-third to one-half of the normal adult recommended dosage and then gradually increase the dosage at appropriate intervals to assess for the therapeutic effect and the development of adverse effects. The starting range allows the healthcare provider to assess for therapeutic effects and the development of adverse effects. With measurement over time, the medication dosage for the elderly patient can be increased based on therapeutic effects and the absence of adverse reactions. One-fourth to one-third is too low. One-eighth to one-fourth is also too low. One-half to three-fourths is too high and may cause adverse reactions in the patient.

Which drug action describes a medication that can induce a pharmacologic response at a certain concentration? O Onset of action O Drug blood level O Duration of action O Minimum effective concentration

O Onset of action Rationale The onset of action is the amount of time taken for the concentration of medication to start a physiologic or pharmacologic response. The drug blood level determines the amount of medication present in the blood The duration of action determines how long the medication shows its desired pharmacologic effect. If a medication does not reach its minimum effective concentration, there will be no pharmacologic effect

Which drug action describes a medication that can induce a pharmacologic response at a certain concentration? O Onset of action O Drug blood level O Duration of action O Minimum effective concentration

O Onset of action Rationale The onset of action is the amount of time taken for the titration of medication to start a physiologic or pharmacologic response. The drug blood level determines the amount of medication present in the blood. The duration of action determines how long the medication shows its desired pharmacologic effect. If a medication does not reach its minimum effective concentration, there will be no pharmacologic effect.

Which report is used to record findings in a patient with severe chest pain? O Graphic record O Consultation report O Laboratory test record O Other diagnostic report

O Other diagnostic report Rationale A patient with severe chest pain may undergo an electrocardiogram. Electrocardiograph reports are kept with other diagnostic reports Graphic records are used to store manual recordings of temperature, pulse, respiration, and blood pressure. When primary care providers are asked to consult about a patient and recommend treatment these types of data are recorded in the consultation reports. Laboratory test results are usually recorded in the laboratory test records

Which medication may cause serious side effects when administered with aminoglycoside antibiotics? O Aspirin O Probenecid O Pancuronium O Acetazolam de

O Pancuronium Rationale When it is coadministered with pancuronium, aminoglycoside antibiotics increase the neuromuscular blockade, prolonging the body's return to normal respirations and recovery time. Aspirin shows a synergistic effect when coadministered with codeine Probenecid prolongs the antibacterial effect of ampicilin.. Acetazolamide increases the gastric pH when administered concomitantly with quinidine.

Which factors are responsible for an increase of serum concentrations of ampicillin in an elderly patient? Select all that apply. O Passive diffusion O Enzymatic activity O Intestinal transit time O Gastric emptying time O Gastrointestinal motility

O Passive diffusion O Gastric emptying time

Which information is recorded in the nurse's notes if a medication error occurs? O Circumstances surrounding the error O The fact that an incident report was filed O Patient assessments related to adverse effects of the error O The time name of the drug dosage and type of error made

O Patient assessments related to adverse effects of the error Rationale The only information recorded in the nurse's notes are the clinical observations of the patient related to the occurrence. These will serve as a baseline for future comparisons. Circumstances surrounding the error, the fact that an error has occurred, and the fact that an incident report has been completed are not recorded in the nurse's notes

Which source of drug information includes a tear-out form for use by healthcare professionals to voluntarily report a drug's adverse effects? O Drug Interaction Facts O Physicians' Desk Reference O LactMed Database O Drug Facts and Comparisons

O Physicians' Desk Reference

The nurse finds pills in a patient room with an unidentifiable label and without an accompanying prescription. To which drug information resource would the nurse refer to determine the name of the drug? O American Drug Index O Physicians' Desk Reference O rug Facts and Comparisons O Martindale The Complete Drug Reference

O Physicians' Desk Reference Rationale Referring to the Physician's Desk Reference is recommended because it contains a separate section on product identification. The American Drug Index consists of an index of medicines that are available in the United States the index is used to compare brand names with generic names. Drug Facts and Comparisons consists of drug monographs and is used when similar products or cost indices are to be compared. Martindale: The Complete Drug Reference provides information regarding the international names, pharmacological activity, and side effects of drugs

Which source of drug information discusses more than 3000 therapeutic agents? O LactMed O Physicians' Desk Reference O Martindale: The Complete Drug Reference O Natural Medicines Comprehensive O Database

O Physicians' Desk Reference Rationale The Physicians Desk Reference contains information regarding more than 3000 therapeutic agents. Information on drugs and other chemicals that breastfeeding mothers may be exposed to is described in LactMed, Martindale: The Complete Drug Reference is a comprehensive text that contains information about more than 500 drugs in current use throughout the world. The Natural Medicines Comprehensive Database is a scientific gold standard for evidence-based information about herbal medicines and combination products involving herbal medicines.

Which type of oral medication is an obsolete dose form? O Pills O Tablets O Capsules O Lozenges

O Pills Rationale Pills are an obsolete dose form and are no longer manufactured. Tablets, capsules, and lozenges are solid form oral medications that are still manufactured.

Which course of action would be taken if a nurse notices that a rectal suppository is soft before opening the wrapper? O Refrain from using the suppository. O Apply water-soluble lubricant to its tip. O Moisten the suppository with plain water O Place the suppository in ice water for a short time.

O Place the suppository in ice water for a short time. Rationale The nurse should place the unwrapped suppository in ice water to harden if it becomes soft before administering it to the patient. The nurse does not need to discard the suppository if it is still unwrapped. The nurse should apply water-soluble lubricant to the tip of the suppository after ensuring that it is not soft. If water-soluble lubricants are not available, the nurse should moisten the tip of the suppository with water.

Which information should the nurse not provide to a patient scheduled for patch testing for allergens? O "Do not take any anti-inflammatory drugs for at least 24 hours before the test." O Plan to remain at the clinic for 4 hours after the test for an initial reading of the results O "Avoid any activities that cause sweating on the day the test is scheduled O "Expect some itching, burning, and/or wheezing to develop during the test period."

O Plan to remain at the clinic for 4 hours after the test for an initial reading of the results Rationale No anti inflammatory or antihistamine medications should be taken for 24 to 48 hours before patch testing because of the risk of a false negative result. The patient will not need to wait for the results because they are read at 24, 48, and 72 sometimes more hours. Actions that cause sweating in addition to hot baths or showers, should be avoided during the testing period. Itching and burning are side effects that may occur wheezing indicates a severe allergic reaction

Which genetic factor influences how a person responds to a medication? O Genome O Polymorphisms O Pharmaceutics Pharmacogenetics

O Polymorphisms Rationale Naturally occurring variations in the structures of genes and the instructions that they give to the organism are termed polymorphisms. This greatly influences how an individual responds to medications. Genome is the genetic coding of an organism. Pharmacokinetics refers to the movement of the drug in the body. Pharmacogenetics is the genetic study on how the drug response varies in accordance with the inheritance

Which action by the licensed practical nurse (LPN) is punishable according to the Controlled Substances Act? O Taking prescribed controlled drugs as a patient O Possessing a controlled substance as a professional O Administering controlled drugs to a patient on a physician's order O Having official custody of a limited supply of the controlled substance

O Possessing a controlled substance as a professional Rationale Federal and state laws make the possession of controlled substances without a valid prescription a crime. A licensed practical nurse who possesses controlled substances as a professional is liable for punishment because the law makes no distinction between professional and practical nurses with regard to the possession of controlled drugs. The licensed practical nurse can possess controlled substances in a limited quantity if he or she is a patient and has been prescribed controlled drugs. The licensed practical nurse can administer controlled drugs to a patient on a physician's order. The licensed practical nurse can possess controlled substances if he or she has official custody of a limited supply af the controlled substance

Which drug interaction may cause interference? O Aspirin + codeine O Probenecid + ampicillin O Hydrocodone acetaminophen O Warfarin valproic acid

O Probenecid + ampicillin Rationale Probenecid and ampicillin may cause interference when used together. Interference may occur because of the prolonged antibacterial activity of ampicillin because probenecid blocks the renal excretion of amoxicillin. Aspirin and codeine show a much greater analgesic effect when coadministered, Hydrocodone and acetaminophen may cause an added analgesic effect when used concomitantly. Warfarin and valproic acid may produce an increased anticoagulant effect when coadministered.

Which medication when taken with oral contraceptives may cause menstrual abnormalities? O RIfampin O Furosemide O Gentamicin O Acetaminophen

O RIfampin Rationale Rifampin, an antimicrobial medication, acts as an enzyme inducer. It induces the enzymes that metabolize both the progesterone and estrogen components of the oral contraceptive, thereby Causing increased incidence of menstrual abnormalities Furosemide is a loop diuretic and can be safely used by a patient using oral contraceptives. Gentamicin is an antibiotic drug that has no evidence of interaction with cra contraceptives. Acetaminophen does not inhibit the actions of oral contraceptives.

Dosages of which medications should be adjusted in patients with renal failure? Select all that apply. O Ramipril O Nadolol O Efavirenz O Felbamate O Oxcarbazepine

O Ramipril O Nadolol Rationale Ramipril and nadolol are cardiovascular agents that can be used to treat dysrhythmia. The serum level of these medication drugs should be regularly monitored in individuals with renal failure. Regular hepatic monitoring of efavirenz, felbamate, and oxcarbazepine is important to prevent overdosing, which can cause increased serum drug levels that may lead to toxicity

Which procedural step for administering liquid-form medications would be performed first? O checking the number of doses remaining in the drawer O Verifying the label of all the medications against the patient's profile O Reading the patient's drug profile for prescribed medications and administration timings O Obtaining the prescribed medication from the drawer in the medication can allocated to the patient

O Reading the patient's drug profile for prescribed medications and administration timings Rationale Before administering any medication, the nurse should first read the patient's drug profile and time of administration. The nurse should check the number of medications in the drawer after reading the patient's drug profile, obtaining the prescribed drugs, and verifying them against the patient's profile. The nurse may verify the label of the medications against the patient's profile after reading through the profile and obtaining prescribed drugs from the medication cart. After reading through the patient's drug profile, the nurse may obtain the prescribed medications from the patient's medication cart.

Which step would the nurse perform when administering a unit-dose medication before proceeding to the patient's bedside? O Educating the patient regarding the names and usage of prescribed drugs O Verifying the patient's identification bracelet against the medication profile O Checking the appropriate patient monitoring parameters, such as apical pulse O Reading the patient's medication profile for drugs prescribed and their administration timings

O Reading the patient's medication profile for drugs prescribed and their administration timings Rationale Before proceeding to the bedside, the nurse is required to read through the patient's medication profile thoroughly for drugs prescribed and their administration timings. The nurse then educates the patient regarding the names and usage of prescribed drugs, verifies the patient's identification bracelet against the medication profile, and finally checks the appropriate patient monitoring parameters.

Which actions would the nurse expect to be performed to provide appropriate drug dosage for a 45-year-old patient with hypertension who has prescribed propranolol: Select all that apply. O Some med answers were not selected O Reduce the initial dose O Increase the dosage gradually. O Assess the patient's liver function O Assess the patient's renal function O Decrease the time interval between doses.

O Reduce the initial dose O Increase the dosage gradually. O Assess the patient's liver function O Assess the patient's renal function Rationale Propranolol is a highly protein-bound drug, and in patients above 40 years old, albumin levels may diminish So, the initial dose should be reduced, and the dosage should be increased slowly to prevent potential drug toxicity. The patient's renal function should be assessed by measuring creatinine clearance to adjust the drug dosages A specific laboratory test is not available to assess the liver function for adjusting drug dosages, but liver function tests should be performed to assess potential liver damage or inflammation. Propranolol is extensively metabolized by the liver. Therefore the time interval between doses should be increased to avoid drug toxicity.

Which action should be performed to ensure safety for a patient with an elevated serum level of valproic acid O Changing the route of administration O Reducing the frequency of medication O Hydrating the patient Administering the medication along with meals

O Reducing the frequency of medication

Which instruction would the nurse provide to a patient after administration of a vaginal medication? O Wipe back to front to remove excess medication n 15 to 20 minutes O Remain supine with hips elevated for 5 to 10 minutes O Lie on the left side for about 5 minutes. O Cleanse the perineum with warm water in 30 minutes.

O Remain supine with hips elevated for 5 to 10 minutes Rationale The patient should remain supine with hips elevated for 5 to 10 minutes to keep the instilled medication in contact with the vaginal mucosa. If there is vaginal discharge when the patient rises, the patient should wipe front to back when cleansing. Lying on the left side is incorrect because the medication tends to pool. Warm water may be used to cleanse the perineum, if needed, but it is not essential.

What parameter should be monitored in a patient before the initiation of digoxin treatment? O Drug allergy O Renal function test O Level of consciousness O Bleeding and clotting time

O Renal function test Rationale The patient's renal function should be monitored before initiating digoxin treatment to reduce the chances of drug accumulation in the plasma as a result of impaired metabolism and excretion. A digoxin allergy is negligible, and the patient may not need to be monitored for drug allergies. A patient undergoing treatment with anesthetics and sedative-hypnotic agents should be assessed for level of consciousness. A patient on anticoagulant treatment must be monitored for bleeding and clotting time.

A patient with osteoporosis has abnormal vitals and no relief from pain even after the daily dosing of raloxifene (Evista). What is the primary step in dealing with this patient problem? O Reporting variance O Recording in the PRN record O Standardizing administration times O Performing medication reconciliation

O Reporting variance Rationale The abnormality in the vitals and lack of desired effect may have occurred because of sound-alike medication error. Evista may sound similar to Avinza, a brand of morphine sulfate, which might have led to this medication error. Evista is a brand of raloxifene, which is used to prevent osteoporosis in postmenopausal women, whereas Avinza is an extended-release form of morphine sulfate used to relieve severe pain. In this situation, reporting a variance is important to reduce further incidences, PRN records have the data about the as-needed (PRN) medications, which are administered as and when needed. Standardizing administering time is standardization of time for administering a drug at a particular time throughout the facility. Medication reconciliation is done before administering a drug to reduce medication errors:

Which characteristic indicates a patient is experiencing tolerance to a drug O Recurrent use of the drug O Voluntary discontinuation of the drug O Requirement for larger doses of the drug after few weeks of use O Development of symptoms after withdrawing the drug for certain period

O Requirement for larger doses of the drug after few weeks of use Rationale a patient requires larger doses of a drug after a few weeks of its use, it indicates that the patient has developed Ifa tolerance to the medication and requires larger doses to produce the same therapeutic effect, Recurrent use of the drug indicates drug abuse or drug dependence. Voluntary discontinuation of the drug may be a result of the patient's fear of becoming addicted, experiencing undesirable side effects, or feeling like the drug is no longer needed. Drug withdrawal symptoms are evident in the patient if the drug is withdrawn abruptly after establishing drug dependence.

Which drug acts as an enzyme inducer? O verapamil O Rifampin O Quinidine O Mexiletine

O Rifampin Rationale Rifampin acts as an enzyme inducer, it binds to an enzyme and increases its metabolism. Verapamil, quinidine, and mexiletine are rapidly metabolized and do not require any inducers

Which medication when given with an oral contraceptive can reduce the oral contraceptive effectiveness? O Rifampin O Furosemide O Warfarin O Hydrocodone

O Rifampin Rifampin will induce enzymes that metabolize both the progesterone and estrogen components of many oral contraceptives, thereby causing an increased incidence of menstrual abnormalities. Furosemide shows an increased anticoagulant effect when coadministered with warfarin. Warfarin may increase the anticoagulant effect when coadministered with valproic acid. Hydrocodone may cause an added analgesic effect when coadministered with acetaminophen.

Which instruction would the nurse give to a patient who has just used a steroid inhaler? O Rinse your mouth with water O Take five or six slow, deep breath O "Use your bronchodilator nest O Blow your nose forcefully

O Rinse your mouth with water Rationale After using a steroid inhaler, the mouth must be rinsed with water to remove any remaining drug and prevent fungal overgrowth. Taking five or six slow, deep breaths is unrelated to the use of a steroid inhaler. Bronchodilators should be used before the steroid so the airways are maximally open to allow the steroid to enter deep into the lung Blowing the nose has no relevance to the use of steroid nebulizers

What factor affects the onset of the action of medications? O Enzyme induction O Medication toxicity O Medication half-life O Route of administration

O Route of administration Rationale The concentration of medication at the site of action that is sufficient to produce a pharmacologic response is known as the onset of action. It is dependent on various factors such as the route of administration, the rate of absorption, distribution, and binding to receptor sites. Factors such as enzyme induction, medication toxicity, and medication half-life do not affect the onset of action

In which way do Schedule Il drugs differ from Schedule V drugs? O Schedule Il drugs have less potential for abuse. O Schedule V drugs require a new prescription for every refill O Schedule || drugs are more likely to cause dependence. O Schedule V drugs have greater risk for toxicity

O Schedule || drugs are more likely to cause dependence.

Which action is appropriate regarding the disposal of unused medications? O Disposing of all unused drugs in the toilet O Disposing of controlled substances into waste bins O Avoiding mixing drugs with undesirable substances before disposal O Scratching out information on the prescription bottles before disposal

O Scratching out information on the prescription bottles before disposal Rationale Before disposal of a prescription container, all information should be scratched off the bottle so that it does not reveal any patient information, Not all drugs should be flushed down the toilet, only drugs with specialized instructions from the manufacturer to flush down the toilet should be flushed Controlled substances are usually flushed down the toilet, rather than thrown in the trash can, to avoid accidental ingestion or ingestion by the wrong person. Emptying the drug from the container and mixing it with undesirable substances will help reduce abuse or accidental ingestion.

Which substance is responsible for the exudate absorbing property of alginate (Sorbsan) dressing? O Sand O Cotton O Seaweed O Collagen

O Seaweed Rationale Sorban is a calcium alginate dressing manufactured from seaweed and is used on infected wounds to absorb exudates. Sorbsan is not manufactured from sand, cotton, or collagen, as none of these substances have exudate absorbing properties.

Which method should the nurse use to apply a medicated antifungal lotion O Take the desired amount and smoothly apply to the area with the hands O Shake the container thoroughly before use and apply it firmy by gently patting the skin surface O Squeeze the amount needed onto the tongue blade and apply with firm strokes. O Use a longue blade to remove the desired amount and gently rub it into the area

O Shake the container thoroughly before use and apply it firmy by gently patting the skin surface Rationale A lotion should be shaken before application until the suspension appears uniform. it should then be applied firmly by firmly patting on the skin surface. A medicated lotion should never be applied by hand without wearing gloves. Ointment and creams are squeezed in the desired amount and applied using firm strokes. A cream is removed using a tongue blade and applied by gently rubbing it onto the surface.

What factor affects drug absorption through the topical route? O Blood supply to the area O Size of the affected area O Size of the drug particles O Amount of the dose administered

O Size of the affected area Rationale The area of the skin affected influences the amount that the drug is absorbed into the skin. The larger the surface area, the more easily the drug is absorbed. Blood supply to the area, size of the drug particles, and amount of the administered dose are the factors that affect drug absorption through the inhalational route

Which statements made by a nurse indicate effective learning on drug administration in an infant? Select all that apply. O Slow-release tablets can be crushed O Penicillin may cause allergic reaction." O Aspirin can be prescribed: O "Acetaminophen should not be prescribed O Dosage adjustments of drugs are frequently required.

O Slow-release tablets can be crushed O Penicillin may cause an allergic reaction." O Dosage adjustments of drugs are frequently required.

Which action would the nurse take to prevent choking when administering an oral medication to an infant using a dropper? O Place the dropper at the front of the mouth and allow the infant to suck it. O Slowly administer the medication using the dropper and allow the infant to swallow it O Place the dropper between the infant's cheek and gums, halfway back into the mouth O Quickly administer the medication using the dropper and allow the infant to swallow it.

O Slowly administer the medication using the dropper and allow the infant to swallow it Rationale The nurse should inject the medication using the dropper slowly and allow the infant to swallow it to prevent choking. Placing the dropper at the front of the mouth might cause the infant to spit out the medication inadvertently. The nurse should place the dropper between the infant's cheek and gums, halfway back into the mouth to prevent the patient from spitting out the medication with tongue movements. The nurse should not administer the medication quickly because this could lead to choking and aspiration.

Phase 3 studies determine which aspect in the new drug development process? O Safe therapeutic dose OSafety at different dosing levels O Statistical significance of earlier results O Pharmacologic properties of the drug

O Statistical significance of earlier results Rationale In phase 3 trials, the statistical significance of phase 1 and phase 2 results is determined. A safe therapeutic dose is determined in preclinical trials. The safety of the new drug at various doses and pharmacologic properties are determined in phase 2 trials

Phase 3 studies determine which aspect in the new drug development process? O Safe therapeutic dose O Safety at different dosing levels O Statistical significance of earlier results O Pharmacologic properties of the drug

O Statistical significance of earlier results Rationale In phase 3 trials, the statistical significance of phase l and phase 2 results is determined. A safe therapeutic dose is determined in preclinical trials. The safety of the new drug at various doses and pharmacologic properties are determined in phase 2 trials.

Which action by the nurse when giving a continuous tube feeding might lead to complications in the future? O Storing formula at room temperature O Threading the tube through the pump O Initiating feedings at room temperature O Setting the flow rate after connecting the tube

O Storing formula at room temperature Rationale When administering continuous feedings, the nurse should always store the extra feeding formula in the refrigerator to ensure that it does not spoil. The nurse is required to thread the tubing through the pump according to the pump manufacturer's instructions. The nurse should ensure that the feeding is at room temperature before initiating the infusion. The nurse should set the flow rate of the feeding per the prescription to ensure that the correct volume of formula infuses at the specified intervals.

Which descriptions are characteristic of monitoring medication errors? Select all that apply. O Suboptimal patient education O Suboptimal drug therapy decisions O Drug for patient with known allergy or intolerance O Suboptimal assessment of drug response or revision of regimen O Misinterpretation or misunderstanding of drug ordered or any directions listed

O Suboptimal patient education O Suboptimal assessment of drug response or revision of regimen Rationale Suboptimal assessment of drug response and suboptimal patient education are examples of a monitoring type of medication error. Suboptimal drug therapy decisions and drugs for patients with known allergies or intolerance are examples of prescribing error. Misinterpretation or misunderstanding of drug ordered or any directions listed is an example of transcription error.

Which dose form contains solid, insoluble drug particles dispersed in a liquid base? O Elixirs O Syrups O Emulsions O Suspensions

O Suspensions

Which actions by a mother who is breastfeeding while taking an antibiotic can help prevent complications in the infant? O Breastfeeding just 2 times a day O Takıng lower dose of the medications O Breastfeeding just after taking the drugs O Taking the drug just before the infant's longest sleep period

O Taking the drug just before the infant's longest sleep period Rationale A breastfeeding mother should take medications before the infant's longest sleep period, because the drug would enter into the bloodstream before appearing in the milk. The mother should breastfeed the infant depending on the baby's needs but should not reduce feeding unless advised by a healthcare provider. The mother should take medications according to the prescription and should not reduce the drug dose on her own. The mother should not breastfeed her infant just after taking the medication because the drugs will be present in the milk

Which material is a self-adhesive transparent film-like dressing that acts as a second skin? O Telfa O DuoDERM O Tegaderm O Kaltostat

O Tegaderm Rationale Tegaderm is a self-adhesive transparent film that acts as a second skin. Telfa is a nonadherent gauze dressing DuoDERM is a hydrocolloid adhesive that is applied to damaged skin. Kaltostat is a calcium alginate dressing used to absorb exudates from infected wounds

Which measures should be adopted to perform a patch test correctly? Select all that apply. O Cleansing the selected area with cotton dipped in water O Positioning the patient with the patch site lying vertically O Telling the patient to avoid bathing until the patches are read O Checking for the use of any antiinflammatory or antihistamine drugs O Reviewing the chart to ensure the absence of any immunocompromising disease

O Telling the patient to avoid bathing until the patches are read O Checking for the use of any antiinflammatory or antihistamine drugs O Reviewing the chart to ensure the absence of any immunocompromising disease Rationale To perform the patch test correctly, the nurse should instruct the patient not to bathe until the patch site is read. Before starting the patch test, the nurse should make sure that the patient has not taken any anti inflammatory or antihistamine agent 24 to 48 hours before the test. The nurse should also review the patient's chart to check for any immunocompromising disease.

Which electronic database provides a wealth of information about medicines for nurses in the United States? O The Cumulative index to Nursing and Allied Health Literature (CINAHL) O DailyMed O UpToDate O Lexi-Comp

O The Cumulative index to Nursing and Allied Health Literature (CINAHL) Rationale The Cumulative Index to Nursing and Allied Health Literature (CINAHL) is an electronic database provided by the US National Library of Medicine that provides a wealth of information to nurses about medicines DailyMed provides comprehensive, standard, and up-to-date information about medicines to primary healthcare providers and the public. UpToDate and Lexi-Comp are electronic databases that contain regularly updated information about medicines and health for primary healthcare providers.

Which act was passed because of the effects of thalidomide during pregnancy? O Orphan Drug Act O Controlled Substances Act O The Durham Humphrey Amendment O The Kefauver-Harris Drug Amendment

O The Kefauver-Harris Drug Amendment Rationale Passed in 1962, the Kefauver-Harris Drug Amendment to the Federal Food Drug, and Cosmetic Act was a result of a thalidomide tragedy where fetuses exposed to the drug developed serious birth defects The Kefauver-Harris Drug Amendment provides greater control and surveillance of the distribution and clinical ng of investigational drugs. The Orphan Drug Act stimulates the development and market availability of Testing products that are used for the treatment of rare diseases. The Controlled Substances Act improves the administration and regulation of the manufacture, distribution, and dispensation of drugs that require control by the government because of their high potential for abuse. The Durham Humphrey Amendment of the Federal Food, Drug, and Cosmetic Act divides medicines into prescription and nonprescription categories based on safety.

Which statement by the nursing student indicates understanding of the Canadian drug names? O The term "official drug" pertains to a nonproprietary drug. O The chemical name is the proprietary name of a drug O The brand name of a drug in Canada may be different from that in the United States O The proper name of a drug in Canada may be different from that in the United States

O The brand name of a drug in Canada may be different from that in the United States Rationale The brand name is the name assigned to a drug by its manufacturer, a drug's brand name may be different in Canada and the United States. The term official drug pertains to a drug for which a standard is described specifically in the Food and Drug Regulations. The chemical name is not the proprietary name of a drug. The proper name of a drug is same in both Canada and the United States.

Which statement is true regarding Canadian drug names? O The brand name is the nonproprietary name. O The chemical name is most meaningful to the chemist O The generic name distinguishes the drug for advertisement O The proper name is assigned to the drug by its manufacturer.

O The chemical name is most meaningful to the chemist

Which statement is true regarding placebos? O A placebo has an active ingredient. O The meaning of placebo is "I will please." O Placebos play a major role in psychogenic illness O Placebo refers to the withdrawal symptoms of a drug

O The meaning of placebo is "I will please." Rationale Placebo is a Latin word meaning "I will please." A placebo has no active ingredient in it. Nocebo effect, not placebo, plays a major role in psychogenic illness. Drug dependence refers to the withdrawal symptoms of a drug

Which step is characteristic of administering a drug through a dry powder through a metered-dose inhaler? O The patient should hold his or her breath after the inhaler is taken out. O The mouthpiece is to be placed inside the patient's mouth O The patient has to breathe in while the inhaler is in his or her mouth O The patient must be in a supine position while the drug is administered,

O The mouthpiece is to be placed inside the patient's mouth Rationale A dry powder inhaler requires the mouthpiece to be placed inside the patient's mouth, whereas a metered dose inhaler is placed 2 to 4 inches in front of the mouth. Both systems require the patient to hold his or her breath after the inhaler is introduced and to breathe in while the inhaler is in the mouth. Neither system requires the patient to be in a supine position while the drug is administered

Which steps would a nurse take to help a patient who is complaining of difficulty swallowing? Select all that apply. O Use a tablet-crushing device to crush the medication O Mix the crushed medication in a small amount of soft food. O Place the medication toward the back of the patient's tongue. O Ensure that timed-release or enteric-coated medications are not crushed. O Ask the patient to drink a small amount of water before administering the medication

O Use a tablet-crushing device to crush the medication O Mix the crushed medication in a small amount of soft food. O Ensure that timed-release or enteric-coated medications are not crushed. When administering medication to a patient who is having difficulty swallowing the nurse should use a tablet-crushing device to crush the medication and then mix the crushed medication in a small amount of soft food to stabilize the bitter taste and consistency of the mixture. Timed-release medications are not crushed, because the drug's absorption rate will be altered and can result in a drug overdose or subtherapeutic activity. Enteric-coated medications are not crushed because the active ingredients may be prematurely released The nurse should ideally place the medication toward the back of the tongue. However, this method is not applicable for all patients. The nurse should not ask the patient to drink a small amount of water before taking medication.

Which statements about the legalities of medication administration are true? Select all that apply. O The nurse must have a current license to practice O There must be a dear policy statement that authorizes the act of administering medicines. O The pharmacist assumes responsibility for verification and safety of the medication order O Barcoding and handheld devices have eliminated the need for the nurse to check the medication order from the provider O Daily medications can be recorded just before administering the medication

O The nurse must have a current license to practice O There must be a dear policy statement that authorizes the act of administering medicines. Rationale Medication administration is covered under the nurse practice acts. Therefore a current license is required. A policy statement that authorizes medication administration by the nurse must be present in order for the nurse to safely and legally administer drugs. The nurse, not the pharmacist, assumes responsibility for verification and safety of the medication order Although bar coding and handheld devices have helped streamline medication administration practices, the nurse still must use standard procedures such as checking all aspects of the drug order, right patient, right drug, right time, right dose, right route, and document drug response. The nurse should not record any medication until after it has been taken, because the patient may refuse to take the medication,

Which statements are true regarding the technology of automated ordering systems? Select all that apply. O They are used to minimize medication errors. O They help prevent adverse effects. O They can free the pharmacist for deployment to clinical areas. O They are unable to check the medication response. O They are used to ignore orders entered by the healthcare providers.

O They are used to minimize medication errors. O They help prevent adverse effects. O They can free the pharmacist for deployment to clinical areas. Rationale Automated ordering and dispensing systems have been developed to minimize medication errors. Automated systems use robotics that can review the current laboratory data and help in preventing adverse events. Robotics in the pharmacy can free some of the pharmacists for deployment to clinical units. They do not document adverse responses and are not designed to ignore orders entered by healthcare

Which information would a nurse know about elixirs? Select all that apply. O They are used when the drug does not dissolve in water alone O They are found in many cough medications and mouthwashes O They contain solid, insoluble drug particles dispersed in a liquid base. O The alcohol content varies depending on the solubility of the drug. O They contain drugs dissolved in a concentrated sugar and water solution.

O They are used when the drug does not dissolve in water alone O They are found in many cough medications and mouthwashes O The alcohol content varies depending on the solubility of the drug. Rationale Elixirs are used when the drug does not dissolve in water alone, Elixirs containing alcohol are found in many cough medications and mouthwashes. The alcohol content of elixirs is variable depending on the solubility of the drug. Suspensions contain solid, insoluble drug particles dispersed in a liquid base. Syrups contain medicinal agents that are dissolved in a concentrated solution of sugar and water

Which statement describes an advantage of timed-release capsules? O They dissolve rapidly when placed on the tongue. O They readily dissolve in the alkaline pH of the intestine O They reduce the number of doses administered per day. O They make the product taste better and allow the medication to go smoothly down the throat.

O They reduce the number of doses administered per day. Rationale Timed-release capsules reduce the number of doses that need to be administered per day. Orally disintegrating tablets dissolve rapidly when placed on the tongue. Enteric-coated tablets readily dissolve in the alkaline pH of the intestine Emulsions make the product taste better and reduce throat irritation.

Which statement describes timed-release capsules? O Timed-release capsules rapidly dissolve when placed on the tongue. O Timed-release capsules should always be crushed before administration. O Timed-release capsules contents should never be emptied into food and liquids O "Timed-release capsules require more than four doses of the drug a day and are administered multiple times during the day

O Timed-release capsules contents should never be emptied into food and liquids Rationale The contents of timed-release capsules should not be mixed with food and/or liquids because this action will change the rate of absorption and lead to a drug overdose or subtherapeutic activity. Orally disintegrating tablets dissolve rapidly when placed on the tongue. Crushing timed release capsules before administration may alter their absorption rate and lead to a drug overdose or subtherapeutic activity. Timed-release capsules allow for fewer dosages to be required every day

Which statement provides the rationale for parallel tracking done in the clinical research and development stage? O To determine the success rate and safety of drugs for intended use O To provide additional information about proper dosing and safety of drugs O To make Investigational New Drugs (IND) available to patients with life-threatening illnesses O To expedite the development and approval of drugs for the treatment of life-threatening illnesses

O To make Investigational New Drugs (IND) available to patients with life-threatening illnesses Rationale Parallel tracking is a mechanism that makes Investigational New Drugs (INDs) available to patients with life threatening illnesses and patients who cannot participate in controlled clinical trials. Phase 3 clinical trials determine the success rate and safety of drugs for intended use. Phase 2 clinical trials provide additional information about proper dosing and safety of drugs Fast-tracking is a mechanism that expedites the development and approval of drugs for the treatment of life threatening illnesses.

Why have many drugs that were previously available in capsule form reformulated into caplets? O To prevent contamination of contents O To promote rapid dissolution of the drug in the mouth O To provide a gradual but continuous release of the drug O To resist the dissolution of the drug in the gastric pH of the stomach

O To prevent contamination of contents Rationale Many capsules have been reformulated into caplets to prevent patients from opening the capsules and contaminating the contents. Orally disintegrating tablets dissolve rapidly when placed in the mouth. Timed release capsules are used to provide gradual but continuous release of the drug. Enteric-coated tablets have a kind of coating that helps resist the dissolution of the drug in the stomach.

Which drug combination taken by the patient may lead to increased neuromuscular blockade? O Probenecid and ampicillin O Acetazolamide and quinidine O Tobramycin and pancuronium O Norethindrone and ethinyl estradiol and rifampin

O Tobramycin and pancuronium Rationale Aminoglycosides such as tobramycin and pancuronium, when taken together, increase the neuromuscular blocking effect. Probenecid blocks the renal excretion of ampicillin, thereby prolonging the activity of the antibiotic. Acetazolamide increases urine pH, which Improves the reabsorption of quinidine and leads to its toxicity. Rifampin induces the enzymes that Mictabolize norethindrone and ethinyl estradiol, resulting in increased incidence of menstrual abnormalities and reduced effectiveness of conception control

Which equipment does the nurse need to properly apply a patient with eczema? Select all that apply. O Penlight O Tongue blade O Applicator paper O Hypoallergenic tape O Cotton-tipped applicators O corticosteroid

O Tongue blade O Cotton-tipped applicators Rationale A tongue blade is used to remove the desired amount of ointment from a wide-mouthed container. Cotton- tipped applicators are needed to apply the ointment. A penlight is needed to assess the nostrils during the administration of nasal spray. Applicator paper is used during the administration of nitroglycerin, not corticosteroid, cintment. Hypoallergenic tape is used to perform patch testing

Which equipment would the nurse use to measure less than 1 mL of a liquid medication? O Teaspoon O Soufflé cup O Medicine cup O Tuberculin syringe

O Tuberculin syringe Rationale When measuring liquid medication that is less than 1l mi, the nurse should ideally use a tuberculin syringe

Which drug distribution process has reduced both errors and the time nurses spend in preparing medication? O Unit dose O Floor and ward stock O Individual prescription order system O Patient medication prescriptions brought from home

O Unit dose Rationale The unit-dose drug distribution process has certain advantages. This system reduces the time normally spent by a nurse preparing drugs for administration Counting drugs from multidose packets is no longer necessary as a result of unit-dose packaging, thereby reducing errors: Floor and ward stock system helps in stocking the rarely used medications in stock containers at the nursing station. Dispensing of medications with the receipt of a prescription or drug order is done with the help of an individual prescription order system. Use of the patient's personal prescriptions may not meet the dosage ordered and may not be sufficient in number, placing further pressure on the nurse.

Which drug information source gives information regarding nutritional supplements? O LactMed Database O Natural Medicines Comprehensive Database O United States Pharmacopeia (USP/National Formulary (NF) O USP Dictionary of United States Adopted Names (USAN) and international Drug Names

O United States Pharmacopeia (USP/National Formulary (NF)

Which parameter should be monitored to determine the optimal functioning of the kidneys in an elderly patient? O Serum proteins O Serüm creatinine O Urinary creatinine O Blood urea nitrogen

O Urinary creatinine Rationale Renal function should be calculated by measuring urine creatinine levels over time. Serum proteins such as albumin and globulin should be measured if there is a concern in a patient who is taking protein-binding medications. Serum creatinine can give a general estimate of renal function, but in older adult patients these determinations tend to exaggerate actual functional capability. Blood urea nitrogen is a poor predictor of renal function because this parameter can be altered by diet, the status of hydration, and blood loss.

Which is the most common symptom of a hypersensitivity reaction to a medication? O Wheezing O Urticaria O Anaphylaxis O Vomiting

O Urticaria Rationale Allergic reactions, also known as hypersensitivity reactions, occur among patients who have previously been exposed to a drug and whose immune systems have developed antibodies to the drug On reexposure to the drug, the antibodies cause a reaction; this reaction is most commonly seen as raised, irregularly shaped patches on the skin known as hives, which cause severe itching, known as urticaria. This should be taken as a warning that an additional exposure to the drug could result in a life-threatening anaphylactic reaction Although wheezing is a hypersensitivity reaction to a medication, it is not the most common reaction Although anaphylaxis is a life-threatening reaction to a medication, it is not the most common hypersensitivity reaction. Although vomiting is a side effect of taking a medication, it is not the most common hypersensitivity reaction

Which practice helps ensure safety when administering medications such as heparin? O Receiving verbal orders for drug administration O Developing a list of current medications being administered O Using a computerized provider order entry for controlled administration O Avoiding the use of brand names and generic names on medication administration records

O Using a computerized provider order entry for controlled administration Rationale Heparin, if not administered as prescribed, may cause complications. Using a computerized provider order entry for controlled administration helps prevent these complications by avoiding medication errors. Developing a list of current medications is a part of medication reconciliation. It helps in preventing medication errors in general. Verbal orders are strictly avoided to promote medication safety. The use of brand names and generic names in medication administration records helps avoid errors and improve medication safety.

Which guideline does the nurse follow when administering oral medication to a preschool child O Placing the capsule or tablet under the tongue Using chewablables O if the child's teeth are loose O supporting the child's head and holding the child in the O Using a follow up rinse with a flavored drink

O Using a follow up rinse with a flavored drink Rationale Taste becomes a factor when administering oral liquids because the liquid comes into contact with the taste buds. Using a follow-up rinse with a flavored drink helps minim any unpleasant medication aftertaste capsule or tablet should be placed near the back of the tongue. If a child's teeth are loose, chewable tablets should not be used. The preschool child should be allowed to make decisions about how medication is administered. Supporting the head while holding the child in the lap is typically done for infants.

Which phrase is a disadvantage of rectal administration of medications? O Slow onset of action O Resulting initiation of the large bowel O Variability in absorption O Risk of damage to the rectal sphincter

O Variability in absorption Rationale The presence of stool in the rectum and the risk of the patient expelling the drug before absorption can cause variability in medication absorption. Absorption through the mucous membrane of the rectum is rapid if the drug is in contact with it and therefore the onset of action is not necessarily slow. Preparations designed for rectal administration do not enter the large bowel. No significant risk of damage to the rectal sphincter occurs.

Which statement is true about the use of identification bracelets in the administration of medications? O One patient identifier is enough to confirm the identity O It is not necessary to check the identification bracelet every time. O Children should be asked their names before administering a drug. O Verbal confirmation of the name of all patients on the identification bracelet is needed

O Verbal confirmation of the name of all patients on the identification bracelet is needed Rationale It is important to verbally confirm the identity of an older patient and check it on the identification bracelet According to the Joint Commission, it is always advisable to have two patient identifiers for confirmation of identity. It is mandatory that the identification bracelet is checked every time an interaction happens. Asking a child his or her name is not enough for confirmation, because a child may be easily confused and possibly misidentify himself or herself

Which statement is true about the use of identification bracelets in the administration of medications? O Once patient identifier is enough to confirm the identity. O It is not necessary to check the identification bracelet every time O Children should be asked their names before administering a drug O Verbal confirmation of the name of all patients on the identification bracelet is needed.

O Verbal confirmation of the name of all patients on the identification bracelet is needed. Rationale It is important to verbally confirm the identity of an older patient and check it on the identification bracelet. According to the Joint Commission, it is always advisable to have two patient identifiers for confirmation of identity. It is mandatory that the identification bracelet is checked every time an interaction happens. Asking a child his or her name is not enough for confirmation, because a child may be easily confused and possibly misidentify himself or herself.

When administering a drug to a patient with renal failure, which action is a priority to promote medication safety? O Using smart pumps for controlled administration O Verifying dose adjustment before administration O Contacting the healthcare provider for repeated dose adjustments O Recording adverse clinical observation in medication administration report

O Verifying dose adjustment before administration That's right! Rationale In patients with renal and/or hepatic failure, dose adjustment is required to prevent drug toxicity, according to the drug metabolism and the excretion rate. Although smart pumps are used for controlled administration dose adjustments are to be calculated before any action is taken. The verifications and adjustments are noted in the nurse's notes and on the Kardex or drug profile, and thus the healthcare provider does not need to be contacted for repeated dose adjustments. Adverse clinical observation is recorded in the medication administration record after the administration is performed but does not contain orders of dose adjustments

When teaching a patient how to self-administer nitroglycerin ointment, which instruction does the nurse include? O Do not rotate the site medication placement because this will decrease the absorption of the medication O "Rub the ointment into the skin. O "Place the ointment on any area of the skin O You may use measuring paper to apply the next dose

O You may use measuring paper to apply the next dose Rationale The use of measuring paper will prevent the absorption of the medication through the fingertips when applying the medication and will help in measuring the correct dose. The site should be rotated to decrease skin irritation from the medication. This ointment should not be rubbed into the skin, just placed on the skin surface. The ointment should not be placed on a hairy area of the skin because this will decrease the medication's absorption

Which step would the nurse take to administer nasal spray who has a bloody nose? O Ask the patient to gently blow his or her rose O keep the patient in an upright sitting position O Avoid shaking the bottle before instillation O Ask the patient to exhale after inserting the tip into the nostri

O keep the patient in an upright sitting position Rationale To administer a nasal spray, the nurse should have the patient assume an upright sitting position. A patient with a bleeding nose should not be asked to blow his or her nose. The bottle should be properly shaken before introducing it into the nostrils. After the tip is inserted into the patient's nose, the nurse should ask the patient to inhale and not exhale.

Which instruction would the nurse include when teaching a patient to use a nebulizer O sit upright when using the nebulizer O Take three slow, deep breaths before starting the treatment. O Seal lips tightly around the mouthpiece O Breathe in and out deeply without interruption until the medication is used up.

O sit upright when using the nebulizer Rationale Nebulizers are used with the patient in a sitting position to allow maximum lung expansion. Before using the nebulizer, the patient should exhale through pursed lips. The lips are placed around the mouthpiece but are not completely scaled. The patient activates the nebulizer, inhales to capacity, exhales through pursed lips, waits a minute, and then repeats the cycle until the medication is used up.

Which therapeutic approach would be beneficial in caring for a patient with congestive heart failure? Select all that apply. O Medication therapy O Homecare O Daily hygiene O A low-sodium diet O Treatment with natural forces

OA low-sodium diet O Treatment with natural forces O Medication therapy

10. The nurse assesses the patient for the treatment effectiveness of the percutaneous medication nitroglycerin, and documents which assessment findings? (Select all that apply.) 1. Blood pressure 2. Pulse 3. Pain relief 4. Location of patch 5. Urine output

1. Blood pressure 2. Pulse 3. Pain relief 4. Location of patch

5. Drug absorption in the elderly is affected by which of these physiologic factors? (Select all that apply.) 1. Changes in albumin levels 2. Increased filtration capacity of the kidneys 3. Reduced cardiac output 4. Higher gastric pH 5. Decreased GI motility

1. Changes in albumin levels 3. Reduced cardiac output 4. Higher gastric pH 5. Decreased GI motility

9. The drug interaction between furosemide (Lasix) and warfarin (Coumadin) in which the interaction is managed by decreasing the warfarin dose is caused by which action? 1. Changes in distribution 2. Changes in absorption 3. Changes in metabolism 4. Changes in excretion

1. Changes in distribution

10. Immediately after administering morning medications for a patient, the nurse is expected to perform which action next? 1. Document the medications administered. 2. Evaluate the effectiveness of the medications. 3. Educate the patient on the adverse effects to expect. 4. Complete the nursing care plan for the day.

1. Document the medications administered.

5. After the nurse injects the patient with the morning insulin dose, when will the action of the drug reach its highest physiologic effect? 1. During peak action 2. During displacement 3. During the half-life 4. During onset of action

1. During peak action

1. A nurse was reviewing the drug route for an order written to be given via nasogastric tube and understood that this meant the drug would be administered by which route? 1. Enteral 2. Parenteral 3. Percutaneous 4. Intramuscular

1. Enteral

5. What nursing action causes most medication errors to occur? 1. Failing to follow routine procedures 2. Administering numerous medications 3. Caring for too many patients 4. Administering unfamiliar medications

1. Failing to follow routine procedures

4. Which electronic database(s) provide(s) drug information for healthcare providers? (Select all that apply.) 1. Lexicomp 2. CINAHL 3. Medline 4. DailyMed 5. Health on the Net

1. Lexicomp 3. Medline

Which nursing interventions are most appropriate while administering oral medicine to a toddler? Select all that apply. O Giving chewable tablets when the teeth are loose O Supporting the head of the patient while administering the drug OAllowing the patient to become familiar with the oral dosing device O Rinsing the mouth with water to minimize the unpleasant after taste O Allowing the patient to choose the medication to take first in the case of multiple medication therapies

Allowing the patient to become familiar with the oral dosing device Rinsing the mouth with water to minimize the unpleasant aftertaste Allowing the patient to choose the medication to take first in the case of multiple medication therapy Rationale Allowing the patient to become familiar with the oral dosing device is also important. Rinsing the mouth with water to minimize the unpleasant aftertaste is helpful for both toddler and preschool children. Allowing the patient to take the medication of his choice in case that there are many medications to take may help make the child more comfortable with the medication and may also help disguise the taste of other drugs. Chewable tablets should not be given to toddlers because their teeth are not developed completely, and in a child, chewable tablets are not given when the teeth are loose Supporting the head of the patient while administering a drug is necessary in infants because the musculoskeletal system is not fully developed. As toddlers musculoskeletal systems develop, supporting the head while administering the medication is not necessary

Which statement by a student indicates the need for further teaching regarding entries that should be recorded in the nurses' note? Select all that apply O I will record the treatment of a sudden change in the patient's health condition O I will record the information regarding transfer, discharge, or death of a patient O I will record the time of administration and effectiveness of the stat medication O I will ask the patient's family member to record the changes in the patient's health condition O I will assess and record the vital signs in the patient immediately after the admission in the hospital

I will record the time of administration and effectiveness of the stat medication I will ask the patient's family member to record the changes in the patient's health condition Rationale Stat medication order represents that the medication has to be given immediately and only once. This is not included in the nurses' notes. PRN (as needed) medications are noted in the nurses' notes. Patients' family members should not be asked to record the changes because they may not have sufficient knowledge regarding this. A nurse is responsible for discussing the treatment of sudden change in the patient's health condition. To keep a record for future reference, the nurse should record the information regarding transfer discharge, or death of a patient. Assessing and recording the vital signs in a patient after admission to the hospital will help the primary healthcare provider in treating the patient.

Which statements from a student indicate the need for further teaching regarding medication safety? Select all that apply. O I will use verbal orders for high-alert medicines. O will prepare and use checklists for high-alert drugs. O will use high-alert medications during the dispensing process O will double-check the medicines before administering them to the patient O "I will use both generic and brand names for drugs that sound similar to other drugs

I will use verbal orders for high-alert medicines. I will use high-alert medications during the dispensing process Rationale Verbal orders should be avoided to promote medication safety, Use of verbal orders may increase the risk for medication errors resulting from lack of awareness or communication between the person entering the data in the order sheet and the nurse caring for the patient. The use of high-alert medications during the dispensing process should be avoided to prevent the risk for serious complications in the patients. Checklists should be prepared and used in case of high-alert drugs. This may help in eliminating the risk related to improper dosage or improper method of drug administration. Double-checking the medications is an effective way to ensure medication safety in the patient. Drugs that are similar in sound may create confusion in the patient or the caretaker, which may hamper the medication safety. Therefore the nurse should use both generic and brand names to avoid confusion or misunderstandings

Which drug changes would the nurse expect to see in a patient who has renal failure? O Increased half-life of the drug O Increased peak action of the drug O A Slowed onset of action of the drug O Decreased duration of action of the drug

Increased half-life of the drug Rationale Renal impairment causes decreased elimination of the drug, which leads to an increase in the drug half-life. Peak action is the time at which the drug attains its highest concentration at the target site. Renal failure does not directly increase the peak action of the drug. The onset of action refers to the time when the concentration of the drug is able to elicit a pharmacologic response. Because the patient has impairment of the kidneys, large quantities of the drug would be available and the onset of action would be rapid. The duration of action is the time period during which the drug shows its action. Patients with renal failure will have a prolonged duration of action, because the rate of elimination is slow.

Which instructions would be included on how to administer intermittent feeding through a gastrostomy tube? Select all that apply. O "Check whether the formula is running as frequently as possible. O "Flush the tube with 50 to 60 ml of water after the feeding bag is empty O "Fill the disposable feeding bag with the prescribed formula for an 8-hour period." O "Wash reusable equipment and keep them in a clean area far away from the patient O Instruct the patient to remain in a semi-Fowler's position for 30-60 minutes after feeding

O "Check whether the formula is running as frequently as possible. O "Flush the tube with 50 to 60 ml of water after the feeding bag is empty O Instruct the patient to remain in a semi-Fowler's position for 30-60 minutes after feeding Rationale As long as the feeding is being administered to the patient through the tube, the nurse should check whether the formula is running as frequently as possible. After the feeding bag is empty, the nurse should flush the tube with 50 to 60 mL water. This action removes excess formula from the tubing, maintains tube patency, and prevents bacterial growth in the tube. The patient should also remain in a semi-Fowler's position for 30 to 60 minutes after the feeding to ensure that normal digestion takes place and prevents gastric reflux. When administering continuous feeding, the nurse should fill the disposable bag with enough formula for an 8-hour period. The nurse should wash and dry reusable equipment and keep them in a clean area within the patient's environment.

The child of a mother using fentanyl patches was admitted for respiratory depression caused by accidental exposure to the patches. Which suggestion can stop further such instances at home? O "Use narcotic-controlled systems to reduce such instances." O "Dispose of fentanyl patches by flushing therti down the toilet O "Mix the fentanyl patches with undesirable substances to make them unappealing O Always dispose of fentanyl patches in the household trash to reduce the risk for unintentional use

O "Dispose of fentanyl patches by flushing therti down the toilet Rationale Fentanyl patches are controlled drugs and it is always advisable to flush them dawn the toilet to avoid accidental ingestion at home. Narcotic-controlled systems are used only at the healthcare center Medications other than controlled medications should be mixed with undesirable material before disposal to make them unappealing, Fentanyl patches are controlled substances and should not be disposed in the household trash because there may be a risk for unintentional use resulting in severe adverse effects.

Which instruction provided to a pregnant woman who complains of poor fatigue is the most appropriate health teaching to reduce birth defects? O limit fat content in meals." O at small and frequent meals O "Eat foods rich in folic acid such as spinach! O "Avoid calcium-rich foods such as dairy products.

O "Eat foods rich in folic acid such as spinach! Rationale Poor appetite and fatigue indicate that the patient has poor nutrition. So the nurse should advise the patient to take foods rich in folic acid to avoid birth defects. Fat content should be limited in meals, and the meals should be taken in small amounts frequently if the patient has morning sickness Dairy products should be avoided in case of morning sickness, instead, the patient should be advised to take other calcium rich products to reduce birth defects

Which medication administration instructions would the nurse provide to a patient using a metered-dose inhaler O "Take several deep breaths before inhaling the medication." O "Rinse your mouth with water before medication administration." O Place the inhaler at a 45-degree angle so the majority of medication will get into the lungs O "Hold your breath and exhale slowly after medication administration

O "Hold your breath and exhale slowly after medication administration Rationale Holding the breath and exhaling slowly allow the medication to settle in the pulmonary tissue. Deep breathing before administration is irrelevant in relation to the use of a metered-dose inhaler. The patient should rinse the mouth with water after medication administration. The inhaler should be horizontal to the mouth, not held at a 45-degree angle.

Which statements made by an elderly patient indicate inability to self-medicate? Select that apply. O use herbal medicines O "I have difficulty reading O "I have loose-fitting dentures O I have weakness in my upper limbs

O "I have difficulty reading O I have weakness in my upper limbs Rationale Functional health assessments, such as vision and motor control (weakness in the upper limb), are helpful in determining an elderly patient's ability to self-medicate. Poor appetite may indicate poor nutrition, which is assessed to determine whether the patient is having a balanced diet or not Dentures should be assessed to know the ability of chewing While caring for the patient, the use of nonprescription medicines, herbal drugs, or alternative therapies are assessed to know the drug history. This helps provide a proper care plan to the patient

Which statement made by a nurse indicates the need for further teaching about the percutaneous route of drug administration? O "I should firmly place the patch on the skin. O should place the tablet under the patient's tongue O "I should teach the patient to use the inhaler properly O "I should make sure that the needle goes tight under the skin

O "I should make sure that the needle goes tight under the skin Rationale The percutaneous route of drug administration involves the administration of drugs via the topical, sublingual, and inhalational routes. Injection of the drug into the skin is called the subcutaneous route of drug administration. Use of patches for drug administration is an example of topical administration. Sublingual administration involves placing the formulation under the tongue. An inhaler uses inhalational route of drug administration, not the percutaneous route

Which statement by a student is accurate regarding dosage calculations and minimizing medication errors? O "I will refer to a current drug book. O I will forward the calculation to the physician O "I will double-check my calculations with another nurse O I will use different mathematical formulas to calculate the dose.

O "I will double check my calculations with another nurse Rationale It is essential for the nurse to maintain medication safety. Therefore the student nurse should not hesitate to get the dosage calculation checked by the registered nurse. The drug book will have information about the generic name, dose, dosage form, and route of administration but not dosage calculation details. The physician will prescribe the drug and dosage but will not perform the dosage calculations. Personal mathematical formulas should not be used, rather, appropriate formulas should be used for performing dosage calculations

Which statement by a student is accurate regarding dosage calculations and minimizing medication errors? O "I will refer to current drug books O "I will forward the calculation to the physician O "I will double-check my calculations with another nurse." O I will use different mathematical formulas to calculate the dose.

O "I will double check my calculations with another nurse."

Which action would a nurse take when administering medication with a dropper? Select all that apply. O "Refrain from tipping the dropper after drawing up the medication." O "Familiarize yourself with the calibrations on the barrel after drawing medications." O "Avoid transferring medication into another container after drawing up the medication." O "Use the specific dropper supplied by the manufacturer along with the liquid medication: O "Dissolve the contents of timed-release capsules in a liquid before administering them with a dropper."

O "Refrain from tipping the dropper after drawing up the medication." O "Avoid transferring medication into another container after drawing up the medication." O "Use the specific dropper supplied by the manufacturer along with the liquid medication Rationale The patient should refrain from tipping the dropper after the medication is drawn because this action may cause a loss of some medication. If the medication is transferred from the dropper to another container, part of the medication might adhere to the second container, which may alter the dose administered. The patient should use the specific dropper provided by the manufacturer along with the liquid medication because there are great variations in the size of drops formed. The patient should familiarize himself or herself with the calibrations of the dropper before drawing the medication. The contents of timed release capsules should not be mixed in liquids before administration.

Which action would a nurse take when administering medication with a dropper? Select all that apply. O "Refrain from tipping the dropper after drawing up the medication." O "Familiarize yourself with the calibrations on the barrel after drawing medications." O "Avoid transferring medication into another container after drawing up the medication." O "Use the specific dropper supplied by the manufacturer along with the liquid medication: O "Dissolve the contents of timed-release capsules in a liquid before administering them with a dropper."

O "Refrain from tipping the dropper after drawing up the medication." O "Avoid transferring medication into another container after drawing up the medication." O "Use the specific dropper supplied by the manufacturer along with the liquid medication: Rationale The patient should refrain from tipping the dropper after the medication is drawn because this action may cause a loss of some medication. If the medication is transferred from the dropper to another container, part of the medication might adhere to the second container, which may alter the dose administered. The patient should use the specific dropper provided by the manufacturer along with the liquid medication because there are great variations in the size of drops formed. The patient should familiarize himself or herself with the calibrations of the dropper before drawing the medication. The contents of timed-release capsules should not be mixed in liquids before administration.

Which information would the nurse give to a nursing student concerning rectal suppositories? Select all that apply. O "Refrain from using a suppository that has become soft." O "Use the index finger when inserting a rectal suppository into an infant O "Refrain from using a suppository on patients who had recent rectal surgery O "Insert the suppository into a body orifice when the medication is in a solid form." O "Position the patient in the Sims position when administering a rectal suppository

O "Refrain from using a suppository on patients who had recent rectal surgery O "Insert the suppository into a body orifice when the medication is in a solid form." O "Position the patient in the Sims position when administering a rectal suppository Rationale To minimize complications, the nurse should not give rectal suppositories to patients who recently had rectal surgery. The nurse should insert the suppository into a body orifice in a solid form because it dissolves at body temperature and is absorbed by the mucous membranes. The nurse should position the patient in Sims' position when administering rectal suppository for easy access. If the suppository has become soft and the package has not yet been opened, the nurse should place the medication under cold running water or in ice water until it hardens. When inserting a suppository in an infant, the nurse should use the fourth finger of the hand.

Which statements by a nursing student about general principles of administering liquid form oral medications to adults need correction? Select all that apply. O "The medication can be mixed in oral fluids that may be at the patient's bedside O Loud medications should not be diluted unless specified O "Refrain from leaving medications at the patient's bedside." O Instruct the patient to drink a full glass of fluid after taking the medication O Provide a little water to the patient before giving the medication

O "The medication can be mixed in oral fluids that may be at the patient's bedside! O Instruct the patient to drink a full glass of fluid after taking the medication O Provide a little water to the patient before giving the medication Rationale When administering liquid medications, the nurse should not dilute any medication, unless there is an order to do so. After giving solid-form medications the nurse should instruct the patient to drink a full glass of fluid Before administering solid-form medications to the patient, the nurse should provide a glass of water to help moisten the tongue and make swallowing easier. The nurse should never dilute liquid medications unless ordered to do so. Liquid medications should also not be left at the patient's bedside table unless specific orders exist to that effect.

Which drug information is beneficial for a patient with a prescription for aspirin with codeine O "There is a low potential for abuse required O 'A prescription may not be O "There is a potential for severe physical dependence O "There is a high potential for psychological dependence

O "There is a high potential for psychological dependence Rationale Aspirin with codeine is a Schedule III drug: these drugs have a high potential for psychological dependence because of their high potential for abuse. Schedule III drugs require a prescription that expires in é months Aspirin with codeine has a low physical dependence

Which interpretation of a patch test that has an induration of more than 5 mm, but no erythema, is correct? O (1+) O (2+) O (3+) O (4+)

O (4+) Rationale When there is an induration of more than S mm, the nurse records it as (4+). If there is no wheal with a 3-mm flare, the correct symbol and reading is (1-). If there is 2-to 3-mm wheal with flare, the correct interpretation is (2+). For a 3- to 5-mm wheal with flare, the correct symbol and reading is (3+).

In which clinical phase of new drug development studies are a drug's pharmacological properties determined O 1 O 2 O 3 O 4

O 1 Rationale Phase l clinical studies of new drugs determine a drug's pharmacological properties. Phase 2 studies determine the drug's success rate and safety, Phase 3 studies determine the statistical significance of the study results. Phase 4 studies determine the drug's adverse reactions after marketing.

A patient with acquired immunodeficiency syndrome (AIDS) does not qualify for the study protocol for a new antiviral drug and has no alternative therapy. Which action would the Food and Drug Administration take to expedite treatment for AIDS in this patient? Select all that apply. O Approve treatment with an investigational new drug (IND) O Provide fast-tracking of an investigational new drug (IND) O Extend the clinical trial phase of an investigational new drug (IND) O Allow parallel tracking of an investigational new drug (IND) O Approve postmarketing surveillance of an investigational new drug (IND)

O Approve treatment with an investigational new drug (IND) O Provide fast-tracking of an investigational new drug (IND O Allow parallel tracking of an investigational new drug (IND) Rationale The treatment of AIDS in a patient who does not fit the study protocol for the drug and has no alternative therapy is expedited by approving treatment with an investigational new drug (IND) Treatment with an IND refers to the availability of a new drug to a patient who is desperately ill as early as possible in the drug development process. Fast-tracking an IND refers to accelerating the drug's development and approval Parallel tracking is another process that makes an IND available when there is no standard therapeutic alternative. Extending the clinical trial phase is not done because the patient requires immediate treatment with the IND. Approval for postmarketing surveillance of an IND is required after the IND has undergone preclinical and clinical trials

Which drug combinations produce synergistic reactions? O Aspirin + codeine O Ampicillin+gentamicin O Tetracycline antacid O Probenecid + ampicillin

O Aspirin + codeine Rationale A synergistic effect is a combined effect of two medications that is greater than the sum of the effect of each drug given together. When given in combination, aspirin and codeine produce a greater effect than the sum of each medication. Ampicillin and gentamicin are chemically incompatible medications, in which the active ingredient of each medication deteriorates when mixed together. Antacids decrease the absorption of tetracycline, producing an antagonistic effect. Probenecid blocks the renal elimination of ampicillin, thereby Increasing the antibiotic effect.

Which steps would the nurse take to administer a corticosteroid-containing aerosol to a patient? Select all that apply. O Some terretanwers were not selected O Assess the patient's ability to operate a nebulizer O Prevent oily preparations from contacting the respiratory mucosa O Place the canister outlet 2 to 4 inches inside the mouth O Avoid shaking the car ister before administration. O Ask the patient to rinse the mouth after administration.

O Assess the patient's ability to operate a nebulizer O Prevent oily preparations from contacting the respiratory mucosa O Ask the patient to rinse the mouth after administration. Rationale When a nurse is administering an aerosol, the nurse should teach the patient how to use a nebulizer. Oily preparations should not be applied to the respiratory mucosa, because bil droplets may be carried to the lungs and cause lipid pneumonia. The nurse should ask the patient to rinse the mouth after administration. The canister outlet should be placed 2 to 4 inches in front of the mouth, not 2 to 4 inches inside the mouth, to allow the propellant to evaporate and prevent large particles from setting in the mouth. The nurse should also shake the canister to allow the active bronchodilator and propellant to disperse and mix

Which actions are appropriate regarding preventing medication errors with medications? Select all that apply. O Avoid verbal orders O Develop processes to make errors stand out O Develop methods to depreciate the consequences of errors. O Use only brand names in the medication administration record O Double check medications before administration.O

O Avoid verbal orders O Develop processes to make errors stand out O Develop methods to depreciate the consequences of errors. O Double-check medications before administration.

Which information would be included when the instructor is teaching nursing students about drug naming conventions? Select all that apply. O The first letter of the generic name is capitalized. O The chemical name is most meaningful to the patient. O A drug is introduced into the market with the generic name O Brand names are easier to pronounce, spell, and remember O The drug is listed by the US Food and Drug Administration (FDA) based on its generic name

O Brand names are easier to pronounce, spell, and remember O The chemical name is most meaningful to the chemist O The drug is listed by the US Food and Drug Administration (FDA) based on its generic name Rationale The brand name of a drug is provided by the manufacturer and is easy to pronounce spell, and remember The US Food and Drug Administration list drugs by their official or generic names. The first letter of the generic name should not be capitalized. The chemical name of the drug is most meaningful to the chemist, who uses the information to figure out the chemical constitution of the drug and the placement of the molecule groupings. A drug is introduced by a company into the market with its trade name, not the generic name

Which is a Schedule IV drug according to the Canadian Controlled Drugs and Substances Act, 1997 O Methadone O Methaqualone O Propylhexedrine O Butorphanol

O Butorphanol Rationale Butorphanol belongs to Schedule IV of the Controlled Drugs and Substances Act, 1997. Methadone falls under Schedule l; methaqualone and propylhexedrine belong to Schedules Ill and V, respectively.

Which drug is likely the cause of epidermal necrolysis in a patient with epilepsy with human leukocyte antigen allele HLA-B* 15022 O Phenytoin O Valproic acid O Carbamazepine O Trimethadione

O Carbamazepine Rationale Carbamazepine may cause toxic epidermal necrolysis in a patient with human leukocyte antigen allele HLA 8*1502. Phenytoin, valproic acid, and trimethadione are antiepileptic drugs that have effect on the fetus; therefore these drugs are considered as teratogens, but no known effects on those with the human leukocyte antigen allele HLA B*1502.

Which nursing assessment findings would affect the absorption transdermal patch? Select all that apply. O Inflammation O Cardiac output O Dermal thickness O Occlusive dressing O Number of hair follicles

O Cardiac output O Dermal thickness O Number of hair follicles Rationale Decreased cardiac output may affect the transdermal drug absorption. Dermal thickness enhances the absorption of drug in older adults. Decreased number of hair follides may also decrease the affect the transdermal drug absorption Inflammation increases the amount of drug that is absorbed in infants during topical administration. Occlusive dressing enhances absorption of topical drug in infants by increasing the hydration of skin

Which statements made by a patient regarding the disposal of prescription and nonprescription medications are correct? Select all that apply. O I will throw away opioid analgesics along with the household trash O I Will throw away empty prescription bottles without removing the labels O I will dispose of the drugs in the household trash without emptying the drugs from the container O I will dispose of the drugs as per the instructions given on the drug label or in the patient information leaflet O I will dispose of the drugs in the household trash after mixing them with an undesirable substance in a sealed bag

O I will dispose of the drugs as per the instructions given on the drug label or in the patient information leaflet O I will dispose of the drugs in the household trash after mixing them with an undesirable substance in sealed bag Rationale Prescription and nonprescription medicines should be disposed of as per the instructions given on the drug label to avoid the risk for contamination or pollution Drugs should be disposed of in the household trash by mixing them with undesirable substances in a sealed bag to make them unappealing to children and pets and to prevent the medication from leaking out of the garbage bag Opioid analgesics should be thrown out with household trash because t may increase the risk for unintentional or illegal use. Empty bottles should not be thrown out without removing the label from bottles or containers. Removing the label may help in protecting the identity and health information of the patient. Drugs should be emptied from their container into the household trash and not thrown out in their original container

Which drug schedule includes restricted-access nonprescription drugs according to the National Association of Pharmacy Regulatory Authorities (NAPRA) of Canada? O I O II O III O Unscheduled

O II Rationale The National Association of Pharmacy Regulatory Authorities (NAPRA) of Canada proposed a drug scheduling model consisting of four schedules. Schedule Il includes restricted-access nonprescription drugs. Schedule ! includes all prescription drugs, including narcotics. Schedule Ill includes pharmacy-only nonprescription drugs. Drugs that are not categorized in Schedules I, Ii, or all are considered unscheduled

Which drug schedule would the nurse review before administering phenobarbital? O II O II OV O IV

O IV Rationale Schedule IV drugs include phenobarbital and chlordiazepoxide. Morphine, Vicodin, methadone, and methylphenidate are examples of Schedule. Il drugs. Schedule ll drugs include Norco and acetaminophen, Schedule V drugs include Lomotil and Robitussin AC

Before starting a patch test, which medication is the nurse most likely to ask if the patient has taken within the past 48 hours? O Clonidine O Ibuprofen O Scopolamine O Nitroglycerin

O Ibuprofen Rationale Before starting a patch test, the nurse should ask whether the patient has taken any anti inflammatory or antihistamine drugs. Thus the nurse is most likely to ask about ibuprofen, which is an antiinflammatory drug and should not be taken 24 to 48 hours before the test. Clonidine is an antihypertensive drug scopolamine is an anticholinergic medication, and nitroglycerin is an antianginal medication. None of these drugs act as an antiinflammatory drug or antihistamine, and they may be taken before a patch test.

The MedWatch form serves which purpose? O Tracking numbers of prescriptions written for a specific drug O Determining the therapeutic effectiveness of the drug O Assessing the acceptability of the drug to individual patients O Identifying adverse effects of a drug in the general population

O Identifying adverse effects of a drug in the general population Rationale Healthcare practitioners make a significant contribution to the knowledge of drug safety by reporting adverse effects to the FDA using the MedWatch program for the voluntary reporting of adverse events and product problems. This method of identifying adverse effects of a drug in the general population is part of the postmarketing surveillance phase of drug development. More than 200,000 MedWatch forms are filed with the FDA annually MedWatch is not designed to track the numbers of prescriptions written for a specific drug is not a program involved in determining the therapeutic effectiveness of a drug. It is not involved in assessing the acceptability of a drug to individual patients.

What is the effect of protein binding on drugs in the bloodstream? O Accumulation of the drug O Increased risk for allergic reaction O Inactivation of the drug O Precipitation of an idiosyncratic reaction

O Inactivation of the drug Rationale Drugs bound to plasma proteins are pharmacologically inactive because the large size of the complex keeps them in the bloodstream and prevents them from reaching the sites of action, metabolism, and excretion. Only the free or unbound portion of a drug is able to diffuse into tissues, interact with receptors, and produce physiologic effects; it is also only this portion that can be metabolized and excreted. Protein binding is not associated with accumulation of a drug in the bloodstream, not involved in an allergic reaction to a drug, and not associated with an idiosyncratic reaction to a drug

Which principles would a nurse remember when administering liquid-form oral medications to infants? Select all that apply. O Place the infant's head in a flat position O Inject the medication slowly when using an oral syringe. O Place the medication at the back of the nipple after the infant starts to suck it. O Place the dropper between the infant's cheek and gums, halfway back into the mouth

O Inject the medication slowly when using an oral syringe. O Place the medication at the back of the nipple after the infant starts to suck it. O Place the dropper between the infant's cheek and gums, halfway back into the mouth Rationale The nurse should inject the medication slowly when using an oral syringe and allow the infant to swallow it This action helps prevent choking. When the infant is conscious, the nurse may provide a nipple. After the patient begins to suck, the medication may be placed on the back of the nipple with a dropper. When using a dropper, the nurse should place it between the infant's cheek and gums, halfway back into the mouth. This ensures that the infant does not spit out the medication. The nurse should ascertain that the infant is alert, and the infant's head should be placed in a slightly elevated position

Which statements by a nurse demonstrate a need for more education about medication administration? Select all that apply. O The parenteral route involves nasogastric intramuscular, or intravenous administration." O Methods of the percutaneous route include inhalation, rectal, and topical administration O Percutaneous absorption is greatly increased in newborns and infants who have thin, well-hydrated skin O "Subcutancous injections have the slowest absorption rate, especially if peripheral circulation is impaired." O The enteric route involves administering medication directly into the gastrointestinal (GI) tract via the oral, nasogastric or rectal route

O The parenteral route involves nasogastric intramuscular, or intravenous administration." O Methods of the percutaneous route include inhalation, rectal, and topical administration Rationale The parenteral route involves subcutaneous, intramuscular, or intravenous administration. The nasogastric route is an enteral route of administration Methods of the percutaneous route include inhalation, sublingual, and topical administration. The rectal route involves the enteral route of administration Percutaneous absorption is greatly increased in newborns and infants who have thin well-hydrated skin as a result of its increased absorption rate. Subcutaneous injections have the slowest absorption rate, especially if peripheral circulation is impaired. The enteric route involves administering a medication directly into the gastrointestinal tract via the oral, nasogastric or rectal route.

Which finding in a written prescription for an inflammation medication would cause the nurse concern? O There is no birth date written O The prescription includes an unusually low dose. O The prescribed frequency of the medications is significant. O The exact times of taking the medication are not mentioned

O The prescribed frequency of the medications is significant. Rationale If the order has the medication being administered more frequently than usual, it indicates that the patient is at higher risk for developing complications. A higher than normally prescribed intake of medicine may lead to adverse events. The patient's birthdate is usually not a part of the prescription: If there is an atypical low dose mentioned on the prescription, it may not cure the inflammation and do no harm to the patient's health. If the accurate times to administer the medication nat specified in the prescription, it may not affect the well being of the patient

Which statement provides a definition of the trade name of a drug? O The name under which the drug is listed in the US Pharmacopeia O The name was given to the drug by the US Food and Drug Administration (FDA) O The proprietary name of the drug given by a manufacturer O The chemical name of the drug given by its developer

O The proprietary name of the drug given by a manufacturer

Which statement about nursing journals, made by a nursing student, indicates a need for further education? O The purpose of journals is to gather primary sources of drug information O The purpose of journals is to provide current evidence-based practice changes. O "The specialty nursing journals have articles about drug therapy related to specific fields of interest. O The dates on the articles in the journals should be checked to determine whether the information is current

O The purpose of journals is to gather primary sources of drug information

Which statement about nursing journals, made by a nursing student, indicates a need for further education? O The purpose of journals is to gather primary sources of drug information. O The purpose of journals is to provide current evidence-based practice changes O "The specialty nursing Journals have articles about drug therapy related to specific fields of interest: O "The dates on the articles in the journals should be checked to determine whether the information is current

O The purpose of journals is to gather primary sources of drug information. Rationale The purpose of nursing journals is not to gather primary sources of drug information but to provide current evidence-based practice changes. Specialty nursing journals have articles about drug therapy related to specific fields of interest such as geriatric nursing and critical care nursing. The accuracy of the information in the journal should be noted, and the dates on the articles should be checked to determine whether the Information is current

Which statement about drug action is true? O The drug blood level is assayed to determine the desired action of the medication O An injury resulting from a medical intervention related to a medication is an adverse drug reaction O The range between the minimum effective response and the toxic response is the intensity of a medication O The time at which the medication reaches the highest concentrations on the target sites is the peak

O The time at which the medication reaches the highest concentrations on the target sites is the peak Rationale Peak action is the time at which a medication reaches its highest concentrations on the target receptor sites, inducing the maximal pharmacologic response for the given dose. The drug blood level is assayed 16 determine the amount of the medication present in the patient's blood. An injury resulting from a medical intervention related to medication is called an adverse drug event. The range between the minimum effective response and the toxic response is called the therapeutic response.

Which statements are advantages of a caplet when giving an oral medication Select all that apply. O The unpleasant taste of the medication is hidden O Its smooth coat is easier to swallow. O Caplets dissolve more rapidly. O Caplets require lower dosage. O Is structure can prevent contamination.

O The unpleasant taste of the medication is hidden O Its smooth coat is easier to swallow. O Is structure can prevent contamination. Rationale A caplet is a tablet that has an elongated shape and a smooth coating like a capsule. A caplet is designed to hide unpleasant taste. The smooth coating facilitates swallowing. The solid formation prevents the caplet from opening and possibly contaminating the contents. Rate of dissolution and dosage are unrelated to the characteristics of a caplet.

Which drug information is beneficial for a patient with a prescription for aspirin with codeine? O "There is a low potential for abuse. O "A prescription may not be required." There is a potential for severe physical dependence O There is a high potential for psychological dependence."

O There is a high potential for psychological dependence." Rationale Aspirin with codeine is a Schedule III drug, these drugs have a high potential for psychological dependence because of their high potential for abuse. Schedule lill drugs require a prescription that expires in 6 months. Aspirin with codeine has a low physical dependence,