Chapter 4: The Nursing Process in Drug Therapy

The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first? a. verify client understanding of the medication. b. evaluate the client's ability to swallow. c. obtain temperature and evaluate hydration status. d. obtain vital signs especially blood pressure.

b. evaluate the client's ability to swallow.

What is the nursing diagnosis the framework for? a. medical interventions b. nursing interventions c. evaluation summations d. outcome statements

b. nursing interventions

A nurse notes a medication error. Which action would be most appropriate? a. Notify the drug manufacturer. b. Make a report to the institution. c. Contact the Food and Drug Administration. d. Inform the Institute for Safe Medication Practices.

b. Make a report to the institution.

What is the primary purpose associated with the use of the nursing process related to the implementation of medication therapy? a. That the drug is given at the right time b. That holistic, evidence-informed care is given c. That the right dose is given to the patient d. That the drug is given to the right patient

b. That holistic, evidence-informed care is given

Which statement is true about a nursing diagnosis? a. This is done first in the nursing process. b. The nursing diagnosis relates the client's status. c. The nursing diagnosis cannot be verified. d. Nursing diagnoses are made up as the client needs them.

b. The nursing diagnosis relates the client's status.

After assessing a client, what step of the nursing process will the nurse perform before planning care? a. assessment b. diagnosis c. planning d. intervention

b. diagnosis

What is true concerning the "placebo effect" in drug administration? a. Thinking that the drug will help the patient creates the placebo effect. b. The administration of pretend medications creates the placebo effect. c. The illegal administration of medication creates the placebo effect. d. The improper dosing of medication creates the placebo effect.

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

To determine a client's self-care ability, it is most important for the nurse to perform what step of the nursing process? a. assessment b. evaluation c. implementation d. planning

a. assessment

A nurse has been assigned to care for a 52-year-old client with hypertension and peptic ulcer disease. Before administering the client's medications, the nurse must complete an initial assessment. From what sources should core variables must be obtained? (Select all that apply.) a. interview b. medical history c. medical record d. physical examination e. health insurer

a, b, c, d

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.) a. Ask the client to state the birthdate. b. Check the client's wristband for the name. c. Check the client's room number on the outside of the door. d. Request another nurse to verify the client's identification. e. Request that the client state their name.

a, b, e

The nurse teaches a parent the importance of administering appropriate dosages of acetaminophen when the client's infant has a fever. What information should the nurse provide to this client? (Select all that apply.) a. "Children's dosages will change with time as they grow." b. An infant's dose of acetaminophen is about 1/2 of an adult dose." c. "It is important to give the right dose to prevent toxic effects of the medication." d. "Infant's and children's doses should be based on their weight or age." e. "In most cases, infants cannot be given medications because of their immature organs."

a, c, d

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? a. "I will make sure to store the medications in the bathroom medicine chest." b. "I'll keep a written record of all medicines, prescription or otherwise, that I take." c. "I need to take the medicines like the health care provider said, before each meal and at bedtime." d. "The drugs that the health care provider prescribed are used to control my blood pressure."

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

A client recently discovered that she is pregnant. She currently takes herbal medications to control her diabetes and the symptoms related to pregnancy. She asks the nurse if it is safe to take herbal medications while she is pregnant. What would the nurse tell this client? a. "Most herbal and dietary supplements should be avoided during pregnancy or lactation." b. "Most herbal and dietary supplements are safe during pregnancy and are used by many cultures to control the symptoms of nausea." c. "Dietary supplements are high in fat and protein; they are safe to take during pregnancy and help to maintain health during lactation." d. "Herbal and dietary supplements will cause premature labor."

a. "Most herbal and dietary supplements should be avoided during pregnancy or lactation."

The nurse is teaching the parents of a school-aged child who is to receive medication therapy. What instructions should the nurse include? a. "Tell your health care provider about all the medicines that your child is taking." b. "Carefully use a common household teaspoon or tablespoon to administer the liquid medication." c. "Teach your child to take the medication independently in order to promote autonomy." d. "Over-the-counter medicines are usually safe, but make sure not to exceed the recommended dose."

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

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: a. blood volume decreases. b. subcutaneous tissue increases. c. total body water increases. d. muscle mass increases.

a. blood volume decreases.

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? a. "When are you taking your medication?" b. "What is the dosage of your medication?" c. "Have you increased your fluid intake since starting the drug?" d. "Are you taking any herbal medicines?"

a. "When are you taking your medication?"

What action should the nurse perform during the implementation step of the nursing process? a. Administrations and documentation of medications. b. Obtain information about the client's chronic condition. c. Determine the client's level of understanding. d. Question the client about financial resources.

a. Administrations and documentation of medications.

A nurse has identified the following: Risk for injury related to central nervous system (CNS) effects of the prescribed drug therapy. What intervention should the nurse complete in order to arrive at an appropriate nursing diagnosis? a. Analyzed the data gathered during assessment b. Taught the client about safety measures related to CNS effects c. Planned relevant interventions d. Created a plan of care that include medication safety

a. Analyzed the data gathered during assessment

What is the first of the five steps in the nursing process? a. Assessment b. Documentation c. Analysis d. Planning e. Evaluation

a. Assessment

A client is experiencing difficulty swallowing a large oral tablet. What action by the nurse would be most appropriate? a. Check to determine whether the drug can be crushed or mixed with food. b. Ask the prescriber to change the medication to a parenteral form. c. Have the client drink a large glass of water to aid in swallowing. d. Contact the pharmacy to order the drug in liquid form.

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

A client who has been diagnosed with type 2 diabetes mellitus is being instructed on medication regimen, diet, and exercise. The client is having difficulty grasping information about care. Which nursing diagnosis is most appropriate for this client? a. Deficient knowledge: drug therapy regimen b. Noncompliance: overuse c. Risk for injury related to adverse effects d. Acute confusion related to insulin regimen

a. Deficient knowledge: drug therapy regimen

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? a. Imbalanced nutrition: Less than body requirements b. Risk for imbalanced fluid volume c. Feeding self-care deficit d. Noncompliance

a. Imbalanced nutrition: Less than body requirements

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? a. In older adults, drugs have decreased GI absorption. b. In older adults, drugs are released more quickly into circulation. c. In older adults, drugs are distributed to a smaller portion of the tissue. d. In older adults, drugs have an increased action.

a. In older adults, drugs have decreased GI absorption.

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? a. Research for potential interactions with medications. b. Instruct the client to discontinue them if taking prescription medications. c. Instruct the client to take the supplements 1 hour before prescription medications. d. Instruct the client to take the supplements 3 hours after prescription medications.

a. Research for potential interactions with medications.

A client has begun taking an antidepressant that causes the client to be drowsy. What nursing diagnosis should the nurse prioritize related to drug therapy? a. Risk for injury b. Risk for imbalanced fluid volume c. Impaired memory d. Impaired physical mobility

a. Risk for injury

An instructor is teaching a group of students about client education and drug therapy. The instructor determines a need for additional instruction when the students identify what as an important area to include in a client teaching plan? a. Steps to report a drug error b. Drug toxicity warning signs c. Alternative therapies to avoid d. Administration scheduling

a. Steps to report a drug error

When providing drug therapy to a client, what is a responsibility of the nurse? a. Teach the client how to cope with the effects of the drug to ensure the best outcome. b. Help the client analyze the physiological and pathological effects of drugs. c. Warn the client how most clients respond to the drug therapy. d. Encourage the client to increase or decrease dosages.

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

Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing? a. The North American Nursing Diagnosis Association-International (NANDA) b. The Joint Commission c. The National Council of State Boards of Nursing d. individual state boards of nursing

a. The North American Nursing Diagnosis Association-International (NANDA)

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? a. The client's drug excretion may be slower than normal. b. Lipid-soluble drugs should be avoided whenever possible. c. The client may suffer from chronic urinary tract infections. d. Oral medications should be avoided in order to reduce potential kidney damage.

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

The nurse is providing discharge education for a frail older adult client who lives alone in an apartment. The client will soon be discharged from the hospital with several new prescriptions. What assessment should the nurse prioritize when determining the client's safety in the home setting? a. The client's level of social support b. The client's education level c. The client's financial status d. The client's plans and aspirations

a. The client's level of social support

A nurse is caring for a 49-year-old client with acute gout and arthritis. The nurse interviews the client and checks the medical records. Which additional assessment should the nurse consider before medication administration teaching? a. examining the client physically b. asking closed-ended and precise questions c. determining what medication information the client needs d. observing the client for at least 24 hours

a. examining the client physically

The nurse checks a client's temperature before administering a standing prescription for acetaminophen for temperatures over 100°F (37.8°C). The client's temperature is 98.9°F (37.2°C), so the nurse decides to withhold the dose of acetaminophen. Withholding the dose represents which phase of the nursing process? a. implementation b. analysis c. evaluation d. planning

a. implementation

Before teaching a client about diagnosis and therapy, what information is essential for the nurse to evaluate in the client? a. level of education b. social support systems c. discharge plans d. physician consent

a. level of education

The client is experiencing an adverse effect of a medication. What should the priority nurse action be? a. monitor and intervene. b. only monitor. c. only document adverse effects. d. report events to the pharmacist.

a. monitor and intervene.

Identification of problems that can be solved or prevented by the nurse without involvement of the health care provider is known as which process? a. nursing diagnosis b. nursing assessment c. nursing documentation d. nursing evaluation

a. nursing diagnosis

A nurse designing a drug regimen for a client should consider: a. quality-of-life issues. b. ethnicity. c. gender. d. occupation.

a. quality-of-life issues.

The nurse is planning to educate a client about medication therapy. What is an essential part of the nursing process? a. that the nurse perform all teaching and evaluation b. the delegation of teaching to licensed personnel c. the delegation of teaching to students d. informing the physician about who has taught the client

a. that the nurse perform all teaching and evaluation

To correctly administer a medication, when should the nurse compare the medication with the medication administration record (MAR)? (Select all that apply.) a. after administering the medication b. immediately prior to medication administration c. when removing the medication from the medication cart d. when initially looking at the medication label e. after documenting the medication

b, c, d

When planning a client's treatment regimen for administration of medication, which factors must be considered for inclusion in the teaching plan? (Select all that apply.) a. To call the health care provider after the first week b. Method used to administer the drug c. Ability to calculate dosage d. Type of reaction to expect from the drug e. Information to report to the health care provider

b, d, e

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? a. "The prescriber probably wanted to treat any anticipated depression you may experience." b. "Tell me the name of your prescription please." c. "What symptoms of allergies do you have?" d. "Have you been experiencing any hallucinations lately?"

b. "Tell me the name of your prescription please."

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? a. Implementing b. Assessing c. Planning d. Diagnosing

b. Assessing

The nurse understands that an admission assessment is completed to accomplish what goal? a. Develop a nurse-client relationship. b. Collect data. c. Establish outcomes. d. Initiate the plan.

b. Collect data.

When assessing a client prior to starting a drug regimen, it is often necessary to have a baseline kidney function study done. What might kidney impairment indicate in relation to drug therapy? a. Pharmacodynamics stable at the therapeutic dose b. Contraindication to the use of a drug c. Increased dosage of a drug d. Decreased adverse effects of a drug

b. Contraindication to the use of a drug

"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process? a. Problem b. Goal c. Plan d. Cause

b. Goal

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? a. Effective Self Health Management b. Ineffective Self Health Management c. Noncompliance d. Deficient Knowledge

b. Ineffective Self Health Management

A client is being evaluated for reports of alteration in sleep pattern. When asking a client about current medications and supplements being taken, what is the nurse's best approach? a. Ask the client to list all dosages of prescription medications in alphabetical order. b. Inquire about all prescription medications, over the counter drugs, herbs and supplements. c. Ask the client if any new medications have been prescribed since the last office visit. d. Inquire if the client ingests large amounts of coffee throughout the day.

b. Inquire about all prescription medications, over the counter drugs, herbs and supplements.

The older client forgets to take medications as prescribed throughout the day. The client has medications prescribed several times each day. The nurse best aids the client to take medication by instructing the client to: a. obtain a pill box for the week. b. place medications in a pill box labeled by mealtime. c. line the medication containers on the kitchen counter. d. post a sign on the bathroom mirror reminding of the administration times.

b. place medications in a pill box labeled by mealtime.

In discussing the drug regimen with the client, what factors should be included? (Select all that apply.) a. Cut the tablet in half if the client does not have enough b. Call the health care provider only after two unexpected reactions occur c. Length of time before desired therapeutic effect will occur d. Steps to minimize adverse reactions e. Adverse reactions to expect

c, d, e

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? a. Assess the client's inability to document medication taken. b. Assess the client's inability to communicate with caregivers. c. Assess the therapeutic success of the drug therapy. d. Assess the client's reluctance to purchase the prescribed drug.

c. Assess the therapeutic success of the drug therapy.

Which of the following would be least likely to occur during the assessment phase of the nursing process for drug therapy? a. Obtaining information about the client's drug use b. Determining relevant data about financial constraints c. Developing outcomes for effective response to drug therapy d. Identifying the client's level of understanding

c. Developing outcomes for effective response to drug therapy

Which medication prescription by the health care provider will require the nurse to seek clarification? a. Furosemide 20 mg. IV every 8 hours. b. Warfarin 5 mg. PO every evening at 6 PM. c. Heparin 5,000 u SC every day d. Meperidine 25 mg. IM every 4-6 hours PRN

c. Heparin 5,000 u SC every day

The nurse is teaching the client to self-administer insulin. This occurs during which phase of the nursing process? a. Assessment b. Planning c. Implementation d. Evaluation

c. Implementation

An older adult client must take a variety of medicines under different conditions and at different times of the day. The client's is available to help most of the time. How can the couple best ensure that the client takes all medicines under the correct conditions? a. Keep each vial where it will be used (kitchen, bath, or bedroom) by the client. b. Have the spouse dispense each medicine when it is needed. c. Once a week, dispense all the medicines into a large, divided container. d. Remind the couple of the need for strict medication adherence.

c. Once a week, dispense all the medicines into a large, divided container.

A 7-year-old child fell off a wood pile while playing and has been admitted to the ICU with multiple broken bones and internal bleeding. What factor related to drug therapy will be altered in this client? a. Adverse effects may be decreased. b. Therapeutic effects may be increased. c. Pharmacodynamics may be altered. d. Pharmacokinetics remain the same.

c. Pharmacodynamics may be altered.

When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications? a. Assess the client's nutritional and hydration status b. Weight the client and measure the client's abdominal girth c. Review laboratory values indicative of kidney function d. Review the client's AST, ALT, bilirubin and albumin levels

c. Review laboratory values indicative of kidney function

The nurse is scheduled to administer a tablet of medication to a client and the medication is available as a unit dose. Where would the nurse remove the wrappings of the unit dose? a. in the medication room. b. outside the client's room. c. at the client's bedside. d. at the medication cart.

c. at the client's bedside.

A nurse who had been caring for a client with a cardiac disorder has to now provide care on an outpatient basis. What information should the nurse provide to this client who is willing and now able to manage the treatment regimen? a. composition of the drug b. disorders treated using the drug c. method of drug administration d. contraindications to prescribing the drug

c. method of drug administration

What statement would indicate that a mother is administering the incorrect dosage of liquid medication to her child? a. "I use a calibrated medication cup to administer the medication." b. "I use the measuring teaspoon that I cook with." c. "I give the medication at the times indicated on the prescription." d. "I use a household teaspoon to administer the medication."

d. "I use a household teaspoon to administer the medication."

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: a. Dysfunctional gastrointestinal motility b. Ineffective self health maintenance c. Risk for injury d. Deficient fluid volume

d. Deficient fluid volume

Which of the following would be least important to include when teaching a client about drug therapy? a. Alternative therapies to avoid b. Timing of administration c. Drug toxicity warning signs d. How to report a medication error

d. How to report a medication error

A nurse is assigned to care for a client with a respiratory problem in a health care facility. What should a nurse consider in an expected outcome for a client undergoing drug therapy? a. Amount of time the client will take to recover fully b. Amount of drugs the client will require during the treatment c. Possible adverse reactions that could occur during the therapy d. Maximum level of wellness that is reasonably attainable for the client

d. Maximum level of wellness that is reasonably attainable for the client

Which nursing intervention would the nurse expect to do during implementation? a. Developing statements about a client's actual problem. b. Obtaining baseline information about the client's pattern of health care. c. Identifying the client's social support network. d. Providing client teaching about a drug therapy regimen.

d. Providing client teaching about a drug therapy regimen.

A nurse is caring for a client who is prescribed multiple medications. Which clients are most likely to have adverse drug reactions? a. clients with coronary artery disease b. clients who are non-adherent c. clients who are on the recommended dose d. clients who are very young or very old

d. clients who are very young or very old

A 27-year-old male is admitted to the emergency department (ED) after a serious motorcycle accident. The client has a head injury, abrasions covering the left side of his body, a broken left femur, and internal injuries that are not fully assessed at this time. He is transferred from the ED to the ICU. The nurse who is going to care for this client in the ICU knows that one of their most important responsibilities in regard to drug therapy is to: a. support vital functions. b. continue curative treatment. c. institute life-saving treatment. d. monitor the client's response.

d. monitor the client's response.