Pharmacology Prep U: Ch.2,3,4,

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?"

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."

The nurse educates an older adult about the seven prescribed medications to prevent medication-related reactions and adverse effects. Which client statement indicates the need for further clarification?

"The dietary supplement I used to take before admission to the hospital is all right to restart."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

When a drug is discontinued, what percentage of that drug will remain in the body after three half-lives?

12.5%

The recommended dose of a drug is based on drug evaluation studies and targeted to which population?

150-pound person

A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next?

Assess the client and notify the client's health care provider.

A client has developed a tolerance to a drug. How should the nurse address this when providing care?

Assess whether the client needs larger doses to achieve the effect.

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.

Which activity would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?

Compare the outcome expected with the actual client outcome.

The nurse receives an order for 2.5 mg of diphenhydramine for a client with a mild allergic reaction. The nurse is aware that this is an unusual order. What is the nurse's best action?

Contact the prescriber for clarification.

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.

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

Which statement best describes drug efficacy and toxicity in pediatric clients?

Drug dosage is altered by disease state and weight in children

A mother asks why she cannot use adult dosages of over-the-counter (OTC) medication for her 11-year-old child. Which explanation best demonstrates the nurse's understanding of the importance of the mother's question?

Drug therapy in children requires special considerations because of the child's size, developmental level, and organ function.

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?

Excretion is likely to take place slowly.

Which of the following would be least important to include when teaching a client about drug therapy?

How to report a medication error

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

Which route of administration is most likely to cause toxic effects?

Intravenous

What does the nurse need to do when there is any indication of an allergic reaction in clients?

Maintain the client's safety during drug therapy.

A 7-year-old child fell off a wood pile while playing and has been admitted to the ICU with multiple broken bones and internal bleeding. What factor related to drug therapy will be altered in this client?

Pharmacodynamics may be altered.

Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older?

Physiologic changes affecting all pharmacokinetic processes

Which nursing intervention would the nurse expect to do during implementation?

Providing client teaching about a drug therapy regimen.

An instructor is describing a specific area on a cell membrane where most drugs are thought to act. The students demonstrate understanding of this information when they identify this area as what?

Receptor site

A client with hypertension has been taking spironolactone, a potassium-sparing diuretic, 75 mg PO daily for several weeks. What assessment findings should prompt the nurse to suspect hyperkalemia? (Select all that apply.)

Reports thigh and calf cramps Heart rate of 58 beats per minute Blood pressure is 88/63 mmHg Urine output of 375 mL over the past 24 hours

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

During a health care visit, a client reveals having stopped taking a prescription because the drug made the mouth dry. What would be most appropriate for the nurse to do?

Suggest taking frequent sips of water or sucking on hard candy.

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 client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

Which statement is true about a nursing diagnosis?

The nursing diagnosis relates the client's status.

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

Toxicity

An experienced nurse has observed that female clients sometimes experience a drug's effects for a longer time than male clients of similar age and size. The nurse should attribute this to what factor?

Women have more fat cells so drugs depositing in fat will have a prolonged effect.

Before administering a macrolide antibiotic, the nurse should question the order for what client?

a 12-year-old boy with hearing loss

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?

a decrease in urine output

Which are examples of things that should be included as part of the nurse's initial assessment? (Select all that apply.)

allergy history occupational history vital signs pregnancy status

Relatively few drugs act by mechanisms other than combination with receptor sites on cells. What drugs do not act on receptor sites? (Select all that apply.)

antacids osmotic diuretics purines

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 client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications.

An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes:

digoxin and Lanoxin are the same medications.

A nurse has been assigned the task of preparing educational materials for clients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or the health care provider. Which information is essential to include in the educational materials?

drug administration method

What would the nurse expect to assess if a client develops neuroleptic malignant syndrome?

hypertension

With buccal medications, what factor affects absorption?

integrity of the mucous membranes

What drug administration route should be used to assure the best bioavailability as any particular drug?

intravenous

A nurse is reading an article that describes predictable differences in the effects of drugs in people of particular culture backgrounds due to their genetic makeup. The nurse is reading about:

pharmacogenomics

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

When determining the half-life of a drug, what must be taken into account? (Select all that apply.)

rate of absorption distribution to the tissues excretion rate

Penicillin causes bacterial cell death without disrupting normal human cell functioning. This is an example of:

selective toxicity.

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications?

Drugs can cause unexpected reactions even after thorough screening and testing.

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation.

A nurse has committed a medication error. After ensuring the client's safety, the nurse should perform what action?

Report the event according to the health care facility's policies.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level.

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.)

a 29-year-old client receiving prenatal care in her first trimester of pregnancy a 37-year-old client who is taking fertility drugs

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus.

A nurse has been administering a drug to a client intramuscularly (IM). The health care provider discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to:

first-pass effect

A client is scheduled for a test. Prior to the test, the client must be premedicated. When administering the prescribed pre-procedure sedative, the nurse is performing an intervention associated with what step of the nursing process?

implementation

Drug excretion occurs mainly in which organ?

kidneys

What is the nursing diagnosis the framework for?

nursing interventions

A client will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During client education about drug regimen, the nurse should prioritize teaching about:

potential adverse effects of the drugs that the client will be taking.

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"Do you remember what happened the last time you received penicillin?"

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 nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose?

"We want to make sure you get the benefits of the drug as quickly as possible."

A nurse is teaching a caregiver of a client diagnosed with AD about the medications. What are necessary to include in the teaching about rivastigmine? Select all that apply.

Rotate sites to a dry area daily. Document the placement of the medication. Place the medication on an area where the client will not pick at or remove.

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic response.

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.

A client's most recent laboratory result indicate an elevated potassium level. What drug in this client's medication regimen should the care team consider discontinuing? You Selected:

diuretic

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.

Mental dysfunction in an older adult may seem like a normal part of aging, but it can result from disease or another cause. What should the ER staff do first for a presenting older adult with a mental dysfunction such as extreme confusion?

Review the drugs being taken.

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.

Anaphylactic 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.

Which factor should the nurse take into account when administering medications to older adults on the unit?

As a result of age-related changes, older adults face an increased risk of adverse medication effects.

The client has a daily antihypertensive medication prescribed. Taking the blood pressure prior to administration of the medication is which step of the nursing process?

Assessing

A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?

I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice?

Integrating the new drug into the client's existing schedule promotes adherence.

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

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

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

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.

The nurse understands that an admission assessment is completed to accomplish what goal?

Collect data

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

During assessment, a nurse asks a client about any chronic conditions that might have an impact on the client's prescribed drug therapy. What issue, if reported by the client, would alert the nurse to a possible problem?

kidney disease diagnosed 2 years ago

A client has been brought to the emergency department (ED) following a cold water incident. Which would be a potential effect of medication absorption from this clinical manifestation?

less than therapeutic effect

The nurse is assessing an older client's response to various medications the client is taking. The nurse knows that which body systems require close assessment for impairment? (Select all that apply.)

Cardiovascular Hepatic Renal

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.