Pharm. Ch 1-4, 6

A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?

"I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."

What statement would indicate that a mother is administering the incorrect dosage of liquid medication to her child?

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

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?

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

A nurse is teaching the client about the use of over-the-counter (OTC) drugs. Which statement best informs the client about their safe use?

"OTC drugs need to be taken with caution; they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy."

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 educating a client on over-the-counter (OTC) medications. What information is required to be placed on the label of the medication? (Select all that apply.)

- adverse reactions - dosage of the medication -contraindications to the medication

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.)

-A 29 year old client recovering prenatal care in her first trimester of pregnancy -A 37 year old female client who is taking fertility drugs

Some clients are excessively responsive to either the primary or secondary effects of a drug. This is known as hypersensitivity, and it may result from a pathological or underlying condition. Which are examples of hypersensitivity? Select all that apply.

-A client who has chronic renal failure and is taking diphenhydramine -A client on postoperative day 2 from a prostatectomy who takes ipratropium

What represents a pharmacokinetic phase? (Select all that apply.)

-ABSORPTION -DISTRIBUTION -ADMINISTRATION -EXCRETION

Drugs can affect the special senses, including the eyes and ears. Alterations in seeing and hearing can pose safety problems for clients. What are examples of sensory effects of drugs? Select all that apply.

-Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects. -A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness

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.)

-Diaphoresis -Difficulty breathing -Increased blood pressure

The nurse is preparing to administer antineoplastic medication to a client with cancer who has been receiving these medications for several days. When monitoring for potential adverse effects of this medication, the nurse should perform what assessments? (Select all that apply.)

-Inspect the client's mucous membranes. -Monitor the client's blood cell counts. -Monitor the client's potassium levels.

The nurse is caring for a group of clients and is aware that which client may require a reduction in medication dosage? (Select all that apply.)

-client with cancer of the liver -client with chronic hepatitis C -client with cirrhosis of the liver

A client began a new medication 4 days ago and has been reporting increasing malaise for the past 72 hours. The nurse is reviewing the client's most recent laboratory findings. What findings should suggest the possibility of a cytotoxic reaction? (Select all that apply.)

-decreased hematocrit -decreased leukocytes -increased liver enzymes

It is often necessary to obtain baseline data prior to initiating many forms of drug therapy. What do these baseline data include? (Mark all that apply.)

-education level -allergies -drug use

A nurse has looked up a new drug in a drug guide and is reviewing characteristics of its absorption. Which processes may be involved in this drug's absorption? (Select all that apply.)

-passive diffusion -active transport -filtration

The nurse is reviewing several orders for medications. Which dosage would cause the nurse to be concerned?

.5 mg

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

The nurse understands that medications are not just manufactured and dispensed. How many phases of clinical trials must a drug go through in order to meet approval standards?

4

The nurse is aware that it requires approximately how many half-lives for a client to excrete a medication from the body?

4-5

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 experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

What is the characteristic action of an agonist?

Agonists bind to receptors and cause a physiologic effect.

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

Which of the following would be least likely to occur during the assessment phase of the nursing process for drug therapy?

Developing outcomes for effective response to drug therapy

The charge nurse on the unit transcribes a health care provider's order onto the medication administration record. The nurse writes, "Digoxin 0.25 mg PO qod ×3d" on the MAR. How should the order be written to prevent medication error?

Digoxin 0.25 mg by mouth every other day for three doses

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?

Elevated aspartate aminotransferase (AST) level

The nurse instructs the client that some drugs are no longer covered under patent and may be less expensive. What type of drug is the nurse describing?

Generic

What statement describes a required characteristic of all generic drugs?

Generic drugs must be therapeutically equivalent and less expensive than trade name drugs.

Which are advantages of over-the-counter (OTC) medications? Select all that apply.

Greater autonomy to choose a medication Convenience to access the medications

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.

Which medication prescription by the health care provider will require the nurse to seek clarification?

Heparin 5,000 u SC every day

Which of the following would be least important to include when teaching a client about drug therapy?

How to report a medication error

The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time?

Hydromorphone (Dilaudid) for pain

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

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

The nurse is transcribing physician orders for a client with pneumonia who has been admitted to the hospital. Why should the physician order the medications using the generic name instead of a brand name?

Numerous brand names may exist for the same drug, sothe generic drug should be ordered.

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?

Pharmacodynamics may be altered.

Before administering lithium to a patient, it is most important for the nurse to assess which laboratory value?

Sodium

Since 1962, newly developed drugs have been extensively tested before being marketed for general use. What do drug companies do to test drugs initially?

Test the drugs with animals.

What is the primary purpose associated with the use of the nursing process related to the implementation of medication therapy?

That holistic, evidence-informed care is given

Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing?

The North American Nursing Diagnosis Association-International (NANDA)

The nurse is reviewing a prescription for a medication with a client. On the prescription, the nurse read "DAW." What should the nurse teach the client?

The brand name of the drug must be dispensed.

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.

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?

The client's level of social support

Which characteristics may allow a drug to cross the blood-brain barrier? Select all that apply.

The drug has a transport system. The drug is water soluble.

The nurse is administering a drug that has selective toxicity. What effect will this have on the client?

The drug will affect foreign cells but not healthy body cells.

What is the effect of a significant first-pass effect on the metabolism of a medication?

The medication is biotransformed extensively in the client's liver.

What is the relation between the activity level of older adults and the response to medication?

The older adult who is more physically active is less likely to have an adverse drug effect.

For what reason is the creatinine level alone not a good indicator of renal function in the older adult?

There is a decline in overall muscle mass, which produces a lower creatinine level.

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

Why is it important for the nurse to obtain baseline information from a client, such as a drug profile, an accurate history of the client's usual abilities, and changes in abilities or health status?

To determine any new signs and symptoms in the client that could be related to drug therapy

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug?

Urinary hesitancy

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.

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

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

Which process occurs between the time the drug enters the body and the time that it enters the bloodstream?

absorption

The nurse is assessing a client who has developed shortness of breath, a rash, panic, and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should:

administer epinephrine as prescribed.

What is an example of a secondary action?

an antihistamine causes the client to experience drowsiness

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?

anaphylactic

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

antibodies.

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

The nurse is caring for a client receiving an antineoplastic medication who reports fever, chills, sore throat, weakness, and back pain. The nurse should recognize the possibility of what adverse effect?

blood dyscrasia

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:

blood urea nitrogen and creatinine levels.

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.

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?

cardiac monitoring

The nurse is administering a medication to a client who reports pain in the knees from arthritis. The nurse observes the name of the drug as p-isobutylhydratropic and recognizes that this refers to a:

chemical name.

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

clients who are very young or very old

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus.

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

decreased blood flow to tissues and muscles.

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

decreased glomerular filtration rate.

Which assessment should be made by the nurse before administering a new medication?

determining the client's past medication history

A nurse has been assigned the task of preparing educational materials for clients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or the health care provider. Which information is essential to include in the educational materials?

drug administration method

The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first?

evaluate the client's ability to swallow.

When determining if the client understands teaching, what step of the nursing process is the nurse performing?

evaluation

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

A client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?

frequent rinsing with cool liquids

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia

How are the nursing diagnoses developed by the North American Nursing Diagnosis Association (NANDA) most useful?

identifying problems related to drug therapy

A client in cardiovascular collapse requires pharmacological interventions involving a rapid drug action and response. What route of administration is most likely appropriate?

intravenous

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

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

Drug excretion occurs mainly in which organ?

kidneys

Two years ago, a client was prescribed a medication to control hypercholesterolemia. Now the health care provider prescribes a higher dose of the medication due to enzyme induction. A student nurse asks the nurse to explain the change in the drug dosage. The nurse explains that with chronic administration, some drugs stimulate liver cells to produce:

larger amounts of drug-metabolizing enzymes.

A client has been brought to the emergency department (ED) following a cold water incident. Which would be a potential effect of medication absorption from this clinical manifestation?

less than therapeutic effect

What is the most frequently used drug administration route in clinical practice?

oral

The nurse is administering an antibiotic to a client with a diagnosis of cellulitis of the left leg. Which client condition would have the greatest effect on the drug's distribution?

peripheral vascular disease

What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?

pharmaco-therapeutics

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:

place medications in a pill box labeled by mealtime.

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 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 one hour later. The nurse should assess the client for what adverse effect?

poisoning

A nurse is caring for an 81-year-old client in a long-term care facility who takes nine different medications each day. The client has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the client is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to:

polypharmacy decreasing the number of available protein-binding sites.

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 nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:

potassium levels.

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.

A client has been diagnosed with cardiovascular disorder. The client is age 68; suffers from intermittent joint pain and is under drug therapy; eats meat, salads, and fruits; prefers alternative herb medications along with drug therapy; sometimes smokes; he lives alone and is looked after by a caregiver. Which item of information has the greatest implication for planning his drug therapy?

prefers alternative herb medications

After teaching a group of nursing students about drug classes and categories, the instructor determines that the teaching was successful when the students identify legend drugs as referred to as which medication?

prescription drugs

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

primary action of a drug.

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention?

serum drug level monitoring

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

Prior to the nurse administering a medication, what is essential for the nurse to complete?

the "rights" of medication administration

A drug's ability to alter basic processes in body cells allows for what function?

the alternation in specific cellular functions

Drug evaluation studies are used to determine critical concentration. The nurse understands that the critical concentration is the amount of the drug needed to cause:

therapeutic effect.

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?

"Allergic reactions happen after your body has been sensitized to a drug in the past."

A client has been prescribed an oral drug that is known to have a high first-pass effect. Which measure has the potential to increase the amount of the free drug that is available to body cells?

Administering the drug intravenously rather than orally

What drug category indicates fetal risk where the risk outweighs any potential benefit?

Category X

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.

Which route of administration is most likely to cause toxic effects?

Intravenous

While reviewing a package insert for a drug, what would the nurse identify as the drug's generic name?

Levothyroxine sodium

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 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.

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?

implementation

Identification of problems that can be solved or prevented by the nurse without involvement of the health care provider is known as which process?

nursing diagnosis

A nurse designing a drug regimen for a client should consider:

quality-of-life issues.

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity

With buccal medications, what factor affects absorption?

integrity of the mucous membranes

The client is experiencing an adverse effect of a medication. What should the priority nurse action be?

monitor and intervene.

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

"Have you been taking aspirin on a regular basis?"

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

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 and limb abnormalities -central nervous system alterations -heart defects

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

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

A nurse who is caring for a client receiving drug therapy performs these actions. Place the actions in the proper sequence to reflect the steps of the nursing process.

1. Identifies... 2. Questions... 3. Teaches... 4. Determines...

The nurse understands that the dosage recommended by drug manufacturers is based on an individual weighing:

150 lb (68 kg).

A client with a fever was administered 650 mg acetaminophen orally at 0800. The nurse is aware that the half-life of acetaminophen is 2 hours. How much acetaminophen will be bioavailable at 1200? Record your answer as a whole number.

163

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?

Analyzed the data gathered during assessment

A client's drug level has reached critical concentration. What action should the nurse perform?

Assess for evidence of the expected therapeutic effects.

The nurse is applying the nursing process to the care of a client with diabetes. The client has been prescribed a new antihyperglycemic. What activity should the nurse do first?

Assess the client for any other chronic conditions.

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 client has been diagnosed with depression following several months of reduced concentration and sleep difficulties. The client has been prescribed buproprion SR 150 mg PO b.i.d. What should the priority nursing assessment be?

Assessment of the client's mood and affect

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.

Which statement best describes drug efficacy/toxicity in pediatric clients?

Drug dosage is altered by age and weight in children.

Genetic engineering allows scientists to produce human insulin by altering which type of bacteria?

Escherichia coli

Effectiveness of medication therapy is associated with which phase of the nursing process?

Evaluation

The breakdown of oral drugs in the liver immediately after absorption is known as which of the following?

First-pass effect

The nurse is currently participating in phase IV of a clinical study of a chemotherapeutic drug. What action would the nurse be expected to perform during this phase of testing?

Gathering data from clients taking the drug after it has been released to market.

The nurse is teaching the client to self-administer insulin. This occurs during which phase 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.

A client is being treated with phenytoin for treatment of seizures. What should the nurse monitor to prevent toxic reactions to drugs in a client?

Monitor client's blood level of the drug.

A nurse working for a drug company is administering investigational drugs to patients. What type of drug evaluation study is the nurse participating in conducting?

Phase III

The nurse is reviewing a client's health history and medication administration record. Which drug would most likely induce the effects of the cytochrome P450 enzyme system?

Prednisone

The nurse is preparing a medication that is new to the market and cannot be found in the nurse's drug guide. How should the nurse obtain the most reliable information about this medication?

Read the package insert.

When considering the half-life of naloxone, what are the implications for this medication therapy?

Repeated doses of naloxone will likely be necessary.

A client has informed the nurse that he has begun supplementing his medication regimen with a series of herbal remedies recommended by his sister-in-law. Which is the most important nursing intervention regarding the safe use of herbal supplements?

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?

Risk for injury

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 admnistered 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 nursing student is learning about disease-modifying antirheumatic drugs. The student learns that these drugs have anti-inflammatory and immunosuppressive properties as well as what?

Slow tissue damage.

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.

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

Teratogenicity

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

When drugs are bound to proteins in the blood, they can be transported to different areas of the body. The protein-drug complex is relatively large and cannot enter into capillaries and into tissues to react. What must occur for drugs to do their job in the body?

The drug must be freed from the protein-binding site.

Drugs undergo biotransformation in the liver or gastrointestinal track. What benefit is produced when the drugs become water soluable (hydrophilic)?

The drugs can be excreted through the kidneys.

A nurse who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. Why would the nurse document the generic, rather than proprietary or trade, names of the resident's current drugs?

There is a potential for confusion and miscommunication if proprietary names are used.

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

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

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 female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client?

a larger-than-normal dose of the general anesthetic

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

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The Joint Commission requires performance measures related to safety in drug administration. Some of these performance measures require specific precautions when administering which drug?

anticoagulants

To determine a client's self-care ability, it is most important for the nurse to perform what step of the nursing process?

assessment

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

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications.

A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 PM. The nurse finds the patient drowsy and confused at 10 AM the next day. The nurse is aware that this behavior is most likely due to

decreased hepatic function.

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 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?

examining the client physically

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.

A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient's compromised renal function will likely

increase the half-life of medications that are metabolized by the kidneys.

Organ and tissue damage is one adverse reaction caused by drugs. Which are examples of such organ and tissue damage? Select all that apply.

inflammation of the mucous membranes rash and hives bone marrow suppression poisoning

Before teaching a client about diagnosis and therapy, what information is essential for the nurse to evaluate in the client?

level of education

A nurse is preparing to administer a prescribed drug to a client who has liver disease. The nurse expects a reduction in dosage based on the understanding that what might be altered?

metabolism

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:

move from areas of high concentration to areas of low concentration.

A drug has been approved by the Food and Drug Administration. What study phase would occur next?

phase IV study

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

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.

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."

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."

A client has asked the nurse to research a drug that the client read about online. The nurse's research reveals that it is an orphan drug. What should the nurse teach the client about this drug?

"It could be very difficult to access this drug because it's not readily available on the market."

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.

A nurse is to administer several drugs. A drug belonging to which class would the nurse interpret as being contraindicated for a pregnant woman?

Category X

Which activity would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?

Compare the outcome expected with the actual client outcome.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level.

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

Stevens-Johnson syndrome

During a health care visit, a client reveals having stopped taking a prescription because the drug made the mouth dry. What would be most appropriate for the nurse to do?

Suggest taking frequent sips of water or sucking on hard candy.

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? (Select all that apply.)

atropine-like (anticholinergic) effects Parkinson-like syndrome neuroleptic malignant syndrome

A client with complex health needs takes a large number of medications. In order to reduce the likelihood of drug-food interactions, the nurse should encourage the client to:

avoid drinking grapefruit juice.

Which phase of drug development is associated with continual evaluation of the drug?

phase IV study

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

physiologic changes affecting all pharmacokinetic processes

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

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin

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."

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."

In discussing the drug regimen with the client, what factors should be included? (Select all that apply.)

-Length of time before desired therapeutic effect will occur -Steps to minimize adverse reactions -Adverse reactions to expect

What factors can potentially contribute to a hypersensitivity reaction? (Select all that apply.)

-Pathological condition -unique receptors and cellular responses -age-related changes

A nurse is preparing to administer morphine. The nurse understands that this drug is categorized as which schedule of a controlled substance?

C-II

The nurse is explaining the pharmacokinetics of a drug being administered to a client. What is meant by the term "pharmakokinetics?"

actions of drugs