prep u exam study nrs 115
After a discussion about the half-life of a drug, a nursing instructor concludes further teaching is necessary when nursing students choose which facts as true? Select all that apply:
It can be decreased in clients with renal disease. It does not change throughout a client's life.
What is included in FDA approval of a drug for OTC availability?
evaluation of evidence that the consumer can use the drug safely, using information on the product label
The nurse's discussion of the role of cytochrome P-450 (CYP) enzymes is focusing on what aspect of pharmacokinetics
CYP enzymes metabolize in the liver.
How many insulin syringes will the nurse need to administer 100 units of standard U-100 insulin?
insulin syringes are calibrated to measure up to 100 units of insulin so only one is needed max
A client who is receiving ibuprofen asks the nurse, "What should I take the drug with?" What would the nurse suggest in the response? Select all that apply.
the nruese should adbice the client to take ibuprofen with food, milk and atacids.
How should a nurse best explain the presence of the inflammation process?
the presence of inflammation process is the body attempting to remove damaging agents and repair the damaged tissue
Mrs. Geonity is prescribed a medication, and the health care provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. The client asks the nurse what the rationale is for the dosage changes. How should the nurse respond?
the rationale for dosage change is to determine whether the drug action will be therapeutic or toxic because too much will have be toxic and too little on pharmacologic action.
A client has an order to receive 10 units of Lantus insulin at bedtime via subcutaneous injection. Which sites would be ruled as inappropriate for the injection? Select all that apply.
the site for subcutaneous injections are the upper posterior arms, the upper abdomen and the upper thighs. where you wouldn't do it is the gluteus maximus and inner forearm
A nurse is preparing to teach a client about the adverse effects of the prescribed NSAID therapy. Which system would the nurse include as being involved?
the most common side effect for NSAID therapy is involved in the GI tract
To reduce older adults' risk of experiencing adverse drug effects or interactions, what action should the nurse prioritize?
to reduce risk of older adults experincing adverse drug effects or interactions the nurse should assess clients use of herbal remedies and over the counter medications.
Which of the following drugs is considered the prototype of opioid analgesics?
Morphine
Discharge planning for clients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by a client would demonstrate a good understanding of OTC drugs?
"OTC drugs are thought to be safe when taken as directed."
The client is a 6-year-old who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of amoxicillin is 3 hours, approximately how much amoxicillin would be in the child's body at the time of the next administration of the drug?
31 mg because 6 times 2 is 12 and then 12 divided by 3 is 4 then 125 divided by 4 is 31mg
What is the maximum amount of drug a nurse can give a client using the intramuscular method? Fill in the blank with a number.
3ml is the most you can give a client though IM injection
The nurse has just administered a client's medication. What action should the nurse perform next?
Assess for drug effects.
Prescription practices of primary health care providers for controlled substances are monitored by which agency?
Drug enforcement agency is responsible for monitoring prescription practices for controlled substances.
A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should:
Factors that influence dynamic equilibrium is reduced absorption.
What statement describes a required characteristic of all generic drugs?
Generic drugs must be therapeutically equivalent to brand name drugs.
The nurse is preparing to teach a client about a new drug which is in the fourth phase of development. Which activity will the nurse explain best illustrates this phase?
Health care providers report adverse effects to FDA
One of the phases of drug development is the post-marketing surveillance phase. Which activity is carried out during this phase?
Health care providers report adverse effects to FDA.
While collecting a medication history, the client admits to doubling the recommended dosage of acetaminophen, saying "It's harmless or they would require a prescription." What is the nurse's best response?
OTC drugs are serious medications and carry serious risks if not taken as directed."
Which client should the nurse assess most closely for swallowing difficulties prior to administering an oral medication?
Parkinson's disease causes difficulties in swallowing.
What is a major disadvantage of using over-the-counter (OTC) medications?
People may choose an OTC that interacts with another medication.
Which statement is true regarding either prescription or nonprescription drugs?
Prescription drugs require a written order from a prescriber
According to Quality and Safety Education for Nurses (QSEN), what intervention will best help reduce the risk of medication errors?
QSEN recommends quiet zones for preparing medications and alerting nurse and staff not to interrupt
In determining why a medication error occurred, what is an effective strategy for nurses to implement?
Root cause analysis
The nurse is collecting information about the cell cycle for a teaching tool. In which phase will the nurse identify that DNA is synthesized?
S phase is the phase where DNA is synthesized
A nurse is preparing a presentation for a local community group about over-the-counter analgesics, including NSAIDs. Which possible reaction would the nurse integrate into the presentation as a serious risk with this class of drugs?
Serious risk involved with NSAID is cardiovascular thrombosis
Since 1962, newly developed medications have been extensively tested before being marketed for general use. Which step must the pharmaceutical companies prioritize when beginning the testing?
Test the drugs with animals
A nurse, preparing to administer a Schedule II medication, should provide what information to the client?
The drug carries a high potential for abuse.
During phase I drug testing, a drug has been found to be therapeutic at concentrations of between 2.5 and 2.9 mEq/L with toxicity occurring at 3.1 mEq/L. What consequence of this finding should the nurse anticipate?
The drug will likely not proceed to phase II testing.
Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing?
The north america nursing diagnosis association -internation(NANDA) is formed to standardize the terminology used for nursing diagnoses
Which client is most likely to experience the benefits of the placebo effect?
The placebo effect is an effect where the person believes the drug will work will be more effective than not believing it will work
Which are true of nonprescription drugs? (Select all that apply.)
They are referred to as over-the-counter drugs. They have certain labeling requirements. They should be taken only as directed on the label.
A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods?
Vitamin K reverses the effects of Warfarin
A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics?
absorption takes place in the small intestine having the small intestine removed means that the nurse should focus on the alteration of the medication.
A client with acute joint inflammation tells the nurse , "I've been taking acetaminophen as it's ordered on the bottle, but my swelling and inflammation doesn't seem to be getting better." What should the nurse teach the client?
acetaminophen does not effect inflammation.
A 6-year-old client is presenting with signs and symptoms of fever, cough, stuffy nose, general malaise, and muscle aches. The nurse prepares to administer which medication to this client?
acetaminophen is used to treat mild to moderate pain and reduce fever.
The nurse is caring for a client who is exhibiting adverse medication effects. The nurse should recognize that adverse effects can be extensions of what?
adverse effects can be an extension of the primary action of the drug meaning an overdose of therapeutic medication.
The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?
adverse effects of niacin is some people get very flushed skin when they take the medicine, nausea never happens.
A client asks the nurse, "What is a Drug Enforcement Agency (DEA) number?" What is the nurse's best response?
all pharmicists and physicians must register with the DEA, to prescribe and dispense controlled substances.
A client diagnosed with gout reports having no symptoms of the disease and asks why allopurinol was prescribed. How will the nurse best respond?
allopurinol is used to prevent or treat hyperuricemia not cure it
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?
always discontinue a drug that causes a reaction first priority after the prescriber is notified
What effects are exerted by aspirin? (Select all that apply.)
anti-inflammatory, antipyretic and analgesic are exerted by asprin
The nurse teaches the client to do which of the following prior to surgery?
avoiding salicylates or aspirin before surgery helps decrease bleed effect
The processes that largely determine serum drug levels, adverse effects, and other important aspects of drug therapy is known by what term?
clearance
A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with:
clecoxib is contraindicated among patients with allergy to sulfonamides.
The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?
client diagnosed with peptic ulcers is more at risk for further GI irritation and bleeding so it should not be given
A nurse is assessing a client for possible factors that may affect the pharmacokinetics of a drug. A history of what disease would lead the nurse to suspect that the client may experience an alteration in the distribution of a drug?
clients with a history of vascular disease or low blood pressure may experience an alteration in the distribution of a drug
What would the nurse identify as the desired response of the combination of codeine and acetaminophen rather than each given separately?
codeine and acetaminophen work differently to reduce pain. so combining the two drugs work to better control the pain.
A client with Paget disease who weighs 110 lbs is prescribed 8 mg/kg PO of etidronate disodium. The nurse should administer how many 200 mg tablets?
convert Ib to kg by dividing by 2.2 and get 50kg then times that by 8 and then divide 400 to 200 and get the answer.
A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to
decrease in blood flow to tissues and muscles can alter the absorption of drugs administered intramuscularly or subcutaneously.
What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?
decreased glomerular filtration rate impacts changes to to aging that effect excretion and promote accumulation.
A black male client asks the nurse why the health care provider orders a diuretic as part of his treatment plan for hypertension, when the health care provider ordered an ACE inhibitor for his friend with the same diagnosis. After consulting with the provider, how would the nurse respond?
drugs affect different races differently so in this case black client is proved to be more effective with ACE inhibitors.
The client with a history of ischemic heart disease is prescribed aspirin 81 mg daily. The nurse should explain that less than 81 mg actually reaches target tissue due to which action?
first-pass effect because most of the drug is broken down through metabolism so less than 81 mg actually reaches the tissue
A new drug has been created by altering DNA. What process has been utilized to create this drug?
genetic engineering
An unconscious client has been brought to the hospital, and the client has prescribed a life-saving drug to be administered parenterally. Which method would be the most appropriate for the nurse to use when administering the medication?
intravenous infusion is preferred method in emergency situations when rapid drug effect are desired.
During a health care visit, a client tells the nurse that they stopped taking a prescription because the drug made their mouth dry. Which would be most appropriate for the nurse to do?
it is important for the nurse to help reduce adverse effect first which is suggest taking frequent sips of water or sucking on hard candy.
What client is most likely to have impaired drug metabolism?
kidney is the most important place for drug metabolism, hence hepatitis C is liver infection which impairs the liver from metabolizing
What unique characteristic is present in lipid soluble drugs?
lipid-soluble drugs only have active transport system which helps them cross the blood-brain barrier and no other drug can do that.
A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?
monitor blood counts would be the most important because it is most important for bone marrow suppression
A health care provider instructs a nurse to administer a medication to a client STAT. Which action by the nurse would be most appropriate?
nurse should administer the drug as instructed without a written order as it is an emergency.
The nurse is assessing a 10-year-old child who has been experiencing chronic headaches. The child's parent reports the administration of acetaminophen three to four times a day for the past several weeks. What assessment should the nurse prioritize?
nurse should priotize liver enzyme because it is the most acute threat and acetaminophen overdose deals with liver enzyme
A nurse is conducting an assessment of a client who has recently had several changes made to the drug regimen. What assessment question most directly addresses the safety implications of the client's drug regimen?
the use of alternative medications and herbal treatments is high in older adults so for safety ask what do they take any herbal supplements or alternative medication.
A patient comes to the clinic reporting throbbing pain that started at night and intolerance to covers on the foot. The nurse observes swelling at the site of the first metatarsophalangeal (MTP) joint. For what disorder does the nurse anticipate the patient will be treated?
throbbing pain is acute, and gouty arthritis is pain on the cover on the foot
A nurse caring for a patient administered an NSAID for fever reduction records a decrease in urinary output for the patient. Which of the following should the nurse consider as a probable reason for the patient's condition?
when temperature elevation is prolonged while on NSAID therapy decrease in urinary output may develop
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 the drug takes a longer time to have an effect. But for men have vascular muscle so the drug takes effect faster.
A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance?
C-II
The nurse should caution an older adult client against using diphenhydramine hydrochloride because of what increased risk?
diphenhydramine hydrochloride should be avoided by older clients because it causes confusion.
When caring for a group of clients, the nurse will monitor which clients for effects related to impaired drug excretion? (Select all that apply.)
groups that are risk of impaired drug excretion is infants with immature kidney function (pertussis) and skin infection is due to kidney problem, and chronic renal failure also from kidney problem.
A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?
high consumption of meat products and seafood increases the risk of gout.
Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen?
highest risk is people who drink more than four beers a day because drinking causes damage to the liver.
The nurse is caring for a patient who is taking bisoprolol, a cardioselective beta blocker. She expects that the patient will have a drop in blood pressure, but during her assessment of the patient she notes the blood pressure to be 210/112, which is elevated. What is the explanation of this reaction?
idiosyncratic response to a drug is another form of adverse effect meaning these responses are unusual and are the opposite effect of what is anticipated.
A nurse, who is required to administer a drug twice a day to a client, forgets to administer the first dose. What would be most appropriate for the nurse to do? Select all that apply.
if forgot to administer first dose nurse should report the drug immediately, then notify the primary care provider immediately, then after complete an unusual occurrence report regarding the error
A nurse is planning client teaching about a newly prescribed drug. What teaching point should the nurse provide to best improve adherence and safety?
if the client is aware of the adverse effects and how to alleviate or decrease the discomfort. they are more likely to continue taking the medication
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?
if the kidneys are not functioning properly, a drug may not be excreted properly and could accumulate in the body.
The nurse is administering a drug that is known to be absorbed by passive diffusion. The nurse should plan care in the knowledge that this drug will:
passive diffusion occurs across a concentration gradient from high to low
What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?
pharmacotherapeutics
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 clients airway. This is always a priority of trying to help open the airway first before assessing for vitals
A nurse is preparing to give a client's scheduled medication and is reviewing the rights of medication administration. What will be included in these rights? Select all that apply.
right drug right route right client right time
A salicylate is contraindicated in clients who have had surgery within the past week for which reason?
salicylate is contraindicated in patients with an increased risk of bleeding
A client presents at the emergency department reporting dizziness, mental confusion, and difficulty hearing. What should the nurse suspect is the client's issue?
salicylism can ovvur with high levels os aspirin which causes dizziness, mental confusion, difficulty hearing.
The care provider has prescribed intravenous hydromorphone for a client using a client-controlled analgesia (PCA) pump. The nurse is aware that this drug has a high abuse potential. Under what category would hydromorphone be classified?
schedule II
A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance?
schedule II (C-II)
The nurse administers a medication and the client has an immediate anaphylactic reaction following injection. What symptoms assessed by the nurse would indicate anaphylaxis? (Select all that apply.)
so during anaphylaxis what occurs is blood pressure to go up, dilated pupils, fast heart rate, difficulty breathing, and diaphoresis(excessive sweating)
The nurse is preparing to administer medications and demonstrates knowledge of the 6th right by:
the 6th right to administer medication is document because its the last right
The nurse understands that the dosage recommended by drug manufacturers is based on an individual weighing:
the average recommended dosage of a drug is targeted for people of 150lb(68kg) people who weigh more or less the dosage changes.
After teaching a group of students about drugs used to treat hyperlipidemia, the instructor determines that the teaching was successful when the students identify which of the following? Select all that apply.
to treat hyperlipidemia bile acids resins, fibric acid derivatives, and HMG-CoA reductase inhibitors.
Which of the following is considered a unit dose system? Select all that apply.
unit dose medications examples are single-dose cup of maalox, one phenergan suppository, a prefilled lovenox syringe. Anything that is pre done.
A nurse is administering digoxin to a client. To administer medications so that the drug is as effective as possible, the nurse should prioritize what factor?
when administering a drug the nurse should consider the phase of the pharmacokinetics so that the drug regimen can be effective as possible.
The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is now preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action?
when assessing the client's bp or anything else, that would be evaluation.
The client has been taking acetaminophen daily for two years. The health care provider has now prescribed ketoprofen in addition to the acetaminophen. The nurse plans to educate the client on NSAIDs and acetaminophen and that their interaction can cause what condition?
when client has long term acetaminophen use and NSAIDS are suddenly added the client in in risk for renal impairment.
A nurse is performing discharge teaching for a client who is prescribed ibuprofen. After teaching the client about the possible cardiovascular effects of the drug, the nurse determines that additional teaching is needed when the client states which comment?
when client says my blood pressure wont change that needs additional teaching because NSAID may result in increased or decreased blood pressure
The nurse is caring for a client who experienced a severe headache. When the prescribed dose of analgesics did not cause relief the client took double the dosage 1 hour later. The nurse should assess the client for what adverse effect?
when client takes overdose of a medication it causes poisoning
A client is receiving a maintenance dose of aminophylline, 3 mg/kg PO q 6 hr. The client weighs 50 kg. How many mg should the client receive in a 24-hour period?
when comes to weight times dosage to weight =150, then he takes it every 6 hours orally in a 24-hour period you divide 24 by 6 and get 4. Then times 4 to 150 and get an answer.
The nurse is converting grams to milligrams. How would the nurse move the decimal point?
when converting to large to small in this case grams to milligrams is 3 spaces to the right
A client prescribed a drug that has an exceptionally narrow margin of safety should be educated about the need for what intervention?
when deailing with narrow margin of safety measuring serum drug level is useful
The nurse is caring for a client who is receiving gentamicin, 250 mg, and fluconazole, 500 mg, at the same time. What effect should the nurse anticipate if these two drugs competed with each other for protein-binding sites?
when drugs are given together and compete for protein binding sites the effectiveness will be altered or causes toxicity
A male client presents to the health care provider's office with inflammation and edema in his left great toe, lasting several days. The provider orders a uric acid level and diagnoses the client with gout, and orders oral colchicine. The nurse is responsible for developing an education plan. The client asks how long it will take for the pain and swelling to subside from his toe. When colchicine is taken for acute gout, how long does it usually take until pain is relieved?
when taken for acute gout and takes colchicine pain is usually relieved in 4 to 12 hours with IV but orally is 24 to 48 hours.
A client has been diagnosed with gonorrhea and been prescribed oral tetracycline. What should the nurse include in health education about tetracycline? Select all that apply.
when taking tetracycline patients should avoid calcium and iron supplements.
