Pharmacology Chapter 4
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."
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 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."
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."
After teaching the parents of a child who is receiving drug therapy, which statement indicates the need for additional teaching?
"We can use the same medications that we use for similar problems in our child, but we might need to adjust the dosage."
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
The health care provider orders NPH U100 insulin 16 units SC every AM for a client. The nurse prepares the insulin dose. To ensure safety, what does the nurse do?
Ask another nurse to double-check the measurement.
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.
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 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.
A client comes to the clinic reporting tinnitus and difficulty hearing. What medication in the client's current regimen should the nurse suspect as causing the symptoms?
Erythromycin
Which medication prescription by the health care provider will require the nurse to seek clarification?
Heparin 5,000 u SC every day
A nurse is developing a teaching plan for a client who is receiving medications. Which points would the nurse expect to include in the teaching plan? Select all that apply.
Method for administering the drug Expected effect of the drug Information to report too the PCP
What statement is true concerning nursing diagnoses?
Nursing diagnoses can be actual or potential.
A nurse is beginning to apply the nursing process during a new client interaction. What activity should the nurse perform?
Obtain a medication history.
An older adult client must take a variety of medicines under different conditions and at different times of the day. The client's spouse is available to help most of the time. How can the couple best ensure that the client takes all medicines under the correct conditions?
Once a week, dispense all the medicines into a large, divided container.
A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?
Parkinsonian symptoms
After teaching a group of students about the nursing process, the instructor determines that the teaching was successful when the students explain that establishment of goals and expected outcomes is part of which phase?
Planning
Which nursing intervention would the nurse expect to do during implementation?
Providing client teaching about a drug therapy regimen.
A nurse is performing an admission assessment on a client. During the medication history portion of the assessment, what would be important to assess with herbal supplements?
Research them for interactions with other 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 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
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.
A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?
Techniques for providing safe and effective mouth care
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
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
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
What is true concerning the "placebo effect" in drug administration?
Thinking that the drug will help the patient creates the placebo effect.
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.
Preoperative atropine belongs to what classification of drugs?
anticholinergic
To determine a client's self-care ability, it is most important for the nurse to perform what step of the nursing process?
assessment
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
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.
central nervous system alterations limb abnormalities heart defects skeletal abnormalities
A nurse is caring for a client who is prescribed multiple medications. Which clients are most likely to have adverse drug reactions?
clients who are very young or very old
After assessing a client, what step of the nursing process will the nurse perform before planning care?
diagnosis
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.
A client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?
frequent rinsing with cool liquids
"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process?
goal
What is the nursing diagnosis the framework for?
nursing interventions
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 nurse has been caring for a client in a health care facility. The nurse should consider the evaluation of a client to be positive if:
the expected outcomes are accomplished.
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."
Which of the following would be least important to include when teaching a client about drug therapy?
How to report a medication error
Assessment of a client receiving drug therapy reveals that the client has been experiencing gastrointestinal upset related to the drug. The client states, "My stomach has been so upset that all I've been able to eat is soup and dry crackers." Which nursing diagnosis would be most likely?
Imbalanced nutrition: Less than body requirements
Which nursing step refers to the preparation and administration of one or more drugs to a specific client?
Implementation/intervention
After assessing a client, the nurse determines a nursing diagnosis of Deficient Knowledge related to drug self-administration applies to this client. Which findings would support this nursing diagnosis? Select all that apply.
Inability to remember Lack of interest in learning Cognitive limitation
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)
Considering drug therapy, what would be an appropriately stated expected outcome for a client?
"The client will verbalize three medication side effects prior to discharge."
The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize?
"When are you taking your medication?"
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 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."
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
What action should the nurse perform during the implementation step of the nursing process?
Administrations and documentation of medications.
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
The nurse is preparing a teaching plan for a client who will be discharged home with several new medications. When preparing the teaching session, what is the nurse's best action?
Determine the client's level of education.
After assessing a client, what step of the nursing process will the nurse perform before planning care?
Diagnosis
When assessing a client who has developed an anaphylactic reaction, what would the nurse expect to find?
Difficulty breathing
When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?
Review laboratory values indicative of kidney function
Which statement is true about a nursing diagnosis?
The nursing diagnosis relates the client's status.