Chapter 4: The Nursing Process in Drug Therapy and Patient Safety
True or False: A nurse should teach parents to call their child's health care provider if the child seems to be getting worse even w/ drug therapy
True
True or False: Most institutions have their own policies for reporting med errors
True
True or False: The right route of the drug is usually determined by the drug's formulation
True
A nurse is performing the following activities, place them in their proper order based on the nursing process Questioning the client about the use of OTC meds Obtaining the client's weight Analyzing the client for changes in condition Instructing client to take meds with meals Identifying if the client is at risk for skin breakdown
1) Questioning the client about the use of OTC meds 2) Obtaining the client's weight 3) Identifying if the client is at risk for skin breakdown 4) Instructing client to take meds with meals 5) Analyzing the client for changes in condition
A nurse has committed a med error. After ensuring the pt. safety, the nurse should perform what action? A) Report the event according to the healthcare facility's policies B) Report the event to the Institute for Safe Medication Practices C) Ensure that each of the nurse's colleagues knows about the event D) Submit a drug error report to the National League for Nursing
A
A patient is receiving an antihistamine complains of dry mouth and nose. An appropriate comfort measure for this patient would be to: A) Suggest that the patient use a humidifier B) Encourage voiding before taking the drug C) Have the patient avoid sun exposure D) Give the patient a back rub
A
After teaching a patient about dioxin (a drug used to increase the effectiveness of the heart's contractions) which statement indicates that the teaching was effective? A) "I need to take my pulse everyone morning before I take my pill." B) "If I forget my pills, I usually make up the missed dose once I remember." C) "This pill wil help my hay fever when it becomes a problem." D) "I don't remember the name of it, but it is the white one."
A
The nurse is preparing a teaching plan for a client who will be discharged home with several new meds. When preparing the teaching session, what is the nurse's best action? A) Determine the client's level of education B) Adminiser the meds as a way of prompting discussion C) Make copies of med package inserts for the client D) Ask the client if he or she would like to receive info on new meds
A
The nurse is providing discharge education for a frail older adult pt who lives alone in an apartment. The pt will soon be discharged from the hospital with several new prescriptions. What assessment should the nurse prioritize when determine the pt safety in the home setting? A) The pt level of social support B) The pt financial status C) The pt plans and aspirations D) The pt education level
A
The nurse obtains a medical history from a patient before beginning drug therapy based on an understanding of which of the following? A) Medical conditions can alter a drug's pharmacokinetics and pharmacodynamics B) A medical history is a key component of any nursing protocol C) A baseline of info is necessary to evaluate a drug's effects D) The medical history is the first step in the nursing process
A
The nurse receives an order for 2.5 mg of diphenhydramine. The nurse is aware that this is an unusual order. What is the nurse's best action? A) Contact the prescriber for clarification B) Complete an unusual incident form C) Document the potential drug error in the client's health record D) Contact the pharmacy for clarification
A
When describing the nursing process to a group of new students, what should a nurse describe? A) "The nursing process involves a set of sequential yet dynamic and cyclical steps." B) "The nursing process outlines a continuous, linear approach to problem solving." C) "By applying the nursing process you can respond systematically to a client's medical needs." D) "The nursing process gives a framework to clients so they can plan their care."
A
The nurse is preparing to administer a drug to a client for the first time. What questions should the nurse consider before actually administering the drug? Select all that apply A) Is this the right pt? B) Is this the right drug? C) Is there a generic drug available D) In this the right route for this pt. E) Is this the right dose, as ordered? F) Did I record this properly
A B D E
A client is being started on a laxative regimen. Before beginning the regimen the nurse performs which of the following assessments? Select all that apply A) Liver function test B) Abdominal examination C) Skin color and lesion eval. D) Lung auscultation E) 24 hr using analysis F) Cardiac assessment
A, B, & C
A nurse is preparing to give client education about med therapy. The nurse should plan to address what topics? Select all that apply A) Alternative therapies to avoid B) OTC alternatives to prescriptions C) Drug toxicity warning labels D) Steps for reporting a rug error E) Drug administration scheduling
A, C & E
The nurse is completing the seven "rights" of med administration. What aspects of drug administration should the nurse confirm? Select all that apply A) Right route B) Right education C) Right evaluation D) Right documentation E) Right timing
A, D & E
A client is experiencing difficulty swallowing a large oral tablet. What action by the nurse would be most appropriate? A) Have the client drink a large class of water to aid in swallowing B) Check to see if the drug can be crushed or mixed w/ food C) Contact the pharmacy to order the drug in liquid form D) Ask the prescriber to change the med to a parenteral form
B
A nurse has identified the following risk: risk for injury related to CNS effects of the prescribed drug therapy. What event should the nurse have performed immediately before this during the nursing process? A) Planned relevant interventions B) Analyzed the data gathered during assessment C) Created a plan of care that include medication safety D) Taught the client about safety measures related to CNS effects
B
The nurse is admitting a new client whose health history includes chronic kidney disease. How should the nurse best interpret this info from assessment data? A) The client may suffer from impaired drug metabolism B) The client's drug excretion may be slower than normal C) Oral meds should be avoided in order to reduce potential kidney damage D) Lipid-soluable drugs should be avoided whenever possible
B
The nursing care of a pt. receiving drug therapy should include measure to decrease the anticipated adverse effects of the drug. Which of the following measures would a nurse consider? Select all that apply A) A positive approach B) Environmental temperature control C) Safety measure D) Skin care E) Refrigeration of the drug F) Involvement of the family
B, C & D
What types of nursing interventions are involved in drug therapy? Select all that apply A) Identification of a problem B) Provision of comfort C) Drug administration D) Collection of data E) Client education
B, C & E
A nurse is beginning to apply the nursing process during a new client interaction. What activity should the nurse perform? A) Confirm or rule out nursing diagnoses B) Identify potential client problems related to drug therapy C) Obtain a medication history D) Educate the client about basic med safety
C
A patient reports that she has a drug allergy. In exploring the allergic reaction with the patient, which of the following might indicate an allergic response? A) Increased urination B) Dry mouth C) Rash D) Drowsiness
C
The evaluation stop of the nursing process: A) Is often used as a last resort B) Is important primarily in the acute setting C) Is a continuous process D) Includes making nursing diagnoses
C
The nurse admits a client who has known history of recreational drug use but denies it during the nursing assessment. How should the nurse best explain the need for disclosure when obtaining the client's med history? A) "I suspect you taking meds that you aren't telling me about and that could be very dangerous." B) "I can't help you withdraw safely from illegal drugs if I don't know what you are taking." C) "Drugs often have an effect on other drugs, so it is important to know what you take before I give you any additional meds." D) "I have a professional obligation to find out every drug that you're taking."
C
The nurse is applying the nursing process to the care of a client with diabetes who has been prescribed a new antihpyerglycemic. What activity should the nurse do first? A) Teach the client how to safely store the med B) Teach a client about the drug's potential adverse effects C) Ask the client about any other chronic conditions D) Determine that drug has stabilized the client's blood glucose levels
C
The nurse is performing an assessment of a child so that the care team can select the appropriate dose for the client. What assessment should the nurse perform? A) Measure the child's height B) Calculate the child's age in months C) Weigh the child D) Assess the child's hydration status
C
The nurse is providing health education for a middle-aged pt who has been prescribed two new meds following a clinic visit. What characteristic of the pt status should the nurse recognize as a risk for noncompliance w/ drug therapy? A) The pt lives in an inner-city neighborhood B) The pt has a history of repeated hospital visits C) The pt reports being "desperately poor." D) The pt has minimal education
C
The nurse writes a nursing diagnosis for which reason? A) Direct medical care B) Help to increase patient compliance C) Identify actual or potential alteration in patient function D) Determine insurance reimbursement in most case
C
What action should the nurse perform during the implementation step of the nursing process? A) Determining the client's level of understanding B) Obtaining info about the client's chronic condition C) Documenting meds that were administered D) Questioning the client about financial resources
C
What client is most likely to experience the placebo effect of a new med? A client who: A) Has a preference for herbal remedies and alternative therapies B) States, "I'm in agony. Can you please give me something for my pain?" C) States, "I"m certain this new drug is going to work for me." D) States, "I'm very organized, so I'm sure I'll stick to the drug schedule closely."
C
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 imbalanced fluid volume B) Impaired memory C) Impaired physical mobility D) Risk for injury
D
A public warning has been issued about med errors involving sound-alike drug names. This warning will be coordinated by what organization? A) The Institute for Safe Medication Practices B) The Joint Commission C) FDA D) The U.S. Pharmacopeia
D
The nurse is caring for a pt w/ a history of osteoporosis who is being treated w/ a bisphosphonate. What education should the nurse provide to the pt in order to reduce the risk of adverse effects? A) "Make sure that you don't drink any grapefruit juice until this drug is discontinued." B) "You health care provider will give a list of food that you'll need to avoid." C) "Try to remember to get up slowly from bed or chairs while you're on this drug." D) "It's important to stay sitting upright for 30 min after taking this pill."
D
The nurse is preparing to administer a med to a hospitalized pt. How should the nurse confirm the pt identity? A) Ask the client to state and then spell her name B) Read the pt identification band out loud C) Ask the client, "Are you Mrs. Banks?" D) Ask the client's name and read her identification band
D
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 drugs are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize? A) "Have you increased your fluid intake since starting the drug?" B) "What is the dosage of your med?" C) "Are you taking any herbal medicines?" D) "When are you taking your med?"
D
The nurse is teaching a client about his drug therapy regimen before being discharged. The nurses emphasizing safety in the home setting. Which statement by the client indicates a need for additional teaching? A) "I'll keep a written record of all medicines, prescription or otherwise, that I take." B) "I need to take the medicines like the doctor said, before each meal and at bedtime." C) "The drugs that the doctor prescribed are used to control my BP." D) "I will make sure to store the meds in the bathroom med chest."
D
The nurse is teaching the parents of a school-aged child who is to receive mediation therapy. What instructions should the nurse include? A) "Carefully use a common household teaspoon or tablespoon to administer the liquid med." B) "OTC meds are usually safe, but make sure not to exceed the recommended dose." C) "Teach your child to take the med independently in order to promote autonomy." D) "Tell your health care provider about all the meds your child is taking."
D
When establishing the nursing interventions appropriate for a given patient: A) The patient should not be actively involved B) The patient support systems should be included only at discharge C) Teaching should be done when the patient states he or she is ready to learn D) An evaluation of all the data accumulated should be incorporated to achieve an effective care plan
D
True or False: A nursing diagnosis indicates a client's problem that requires collaboration w/ other health disciplines.
False
