Pharmacology Exam 1

After speaking with college students about birth control, the nurse realizes more education is needed when one student says:

"Birth control pills will help prevent sexually transmitted diseases."

A nurse is conducting an assessment of a client who has recently had several changes made to the drug regimen. What assessment question most directly addresses the safety implications of the client's drug regimen?

"Do you take any herbal supplements or alternative medications?"

What statement, made by the nurse to a client prescribed a sublingual medication, demonstrates an understanding of the appropriate method of administration for this specific route?

"Hold the medication under your tongue until it is dissolved."

A pregnant client asks the nurse about what medications are safe during pregnancy. Which statement is correct?

"It is safe to take any medication in the pregnancy risk category A."

The nursing student incorrectly calculated a pediatric medication that should read 0.12 mg. The student calculated 1.2 mg and stated to the instructor, "It was only off by a decimal point. I got the numbers correct." What is the best response by the instructor?

"Pediatric dosages must be accurate because even small errors can cause adverse effects, toxicity, or death."

A client has been given a prescription for sildenafil (Viagra) for treatment of erectile dysfunction. The nurse will instruct the client to take this medication at what time prior to the onset of sexual intercourse?

30 minutes

The nurse is aware that oral contraceptives are effective but associated with potential health risks that must be carefully considered. Which client has the highest risk of experiencing the adverse effects of oral contraceptive use?

A 38-year-old diabetic woman who smokes one-and-a-half packs of cigarettes daily.

The nurse who is caring for an older client sees that the latest laboratory report reveals a decreased creatinine clearance. The nurse anticipates what modification to the client's drug regimen?

A decrease in the dosage of medication

After administering a medication to a client, the client reports an upset stomach. The nurse interprets this as a negative effect of the drug and identifies it as a(n):

Adverse Effect

A client at the clinic reports amenorrhea and has participated in competitive bodybuilding for years. She tested positive for pregnancy. After obtaining a health history, the nurse finds the client has healthy eating habits, regular exercise, herbal supplement use, and alcohol avoidance. What client education should follow?

Anabolic steroid use is contraindicated in pregnancy.

The elderly client reports to the clinic nurse difficulty sleeping of recent duration. How will the nurse intervene? (Select all that apply.)

Assessing the client's activity level Asking the client about time of food ingestion Determining sleep patterns of the client

A nurse is gathering information about a client. The nurse is participating in which step of the nursing process?

Assessment

The nursing process consists of the following five major steps:

Assessment, diagnosis, planning, implementation, evaluation.

When considering controlled substances, what actions are considered nursing responsibilities?

Assuring that the controlled substances in safely stored in locked containers Keeping accurate recordings of the administration of prescribed controlled substances Assuring that the inventory of narcotics is accurate and sufficient for patient needs

Which safety measure is important for nurses to teach clients taking enteric-coated drugs?

Avoid crushing and chewing medications

What schedule of medication dosing assists older adults in adhering to a medication regimen?

Begin with a low dose to minimize adverse effects

A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition?

Blood flow to the penis will be improved

A male client is using a transdermal testosterone patch for treatment of hormonal deficiency. He also has type 2 diabetes mellitus. He is taking glyburide (DiaBeta). Which laboratory value should be monitored closely?

Blood glucose

The nurse's ongoing assessment of outpatient clients receiving estrogen, progestin, or combination products should include what assessments? (Select all that apply.)

Blood pressure Pulse Respiratory rate Therapeutic effects

The nurse knows that pharmacodynamics across the lifespan are affected by what variables? (Select all that apply.)

Body composition Genetic makeup Immature organ systems

Which factor has the most significant effect on a child's response to the administration of a medication?

Body weight

The health care provider has asked a nurse to administer a drug intravenously to a client who is unresponsive. How can the nurse ensure that the drug is administered to the right client?

By checking the client's wristband.

Which of the U.S. FDA Pregnancy Categories should the nurse consider in assessing the risk vs. benefit of a drug for use in pregnant women before administration of the medication? (Select all that apply.)

C D X

Anabolic steroid use causes an increase in muscular work capacity, which is what makes these agents popular as performance-enhancing drugs. They are dangerous specifically to teens because they:

Can damage heart, liver, and kidneys

A 9-year-old child has been prescribed a medication but is not able to safely swallow pills. What type of medication formulation would work best for this child?

Chewable tablets

What is the manufacturer's responsibility during phase IV of a drug trial?

Continue to monitor the drug's effects while the drug is in general use.

Mrs. Herrera discovers she is pregnant. She asks the health care provider for a rubella vaccination. What does the nurse anticipate the provider will do?

Decline, because the rubella vaccine is a live-virus vaccine

The nurse examines the history of a client prescribed oral contraceptive with estrogen and progestin and should report which as contraindication(s)? Select all that apply.

Deep vein thrombosis Estrogen dependent breast cancer Fatty liver disease Migraine headaches

To evaluate the client's understanding of the drug regimen, the nurse may note which of the following? Select all that apply.

Facial expressions Regimen being followed correctly Correct answers to questions asked

To prevent neural tube defects, a health care provider may prescribe what drug during pregnancy?

Folic Acid

Which organization is responsible for approving new drugs in the United States?

Food and Drug Administration (FDA)

In order to protect the environment, what is it important to teach clients to do?

How to dispose of drugs properly

Which drug may be derived from an animal source?

Insulin

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

Intravenous

Which legislative act allowed the FDA to tighten control over the quality of drugs and required that safety and efficacy standards be established?

Kefauver-Harris Act of 1962

What plays the largest role in drug excretion?

Kidneys

Before a patient starts an estrogen regimen, a thorough assessment is necessary to ensure that she is not put at unnecessary risk. The nurse recognizes that this assessment should most include which of the following laboratory studies?

Lipid panel

An infant with a seizure disorder who must take phenytoin (Dilantin) is at risk for developing toxic levels of the medication. This is because of what immature organ function?

Liver

The nurse is obtaining a list of the medications that an elderly client is taking. The client is known to be taking 14 different medications. What is the greastest risk for the client?

Morbidity and Mortality

Which are frequently used nursing diagnoses related to the administration of a drug? (Select all that apply.)

Noncompliance Anxiety Deficient knowledge Effective therapeutic regimen management Ineffective therapeutic regimen management

Administration of a drug is primarily the responsibility of which health care provider?

Nurse

What is a major disadvantage of using over-the-counter (OTC) medications?

People may choose an OTC that interacts with another medication.

Which term is used to describe the study of drugs and their action on living organisms

Pharmacology

A nurse is teaching a patient about drug therapy for a disease process. What is the appropriate terminology for this therapy?

Pharmacotherapy

The nurse explains that which drug resource book is compiled from package inserts?

Physician's Desk Reference (PDR)

A nurse who is working with an older adult who takes eight medications a day wants to promote medication adherence. Which nursing intervention would best promote medication adherence?

Place pills in a daily or weekly pillbox organized according to hours of the day or mealtimes.

Medications are derived from which of the following sources? Select all that apply.

Plants Laboratories Mold Minerals Animals

The nurse should be aware that many older adults take multiple prescribed and over-the-counter (OTC) drugs. What is taking several drugs simultaneously known as?

Polypharmacy

A nursing student in a pharmacology class should be encouraged to study the medications according to which categorization? Select all that apply.

Prototype therapeutic classification

Medication orders are written with very specific criteria and coincide with the rights of medication administration. What critical piece of information is missing from the following medication order? Cephalexin 250 mg every 8 hours.

Route

A nurse is administering a Schedule II drug to a patient. What most concerns the nurse about this medication therapy?

Schedule II drugs have a high potential to become addictive and be abused.

A 36-year-old client has been a long-time user of oral contraceptives. She calls the office to request a visit because of sudden and severe leg pain. Why is this concerning?

She has an increased risk of thrombophlebitis.

Before a pregnant client is given any medication, consideration must be given to its effects on the fetus. The main concern is for medications that potentially have which effects?

Teratogenic

A female client expresses the desire to suppress her female sex characteristics to facilitate a transition to being male. Which androgen does the nurse anticipate the provider will prescribe?

Testosterone

The nurse is reviewing a client's medication list. This client just recently delivered her first child but has a few chronic problems. The nurse recognizes which of the following drugs are not recommended to be used during lactation? Select all that apply.

Tetracycline Loratadine Lithium

The nurse knows that the orovider has ordered a creatinine clearance test for a 77-year-old client because this test reveals what information?

The ability of the kidney to excrete medications

What factors are important for the fetus during pregnancy when the mother must take medication? (Select all that apply.)

The dose and duration of drug therapy The type of adverse effects that may appear When during pregnancy the drug is taken

Which statement regarding infant pharmacokinetics is most accurate?

The immature liver of infants makes drug metabolism less efficient.

A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the health care provider prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission?

The laxatives can interact with and complicate prescribed drug therapy.

A healthy 70-year-old man has been having trouble sleeping at night. Additionally, he has been having difficulties with gastroesophageal reflux. He buys generic Benadryl to help him sleep and buys generic Tagamet for his reflux. After 7 days of taking these over-the-counter medications, he exhibits signs of confusion and disorientation. His wife calls the primary care facility to speak with the nurse. What should the nurse suspect first?

The older adult is experiencing mental changes as an adverse drug effect

A nurse is teaching a patient about medications referred to as "antihypertensives." To what is the term "antihypertensive" referring?

Therapeutic Classification

Drug errors can occur at which of the following stages? Select all that apply.

When transcribing the drug order. When dispensing the drug. When administering the drug.

After teaching a student about the roles the U.S. Food and Drug Administration (FDA) plays in regulating the pharmaceutical market, the nurse recognizes that the information was understood when the student identifies what as a responsibility of the agency? (Select all that apply.)

assigning a pregnancy category for each new drug enforcing standards for testing drug toxicity setting standards for efficacy and safety

The nurse understands that when administering drug therapy to older clients there are normal age-related absorption changes. How is absorption affected in the older client? (Select all that apply.)

decreased blood flow decreased absorption surface decreased gastrointestinal (GI) motility increased gastric pH

What phenomenon is primarily responsible for the changes in pharmacokinetics that accompany the aging process?

decreased function of vital organs

What factors affect drug absorption in neonates? (Select all that apply.)

delayed gastric emptying increased gastric pH irregular gastric emptying

After teaching a class of nursing students about genitourinary changes that occur with aging, the instructor determines that the teaching was successful when the students identify which finding as a change? Select all that apply.

diminished estrogen secretion shortening of the vaginal wall scar tissue formation in the prostate diminished testicular tissue

A nurse is caring for a female client who states she has a 28-day cycle. Which two hormones are influential in the female fertility cycle?

estrogen and progesterone

A nurse is talking to a client about estrogen which has been prescribed after a hysterectomy. Which are adverse effects the nurse should including in the teaching plan? (Select all that apply).

headache breast pain depression abdominal cramps

A client is prescribed oxybutynin in a transdermal form. The nurse would instruct the client to apply the patch to which area? Select all that apply.

hip abdomen buttocks

Reasons for noncompliant behavior in clients administering their own medications include which actions? (Select all that apply.)

knowledge deficit of expected results bothersome adverse effects anxiety lack of information about the drug

The Controlled Substances Act of 1970 regulates what actions in regards to drugs classified as controlled substances? (Select all that apply.)

manufacturing distribution dispensing

The nurse administering pediatric medications understands that it is important to double check each calculated dose for accuracy. Who is responsible for ensuring the accuracy of a prescribed drug dose before it is administered?

nurse administering the drug

What is part of the assessment phase of the nursing process? (Select all that apply.)

obtaining a medication history obtaining vital signs asking about chief reason for seeking medical attention determining therapeutic response

On occasion, medications can be administered to a fetus through maternal ingestions. Which medication can be used for such treatment? Select all that apply.

penicillin levothyroxine digoxin

A client is administered amoxicillin. The generic name of this medication belongs to which drug group?

penicillins

What action should the nurse take when completing a list of medications developed from the medication history? Select all that apply.

places in the client's medical record compares to newly prescribed medications

The Food and Drug Administration assigns newly approved drugs to which categories? (Select all that apply.)

prescription nonprescription controlled substance

A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. What are the rights of medication administration? Select all that apply.

right to refuse prescribed medication right route for effective medication therapy right to effective medication education right evaluation of expected results

Absorption is the process by which a drug is made available for use in the body. What factors influence the rate of absorption? Select all that apply.

route first-pass effect solubility of the drug conditions in the body

Which would the nurse identify as a factor in the distribution of a drug? Select all that apply.

solubility protein binding blood flow

A nurse is teaching an older adult about polypharmacy. Which statement best describe this term?

taking several drugs simultaneously

Drugs are classified according to what standard?

their effects on particular body systems, therapeutic uses, and chemical characteristics

What is the primary purpose of American drug laws?

to protect safety of the public

The exact dose of a medication for a pediatric client is based on what parameter?

weight