Pharm CH 3&4

When caring for an elderly patient, what are the physiologic cardiac changes that the nurse will evaluate to assess for impact of the drug action? Select all that apply. Blood flow 2 Blood group 3 Blood viscosity 4 Cardiac output 5 Blood cell count

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The nurse is teaching an elderly patient about the various factors leading to decreased metabolism of drugs. Which statement of the nurse is appropriate about decreased metabolism in elderly patients? Select all that apply. There is a decrease in liver mass." 2 "There is decreased bile production." 3 "There are defective microsomal enzymes." 4 "There is a reduction in blood flow to the liver." 5 "There is reduced production of microsomal enzymes.

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What are the drug dosage variables that impact the drug transfer to the fetus during gestation? Select all that apply. Dose 2 Lipid solubility 3 Protein binding 4 Molecular weight 5 Duration of therapy

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A diabetic patient tests positive for a urine pregnancy test. What is the appropriate intervention for this patient? 1. Instruct the patient to continue taking all antidiabetic medications. 2. Instruct the patient to take low dose of antidiabetic drug. 3. Withhold anti-diabetic medication for the perinatal period. 4. Educate the patient about risks associated with anti-diabetic medications.

1. Instruct the patient to continue taking all antidiabetic medications

A group of nurses conduct a single-blinded investigation drug study. What points will the group consider while conducting the study? Select all that apply. 1. The researcher knows that the subject belongs to either the drug or the placebo group 2. The researcher does not know whether the subject belongs to the drug or the placebo group 3. the subject is aware of which group (drug or placebo) they belong to 4. The subject is not aware of which group (drug or placebo) they belong to 5. The researcher and subject are not aware of which group (drug or placebo) the subject belongs to

1. The researcher knows that the subject belongs to either the drug or the placebo group 4. The subject is not aware of which group (drug or placebo) they belong to

An elderly patient has developed heart failure due to hypertension. Which drugs require caution while being used in this patient? Select all that apply. 1. Narcotics 2. Decongestants 3. Amphetamines 4. Long-acting sedatives 5. Over-the-counter cold medications

2. Decongestants 3. Amphetamines 5. Over-the-counter cold medications

Which condition in elderly patients requires caution with the use of bronchodilators? 1.Syncope 2.Insomnia 3.Clotting disorders 4.Overactive bladder

2. Insomnia

The nurse is responsible for dispensing medications to children. Which characteristics of pediatric children have significant impact on dosage of drugs? Select all that apply. 1. Risk of excessive hydration 2. Lack of acid in stomach 3. Weaker mucous barrier in the lungs 4. Thin skin with reduced permeability 5. Immature liver and kidney function

2. Lack of acid in stomach 3. Weaker mucous barrier in the lungs 5. Immature liver and kidney function

The nurse is explaining the changes in the distribution process of drugs occurring in elderly patients. Which pharmacokinetic changes occur in patients older than 60 years? Select all that apply. Reduction in body fat content 2 Increase in protein binding sites 3 Presence of 55% of total body water in males 4 Reduced protein concentration 5 Presence of 46% of total body water in females

Reduced protein concentration 5 Presence of 46% of total body water in females

Which actions will the nurse perform to ensure that the medication dose for a pediatric patient is correct? Select all that apply. 1. Use the patient's weight in pounds. 2. Use a current drug reference to determine usual dosage per 24 hours. 3. Determine the dose parameters by multiplying the weight by the minimum and maximum daily doses of the drug (the safe range). 4. Determine the total amount of the drug to administer per dose and per day. 5. Compare the drug dosage prescribed with the calculated safe range. 6. If the drug dosage prescribed varies from recommended reference range, notify the provider

2. Use a current drug reference to determine usual dosage per 24 hours. 3. Determine the dose parameters by multiplying the weight by the minimum and maximum daily doses of the drug (the safe range). 4. Determine the total amount of the drug to administer per dose and per day. 5. Compare the drug dosage prescribed with the calculated safe range. 6. If the drug dosage prescribed varies from recommended reference range, notify the provider

What will a nurse need to know about differences in drug distribution in neonates compared with drug distribution adults? Select all that apply. Neonates have increased body fat. 2 Neonates have an immature blood brain barrier. 3 Neonates have reduced protein synthesis. 4 Neonates have total body water of 85% if full-term. 5 Neonates have total body water of 70% if premature.

2Neonates have an immature blood brain barrier. 3Neonates have reduced protein synthesis.

An elderly patient has a history of falls and syncope. Which drugs will the nurse use with caution in this patient? Select all that apply. Decongestants 2 Anticholinergics Correct 3 Antidepressants Correct 4 Muscle relaxants Correct 5 Antihypertensives

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What are the changes that occur in the absorption process due to aging in elderly patients? Select all that apply. Decreased gastric pH 2 Increase in the absorptive surface area Correct 3 Reduced motility in the gastrointestinal tract 4 Increased motor activity in smooth muscles Correct 5 Reduced blood flow to the gastrointestinal tract

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Which best describes a placebo? 1. A formulation with no adverse effects 2. A formulation with no side effects 3. A formulation with no pharmacological effects 4. A Formulation with no therapeutic effects

3. A formulation with no pharmacological effects

Which drugs may be used without restrictions in patients who have bleeding disorders? Select all that apply. 1. Nonsteroidalantiinflammatory drugs (NSAIDs) 2. Aspirin 3. Antihistamines 4. Antiplatelet drugs 5. Anticholinergic drugs

3. Antihistamines 5. Anticholinergic drugs

The nurse administers warfarin to an elderly patient. What is the impact of the administration of an adult dose of warfarin to the patient? 1. Clinically insignificant effect 2. Increased protein binding of the drug 3. Increased unbound drug in plasma 4. Decreased efficacy of drug action

3. Increased unbound drug in plasma

Which drug is safest for use by young children during the growth years? 1. Tetracycline antibiotics 2. Quinolone antibiotics 3. Inhaled corticosteroids 4. Systemic corticosteroids

3. Inhaled corticosteroids

In which clinical disorder are antipsychotic drugs used with caution? 1. Heart failure 2. Clotting disorder 3. Parkinson's disease 4. Chronic obstructive pulmonary disease

3. Parkinson's disease

The nurse is caring for an elderly patient. The laboratory reports reveal decreased liver function. How does this change impact the drug action? 1. Increased excretion 2. Reduced absorption 3. Reduced metabolism 4. Increased first pass metabolism

3. Reduced metabolism

Which are the highly protein-bound drugs that require dose adjustment before administering to an elderly patient? Select all that apply. 1. Sedatives 2. Hypnotic drugs 3. Warfarin 4. Anxiolytics 5. Phenytoin

3. Warfarin 5. Phenytoin

When calculating pediatric dosages, what will the nurse take into consideration? 1. Utilization of drug reference recommendations based on mg/kg of body weight is the preferred method. 2. Calculated doses based on body weight need to be increased by 10% because of immature renal and hepatic function. 3. Dosage calculation according to body weight is the most accurate method because it takes into account differences in maturational development. 4. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

4. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

A patient is treated with a thiazide diuretic to control hypertension. To reduce the adverse effect of this diuretic, what will the nurse contact the provider to discuss? 1.Sodium supplementation 2.Calcium supplementation 3.Chloride supplementation 4.Potassium supplementation

4. Potassium supplementation

A child who weighs 10 kg needs a drug with an ordered dose of 10 mg/ kg of body weight per day in two equally divided doses. What dose will the nurse dminister twice a day? Record your answer using a whole number. _____ mg

50mL

A child has a body surface area (BSA) of 2.0 m2. What is the dose required for this child if 10 mg of the same drug is given to an adult who has a body surface area of 1.0 m2? Record your answer using a whole number. _____ mg

5mg The dose is calculated by the formula: Child dose = (BSA of adult/BSA of child) × adult dose = (1.0/2.0)*10 = 5 mg