NUR316 Exam 1 Practice questions
The 68-year-old client states, "I have been taking aspirin on occasion for my arthritis for many years but notice that it takes longer for it to start working now." What is the best response by the nurse?
"As you get older, absorption is prolonged and medications may take a little longer to act than normal."
A client is prescribed sumatriptan. Which statement should be included in the teaching plan regarding how the medication works?
"It produces vascular constriction of cranial blood vessels."
A nurse is preparing to administer digitalis to a client with congestive heart failure. The client asks the nurse, "Tell me something about this drug. Where does it come from?" What is the bestresponse by the nurse?
"This drug comes from a plant called the purple foxglove
Which client is experiencing a secondary action of a medication?
A client who is drowsy after taking antihistamine
A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client
ALBUTEROL
After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)
ALBUTEROL
What is the characteristic action of an agonist?
Agonists bind to receptors and cause a physiologic effect
What effects are exerted by aspirin? (Select all that apply.)
Analgesic Antipyretic Anti-inflammatory
A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses? Select all that apply
Ananphylactic reactions involve an antibody that causes the release of histamine. Histamines produce immediate reactions. Anaphylactic reactions can lead to respiratory distress and even respiratory arrest.
Drugs can affect the special senses, including the eyes and ears. Alterations in seeing and hearing can pose safety problems for clients. What are examples of sensory effects of drugs? Select all that apply.
Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects. A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness.
The nurse is assessing a client for anticholinergic effects of a prescribed drug. What assessments should the nurse perform? (Select all that apply.)
Assess the moisture level of the client's skin. Assess the client's recent bowel pattern. Assess the client's visual acuity.
A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize
BUN and creatinine levels
A student nurse asks the nurse why acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce cancer pain. What is the nurse's best explanation
Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation
The nurse is administering morphine to a trauma client for acute pain. What is a common side effect of morphine?
DROWSINESS
Which statement made by a nurse would suggest that he/she is involved in a Phase III clinical drug study associated with a new antidepressant?
Evidence is strong that the medication's benefits certainly outweigh any risks that have been noted.
The nurse is caring for a client taking Talwin. What would be an appropriate nursing diagnosis for this client's care plan?
Impaired gas exchange related to respiratory depression
A client is prescribed acetylsalicylic acid for fever and headache. What is the action of acetylsalicylic acid
Inhibiting prostaglandin synthesis in the central and peripheral nervous system
Which statement best describes a drug's characteristic of having no ceiling effect?
It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops
The nurse is caring for a patient who is receiving an opioid analgesic. What would be a priority assessment by the nurse?
LOC AND RR
The nurse is researching a medication by its generic name. What is another term for a drug's generic name? (Select all that apply.)
Official non-propiertary
Which teaching intervention is a priority for the client prescribed an albuterol inhaler experiencing shortness of breath related to the physiological constriction of airways?
Stop smoking due to the bronchoconstriction
While assessing clients receiving opioid analgesics for pain management, what finding would allert the nurse and require healthcare provider notification?
The client with a pulse of 118, a respiratory rate of 8, and a BP of 80/60
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
the nurse is visiting a female client in her home for treatment of a wound. The client is concerned that her husband, a truck driver, is bothered by his seasonal allergies. A friend suggested diphenhydramine. What is the nurse's best response?
The drug may cause drowsiness and make driving unsafe."
A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that the client has been prescribed. What topic should the nurse address?
The effect of the drug on the body
What statement should the nurse include in a discussion to a community group about patent drugs?
The patent prevents other drug manufacturers from making or selling that drug
The patient's admission blood work indicates a low creatinine clearance rate (CrCl). A low CrCl may have what implication for the patient's pharmacotherapy?
The patient may require lower-than-normal doses of a drug
When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs? (Select all that apply
Therapeutic response is achieved and discomfort is reduced. An adequate breathing pattern is maintained. Client maintains adequate nutritional status
What client may be receiving a drug from an animal source?
a pt with hypothyroidism
When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide
a return to normal respiratory rate, rhythm, and depth
What represents a pharmacokinetic phase?
absorption distribution metabolism excretion
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome
acelystaic acid
When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing?
acute somatic pain
In Phase 1 clinical trials, the potential uses and effects of a new drug are determined by which method?
administering doses to healthy volunteers
A client has been prescribed an oral drug that is known to have a high first-pass effect. Which measure has the potential to increase the amount of the free drug that is available to body cells
administering the drug intravenously rather than orally
A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with:
allergy to sulfamides
After reviewing class material about the natural sources of drugs, the students demonstrate understanding of the material when they identify which as an example of a drug that is derived from inorganic compounds?
aluminum hydroxide
What is an example of a secondary action?
an antihistamine causes the client to experience drowsiness
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 called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?
anaphylactic shock
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?
anticholingeric
A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find?
antipsychotic drugs
How should a nurse best explain the presence of the inflammation process?
as an attempt by the body to remove the damaging agent and repair the damaged tissue
A client with a recent history of peripheral edema has been taking hydrochlorothiazide 75 mg PO daily. The client reports increased appetite and restlessness to the nurse and inspection reveals warm, flushed skin. What is the nurse's best action?
assess blood glucose level
A client's drug level has reached critical concentration. What action should the nurse perform?
assess for therapeutic effects
A parent states that they generally give their children "half an aspirin" in the event that any of them has a fever. What is the nurse's best response to the client's statement?
avoid aspirin because reye syndrome
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 fluids and stay hydrates
A client is receiving anakinra as treatment for arthritis. The nurse understands that this drug acts in which manner?
blocks interleukin 1
Which factor has the most significant effect on a child's response to the administration of a medication?
body weight
A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?
cold, clammy skin
A group of nursing students are reviewing the pain-relieving action of NSAIDs. The students demonstrate understanding of the information when they identify which actions as being blocked to achieve pain relief?
cyclooxygenase-2
A client is ordered to receive an nonsteroidal anti-inflammatory drug (NSAID) for pain. The client states that NSAIDs are taken only to decrease inflammation. The nurse instructs the client that these medications are also used for which?
decrease body temperature
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?
decrease in urine output
A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to
decreased blood flow to tissues and muscles.' low serum blood: liver disease, inflammatory disease high serum blood level: infection, burns, stress
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?
decreased gi absorption
A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 PM. The nurse finds the patient drowsy and confused at 10 AM the next day. The nurse is aware that this behavior is most likely due to
decreased hepatic function rationale: sedatives reduce blood flow to liver
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients
drowsiness
The nurse is admitting a new client whose health history includes chronic kidney disease. How should the nurse best interpret and document this assessment data on the nurses notes?
drug excretion may be lower
Genetic engineering allows scientists to produce human insulin by altering which type of bacteria?
e-coli
A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis
elevated AST level
A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?
epinpehrin
The mentoring nurse is orienting a new graduate RN to the geriatric floor. What assessment technique will the new graduate nurse perform to identify an age-related physiological change associated with medication metabolism?
external palpation of liver
Naloxone (Narcan) will reverse the effects of which drug?
fentanyl
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 client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?
frequent rinsing with cool liquids
When asked by a client about the generic name of a drug, what is the nurse's best response
generic name is official name given by FDA
An 80-year-old male client presents to the health care provider's office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The provider orders a stool test for guaiac, which yields positive results. The provider discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs?
gi bleed
A nurse has admitted a 10-year-old to the short-stay unit. The child reports chronic headaches, and his mother states that she gives the child acetaminophen at least twice a day. What will the nurse evaluate?
hepatic function
A nurse is caring for a client who has just been diagnosed with rheumatoid arthritis. What first-line treatment should the nurse anticipate?
ibuprofen
The nurse is teaching the client to self-administer insulin. This occurs during which phase of the nursing process?
implementation
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?
inhibit platelet aggreation
What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)
inhibit prostylangin sythnesis
A female client with acute joint inflammation asks the nurse why she shouldn't use acetaminophen for her condition. What would be the nurse's best response to this client?
it has no effect on inflammation use ibuprofen
It is crucial for the client to understand what about any prescribed medication? (Select all that apply.)
medication administration dosage expected effect adverse reactions
The nurse administering ibuprofen should assess an adult client for which potential symptoms? Select all that apply.
moderate pain fever inflammation
The nurse knows that the pharmaceutic phase of drug activity must take place for which formulation of medication?
oral tablets
What conditions are salicylates are effective in managing? (Select all that appl
pain fever inflammation
Which phase of drug development is associated with continual evaluation of the drug?
phase 4
A drug has been approved by the Food and Drug Administration. What study phase would occur next?
phase IV study
male client is given regular doses of morphine for a period of 6 months. His dosage now needs to be reduced gradually. The health care provider advises the nurse to pay attention to the clinical management of the client's pain to allow proper agonist coverage during the change in drug dosage. Why is the client likely to suffer unnecessary pain and discomfort if proper management is not ensured?
physical dependence of drug
During drug evaluation, chemicals that may have therapeutic value are tested on laboratory animals and would be considered in which stage of development?
preclinical
Which nursing intervention would the nurse expect to do during implementation?
providing education
The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity
reduced efficiency of renal function
A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client and his wife. What would be the nurses best explanation?
reduces risk of second heart attack
When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?
review BUN and creatinine levels
Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, what determines the patient's response to morphine?
route
Which schedule drugs have high abuse potential and no accepted medical use?
schedule 1
Which skin condition would be most likely to cause increased systemic absorption of a topical medication?
severe sunburn
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
skeletal and limb abnormalities central nervous system alterations heart defects
The nurse is administering medications and knows that there is a longer distribution time when the drug is intended for what area?
skin slowest 1. parenteral: injection Subq, oral, topical 2. enteral: PO 3. TOPICAL: ointment, lotion
All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?
steven johnson syndrome
A client is being discharged following an allergic reaction after ingesting aspirin. Included in patient education about the allergy, the nurse would inform the client that
the client should not take aspirin or non-aspirin NSAID
The nurse is administering a drug that has selective toxicity. What effect will this have on the client?
the drug will affect foreign cells but not healthy body cells.
What would the nurse expect the prescribing health care provider to order for a client with a delayed allergic reaction?
topical corticosteroid
A female client tells the nurse that the first thing she does when she gets a headache is drink a caffeinated beverage. The nurse is aware that caffeine is known to decrease the pain of migraine headaches by what mechanism?
vasoconstriction of blood vessels
A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of:
weekly subcutaneous injection
The nurse is checking the orders for pain management for a client that had coronary surgery 24 hours ago. The nurse identifies that the client has been receiving Celebrex and a narcotic postoperatively for pain management. What is the most appropriate response of the nurse?
withheld celebrex and contact doctor
A nurse is teaching the client about the use of over-the-counter (OTC) drugs. Which statement best informs the client about their safe use?
"OTC drugs need to be taken with caution; they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy
A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?
Antitussives suppress coughing while expectorants loosen bronchial secretions
A male client is seeking an over-the-counter medication to ease both the pain and inflammation associated with his osteoarthritis of his knee. The nurse knows that which drug will only reduce pain?
acetaminophen
A client with a history of migraine headaches self-medicates with an over-the-counter (OTC) medication that contains a commonly combined combination of drugs. The nurse recognizes the client is medicating with a combination of which drugs? Select all that apply
acetaminophen aspirin coffee
A client's post-surgical pain is severe and persistent. The client states that recent doses of morphine IV have "helped only a little bit." The client has a PRN dose of morphine available, and wants to receive the medication. The client's respiratory rate is 14 breaths per minute. What is the nurse's best action?
administer and monitor respiratory status
The nurse is assessing a client who has developed shortness of breath, a rash, panic, and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should
administer epinephrine
an elderly female client insists her asthma is exacerbated by her least favorite television show. While explaining that her dislike for the show's host may be a contributing factor, the nurse relates that an asthma attack is caused by substances released from mast cells, which cause:
bronchoconstriction and inflammation
The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?
client with peptic ulcers
The nurse is educating a client on over-the-counter (OTC) medications. What information is required to be placed on the label of the medication? (Select all that apply.)
contraindications to the medication adverse reactions dosage of the medication expiration date
A group of nursing students are reviewing information about the different classifications of opioids. The students demonstrate understanding of the information when they identify which as an opioid agonist? Select all that apply
hydromorphone fentanyl oxycodone
nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved
stomach
The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug
urinary hesitancy
Which statement best defines how a chemical becomes a drug?
A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.
What client is experiencing an adverse effect that is a result of primary action?
A client taking anticoagulants who develops a gastrointestinal bleed
The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize?
AST and ALT levels
When considering controlled substances, what actions are considered nursing responsibilities? (Select all that apply.)
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 Food and Drug Administration (FDA) pregnancy category indicates that animal studies on the drug have shown adverse fetal effects, but there are no adequate studies in humans?
category c
What drug category indicates fetal risk where the potential benefit might be acceptable despite the risk?
category d
The nurse is administering a medication to a client who reports pain in the knees from arthritis. The nurse observes the name of the drug as p-isobutylhydratropic and recognizes that this refers to a:
chemical name
A client has developed a fever. What aspect of the client's health history would contraindicate the safe and effective use of acetaminophen?
client has hepatitis c and abuses alcohol
A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain
codeine
After teaching a group of students about the responsibilities of the Food and Drug Administration (FDA) related to drugs, the instructor determines that the students need additional teaching when they identify what as a major responsibility?
enforcement of control of substances with high abuse potential
When determining if the client understands teaching, what step of the nursing process is the nurse performing?
evaluation
The breakdown of oral drugs in the liver immediately after absorption is known as which of the following?
first pass effect
A client who reports joint pain is being seen in the rheumatology clinic. The nurse understands that which element is used to treat rheumatoid arthritis?
gold
A 92-year-old woman is beginning to take a new medication. What may affect drug absorption in this client? (Select all that apply.)
increased gastric pH decreased blood flow to the stomach diminished gastric emptying
The nurse brings the client's afternoon medications and attempts to teach the client about them. The client states, "Just tell my wife about them, she will take care of me at home." What is the most appropriate nursing diagnosis for this client?
ineffective self health management
A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic?
morphine
the pediatric client has a fever, and the nurse is preparing to administer an antipyretic. What drug would be the best choice for this client?
naproxen
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?
nephrotoxicity
Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? (Select all that apply.)
neuroleptic malignant syndrome Parkinson-like syndrome atropine-like (anticholinergic) effects
The client is taking sumatriptan (Imitrex) for migraine headaches. For which client is this medication contraindicated?
or clients with a history of angina pectoris, myocardial infarction, or uncontrolled hypertension
A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route?
oral
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
After teaching a group of nursing students about drug classes and categories, the instructor determines that the teaching was successful when the students identify legend drugs as referred to as which medication?
prescription drugs
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
rebound bronchoconstriction
A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?
review potassium level
nurse instructs the parents of a child or adolescent with influenza or chickenpox to avoid the use of aspirin because the drug is associated with which condition?
reye syndrome
Which diffuse connective tissue disease is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema?
rheumatoid arthritis
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
When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:
secondary actions
Drugs are classified according to what features?
therapeutic uses
Aspirin has been prescribed for a 69-year-old client with a diagnosis of arthritis. The nurse monitors the client for which assessment finding that would indicate the presence of toxicity from this medication? (Select all that apply.
tinnitus impaired hearing tachycardia
Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis
true
