Pharm ch6
The nursing instructor is discussing the off-label use of drugs. What group of drugs would the instructor tell the nursing students is often used for off-label indications? A) Drugs used to treat psychiatric problems B) Drugs used to treat gastrointestinal (GI) problems C) Drugs used to treat cardiovascular problems D) Drugs used to treat musculoskeletal problems
A
The nursing instructor is teaching the class about how prescription drugs become over-the-counter (OTC) drugs and lists what factor as preventing a drug from becoming classified as OTC? A) If the patient cannot reliably self-diagnose the condition the drug is intended to treat B) If it would mask signs and symptoms of an underlying problem, the drug remains available by prescription only. C) If the drug would cause toxic effects if not taken as directed, it remains a prescription drug. D) OTC drugs must not have any adverse effects that could harm the patient.
A
Ipecac, formerly used as the drug of choice by parents for treatment of suspected poisoning in children, was tested by the Food and Drug Administration (FDA) in 2003. What was the finding of this testing? A) Ipecac is ineffective for its intended use. B) Ipecac is the safest treatment for poisoning in children. C) Ipecac was "grandfathered" in as an ineffective drug. D) Ipecac induces vomiting.
A
The local news has been discussing a specific rare disorder that killed a child in the community this week, describing the symptoms of the disease as including nasal congestion, ear pain, and a cough. The pediatrician's office is receiving numerous calls asking to make appointments to rule out this rare disease. What is the nurse's best action? A) Prepare a handout that describes the disorder discussed in the news in greater detail. B) Tell parents their child is experiencing the common cold and do not need to be seen. C) Direct all calls to the local news agency to answer questions and provide details. D) Become familiar with the disorder and screen each call for more specific symptoms.
A
The nurse is teaching the patient how to safely use the Internet for health information and includes what information in the teaching plan? A) The Web site where information is obtained needs to be evaluated for credibility. B) Most information found on the Internet is accurate. C) Information on the Internet is most reliable when people give their reviews of the drug. D) Only a health care professional can tell whether a Web site is reliable.
A
The nurse provides teaching to the patient using herbal therapies and includes what important information related to the effects of the herbal therapy? A) They can interact with prescription drugs. B) They always contain known ingredients. C) They are natural so they are effective and safe. D) The ingredients are natural, meaning toxicity is not a concern.
A
The parent of a 2-year-old child is visiting his or her pediatric health care provider and shows the nurse the advertisement for allergy medication found in a magazine in the waiting room saying, "This drug sounds like it would be far more effective to treat my son's asthma and I'd only have to give it once a day." What is the nurse's best response? A) "Talk with your health care provider about this drug, but be aware that advertisements do not always provide all the important information you need to know." B) "Oh, I need to throw that magazine away because so many people show me that ad and it is all complete nonsense with no truth to it at all." C) "I've been seeing amazingly positive results from that medication so you are absolutely right to want to give it to your child." D) "That drug is dangerous and should not be given to children under the age of 5 unless there are no other good options."
A
The triage nurse in the emergency department sees a patient suspected of abusing amphetamines brought in by friends. While assessing this patient, what would the nurse be likely to find if steroids are being abused? A) Hypertension B) Bradycardia C) Drowsiness D) Elated mood
A
What can make a nurse or any health care provider lose credibility with the patient? A) Being unprepared to deal with "the disease of the week" B) Refusing to write prescriptions for the drug the patient requests C) Not being knowledgeable about diseases described on House D) Being prepared to discuss the role of "concierge" doctor
A
When evaluating information accessed over the Internet, an important question the nurse should teach the patient to ask is what? A) Is the information anecdotal? B) Where has this information been obtained? C) Is this information paid for by the drug company? D) How many patients have had input into the information?
A
With the need to protect our environment, what is it now important for the nurse to teach patients to do? A) Dispose of drugs no longer used on an annual basis. B) Flush drugs down the toilet. C) Bury unused in the yard. D) Throw unused pill bottles in the trash in original containers.
A
The nurse needs to ask what specific questions when collecting a drug history? (Select all that apply.) A) "Do you take any over-the-counter medications?" B) "Do you take any herbal supplements?" C) "Do you use any alternative therapies?" D) "Do you take any natural supplements or vitamins?" E) "What unusual therapies do you take?"
A,B,D
When a drug is ordered off-label, what must the nurse be clear about before administering the drug? (Select all that apply.) A) Why the drug is being given B) Its potential for problems C) The research that has been done D) The age group it was pretested on E) The intended use
A,B,E
What concerns might the nurse legitimately have related to the use of alternative therapies? (Select all that apply.) A) The Food and Drug Administration (FDA) does not test or regulate active ingredients. B) The incidental ingredients are clearly marked on the label. C) The dosage contained in each tablet may vary greatly. D) No alternative therapies have been found to be effective. E) Advertising of alternative products is not as restrictive or accurate.
A,C,E
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do? A) Administer the drug as ordered. B) Question the prescriber concerning the ordered drug. C) Ask a coworker his or her thoughts about the ordered drug for the patient. D) Ask the patient why the drug has been prescribed for him or her.
B
A patient calls the clinic and asks to speak to a nurse. The patient questions the nurse about the use of a drug that was advertised on TV. The patient tells the nurse he or she is sure that the drug will make him or her feel the same way as described in the commercial. What response is most appropriate for the nurse to make? A) "I'm glad that you want to be involved in treatment decisions but you are not qualified to decide what medications are best for your condition." B) "It's important to remember that drug advertisements emphasize the positive effects of drug therapy and not the adverse effects or contraindications." C) "You need to remember that the drugs being advertised are much more expensive than other drugs that have the same effect." D) "I've seen those advertisements and I would want to take that medication too if I had the condition it was designed to treat."
B
The nurse receives a call from a frantic mother saying, "My child swallowed some of my birth control pills. Should I give Ipecac?" What is the nurse's best response? A) "Yes, give Ipecac and follow the dosage directions on the bottle." B) "Ipecac is not effective for this use so you should not give it to your child." C) "Give the Ipecac only if you are absolutely sure your child swallowed the pills." D) "No, don't give Ipecac because it will cause your child to vomit and make a mess."
B
Today, an abundance of information is available in the health care arena for consumers, resulting in the nurse encountering patients who have a much greater use of what? A) Over-the-counter (OTC) therapies B) Alternative therapies C) Prescription drugs D) Off-label drugs
B
When patients do not understand the information provided with their medication, whose responsibility is it to help them sort through and comprehend the meaning? A) Care giver B) Nurse C) Patient D) Physician
B
Because of the amount of care now being done in the home care setting, it is imperative that the nurse teach the patients what? (Select all that apply.) A) Care givers' educational level. B) Generic names of medication C) Over-the-counter (OTC) drugs that need to be avoided D) Alleviation of adverse effects E) How to calculate safe dosages
B,C,D
Federal guidelines state that when advertising a drug, if the company states what the drug is used for, what other information must also be included in the advertisement? (Select all that apply.) A) Symptoms B) Contraindications C) Adverse effects D) Precautions E) Cost
B,C,D
According to Center for Disease Control and Prevention (CDC) recommendations, what is the role of the nurse in preparing for the possibility of bioterrorism? A) Post updated information on signs and symptoms of infections caused by biological agents B) Provide guidelines for treating patients exposed to, or potentially exposed to, biological agents C) Remain current on recognition and treatment of infections caused by biological weapons D) Advocate for increased funding for research involving bioterrorism and patient treatment
C
How has the patient's access to drug information changed the way the patient interacts with the nurse and other health care providers? A) Patients share information from research reports with health care providers. B) Patients are contacting drug companies to see what their latest reports say. C) Patients are more likely to challenge the health care provider with their own research. D) Patients are more likely to self-prescribe and not obtain prescriptions from their health care provider.
C
It is important for the nurse to be aware of what related to the way drugs are marketed? A) The adverse effects the advertisements do not mention B) What magazines and Web sites contain the advertisement C) What patients are seeing in the advertisements about these drugs D) The name of the cheerful, happy models who are advertising these drugs
C
The nurse is providing an inservice on alternative therapies for peers and explains that the term "alternative therapies" includes what? A) Holistic drug therapy B) Hospice care C) Nondrug measures D) Home care
C
The patient tells the nurse that he or she has begun ordering his or her medications over the Internet because it is cheaper. What statement made by the nurse in response to this information is accurate? A) All drugs are manufactured with the same quality controls. B) Any drug that is shipped into this country is safe to use. C) Foreign drugs may have the same name as domestic drugs, but they are not the same drug. D) If you order from Canada or Mexico, the drugs are safe because they undergo testing.
C
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication? A) Antihistamines B) Analgesics C) Antibiotics D) Oral contraceptives
D
A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC) Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this issue to a health care provider. As part of the teaching plan for this patient, the nurse explains what risk associated with not sharing OTC drug use with the provider? A) The OTC drug could be more expensive than seeking health care advice. B) The drug could mask symptoms of a serious problem that is undiagnosed. C) Use of the drug could cause a rebound effect of Pepcid. D) The drug could interact with several cold medicines.
D
How can the nurse find the most up-to-date information about emergency preparedness related to bioterrorism agents? A) Read textbooks devoted to the topic. B) Ask coworkers to explain current events. C) Read journal articles about bioterrorism agents. D) Visit the Centers for Disease Control and Prevention (CDC) Web site.
D
The clinic nurse is talking with a patient about information concerning a drug her or she bought online. What is the nurse's responsibility to the patient concerning this information? A) Encourage the patient to seek information about drugs from a pharmacist. B) Explain that information obtained from the Internet is not always accurate. C) Offer the patient a drug reference guide to read and learn more about the drug. D) Interpret the information and explain it in terms that the patient will understand.
D
The increasing number of patients who go to their health care provider and request a drug they have seen advertised on television or in a magazine has created what continuing challenge to health care providers? A) Treating infections appropriately B) Treating sicker patients C) Prescribing cost-effectively D) Staying knowledgeable about drug therapy
D
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes? A) St. John's wort B) Kava C) Fish oil D) Ginseng
D
The patient calls the clinic and talks to the nurse saying, "I found the same drug the provider prescribed on the Internet and it is much cheaper. Is it safe for me to order my drug from this site?" What is the nurse's best response? A) "It is usually safe to order drugs from Internet Web sites if it is a reliable site." B) "Most drugs ordered online come from another country and are safely used there." C) "The drug you get will be the same chemical prescribed but the dosage may differ." D) "The Food and Drug Administration (FDA) has issued warnings to consumers about the risk of taking unregulated drugs."
D
The patient calls the clinic nurse and says, "I looked this medication up on the Internet after it was prescribed yesterday and there is nothing in the literature about this drug being used to treat my disorder. Should I still take it?" What is the nurse's best response? A) "No, stop taking it immediately until I can consult with the doctor because it is obvious a mistake was made." B) "Oh, that's okay. Go ahead and take it because the doctor wouldn't order it if he or she didn't think it would be effective." C) "It is quite common for drugs to be found to have positive effects for a condition not originally intended so it is safe to take." D) "Let me talk with the physician about why this medication was ordered for you and I will call you back."
D
What patient populations would the nurse expect is most likely to be prescribed a drug for an off-label use? A) Adolescent and middle-aged adult patients B) Patients with diabetes or heart disease C) Obstetric and neonatal patients D) Pediatric and geriatric patients
D