Pharmacology Exam 1 PREPU

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

A parent brings a child to the clinic for an earache. The child receives a prescription for amoxicillin. The parent calls the clinic the next day and says the child has been taking the medicine and now has a rash. The nurse should give the parent instructions about which type of response?

allergic response

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

The nurse would assess a client receiving which medication for possible superinfection?

antibiotics

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing:

antibodies

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the client's response is to taking NSAIDs

A nurse is caring for a 77-year-old. The nurse would know that a normal physiologic change that must be considered when planning drug therapy, and is associated with aging is:

blood volume decreases

Which factor has the most significant effect on a child's response to the administration of a medication?

body weight

A nurse is administering gentamicin, an antibiotic that is ototoxic. Which report or sign would indicate that the client is suffering from ototoxicity?

buzzing or ringing sound in the ears (tinnitus)

A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?

chlordiazepoxide

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?

cold, clammy skin

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate.

After assessing a client, what step of the nursing process will the nurse perform before planning care?

diagnosis

An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes:

digoxin and Lanoxin are the same medications.

Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?

epinephrine

When assessing a client who has developed a serum sickness reaction, which would the nurse expect to find?

facial edema

Which aspect of medical care is an overriding concern of a health maintenance organization (HMO)?

financial

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:

grapefruit.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean that the drug will:

have a long duration of action.

To correctly administer a medication, when should the nurse compare the medication with the medication administration record (MAR)? (Select all that apply.)

immediately prior to medication administration when removing the medication from the medication cart when initially looking at the medication label

With buccal medications, what factor affects absorption?

integrity of the mucous membranes

A post-surgical client rates the pain at 10/10. The nurse confirms that there are standing orders for the administration of opioid analgesics as needed. What route of administration should the nurse choose to achieve the fastest effect?

intravenous.

During assessment, a nurse asks a client about any chronic conditions that might have an impact on the client's prescribed drug therapy. What issue, if reported by the client, would alert the nurse to a possible problem?

kidney disease diagnosed 2 years ago

The nurse questions a client about the use of alternative therapies based on the understanding that these therapies:

may lead to possible interactions with other drugs.

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?

measures to alleviate any discomfort associated with adverse effects

Heroin is classified as which type of street drug?

opioid

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

ototoxicity from the ibuprofen

A nurse is reading an article that describes predictable differences in the effects of drugs in people of particular culture backgrounds due to their genetic makeup. The nurse is reading about:

pharmacogenomics.

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisoning.

The nurse administers a loop diuretic to the client. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?

potassium

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity?

reduced efficiency of renal function

When planning treatment for substance abuse disorder, what goal should the nurse first address?

safe detoxification

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions

There are four main classifications of drug allergies. Which classification would be described as an immune system reaction to injected proteins used to treat immune conditions?

serum sickness

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.

skeletal abnormalities central nervous system alterations heart defects limb abnormalities

In order to promote therapeutic drug effects, the nurse should always encourage clients to:

take their medication at the prescribed times.

A gerontological nurse is conducting a medication assessment of a new client on a subacute medicine unit. Which of the client's statements should signal to the nurse a need for education?

"I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

The nurse is teaching a client about the drug therapy regimen before being discharged. The nurse is emphasizing safety in the home setting. Which statement by the client indicates a need for additional teaching?

"I will make sure to store the medications in the bathroom medicine chest."

The nurse is providing education to the family of a client recently admitted for treatment of a substance use disorder. How should the nurse best explain the etiology of this disorder?

"Substance abuse is multifactorial and involves genetics, personality, and culture."

A client who just picked up a prescription at the pharmacy asks the nurse why the client was prescribed a medication for mental health issues when the client sought treatment for allergies. What is the nurse's best response?

"Tell me the name of your prescription please."

The nurse is teaching the parents of a school-aged child who is to receive medication therapy. What instructions should the nurse include?

"Tell your health care provider about all the medicines that your child is taking."

A nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose?

"We want to make sure you get the benefits of the drug as quickly as possible."

The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize?

"When are you taking your medication?"

Which website extension represents a professional group?

.org

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

31 mg

A client is receiving 250 mg of a drug that has a half-life of 8 hours. How much drug would remain after 24 hours?

31.25 mg

The most serious allergic response is called anaphylaxis. Which clients exhibit possible symptoms of anaphylaxis? (Select all that apply.)

A client showing signs of acute respiratory distress. A client with marked hypotension and experiences convulsions. A client with laryngeal edema and pale, cool skin.

What client is experiencing an adverse effect that is a result of primary action?

A client taking anticoagulants who develops a gastrointestinal bleed

Which client is most likely to experience the benefits of the placebo effect?

A client who states, "I know this drug is going to work for me

A client is administered an oral contraceptive. What is the process that occurs between the time the drug enters the body and the time it enters the bloodstream?

Absorption

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

Which factor should the nurse take into account when administering medications to older adults on the unit?

As a result of age-related changes, older adults face an increased risk of adverse medication effects.

The health care provider orders NPH U100 insulin 16 units SC every AM for a client. The nurse prepares the insulin dose. To ensure safety, what does the nurse do?

Ask another nurse to double-check the measurement.

The nurse is preparing to administer a medication to a client and needs to confirm identification of the client. What may the nurse use to identify this client? (Select all that apply.)

Ask the client to state the birthdate. Request that the client state their name. Check the client's wristband for the name.

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?

Ask the client, "What happens when you take a dose of tetracycline?"

The nurse is caring for a client with migraines who has been prescribed fluoxetine. The nurse has questioned the provider about the prescription, stating, "The client has no history of depression that I'm aware of, so why is she starting Prozac?" The provider replies, "It's an off-label use." What is the nurse's best action?

Assess the client and administer the client's fluoxetine as prescribed.

In today's health care environment, there is often more contact between the client and the nurse than between the client and the health care provider. What does this put the nurse in the best position to do

Assess the therapeutic success of the drug therapy.

The client has a daily antihypertensive medication prescribed. Taking the blood pressure prior to administration of the medication is which step of the nursing process?

Assessing

A nurse taking a client's blood pressure prior to administering a drug could be considered what type of action? (Select all that apply.)

Assessment Objective data

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

Be sure to drink plenty of fluids to prevent dehydration.

The nurse administers a medication to the client that induces the secondary action of hypoglycemia. What organ will be most acutely affected by inadequate circulating glucose?

Brain

A client was prescribed an oral antibiotic but was unable to tolerate the medication due to adverse effects. The client asks the nurse what to do with the remaining medication. What is the nurse's best recommendation?

Bring the medication to a pharmacy that accepts unused medications.

A group of students asks an instructor about where to find the most up-to-date information on biological weapons. What would the instructor recommend?

CDC

The nurse is assessing an older client's response to various medications the client is taking. The nurse knows that which body systems require close assessment for impairment? (Select all that apply.)

Cardiovascular Hepatic Renal

A client is experiencing difficulty swallowing a large oral tablet. What action by the nurse would be most appropriate?

Check to determine whether the drug can be crushed or mixed with food.

What are accurate regarding herbal remedies? (Select all that apply.)

Clients often do not mention their use to health care providers. Herbal remedies produce unexpected effects. Herbal remedies can interact with prescription drugs.

The nurse is unfamiliar with a drug ordered for the client and looks it up in a drug handbook. The client is not diagnosed with any of the problems the drug is identified as being useful in treating. What will the nurse do before administering the drug?

Consult the prescriber.

Which of the following statements about today's health care consumers would the nurse recognize as false?

Consumers are reluctant to use over-the-counter and alternative therapies.

The nurse receives an order for 2.5 mg of diphenhydramine for a client with a mild allergic reaction. The nurse is aware that this is an unusual order. What is the nurse's best action?

Contact the prescriber for clarification.

A 32-year-old client is admitted to the unit with a diagnosis of hypovolemia. The nurse writing a care plan for this client knows that an appropriate nursing diagnosis to help prevent medication errors is:

Deficient fluid volume

The nurse is preparing a teaching plan for a client who will be discharged home with several new medications. When preparing the teaching session, what is the nurse's best action?

Determine the client's level of education.

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult?

Drug clearance is likely to be slower.

What recommendation concerning bioterrorism by the Center for Disease Control (CDC) provides the public with the best protection?

Education of health care providers and the public concerning recognition and treatment of infections caused by biological weapons

It is often necessary for the health care provider to choose a drug therapy based on the costs of the drugs available. Which factors may be considered by a health care provider when prescribing a drug? Select all that apply.

Elderly clients may have a fixed income, so choosing a generic over a brand name drug for them may be ideal. Teach clients not to cut drugs in half in order to save on costs.

A client with newly diagnosed hypertension has received a prescription from the care provider reading "Vasotec 5 mg PO daily." The client has expressed concern to the nurse about the possible cost of the medication. What is the nurse's best action?

Encourage the client to inquire about purchasing a generic equivalent.

The nurse makes an effort to provide high-quality care to clients by obtaining and analyzing the best available scientific research. This activity demonstrates which important component of practice?

Evidence-based nursing

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?

Excretion is likely to take place slowly.

A client asks a nurse about using the Internet to obtain drugs at a cheaper price. The nurse should recommend the client access what site for additional information regarding this practice?

FDA

The clinic nurse is assessing a diabetic client who has presented at the clinic with several hypoglycemic episodes during the past 3 weeks. Each of these episodes has required treatment with increased sugar intake. The nurse questions the client about the use of herbal or alternative therapies. What herbal therapy could cause the hypoglycemic episodes?

Ginseng

"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process?

Goal

Biological assaults are a concern across the health care industry. In order to cope effectively with any biological assault, which group needs to be well-educated?

Health care providers

What is a drawback to HMO insurance?

Health care providers in the organization are the only ones who can be consulted.

A client is scheduled for a test. Prior to the test, the client must be premedicated. When administering the prescribed pre-procedure sedative, the nurse is performing an intervention associated with what step of the nursing process?

Implementation

The nursing instructor is discussing drug therapy in the older adult. The instructor would tell the students that what could affect therapeutic dosing in an older adult?

In older adults, drugs have decreased GI absorption.

Ipecac was found to be ineffective for its intended use in 2003. What was previously an intended use of this drug?

Induce vomiting

The nurse brings the client's afternoon medications and attempts to teach the client about them. The client states, "Just tell my wife about them, she will take care of me at home." What is the most appropriate nursing diagnosis for this client?

Ineffective Self Health Management

What drug administration route should be used to assure the best bioavailability as any particular drug?

Intravenous

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

What does the nurse need to do when there is any indication of an allergic reaction in clients?

Maintain the client's safety during drug therapy.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values

An older adult client calls the health care provider's office and tells the nurse that prescriptions for three medications have run out and the pharmacy will not refill them this close together. A home health referral is made and the client is found to be taking the medication more often than prescribed. What is a priority nursing diagnosis for this client?

Nonadherence to therapeutic medication regimen

What action should the nurse take when identifying that a client regularly self-medicates with herbal supplements?

Notify the healthcare provider of the client's use of herbs.

What statement is true concerning nursing diagnoses?

Nursing diagnoses can be actual or potential.

A nurse is beginning to apply the nursing process during a new client interaction. What activity should the nurse perform?

Obtain a medication history.

Which of the client's medications should the nurse expect to be absorbed most slowly?

Oral acetaminophen, given for a fever

Which drug would be classified as a hallucinogen?

PCP

Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older?

Physiologic changes affecting all pharmacokinetic processes

Which nursing intervention would the nurse expect to do during implementation?

Providing client teaching about a drug therapy regimen.

The nurse has learned that a client has begun supplementing the prescribed medication regimen with a series of herbal remedies. Which is the most important nursing intervention regarding the safe use of herbal supplements?

Research for potential interactions with medications.

When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?

Review laboratory values indicative of kidney function

A nurse is administering IV acyclovir to a client. The pharmacy sent the correct dose in an IV bag with the instructions to give over one hour. The nurse realizes that the dose was ordered to be administered 1 PM and it is now 1:45 PM. What should the nurse do?

Run the infusion as directed (over one hour) and note the time that it was started in the chart. Fill out any medication discrepancy reports that the institution requires when a medication is given late.

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

Safety measures

A client, admitted for the treatment of a fracture, has a history of heavy alcohol use. What event should suggest the implementation of pharmacologic treatment for alcohol withdrawal?

Signs/symptoms of withdrawal are noted.

With the increasing number of clients who go to their physician and request a drug they have seen advertised on television or in a magazine, a continuing challenge to health care providers to do what has emerged?

Stay knowledgeable about drug therapy.

When providing drug therapy to a client, what is a responsibility of the nurse?

Teach the client how to cope with the effects of the drug to ensure the best outcome.

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?

Techniques for providing safe and effective mouth care

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

The nurse is admitting a new client whose health history includes chronic kidney disease. How should the nurse best interpret and document this assessment data on the nurses notes?

The client's drug excretion may be slower than normal.

What is the initial step in the process that occurs in the absorption of an oral drug?

The drug moves from the small intestine directly into the portal venous system.

What is true concerning medication errors?

The nurse is responsible for ensuring medication safety.

Which of the following teaching points about herbal therapies is inaccurate?

The results of available testing involve large groups of people.

What should the nurse include when teaching a client about herbal therapies?

The results of available testing often involve only a small number of people.

What would be most appropriate to teach a client about over-the-counter drugs?

They are safe when you use them as directed.

What is true concerning the "placebo effect" in drug administration?

Thinking that the drug will help the patient creates the placebo effect.

An experienced nurse has observed that female clients sometimes experience a drug's effects for a longer time than male clients of similar age and size. The nurse should attribute this to what factor?

Women have more fat cells so drugs depositing in fat will have a prolonged effect.

The nurse is assessing a number of clients on the acute medicine unit. What client is most likely experiencing an adverse effect from the primary action of the medication?

a client taking antihypertensives who reports dizziness upon standing

Assessment of a client receiving drug therapy reveals that the client has been experiencing gastrointestinal upset related to the drug. The client states, "My stomach has been so upset that all I've been able to eat is soup and dry crackers." Which nursing diagnosis would be most likely?

Imbalanced nutrition: Less than body requirements

Drugs injected intravenously (IV) reach their full strength in which timeframe?

Immediately

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?

Neurotoxicity

A 70-year-old with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse's admission assessment, the nurse realizes that the client has been taking ginkgo biloba supplements in addition to prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this client's care?

Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy

A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the health care provider prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission?

The laxatives can interact with and complicate prescribed drug therapy.

The nursing instructor observes several nursing students administer medications to their assigned clients. What students are demonstrating safe practice? Select all that apply.

The student checks the label on the medication against the administration record three times. The student checks the drug's brand name and generic name before taking it to the client. The student documents the medication upon exiting the client's room. The student inspects the client's arm band prior to giving a medication.

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

a decrease in urine output

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic response

A nurse is caring for a client who is prescribed multiple medications. Which clients are most likely to have adverse drug reactions?

clients who are very young or very old

During a health history, a client states, "I started taking the medicine every 6 hours as I was told. But then I started taking it every 5 hours, then every 4 hours, and eventually every 2 hours." The nurse determines that this client is at risk for:

cumulation.

A client reports that taking St. John's wort. When reviewing the client's medication history, what would be a cause of concern?

digoxin

A 38-year-old client is obese and has abscesses around the inner thigh muscles. The client is receiving IV antibiotics, but no improvement has been seen. The client questions the nurse about the most likely cause for the drug therapy failure. The nurse explains that the:

distribution of the drug to the area of the abscesses is impaired.

A client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of:

first-pass effect.

A client will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During client education about drug regimen, the nurse should prioritize teaching about:

potential adverse effects of the drugs that the client will be taking.

The nurse is admitting a client who has been on a three-day binge of methamphetamine. The nurse should anticipate what sign or symptom?

tachycardia

In the past 20 years, the marketing power for prescription drugs has grown. Because of this, the health care provider must be aware of:

what clients are seeing about these drugs.