pharmacology - chapter 2- prep u
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?
"Diuretics are shown to be more effective than ACE inhibitors for black males with hypertension."
The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?
"Do you remember what happened the last time you received penicillin?"
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."
The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.)
- a 37-year-old client who is taking fertility drugs - a 29-year-old client receiving prenatal care in her first trimester of pregnancy
The nurse is researching a new drug's pharmacokinetics in the nursing drug guide. What information should the nurse read about? (Select all that apply.)
- timing of peak effect - drug half-life - duration - onset of action
The client has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a. The client takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the client takes an injection on Monday, how many micrograms of the drug would still be in the client's system when he or she takes the next injection on Wednesday, assuming the half-life of the drug is 24 hours?
11
The nurse administers amoxicillin 500 mg. The half-life of this drug is approximately 1 hour. At what point would the drug level in the body be 62.5 mg if the drug was not administered again?
3 hours after the original dose
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
Fluoxetine is given to a client at a dosage of 500 mg every 6 hours. Assuming that the half-life of this drug is 3 hours, at what point would the drug level in the body be 62.5 mg of the original dose?
9 hours after the original dose
Which client is most likely to experience the benefits of the the placebo effect?
A client with an infection who states, "I know this antibiotic is going to work for me
A client has developed a tolerance to a drug. How should the nurse address this when providing care?
Assess whether the client needs larger doses to achieve the effect.
A client in distress is brought to the emergency department by ambulance. Emergency medical technicians state that an anaphylactic reaction from oral penicillin is suspected. Which of the nurse's assessment findings best supports this diagnosis?
Blood pressure: 186/100 mm Hg, shortness of breath
A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?
Discontinue the drug immediately as ordered.
The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?
Excretion is likely to take place slowly.
The nurse on a busy medical floor is caring for several clients whose medication regimens vary widely. What action best addresses a client's risk for adverse effects related to primary actions?
Monitoring the international normalized ratio (INR) of a client taking warfarin
A nurse has identified the half-life of drug that will be administered to a client for the first time. The nursing drug guide states the drug's half-life is 90 minutes. The nurse should identify what implication of this fact?
Ninety minutes after drug levels peak, there will be 50% of the peak level.
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?
The patient had an idiosyncratic response to the medication, causing the opposite 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 client's most recent laboratory result indicates an elevated potassium level. What drug in this client's medication regimen should the care team consider discontinuing?
a diuretic
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 is explaining the pharmacokinetics of a drug being administered to a client. What is meant by the term "pharmakokinetics?"
actions of drugs
A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:
an allergic response.
A 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:
assess for factors that may reduce absorption.
What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?
decreased glomerular filtration rate.
The nurse's discussion of the role of cytochrome P450 (CYP) enzymes is focusing on what aspect of pharmacokinetics?
drug metabolism that takes place in the liver
A client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of:
first-pass effect.
A nurse has been administering a drug to a client intramuscularly (IM). The health care provider discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to:
first-pass effect.
A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods?
foods with vitamin K
A drug is 100% bioavailable when it is administered by what routes?
intravenous
What drug administration route should be used to assure the best bioavailability as any particular drug?
intravenous
A nurse is planning client teaching about a newly prescribed drug. What teaching point should the nurse provide to best improve adherence and safety?
measures to alleviate any discomfort associated with adverse effects
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
The client with a history of ischemic heart disease is taking aspirin 81 mg daily. The nurse should explain that less than 81 mg actually reaches target tissue due to which action?
the first-pass effect
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?
the process of pharmacokinetics
Why does the nurse need to be alert for any indication of an allergic reaction in clients?
to maintain the client's safety during drug therapy
