nur 316 prep u
During an assessment, a client says, "I am in a great deal of pain but I am afraid of becoming addicted to the medication I'm receiving." Which statements could the nurse use to educate the client on the difference between tolerance and physical dependence? (Select all that apply.)
"Both tolerance and physical dependence develop over time." "When you become tolerant to the medication, you require more to achieve the same result." "The rate at which a person develops a tolerance is dependent upon the individual, the amount of medication the person is receiving, and whether the person is receiving pills or shots." "Tolerance can develop quickly and a person may need larger doses every few weeks in order to experience relief, whereas someone else may experience relief with the same dosage
The most serious allergic response is called anaphylaxis. Which clients exhibit possible symptoms of anaphylaxis? (Select all that apply.)
A client showing signs of acute respiratory distress. A client with marked hypotension and experiences convulsions. A client with laryngeal edema and pale, cool skin.
The nurse understands that several physiologic changes are related to normal aging. Which change is the least affected by the pharmacokinetic process during aging?
Absorption
How does knowledge of a drug's adverse effects impact the care provided by the nurse? (Select all that apply.)
Drug teaching can address signs and symptoms the client should be alert for. Assessments include monitoring for expected or common adverse effects. Baseline can be established to help identify adverse effects that occur.
Which factors will decrease the rate of drug absorption? Select all that apply.
Higher drug concentration in the circulatory system Drug given by a subcutaneous route versus an intramuscular route A disease that alters the stomach and small intestine lining
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.
A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action?
Promptly inform the prescriber of the client's status
What types of medication can pass through the blood-brain barrier or the placenta? (Select all that apply.)
Water-soluble medications Lipophilic medications Medications unbound to protein
In clinical practice, measurement of serum drug levels is useful in what circumstances? (Select all that apply.)
When drugs with a narrow margin of safety are given, because their therapeutic doses are close to their toxic doses To document the serum drug levels associated with particular drug dosages, therapeutic effects, or possible adverse effects To monitor unexpected responses to a drug dose, such as decreased therapeutic effects or increased adverse effects When a drug overdose is suspected
A nurse is administering medications to a 70-year-old female client. What normal physiologic changes that occur with aging will affect the absorption of medications? (Select all that apply.)
chronic illness decreased blood flow to the GI system decreased body surface area
The nurse administers a specific medication to an older adult client every 4 hours. The client has a history of chronic renal failure. The nurse should assess for indications of:
cumulative drug effects.
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
What would be a key element associated with pharmacodynamics?
enzyme systems
What is the most reliable measure to evaluate renal function?
glomerular filtration rate
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.
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
A hospital nurse works on a unit specializing in neurological problems and frequently provides care to elderly clients who have undergone spinal surgery. The nurse assesses that the client at highest risk for a medication-related problem
prescribed metoprolol, pantoprazole, and docusate
What factors does the nurse take into account that may influence the rate of absorption of medication? (Select all that apply.)
route of administration solubility of the medication condition of the body tissues
The nurse is caring for a client who is exhibiting adverse medication effects. The nurse should recognize that adverse effects can be extensions of:
the primary action of a drug
When assessing a client for possible factors that may affect the pharmacokinetics of a drug, a client with a history of what disease would lead the nurse to suspect that the client may experience an alteration in the distribution of a drug?
vascular disease
