Pharmacology Chapters 8,9,10,11

It is important that the nurse understand that the safety and effectiveness of a medication regimen depend on which​ factors?

Proper storage of the medication Proper administration of the drug Proper procurement

During a class about the use of medications during​ pregnancy, the nurse determines that additional information is required when a client makes which​ statement?

"The baby can only be harmed by medication during the first​ trimester."

The nurse is providing discharge instructions to an adolescent and the family. To increase the likelihood of​ adherence, which questions would the nurse​ ask?

"Are you worried about the fact that you will need to take this medication while you are at​ school? his medication may give you dry mouth. Will you be allowed to suck on hard candy in school to help with the dry​ "This particular prescription has to be taken three times a day. Will that be difficult for you to​ do?

The nurse is conducting a holistic assessment of a client diagnosed with alcoholism. Which priority questions should the nurse include in the assessment

"Have any of your blood relatives been addicted to​ alcohol?" ​"Have you ever attended Alcoholic Anonymous​ meetings?" "Did you see your parents drink alcohol when you were growing​ up?"

A clinic nurse is discussing an acne medication regimen with an adolescent client. Which statements by the adolescent represent common problems with​ adherence?

"I took it the first month but my mom got busy and kept forgetting to get my​ refill." ​"I was taking the medicine for a​ while, but it​ didn't seem to be​ working." "I felt nauseous whenever I took the​ medicine."

he pregnant client plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. Which response by the nurse is the most​ appropriate?

"Most drugs can be transferred to the infant during​ breastfeeding, so this is not​ recommended."

A pregnant client tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. Which response by the nurse is the most​ appropriate?

"This is because high estrogen levels increase stomach​ acid, which may decrease​ absorption."

The nurse plans to administer medication to a​ preschool-age child. Which approach indicates the nurse has an understanding of growth and​ development?

A brief​ explanation, followed by quick administration of the​ medication, is best.

The nurse would determine that which pediatric client is experiencing an adverse effect from a​ medication?

A child taking ibuprofen​ (Advil) for a sports injury who frequently has an upset stomach A child taking an ototoxic antibiotic who does not respond when spoken to A child taking amoxicillin for an ear infection who has diarrhea

What should the nurse educator teach as a common reason for difficulty in assessing for side effects of medications during​ pregnancy?

Adverse effects of medications are often similar to common discomforts of pregnancy.

A woman from an Arab culture is in labor. Her husband insists he must stay with her and will not allow her to receive any analgesia. Which action by the nurse is the most​ appropriate?

Allow this​ request, and be available in the event the request changes

The pediatric nurse is aware that a child might experience the same adverse effects to a medication as an adult. For what class of medication could this reaction​ occur, and what reaction would the nurse​ anticipate?

Antipsychotics; CNS depression

Student nurses are learning about the Food and Drug Administration​ (FDA) pregnancy categories. What is the best information for the nurse educator to include in the​ lecture?

FDA pregnancy category X has been associated with teratogenic effects. FDA pregnancy categories provide a framework for safe use of drugs in pregnant women.

The nurse tells the expectant mothers during their last prenatal class that their fetus might receive a larger dose of a drug in the later period of their pregnancy. Which processes in the​ mother's body systems are responsible for this​ action?

Blood flow to placenta​ increases, and placental vascular membranes become thinner.

The nurse is calculating the medication dose for a​ 4-year-old child by plotting the​ child's height and weight on a​ nomogram, then drawing a line between the two points. The point at which the line intersects the surface area line is the​ child's BSA. The dose is calculated using the BSA. What does this calculation​ represent?

Body surface area method

The nurse is teaching a​ mixed-gender class how to prevent heart attacks. What important factor related to gender will the nurse include in the teaching​ plan?

Certain​ medications, such as​ aspirin, are more effective in preventing heart attacks in men than in women.

The nurse is following the guidelines established by the American Academy of Pediatrics​ (2007) when administering medications to pediatric patients. Which nursing action is included in the​ guidelines?

Check medication calculations with another professional.

The nurse teaching a parenting class would stress what information about adverse drug​ reactions?

Common drug effects seen in breastfeeding infants include diarrhea and irritability. Effects on the infant can be very serious. The concentration of drugs in breast milk is very low but may still result in adverse drug effects in an infant

The nurse is teaching the mother of an infant how to properly administer medication. Which teaching points are important for this age​ group?

Cuddle the infant while administering medications. Deposit oral medication into the cheek area of the​ infant's mouth. Hold the buttocks closed for 5 to 10 minutes after administering a rectal suppository.

A Caucasian nurse is caring for an African American client who has a history of myocardial infarction and is receiving atorvastatin​ (Lipitor). The nurse assesses the​ client's diet to be very high in fat. Which teaching plan would be most effective at improving the​ client's diet and possibly reducing the need for additional​ medications?

Discuss the​ client's diet with whomever prepares meals for the family.

A home health​ nurse's client caseload is ethnically diverse. Which interventions show understanding of cultural​ variables?

Discussing the​ client's beliefs regarding treatment Assessing the​ client's response to acupuncture for pain Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible

The FDA Modernization Act contained several​ flaws, which led to the passage of the Best Pharmaceuticals for Children Act in 2002. What was the major flaw in the modernization​ act?

Drugs were chosen for research based on their financial benefits to the pharmaceutical companies.

A nurse administering medications to a variety of clients on a medicallong dashsurgical floor recognizes which clients may need additional education about medication​ adherence?

Fifty-year-old recently remarried male taking antihypertensive medication ​Twenty-eight-year-old female started on acne medication known to cause​ male-patterned hair growth ​Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive

Which factors does the nurse recognize potentially influence oral absorption of drugs in the pediatric​ client?

Increased gastric pH . Delayed gastric emptying

The nurse recognizes that which physiologic change during pregnancy can alter absorption of​ medication?

Increased levels of progesterone increase pulmonary blood​ flow, resulting in higher serum levels for respiratory drugs.

The nurse is calculating the medication dose for a​ 4-year-old child by use of the body weight method. Which is a disadvantage of this type of drug​ dosage?

It does not account for metabolism and elimination.

The nurse in charge of a clinical study welcomes the participants in an open forum. One client is surprised that there are men and women from several ethnic groups. The nurse tells the group that in the​ past, ethnic variables were largely unknown or ignored for which​ reasons?

Little attention was focused on identifying the different effects drugs had on various ethnic groups. Clinical trials comprised mostly Caucasian males. Clinical trials failed to include ethnically diverse subjects.

The nurse knows that pregnancy affects the​ absorption, distribution,​ metabolism, and excretion of drugs. Which one is the least affected by​ pregnancy?

Metabolism

he clinic nurse will immediately alert the healthcare provider when which category X drugs are identified on a recently diagnosed pregnant​ client?

Methotrexate Oral contraceptives Isotretinoin​ (Accutane)

The nurse is providing discharge instructions to a child and the family. To promote medication​ adherence, the nurse facilitates which​ conditions?

Minimal adverse effects from the medications

The nurse is teaching a​ toddler's mother strategies for administering prescribed oral antibiotics. Which strategies will be​ discussed?

Mix​ unpleasant-tasting medications in appetizing food such as jam or syrup. Physically comfort or praise the toddler following medication administration. Ask the pharmacist to put the medication into sweet​ syrup, if possible.

The nurse has been assigned to the pediatric floor. Which nursing interventions indicate this nurse understands pharmacokinetic variables in​ children?

Monitoring blood sugars for hyperglycemia in an infant with eczema requiring frequent applications of topical corticosteroid cream Monitoring diagnostic lab work for therapeutic levels of phenobarbital in a premature infant Monitoring a​ 5-month-old infant taking propranolol​ (Inderal) for a heart defect for symptoms of toxicity

he nurse is performing a holistic assessment on a client prior to administering antihypertensive medication. Which factors would be included in the holistic​ assessment?

Mood Blood pressure Belief in a higher power Level of education

The nurse is preparing a teaching plan for an adolescent postpartum mother. Which topic will the nurse include in the teaching​ plan?

Most medications are secreted into breast milk. The new​ mother's insulin will not be secreted into her breast milk. ​Over-the-counter (OTC) drugs and herbal products are secreted into breast milk and have the potential to cause harm to the infant. Your answer is correct.

An infant recently prescribed the​ anti-infective gentamicin is brought to the emergency department with​ oliguria, hematuria, cloudy​ urine, and fever. Which diagnosis would the nurse anticipate for this infant based on the assessment​ findings?

Nephrotoxicity

A client admitted to the emergency department for vaginal bleeding is surprised to find she is in the third trimester of pregnancy. An ultrasound determines the fetus is not viable. The nurse recognizes that which drug could be responsible for the fetal​ demise?

Nonsteroidal​ anti-inflammatory drugs​ (NSAIDs) ​Angiotensin-converting enzyme​ (ACE) inhibitor

The nurse is assessing several clients. For which client does assessment reveal a psychosocial history that may affect the​ client's outcome?

Older adult who recently suffered a​ stroke, has an unsteady​ gait, and lives in a​ two-story home Recently divorced mother of three children with breast cancer Middle-aged client with Down syndrome living in a group home

The nurse is caring for an Asian American client diagnosed with terminal cancer. Which factor should the nurse consider to achieve adequate pain control for the​ client?

Opioids are metabolized differently in individuals of Asian and Native American descent.

The primary healthcare provider has prescribed isoniazid​ (INH) for a client of Japanese descent diagnosed with tuberculosis. What factor must be considered in regard to the therapeutic effectiveness of this​ drug?

People of Japanese descent are known as rapid acetylators.

A male client comes to the emergency department with chest pain. Upon assessment the nurse notes that his blood pressure is​ 210/100 mmHg. The​ client's wife says to the​ nurse, "He has not been taking his blood pressure​ medication, and we can afford​ it." What should the​ nurse's plan of action​ include?

Plan to assess the client for sexual side effects such as erection difficulty.

A healthcare provider recommends chemotherapy for a client diagnosed with cancer. The client tells the​ nurse, "This is a punishment from God for the sins I have committed. Some of the women at my church say​ so." Which intervention will best meet the​ client's spiritual​ needs?

Plan to contact the​ client's minister to make a visit

The nurse educator is explaining the factors that impact the transfer of medications across the placenta. Which factor would be responsible for higher concentrations of a drug being transferred to the fetus through the​ placenta?

Plasma drug level in the mother

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. Which information would be included in an effective teaching​ plan?

Prescription drugs for children come in flavored elixirs and can be mistaken for candy. Toddlers put everything in their​ mouths, including topical medications. Poisoning is extremely common during the toddler years. All medications should be locked up or stored out of reach of the toddler.

A pregnant client suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the client about which complications associated with drug use during​ pregnancy?

Preterm birth, Birth defects, Low birth weight

When​ possible, drug therapy is postponed until after pregnancy and lactation. Which acute and chronic conditions must be managed during​ pregnancy?

Sexually transmitted infections Epilepsy Gestational diabetes Hypertension

Which​ classification(s) of drugs​ is/are more commonly prescribed for children due to their high incidence of infectious​ diseases?

Systemic antibiotics Respiratory drugs Dermatologic drugs

The nurse is teaching a prenatal class for mothers with a past history of drug abuse. Which factor would the nurse need to emphasize about the first trimester of​ pregnancy?

Teratogenic agents taken during this phase can lead to structural malformation and spontaneous abortion. This is the correct answer.

An adolescent Hispanic male with​ attention-deficit/hyperactivity disorder​ (ADHD) is taking methylphenidate​ (Ritalin). The adolescent will not go to the school nurse at noon for his medication. Which statement best describes the likely result of the​ nurse's assessment?

The adolescent is embarrassed about having to take medicine at​ school; it is a social stigma.

An African American adult client is prescribed a sulfonamide drug to treat an infection. Why would the nurse question this prescribed medication​ order?

The client may exhibit slow​ acetylation, which can impact the effect of the medication.

For which client would the nurse expect the healthcare provider to continue prescribed medications during​ pregnancy?

The client recently diagnosed with gonorrhea The client with hypertension The client with a history of frequent asthma attacks

The nurse plans to administer medication to a​ 6-month-old infant based on which​ understanding?

The dosage should be based on milligrams per kilogram weight per day.

Which factor would lead to the dilution of the drug furosemide​ (Lasix) in the​ newborn?

The higher proportion of water to fat dilutes​ water-soluble drugs.

The nurse is teaching a prenatal class for mothers with a past history of drug abuse. Which fact about the use of drugs with a breastfeeding infant would the nurse need to​ emphasize?

The infant might experience withdrawal symptoms and test positive for the drug for several weeks to months following exposure.

Native American client is admitted to receive chemotherapy. At any given​ time, five family members are in the​ client's private room. The nurse tells the client that according to hospital​ policy, only two visitors at a time are allowed. What is the nurse​ manager's analysis of the​ situation?

The nurse should have assessed the​ client's preference about the number of family members present.

A client overhears the healthcare team talking about pharmacogenomics. The client asks the nurse what that means. Which statement provides the best example of​ pharmacogenomics?

The study of​ individuals' genetic background and how it affects their response to drug​ therapy."

In​ 1997, the Food and Drug Administration Modernization Act was passed. What was the rationale for this​ legislation?

To improve testing and labeling of pediatric drugs

The nurse teaching a parenting class would stress what information about adverse drug reactions in the breastfeeding​ infant?

Topical medications are safe to use during lactation.

The emergency department nurse is preparing for the arrival of a​ 3-year-old with suspected drug overdose. Which medications are most likely to be the cause of the​ overdose?

Topical ointments, Analgesics Cough syrup Vitamins

The nurse in a pediatric clinic is preparing to give a toddler and a preschooler intramuscular​ (IM) antibiotics. The nurse chooses the injection sites for each child based on which​ considerations?

Use of the dorsogluteal site should be avoided. The vastus lateralis muscle is the preferred site for IM injections in toddlers. After the child has been walking for a​ year, the ventrogluteal site is used for IM injections.

The nurse is providing education about warfarin​ (Coumadin) to a group of Asian American and African American clients who have experienced strokes. The nurse determines that learning has occurred when the clients make which​ statement?

We might need less medication than other ethnic​ groups."

A client asks the nurse why a medication prescribed by the provider​ "didn't do anything at​ all." Which statement by the nurse accurately describes how genetics influence drug​ action?

​"Because of genetic​ differences, medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic​ effect." ​"Genetic differences can result in significant differences in how each​ client's body handles the same​ medication." ​"Genetic differences can cause mutations in​ enzymes, changing the way they function. This can alter how the body

The nurse in the emergency department is caring for several clients from diverse cultures. Which statements show the​ nurse's ability to provide culturally competent​ care?

​"I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate your​ fear?" ​"I understand your religion prohibits blood transfusions. Would you consider nonblood​ alternatives?" ​"I just want to make sure you and your spouse understand the risks as you consider the​ options."

The nurse is planning care for a pregnant client prone to substance abuse. When the client​ states, "My baby​ isn't getting my​ drugs; I​ am," which response by the nurse is the most​ appropriate?

​"Most illicit drugs will cross the placenta and hurt the​ baby." "Even drugs that do not cross the placenta can hurt your baby by preventing nutrients from getting across the​ placenta." "Research shows taking drugs can cause your baby to be born too​ early."