Pharmacology - Exam #1

In which step of the nursing process does the nurse determine the outcome of medication administration? a. Planning b. Assessment c. Evaluation d. Implementation

Evaluation

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the nurse's best response to the mother's question? a. "Drugs can cross from mother to infant in breast milk, it will depend on the specific drug you are taking." b. "All medications pass to infants while breastfeeding." c. "You should not take any medication while breastfeeding." d. "I will leave the health care provider a message to return your call."

a. "Drugs can cross from mother to infant in breast milk, it will depend on the specific drug you are taking."

A patient prescribed massage therapy for musculoskeletal pain asks the nurse, "How is rubbing my muscles going to make the pain go away?" What is the nurse's best response? a. "Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain." b. "Massaging muscles helps relax the contracted fibers and decrease painful stimuli." c. "Massaging muscles activates small sensory nerve fibers that send signals to the spinal cord to open the gate and allow endorphins to reach the muscles and relieve the pain." d. "Massaging muscles decreases the inflammatory response that initiates the painful stimuli."

a. "Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain."

The nurse understands that drugs exert their actions on the body by what process? Select all that apply. a. Altering metabolic chemical processes b. Interacting with receptors c. Making the cell perform a new function d. Inhibiting the action of a specific enzyme

a. Altering metabolic chemical processes b. Interacting with receptors d. Inhibiting the action of a specific enzyme

The acetic acid derivative indomethacin has what properties? (Select all that apply.) a. Antipyretic b. Antinausea c. Anticonvulsant d. Antiinflammatory e. Antirheumatic

a. Antipyretic d. Antiinflammatory e. Antirheumatic

When teaching a patient about potential adverse effects of NSAID therapy, the nurse will teach the patient to immediately notify the health care provider of what effect? a. Black tarry stools b. Nonproductive cough c. Diarrhea d. Mild indigestion

a. Black tarry stools

While conducting a health history for an older adult patient with heart failure, the patient tells the nurse, "I have chronic constipation." The nurse suspects this gastrointestinal complaint is caused by which class of drugs the patient reports taking? a. Calcium channel blockers b. Potassium-sparing diuretics c. Nonsteroidal anttinflammatory drugs d. Anticoagulants

a. Calcium channel blockers

When calculating pediatric dosages, the nurse understands which method is most accurate for dosing calculations? a. Dosage calculation by body surface area because it takes into account the difference in size for children and neonates. b. Medication dosing calculated according to body weight because it is based on maturational growth and development. c. Calculated doses based on body weight need to be increased by 10% because of immature renal and hepatic function. d. Use of drug reference recommendations based on mg/kg of body weight.

a. Dosage calculation by body surface area because it takes into account the difference in size for children and neonates.

The nurse knows that which factors will affect the absorption of orally administered medications? Select all that apply. a. Form of drug preparation b. Time of day c. pH of the stomach d. Patient in high-Fowler's position e. Presence of food in the stomach

a. Form of drug preparation b. Time of day c. pH of the stomach e. Presence of food in the stomach

When administering two medications that are highly protein bound, the nurse understands to monitor the patient carefully for which effect? a. Increase in the risk of drug-drug interaction b. Hypovolemic shock caused by a low albumin level c. Immediate improvement in the patient's condition d. A short duration of medication action

a. Increase in the risk of drug-drug interaction

How would a patient receiving narcotic analgesics for chronic pain can minimize the GI side effects? a. Increasing fluid and fiber in the diet b. Taking Lomotil with each dose c. Eating foods high in lactobacilli d. Taking the medication on an empty stomach

a. Increasing fluid and fiber in the diet

When admitting an older adult patient to an acute care setting, which nursing strategy is most appropriate to prevent medication errors? a. Instruct the patient or family to bring in all medications the patient was taking at home. b. Call the primary care physician to verify current medications. c. Ask the patient to provide you with a written list of all medications being taken at home. d. Have the patient's family verify medications the patient was taking at home.

a. Instruct the patient or family to bring in all medications the patient was taking at home.

What is an advantage of COX-2 inhibitors over other NSAIDs? a. Maintain GI mucosa b. Rapid onset of action c. Less likely to cause hepatic toxicity d. Longer duration of action

a. Maintain GI mucosa

Which nursing action will increase the absorption of a medication administered intramuscularly (IM)? a. Massage the site after injection. b. Apply ice packs to the injection site. c. Administer the medication via the Z-track method. d. Lower the extremity below the level of the heart.

a. Massage the site after injection.

When teaching a patient about the legalities regarding a prescription for methylphenidate (Ritalin), which statement is most accurate? a. Methylphenidate (Ritalin) is a C-II controlled substance that cannot be refilled automatically and can only be filled with a written prescription every month. b. Methylphenidate (Ritalin) is a C-III controlled substance for which a prescription will expire in 6 months. c. Methylphenidate (Ritalin) is a C-I controlled substance that can only be prescribed according to an approved protocol. d. Methylphenidate (Ritalin) is a C-IV controlled substance that is only to be refilled five times per prescription.

a. Methylphenidate (Ritalin) is a C-II controlled substance that cannot be refilled automatically and can only be filled with a written prescription every month.

The nurse would question a prescription to administer misoprostol to a patient with what condition? a. Pregnancy b. Peptic ulcer c. Chronic obtrusive pulmonary disease d. Gastroesophageal reflux disease

a. Pregnancy

In which step of the medication process can a medication error occur? Select all that apply. a. Prescribing b. Transcribing c. Administration d. Procurement e. Verification

a. Prescribing b. Transcribing c. Administration d. Procurement

The nurse is providing discharge teaching to an older patient with short-term memory problems. Which strategies will the nurse use in educating the patient? Select all that apply. a. Provide written instructions for home use. b. Perform several short teaching-learning sessions. c. Repeat information frequently. d. Encourage use of daily medication containers with alarms. e. Instruct the patient to take all medications in the morning.

a. Provide written instructions for home use. b. Perform several short teaching-learning sessions. c. Repeat information frequently. d. Encourage use of daily medication containers with alarms.

The nurse knows that the medication reconciliation process involves which steps? Select all that apply. a. Reconciliation b. Reporting c. Verification d. Administration e. Clarification

a. Reconciliation c. Verification e. Clarification

What assessment is highest priority when monitoring a patient on an opioid analgesic? a. Respiratory rate b. Mental status c. Heart rate d. Blood pressure

a. Respiratory rate

What information should the nurse chart when documenting medication administration? Select all that apply. a. The dosage of medication administered b. The route of administration c. The time of administration d. The patient's age e. Information about an "incident report" in the patient's chart

a. The dosage of medication administered b. The route of administration c. The time of administration

What things should the nurse check when reviewing a prescription before handing the written prescription to the patient? Select all that apply. a. The route of administration b. The age of the patient c. The patient's home address d. The patient's emergency contact e. The signature of the prescriber

a. The route of administration e. The signature of the prescriber

What is the term for the ratio between a drug's therapeutic effects and toxic effects? a. Therapeutic index b. Cumulative effect c. Affinity d. Tolerance

a. Therapeutic index

An emergency department nurse is documenting the medication history of a patient of Asian culture. The patient states, "I am not taking any medications," but the nurse observes a bottle of capsules in the patient's medicine bag. What information would the nurse collect next? a. Use of herbs or over-the-counter medications b. Past use of medicine and home remedies c. Health care provider name d. Vital signs and pulse oximetry

a. Use of herbs or over-the-counter medications

There are multiple factors that affect medication response. The nurse recognizes which factors have a possible effect on the medication response? a. level of education b. body composition c. use of alternative therapies d. genetic influences e. diet and nutrition f. socioeconomic factors g. patient compliance with therapy

a. level of education b. body composition c. use of alternative therapies d. genetic influences e. diet and nutrition f. socioeconomic factors g. patient compliance with therapy

New drugs must go through extensive research and testing before approval for use in humans. The nurse knows that the average length of time a medication is researched before being prescribed for humans is how many years? a. 14 to 16 b. 10 to 12 c. 2 to 4 d. 6 to 8

b. 10 to 12

The nurse would question a prescription to administer acetylsalicylic acid to what patient? a. 18-year-old patient with a history of sports injury b. 7-year-old patient with a history of flulike symptoms c. 42-year-old patient with a history of stroke d. 35-year-old patient with a history of heart attack

b. 7-year-old patient with a history of flulike symptoms

What phase of the nursing process is completed to gather information prior to providing education about a new medication to a patient and the family members? a. Implementation b. Assessment c. Planning d. Evaluation

b. Assessment

The nurse is educating a patient with gout. The nurse explains the action of colchicine to the patient. What statement is accurate in discussing the therapeutic action of the medication? a. Decreases production of lactic acid b. Decreases mobility of leukocytes c. Increases process of phagocytosis d. Increases uric acid metabolism

b. Decreases mobility of leukocytes

A nurse working with older adult patients is concerned about the number of medications prescribed for each patient. Which older adult assessment should be of highest priority related to polypharmacy? a. Schedule of medications b. Drug interactions c. Cost of medications d. Nonadherence to drug regiment

b. Drug interactions

What legislation, which was passed in 19916, ensures that the privacy of patient information is protected? a. Durham-Humphrey Amendment b. Health Insurance Portability and Accountability Act c. Medicare Prescription Drug, Improvement, and Modernization Act d. Federal Food, Drug, and Cosmetic Act

b. Health Insurance Portability and Accountability Act

When assessing a patient for adverse effects related to morphine sulfate (MS Contin), which clinical findings are the nurse most likely to find? (Select all that apply.) a. Excessive bruising b. Inability to void c. Weight gain d. Constipation e. Diarrhea

b. Inability to void d. Constipation

A patient is prescribed an opioid analgesic for chronic pain. Which information would the nurse discuss with the patient to minimize the GI adverse effects? a. Take the medication on an empty stomach. b. Increase fluid intake and fiber in the diet. c. Avoid eating foods high in lactobacilli. d. Take diphenoxylate-atropine (Lomotil) with each dose.

b. Increase fluid intake and fiber in the diet.

What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)? a. Increasing blood flow to painful areas b. Inhibiting prostaglandin production c. Enhancing pain perception d. Increasing the supply of natural endorphins

b. Inhibiting prostaglandin production

What is another term for biotransformation of a drug? a. Absorption b. Metabolism c. Excretion d. Dilution

b. Metabolism

Which medication is used to treat a patient with severe adverse effects of a narcotic analgesic and reverse the adverse effects? a. Flumazenil (Romazicon) b. Naloxone (Narcan) c. Acetylcysteine (Mucomyst) d. Methylprednisolone (Solu-Medrol)

b. Naloxone (Narcan)

The nurse administers a medication to the wrong patient. Which is the appropriate nursing action following this error? a. Document the medication error. No further action is required. b. Notify the health care provider and document a medication error incident report. c. Assess the patient for an adverse reaction and report if an adverse event occurs. d. Report the error and document the medication on the patient chart.

b. Notify the health care provider and document a medication error incident report.

A drug given by which route is altered by the first-pass effect? a. Subcutaneous (subcut) b. Oral c. Intravenous (IV) d. Sublingual

b. Oral

Which of the following would indicate a need for further patient teaching by the nurse related to medication therapy? a. Patient is unwilling to comply with medication therapy. b. Patient is unable to verbalize reasons for taking the medication. c. Patient is not reporting adverse effects as directed. d. Patient is not taking medication as directed.

b. Patient is unable to verbalize reasons for taking the medication.

What is the study of physiochemical properties of drugs and how they influence the body called? a. Pharmacokinetics b. Pharmacodynamics c. Pharmacology d. Pharmacotherapeutics

b. Pharmacodynamics

A pharmaceutical company is voluntarily conducting a postmarketing study to obtain further data to support the therapeutic effects of a new drug. What phase of drug study is this considered? a. Phase III b. Phase IV c. Phase I d. Phase II

b. Phase IV

The nurse is administering probenecid to a patient with recurrent strep throat. The nurse teaches the patient that the reason for taking this medication is for what drug effect? a. Inhibit bacterial growth and replication b. Prolong the effectiveness of penicillin therapy c. Prevent the occurrence of gout d. Increase uric acid excretion

b. Prolong the effectiveness of penicillin therapy

What nursing diagnosis is appropriate for a patient prescribed colchicine? a. Constipation related to adverse effect of the medication b. Risk for fluid volume deficient related to nausea, vomiting, and diarrhea c. Risk for injury related to adverse effect of life-threatening seizures d. Risk for infection related to medication-induced leukocytosis

b. Risk for fluid volume deficient related to nausea, vomiting, and diarrhea

In monitoring a patient for adverse effects related to morphine sulfate (MS Contin), the nurse assesses for stimulation of which area in the central nervous system (CNS)? a. The cough reflex center b. The chemoreceptor trigger zone c. Sympathetic baroreceptors d. Autonomic control over circulation

b. The chemoreceptor trigger zone

What organization announced implementation regulations requiring bar codes for all prescription and over-the-counter (OTC) medications? a. Drug Enforcement Agency (DEA) b. U.S. Food and Drug Administration (FDA) c. Federal Bureau of Investigation (FBI) d. Department of Health and Human Services (DHHS)

b. U.S. Food and Drug Administration (FDA)

Which statement best describes pharmacokinetics? a. Converts medication into its active chemical substance b. What the body does to the drug after it is administered c. Physiologic interaction between a drug and body cells d. Adverse effects and toxic reactions to medications

b. What the body does to the drug after it is administered

Drug's half-life is defined as the amount of time required for 50% of a drug to a. exert a response. b. be eliminated by the body. c. be absorbed by the body. d. reach a therapeutic level.

b. be eliminated by the body.

A nurse teaching a patient receiving allopurinol would include what information? a. "Take the medication with an antacid to minimize GI distress." b. "Include salmon and organ meats in your diet on a weekly basis." c. "Increase your fluid intake to 3 L per day." d. "This medication may cause your urine to turn orange."

c. "Increase your fluid intake to 3 L per day."

A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse's best response to the patient? a. "Drugs administered intravenously enter the portal system before systemic distribution." b. "Medications given orally bypass the portal circulatory system." c. "Medications given intravenously are not affected by the first-pass effect." d. "A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver."

c. "Medications given intravenously are not affected by the first-pass effect."

The patient asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the appropriate response by the nurse? a. "Ginkgo biloba has shown tremendous benefit as an antiinflammatory drug and is used to treat the symptoms of pain." b. "High doses of vitamins and minerals have been used for many years to help maintain joint health." c. "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider." d. "There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications."

c. "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider."

The nurse is teaching a patient about the effects of medication on fetal development. The nurse understands the greatest risk for negative effects from medications on a developing fetus occurs during which time period? a. 3rd trimester b. 2nd trimester c. 1st trimister d. Birthing process

c. 1st trimister

While admitting a patient for treatment of an acetaminophen (Tylenol) overdose, the nurse prepares to administer which medication to prevent toxicity? a. Phytonadione (Vitamin K) b. Naloxone (Narcan) c. Acetylcysteine (Mucomyst) d. Methylprednisolone (Solu-Medrol)

c. Acetylcysteine (Mucomyst)

Which statement best reflects the nurse's understanding of cultural influences on drug therapy and other health practices? a. Regardless of one's cultural background, it is crucial to adhere to recommended medical practices. b. Most cultures are fairly standard in reference to the use of medications during illness. c. Administration of some drugs may elicit varied responses in specific racial/ethnic groups. d. Dietary habits and practices can be of little value to the care of a sick adult.

c. Administration of some drugs may elicit varied responses in specific racial/ethnic groups.

Which action by the nurse helps to prevent possible medication errors? a. Ask the patient what condition the medication is for before administering. b. Administer the patient's medications using his or her own supply of medications while in the hospital. c. Encourage the patient to ask questions if the medication ordered is different than expected. d. Administer any medications that the patient had on admission or transfer.

c. Encourage the patient to ask questions if the medication ordered is different than expected.

The nurse is caring for a patient with opioid addiction. The nurse anticipates that the patient will be prescribed which medication? a. Naloxone (Narcan) b. Morphine (MS Contin) c. Methadone (Dolophine) d. Meperidine (Demerol)

c. Methadone (Dolophine)

What is the nurse's role in the development of new and investigational drugs? a. Identify patients who receive a placebo drug during Phase III studies. b. Select healthy older adult patients to participate in Phase I studies. c. Monitor and report any adverse effects observed during Phase IV studies. d. Inform patients of the specific drug they will receive during Phase II studies.

c. Monitor and report any adverse effects observed during Phase IV studies.

When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self-administer enoxaparin (Lovenox) subcutaneously upon discharge." Which method is best for the nurse to use in evaluating the patient's achievement of this outcome? a. Give the patient detailed written instructions illustrating the procedure. b. Demonstrate the correct administration procedure to the patient. c. Observe the patient's return demonstration of the administration procedure. d. Ask the patient to verbalize the correct administration procedure step by step.

c. Observe the patient's return demonstration of the administration procedure.

The nurse plans pharmacologic management for a patient with pain. The nurse would administer the pain medication based on what dosage schedule? a. Administer the analgesic when the pain level reaches a "6" on a scale of 1 to 10. b. Analgesics should be administered as needed (prn) to minimize adverse effects. c. Pain relief is best obtained by administering analgesics around the clock. d. Opioid analgesics should not be used for more than 24 hours to prevent drug addiction.

c. Pain relief is best obtained by administering analgesics around the clock.

The nurse is educating a patient with newly diagnosed type 1 diabetes mellitus. When the nurse has the patient demonstrate self-injection of insulin, which domain of learning is the nurse assessing? a. Physical domain b. Cognitive domain c. Psychomotor domain d. Affective domain

c. Psychomotor domain

The nurse plans care for a male patient who is 80 years old. The nursing diagnosis is noncompliance with the medication regimen related to living alone, as evidenced by uncontrolled blood pressure. What should the nurse do next? a. Collaborate with the provider on a new medication regimen. b. Assess the impact of home self-management of medications. c. Set up a home care nurse for pharmacotherapy. d. Examine the results of nursing help with the medications.

c. Set up a home care nurse for pharmacotherapy.

Why are specific medications identified as "high-alert" medications? a. Registered nurses must administer these medications. b. States require that these drugs be on the high-alert list. c. These drugs have increased potential for significant patient harm. d. These medications are responsible for adverse drug events.

c. These drugs have increased potential for significant patient harm.

What is the most appropriate time the nurse should begin the patient education and the teaching-learning process? a. When there are written prescriptions for teaching b. At the time discharge planning is begun c. Upon the patient's admission to the health care setting d. After the medical diagnosis is established

c. Upon the patient's admission to the health care setting

How does the nurse best evaluate the patient's understanding of teaching about a new medication? a. Assess the patient for response to the medication. b. Document the education session and most used teaching strategy. c. Observe the patient taking the medication. d. Ask specific questions to assess the patient's understanding.

d. Ask specific questions to assess the patient's understanding.

A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine when I have no pain?" The nurse's response is based on knowledge that codeine also has what effect? a. Increases sputum production b. Bronchodilation c. Expectorant d. Cough suppressant

d. Cough suppressant

Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates the health care provider will perform which action to minimize the risk of toxicity? a. Shorten the time interval between doses. b. Administer the medication intravenously. c. Increase the amount of drug given. d. Decrease the amount of drug given.

d. Decrease the amount of drug given.

The physiologic changes that normally occur in older adult patients have which implication for drug response? a. Protein binding is more efficient. b. Drug elimination is faster. c. Drug metabolism is quicker. d. Drug half-life is lengthened.

d. Drug half-life is lengthened.

The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor? a. Diet of the mother b. Fetal sex c. Maternal blood type d. Drug properties

d. Drug properties

The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval? a. Once a week b. Every 24 hours c. When pain recurs d. Every 72 hours

d. Every 72 hours

Patients with renal failure would most likely have problems with which pharmacokinetic process? a. Distribution b. Metabolism c. Absorption d. Excretion

d. Excretion

To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route? a. IM b. Intrathecally c. Subcut d. IV

d. IV

In developing a plan of care for a patient receiving morphine sulfate (MS Contin), which nursing diagnosis has the highest priority? a. Risk for injury related to CNS adverse effects b. Acute pain related to metastatic tumor cancer c. Constipation related to decreased GI motility d. Impaired gas exchange related to respiratory depression

d. Impaired gas exchange related to respiratory depression

What NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain? a. Indomethacin b. Diclofenac c. Allopurinol d. Ketorolac

d. Ketorolac

A patient needs to switch analgesic drugs secondary to an adverse reaction to the current treatment regimen. The patient is concerned that the new prescription will not provide optimal pain control. The nurse's response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype? a. Codeine b. Meperidine c. Fentanyl d. Morphine

d. Morphine

A patient is transferred from an intensive care unit (ICU) to a general medical-surgical unit. Which nursing action is most appropriate to prevent a medication error? a. Contact the health care provider to rewrite all drug prescriptions. b. Ask the patient what medications need to be taken while in the hospital. c. Communicate a verbal report face-to-face from the transferring nurse. d. Perform a medication reconciliation of the patient's chart during care transition.

d. Perform a medication reconciliation of the patient's chart during care transition.

Which statement is an example of objective data? Select all that apply. a. The patient states that she has a headache. b. The patient says that she feels like someone is touching her arm. c. The patient says that she has felt tired for almost a week. d. The patient has clear urine noted by microscopic examination. e. The patient has had a fever for 5 days.

d. The patient has clear urine noted by microscopic examination. e. The patient has had a fever for 5 days.

What is the professional responsibility of the nurse when the nurses' ethics conflict with the patient? a. Use beneficence, the duty to do no harm to a patient and disregard personal feelings. b. Impose his or her own values on the patient when doing so would help the patient. c. Withhold information from the patient as requested by the family. d. Transfer care of patient to another professional nurse if caring for the patient would violate personal ethical principles.

d. Transfer care of patient to another professional nurse if caring for the patient would violate personal ethical principles.

The nurse is assessing a patient's culture and race on admission to the hospital. Which concept is important for the nurse to understand regarding drug therapy as it relates to different races of individuals? a. polypharmacy b. pharmacokinetics c. pharmacodynamics d. polymorphism

d. polymorphism