Pharmacology PrepU's

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The health care provider ordered 8 mg of morphine sulfate IM. Morphine sulfate is available as 10 mg in a 1-mL vial. How many milliliters will the nurse administer to this client?

0.8

A nurse is performing the following activities. What is the proper sequence of the steps as suggested by the nursing process? A. Questioning the client about medications and health history B. Identifying if the client is at risk for skin breakdown C. Analyzing for changes in the client's condition D. Obtaining the client's weight and vital signs E. Instructing the client to take the medication with meals

1. A 2. D 3. B 4. E 5. C

A client is admitted to the medical unit for the treatment of an abscess resulting from intravenous drug use. When planning this client's discharge education with regard to medication use, what nursing diagnosis is most likely? A. Ineffective self-health maintenance B. Risk for Impaired Liver Function C. Unilateral neglect D. Deficient Fluid Volume

A client is prescribed acetaminophen 1 g every 6 hours. The acetaminophen is supplied in a multidose container. The label reads 500-mg tablets. The nurse would administer how many tablets? A. 2 B. 1 C. 3 D. 4

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize: A. blood urea nitrogen and creatinine levels. B. skin integrity. C. AST, ALT and bilirubin levels. D. sodium, potassium, and chloride levels.

A female client calls the clinic and states she has been taking propranolol for the last week to help decrease the incidence of migraine headaches. The client states that there has been no decrease in the number of headaches yet. What is the nurse's best response? A. "It may take up to 3 months to know whether this medication will be effective in preventing your migraine headaches." B. "Try to drink more decaffeinated beverages and see if that helps decrease the number of headaches you are having." C. "The medication will be more effective if you try to relax a little bit more." D. "I'm sorry the medication hasn't worked for you. The health care provider will try a new medication."

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? a. Drug therapy in children requires special considerations because of the child's size, developmental level, and organ function. b. Drug therapy for neonates, infants, and children is prescribed based upon age. c. It is a generally safe practice to give an 11-year-old half of the suggested adult dosage. d. Children younger than 16 years of age should never be given OTC medications.

A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement? A. milliliter B. ounce C. unit D. gram

A nurse is preparing to give a client an extended-release medication. For how long will the effects of this type of drug typically last? A. 12 to 24 hours B. 3 to 6 hours C. 24 to 36 hours D. 6 to 12 hours

A student nurse is administering medications at a long-term care facility. Which of the following liquid medications is for topical administration? A. Eye drops B. Syrup C. Mouthwash D. Tincture

During a medication pass, the nurse notices that the health care provider ordered a dose of medication that appears to be excessive based on the nurse's knowledge of the medication. The nurse calls the provider, and the provider instructs the nurse to administer the medication anyway. What should the nurse do? A. Consult with the nursing supervisor, refuse to administer the medication, and notify the provider. B. Refuse to administer the medication, and notify the provider. C. Administer the medication. D. Ask the provider on-call for a new order.

The best site selection for a 2-mL intramuscular injection on a 16-month-old infant would be: A. Rectus femoris muscle. B. Deltoid muscle. C. Dorsogluteal muscle. D. Gluteal muscle.

The care provider has prescribed intravenous hydromorphone for a client using client-controlled analgesia (PCA) pump. The nurse is aware that this drug has a high abuse potential. Under what category would hydromorphone be classified? A. schedule II B. schedule IV C. schedule I D. schedule III

The client expresses relief to the nurse after being prescribed a new medication, stating that the client expects to experience great benefits. The nurse suspects this drug will be more effective than usual for this client because of what effect? A. placebo effect B. cumulative effect C. first-pass effect D. cross-tolerance effect

The nurse instructs the client that some drugs are no longer covered under patent and may be less expensive. What type of drug is the nurse describing? a. generic b. orphan drug c. controlled drug d. brand name

The nurse is caring for a client scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the client has an important medication due but it is supposed to be given orally. What is the nurse's best action? A. Call the ordering health care provider and clarify administration. B. Give the medication with a small sip of water. C. Hold the medication and put a note on the front of the chart for the surgeon. D. Give the medication via a different route.

The nurse is caring for an older adult and is teaching the client about medications. The nurse should address what topic during medication education? a. adverse effects b. paradoxical effects c. teratogenic effects d. toxic effects

The nurse is conducting client education for a newly diagnosed diabetic. The order is for 32 units of insulin. The insulin is supplied in a multidose vial that is labeled 100 units/mL. How many cc of insulin would be needed to treat this client? A. 0.32 cc B. 0.032 cc C. 3.2 cc D. 32 cc

The nurse is preparing to administer medications via a client's gastrostomy tube. The health care provider has ordered an extended-release medication. What is the nurse's most appropriate action? A. Call the health care provider and ask for an order for a different formulation of the medication. B. Do not administer the medication because it may clog the gastrostomy tube. C. Crush the capsule and flush the medication with at least 60 mL of water. D. The nurse should open the capsule and empty the powder into 30 mL of water.

The nurse notifies the health care provider that a client receiving a heparin infusion has an abnormally prolonged aPTT result and GI bleeding. What drug will the provider order to antagonize heparin? A. Protamine sulfate B. Vitamin K C. Narcan (naloxone) D. Acetaminophen

The nursing student has learned that drug labels contain two names: trade name and generic name. The student demonstrates an understanding of the differences between the two when stating which of the following? A. The trade name is the same as the brand name. B. The generc name is usually capitalized on the label and the trade name is written in a smaller print. C. Often the trade drug is less expensive than the generic. D. The generic name is the same as the brand name.

What information indicates the client should not take acetaminophen for relief from chronic headaches? A. The patient has elevated liver function test (LFT) results. B. The patient has a decreased hemoglobin and hematocrit (H&H;). C. The patient reportedly takes aspirin daily. D. The patient drinks caffeine every day.

When discussing the various categories of controlled substances, the nurse should provide which example of a schedule III drug? A. Testosterone B. Meperidine C. Heroin D. Pentobarbital

When drugs are bound to proteins in the blood, they can be transported to different areas of the body. The protein-drug complex is relatively large and cannot enter into capillaries and into tissues to react. What must occur for drugs to do their job in the body? a. The drug must be freed from the protein-binding site. b. The binding site on the protein must pick up another chemical to interact with the drug to make it soluble in the serum. c. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues. d. The protein-drug complex must break itself into smaller pieces to enter the capillaries.

Which activity would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy? A. Compare the outcome expected with the actual client outcome. C. Ask questions to prepare an effective client education program. D. Reconsider core drug knowledge and core client variables. E. Establish a baseline for the client's treatment and care.

Which characteristic allows for a drug to be stored in the body and released as needed? A. protein bound B. being inert C. having a long half-life D. being unbound

Which medication prescription by the health care provider will require the nurse to seek clarification? A. Heparin 5,000 u SC every day B. Meperedine 25 mg. IM every 4-6 hours PRN C. Warfarin 5 mg. PO every evening at 6 PM. D. Furosemide 20 mg. IV every 8 hours.

Which statement best describes drug efficacy/toxicity in pediatric clients? A. Drug dosage is altered by age and weight in children. B. Drug requirements for infants have been extensively studied. C. Children always need smaller doses of medication than adults. D. Infants and children are always at greater risk for drug toxicity with any medication.

People and companies that are legally empowered to handle controlled substances must follow what procedures? (Select all that apply.) a. Provide for secure storage of controlled substances. b. Be registered with the DEA. c. Keep accurate records of all transactions. d. Be registered with the FDA. e. Educate health care professionals about adverse effects of controlled substances.

A, B, C

Which are true of nonprescription drugs? (Select all that apply.) A. They are referred to as over-the-counter drugs. B. They have certain labeling requirements. C. They should be taken only as directed on the label. D. They require a prescription to obtain. E. They can be taken without risk to the client.

A, B, C

Which of the following are the three specific items found on a drug label needed to administer a drug? Select all that apply. A. Dosage form B. Dosage strength C. Drug name D. Side effects E. Monitoring parameters

A, B, C

Which are examples of things that should be included as part of the nurse's initial assessment? (Select all that apply.) A. occupational history B. pregnancy status C. allergy history D. treatment response E. vital signs

A, B, C, E

Which of the following are environmental factors that lead to errors in the calculation of drug doses? Select all that apply. A. Heavy workload B. Interruptions C. Noise D. Temperature E. Poor lighting

A, B, C, E

The health care provider has ordered intravenous pain medication for a client. Why are medications given intravenously? Select all that apply. A. There is less irritation to the tissues. B. It is effective when the client has impaired circulation. C. It provides slower onset and longer duration of the medication. D. A smaller dose of the medication is needed to cause the desired effect.

A, B, D

What are the elements of the pharmacokinetic phase of drug activity? (Select all that apply.) a. active transport B. half-life C. alterations in cellular environment D. first-pass effect E. biotransformation

A, B, D, E

The nurse understands the importance of correctly reading drug labels when calculating dosages. Which of the following are included on labels and needed to adminster a drug correctly? (Select all that apply.) A. drug name B. drug form C. side effects D. drug incompatibilities E .dosage strength

A, B, E

The client asks the nurse, "Is it safe to take over-the-counter (OTC) medications with prescription medications?" What are appropriate responses by the nurse? (Select all that apply.) a. "OTC medications could mask or hide signs and symptoms of a disease." b. "Taking OTC medications can make your prescription medication more effective." c. "It is important to tell your provider all medications you take, including OTC." d. "OTC medications can interact with prescription medications." e. "You should avoid taking any OTC medication when taking prescription drugs."

A, C, D

The nurse must use the metric system in dosage calculations. Which conversions are correct? (Select all that apply.) A. 1 milligram = 1000 micrograms B. 1 gram = 100 milligrams C. 1 gram = 1000 milligrams D. 1 kilogram = 1000 grams E. 1 gram = 10 milligrams

A, C, D

Which of the following is part of the concept known as the five + 1 rights of drug administration? Select all that apply. A. Right patient B. Right prescriber C. Right route D. Right drug E. Right documentation

A, C, D, E

What is the nurse responsible for when a drug is prescribed to a client? Select all that apply. A. Reporting adverse reactions. B. Checking for drug-drug interactions. C. Administering the drug to the client. D. Teaching the client information needed to administer drugs safely at home. E. Monitoring for therapeutic response.

A, C, D. E

The nurse teaches a parent the importance of administering appropriate dosages of acetaminophen when the client's infant has a fever. What information should the nurse provide to this client? Select all that apply. a. "Children's dosages will change with time as they grow." b. "An infant's dose of acetaminophen is about ½ of an adult dose." c. "It is important to give the right dose to prevent toxic effects of the medication." d. "In most cases, infants cannot be given medications because of their immature organs." e. "Infant's and children's doses should be based on their weight or age."

A, C, E

What would the nurse expect to assess in a client experiencing an anaphylactic reaction? (Select all that apply.) A. dilated pupils B. swollen joints C. difficulty breathing D. high fever E. feeling of panic

A, C, E

Which of the following factual knowledge should the nurse have prior to administering a drug? Select all that apply. A. Drug's general action B. Special precautions in administration C. Drug's most common adverse effects D. Normal dosage range E. Reason for use of the drug

ALL OF THE ABOVE

A 12-year-old patient presents to the clinic with migraines. The mother states, "I would like her to have sumatriptan, as that is the drug that helps me the most." What is the best information for the nurse to give the mother? A. "We will need to assess if this medication will help your child as well." B. "The triptans are not usually prescribed for children, because safety has not been established." C. "Children do not usually like to receive shots." D. "We will have to give the medication at a lower dose for your daughter."

A client calls the clinic and asks to speak to a nurse. The client questions the nurse about the use of a drug that the client saw advertised on TV. The client believes the drug will make the client feel the same way as described in the commercial. What would be an appropriate response by the nurse? A. "You probably will feel the same way, however, you need to remember that all drugs have adverse effects." B. "It's important to remember that drug advertisements emphasize the positive effects of drug therapy and not the adverse effects or contraindications." C. "How do you know that the drug will make you feel that way?" D. "You will have to talk to your health care provider about that."

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? A. giving the drug with food in order to delay absorption B. administering the drug intravenously rather than orally C. administering the drug in small, frequent doses D. limiting the client's protein intake and encouraging fluids

A client has had symptoms of a migraine headache approximately 2 to 3 days per week for the last 3 months. The nurse is aware that this client has developed what condition? A. Tension headache B. Chronic migraine headache C. Brain tumor D. Cluster headache

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating: A. chicken. B. grapefruit. C. cheese. D. corn.

A drug being tested is removed from testing during a phase II study. What would be the most likely reason for the drug being removed from testing? a. lack of participants for clinical trials b. unacceptable adverse effects c. patent violation d. likelihood of prohibitive cost

A nurse who had been caring for a client with a cardiac disorder has to now provide care on an outpatient basis. What information should the nurse provide to this client who is willing and now able to manage the treatment regimen? A. composition of the drug B. method of drug administration C. disorders treated using the drug D. contraindications of the drug

A patient states, "I am not going to take this propranolol (Inderal) any more for my migraines. I have taken it for 3 days and it just does not work!" What should the nurse say to the patient? A. "I can call your healthcare provider to have another medication ordered." B. "The medication takes several weeks to be effective." C. "The medication is experimental." D. "The dosage can be increased."

An elderly client experiencing recurrent tension headaches reports taking an over-the-counter (OTC) combination of acetaminophen, aspirin, and caffeine several times a week. The nurse should recognize that this combination medication may be contraindicated if the client has a history of what medical condition? A. contact dermatitis B. gastrointestinal (GI) bleeding C. coronary artery disease D. peripheral vascular disease

Effectiveness of medication therapy is associated with which phase of the nursing process? A. Planning B. Evaluation C. Analysis D. Assessment

Mrs. Hone asks the nurse to open her Effexor XR capsule and mix the contents in applesauce to make it easier to swallow. How should the nurse respond? A. "Not a problem; I will mix the medication for you." B. "I am sorry, but opening the capsule may cause you to absorb too much medication too quickly." C. "Effexor XR may only be mixed with food with a provider's order." D. "The health care provider gave you this form of your medication because it is easier to take by mouth."

The charge nurse on the unit transcribes a health care provider's order onto the medication administration record. The nurse writes, "Digoxin 0.25 mg PO qod ×3d" on the MAR. How should the order be written to prevent medication error? a. Digoxin 0.25 mg PO every other day ×3d b. Digoxin 0.25 mg by mouth every other day for three doses c. Digoxin 0.25 mg PO qod ×3d d. Digoxin 0.25 mg PO qod for three doses

The client requests an oral pain medication. The nurse notes that the client is NPO in preparation for laboratory tests. What is the nurse's best response to this client? A. "You are not allowed to have any medication by mouth right now. I will give you this medication in an injection." B. "I will contact your health care provider and ask for an order for a different method of drug administration." C. "I will check with your health care provider and see if it will be all right for you to take a pain pill." D. "You will have to wait for this medication until you eat and drink again."

The health care provider orders a client to receive 1000 mL of intravenous fluid over the next 12 hours. The intravenous delivery system is a microdrip system. The nurse would set the infusion to run at which rate? a. 42 gtts/minute B. 83 gtts/minute C. 120 gtts/minute D. 32 gtts/minute

The home care nurse is teaching a family member about transdermal medication administration. Which statement by the family member indicates a need for further instruction? A. "I will make sure to remove the old patch before I put a new one on." B. "I will throw the old patch away in the trash container in the kitchen." C. "I will wear gloves when I put the patch on my father." D. "I will put the patch between my dad's shoulder blades because of his confusion."

The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is now preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action? A. Intervention B,. Evaluation C. Assessment D. Nursing diagnosis

The nurse assigned to take care of a client is unable to read the primary care provider's handwriting. Which intervention is the most appropriate in this situation? A. The nurse should obtain a verbal order. B. The nurse should question the order with the primary care provider. C. The nurse should try to interpret the handwriting. D. The nurse should confirm the order with a nearby care provider.

The nurse is administering a subcutaneous injection and notices that there is blood in the syringe prior to injecting the medication. What is the nurse's best action? A. Withdraw the syringe and inject into a new site using the same syringe. B. Withdraw the syringe and prepare a new injection. C. Call the health care provider for an order of oral medication. D. Withdraw the needle slightly and continue to administer the injection.

The nurse is caring for a client who has received a prescription for naproxen sodium for the treatment of migraine headaches. This client also takes lithium carbonate for bipolar disorder. The nurse is aware that this client will be monitored for what condition? a. Decreased lithium levels b. Lithium toxicity c. Decreased naproxen effectiveness d. Increased chance of anaphylaxis

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing: a. secondary effects. b. antibodies. c. antihistamine. d. antigens.

The nurse is giving instructions to a client who has just been prescribed sumatriptan for the treatment of migraine headaches. The client will be instructed to take this medication at what time? A. Every 5 minutes until the pain goes away B. At the onset of migraine symptoms C. Every day at the same time D. After other migraine medications have been ineffective

The nurse is preparing to administer a prescribed drug and scans the client's hospital identification band, the drug unit dose package, and the identification badge. Which type of drug distribution system is the nurse using? A. unit dose system B. bar-coded point-of-care medication system C. multidose system D. automated medication management system

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize? A. orientation, judgment, and level of consciousness B. urine output and creatinine clearance C. electrolyte levels and heart rhythm D. fine motor skills and observation for tremors

The nurse understands that an admission assessment is completed to accomplish what goal? A. Initiate the plan. B. Collect data. C. Establish outcomes. D. Develop a nurse-client relationship.

The triage nurse in the emergency department admits a 16-year-old boy brought in by ambulance and accompanied by a friend. The client is in respiratory distress, is vomiting, and blood is noted in the vomitus. The client is somnolent and the electrocardiogram demonstrates an arrhythmia. The friend admits that the client took a "bunch of little green pills" from the cupboard at the grandparents' house. The nurse should recognize the likelihood of what adverse reaction? A. Anaphylaxis B. Poisoning C. Delayed hypersensitivity D. Serum sickness

Two years ago, a client was prescribed a medication to control hypercholesterolemia. Now the health care provider prescribes a higher dose of the medication due to enzyme induction. A student nurse asks the nurse to explain the change in the drug dosage. The nurse explains that with chronic administration, some drugs stimulate liver cells to produce: A. therapeutic amounts of drug-metabolizing enzymes. B. larger amounts of drug-metabolizing enzymes. C. toxic amounts of drug-metabolizing enzymes. D. smaller amounts of drug-metabolizing enzymes.

What beta-adrenergic antagonist is used for migraine prophylaxis? A. valproic acid B. propanolol C. verapamil D. topiramate

What client should not receive a nonsteroidal anti-inflammatory medication as ordered for migraine relief? A. The client who has arthritis B. The client with a gastric ulcer C. The client who drinks 10 cups of coffee a day D. The client who takes one aspirin per day for the prevention of heart disease

What is important for the nurse to teach the patient about sumatriptan (Imitrex)? A. The medication is excreted via the GI tract. B. The medication starts to work within about 90 minutes. C. The medication causes vasodilation. D. The medication has a duration of 3 days.

Which assessment finding would support a client's report of migraine headaches? A. Dull band of pain around the head B. Severe unilateral pulsating pain C. Sharp steady eye pain D. Onset occurring during sleep

Which client is receiving a drug that is an agonist? A. A client who is taking a selective serotonin -reuptake inhibitor B. A client who takes insulin several time daily for type 1 diabetes C. A client who takes a beta blocker for hypertension D. A client whose depression is treated with a monoamine oxidase inhibitor (MAOI)

Which of the following might help the nurse distinguish between the trade and generic names on a drug label? Select all that apply. A. The trade name is written in smaller print. B. The trade name is usually capitalized. C. The trade name is found under the generic name. D. The trade name is followed by a registration symbol. E. The trade name is often in parentheses.

B & D

A nurse should recognize what as a metric system unit? (Select all that apply.) A. teaspoon B. kilogram C. milliliter D. gram E. dram

B, C, D

The nurse has consulted a drug guide to confirm the recommended dosage range of a drug. The nurse should expect to see an adjusted dosage for what clients? Select all that apply. A. 22-year-old female B. 79-year-old male C. 2-day-old neonate D. 39-year-old male E. 6-month-old infant

B, C, E

What are nonpharmacological methods that can be used for tension headaches? Select all that apply. A. Diet of fruits and vegetables B. Rest C. Deep breathing exercises D.. Exercise E. Stress reduction strategies

B, C, E

A client has developed a tolerance to a drug. How should the nurse address this when providing care? a. Assess the client for signs and symptoms of adverse drug effects. b. Assess the client for signs and symptoms of an allergy to the drug. c. Assess whether the client needs larger doses to achieve the effect. d. Advocate for a change in the client's medication.

A client is prescribed sumatriptan. Which statement should be included in the teaching plan regarding how the medication works? A. "It relaxes smooth muscles of the cardiovascular system." B. "The medication impairs the reuptake of norepinephrine." C. "It produces vascular constriction of cranial blood vessels." D. "The medication causes bronchiole constriction."

A client will have bowel surgery in the morning. The health care provider orders 500 mL of GoLytly PO starting at 5 PM this evening. What would this amount be in liters? A. ¼ B. 1 C. ½ D. ¾

A health care provider instructs a nurse to administer a drug to a client STAT. What should the nurse perform in this situation? A. Document the administration of the drug only after receiving the provider's order. B. Forgo obtaining the provider's order after the drug has been administered. C. Administer the drug as instructed by the health care provider. D. Insist on obtaining a written report before administering any drug.

A nurse is preparing to give a client an intermittent infusion. How much fluid would the nurse know that the infusion will be diluted with? A. 150 to 200 mL B. 25 to 50 mL C. 50 to 100 mL D. 100 to 150 mL

A nurse is to give an intermittent infusion. Approximately how long will it take for the infusion to be given? A. 50 to 100 minutes B. 60 to 120 minutes C. 30 to 60 minutes D. 5 to 10 minutes

A nurse who had been caring for a client with a cardiac disorder has to now provide care on an outpatient basis. What information should the nurse provide to this client who is willing and now able to manage the treatment regimen? A. contraindications of the drug B. disorders treated using the drug C. method of drug administration D. composition of the drug

A patient is receiving chlorpromazine hydrochloride (Thorazine) for migraine headache. What will the nurse teach the patient about this therapy? A. This medication will increase photophobia. B. This medication will decrease anxiety. C. This medication is an antiemetic as well as a pain medication. D. This medication will increase alertness.

A woman who has just found out she is pregnant states she has "always taken sumatriptan for her migraines." What is the best advice for the nurse to give this patient? a. "You can continue to take your medication as prescribed." b. "Take half the dose that you previously took before becoming pregnant." c. "Ask your healthcare provider what other medications you can take." d. "Try to control your migraines with behavior modification."

An older adult client who lives independently has just been prescribed a drug that can cause sedation. What would be the priority nursing diagnosis for this client? A. Risk of suffocation B. Risk for vascular trauma C. Risk of injury D. Wandering

At 0700 (7 AM) the health care provider has ordered the nurse to begin an IV infusion and has ordered the client to receive 125 mL/hr of IV fluid. At what time will the nurse be prepared to hang the next liter of IV fluid? A. 1300 (1 PM) B. 1600 (4 PM) C. 1500 (3 PM) D. 1400 (2 PM)

How many milligrams are in 1 gram? A. 10 B. 0.1 C. 1000 D. 100

The nurse administers ergotamine tartrate (Ergot). What is the expected pharmacologic effect? A. Suppression of pain B. Drowsiness C. Vasoconstriction D. Diuresis

The nurse checks a client's temperature before administering a standing prescription for acetaminophen for temperatures over 100°F (37.8°C). The client's temperature is 98.9°F (37.2°C), so the nurse decides to withhold the dose of acetaminophen. Withholding the dose represents which phase of the nursing process? A. evaluation B. analysis C. implementation D. planning

The nurse is administering an antibiotic to a client with a diagnosis of cellulitis of the left leg. Which client condition would have the greatest effect on the drug's distribution? a. hypertension b. diverticulitis disease c. peripheral vascular disease d. liver dysfunction

The nurse is caring for a client who experienced a severe headache. When the prescribed dose of analgesics did not cause relief the client took double the dosage one hour later. The nurse should assess the client for what adverse effect? a. anaphylactic reaction b. sedative effects c. poisoning d. an allergic reaction

The nurse is conducting the evaluation phase of the nursing process. The nurse should perform evaluation primarily based on what data? A. The client's adherence to the drug regimen B. The client's knowledge of the drug regimen C. Whether the client is achieving health outcomes D. The absence of adverse medication effects

The nurse is establishing goals for a client related to a new medication administration. Which phase of the nursing process is characterized by goal setting? A. Analysis B. Evaluation C. Planning D. Implementation

The nurse is in the hall outside Room 433 preparing medications when a member of the client's family in the adjacent room 432 approaches the nurse and asks a question. What is the nurse's best action in this situation? A. Stop the medication administration, answer the family member's question and resume the medication administration. B. Push the medication cart into Room 432 and discuss the issue while finishing the medication for Room 433. C. Explain to the family member that the nurse is unable to discuss the situation at this time but will return later. D. Lock the medication cart and go into Room 432 with the family member.

The nurse is preparing to administer a medication to an older adult. The nurse should consider what factor that could affect therapeutic dosing in an older adult? A. In older adults, drugs are distributed to a smaller portion of the tissues. B. Drugs are likely to have decreased therapeutic effect C. Changes in the gastrointestinal (GI) system can reduce drug absorption. D. In older adults, drugs enter into circulation more quickly.

What is essential for the nurse to assess prior to the patient taking sumatriptan-naproxen sodium (Treximet)? A. If the patient is nauseous B. If the patient is able to eat with the medication C. The patient's cardiac history D. The patient's ability to administer an injection

What is the procedure for dividing fractions? A. Both numbers are changed to improper fractions. B. The whole number is first changed to a fraction. C. The second fraction is inverted and the fractions are multiplied. D. Mixed numbers are changed to improper fractions.

When providing drug therapy to a client, what is a responsibility of the nurse? a. Encourage the client to increase or decrease dosages. b. Warn the client how most clients respond to the drug therapy. c. Teach the client how to cope with the effects of the drug to ensure the best outcome. d. Help the client analyze the physiological and pathological effects of drugs.

Which of the following would be most likely to occur during the planning or implementation step of the nursing process? A. Questioning the patient about his financial resources B. Obtaining information about the patient's chronic condition C. Developing appropriate outcomes for drug response D. Determining the patient's level of understanding

Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing? A. The National Council of State Boards of Nursing B. individual state boards of nursing C. The North American Nursing Diagnosis Association-International (NANDA) D. The Joint Commission

Which statement indicates that more teaching is necessary for the patient taking ergotamine? A. "I will not crush the tablet before taking." B. "I will rest in a dark room after taking the medication." C. "I will hold off taking the medication until the pain is unbearable." D. "I will not chew the tablet."

Which of the following are steps of the nursing process? Select all that apply. A. Reporting B. Documentation C. Assessment D. Planning E. Evaluation

C, D, E

Which of the following can a nurse do to help prevent drug errors? Select all that apply. A. Recheck all calculations. B. Always administer the drug before answering any client's questions. C. Avoid distractions and concentrate on only one task at a time. D. Practice the five + 1 rights of drug administration. E. Confirm any questionable orders.

C, D, E

Which of the following are examples of drugs with local effects? Select all that apply. a. Oral diabetes drugs b. Antihypertensive c. Cold sore medicine d. Sunscreen e. Wart medicine

C, D, E.

"Dose desired / dose on hand = dose administered" is the formula for calculating the dose to be administered. Under which circumstances is this to be used? A. When the dosage is written in the apothecary system. B. When the health care provider is not available to calculate the dosage. C. When the label of the drug is in the metric system. D. When the dose desired and dose on hand are in the same measurement system.

A client is experiencing difficulty swallowing a large oral tablet. What action by the nurse would be most appropriate? A. Ask the prescriber to change the medication to a parenteral form. B. Have the client drink a large glass of water to aid in swallowing. C. Contact the pharmacy to order the drug in liquid form. D. Check to determine whether the drug can be crushed or mixed with food.

A client prescribed sumatriptan as abortive therapy for migraines reports, "I took that pill about an hour-and-a-half ago, and I still don't feel any better. Can I take another?" How should the nurse respond? A. "It's probably advisable for you to go to the emergency department." B. "You can take another pill now and one more in 1 hour, but then no more." C. "Yes, it's likely safe to take one more dose of your sumatriptan." D. "Wait at least half-an-hour before you take another pill."

A client was prescribed a 10-day course of antibiotics for the treatment of sinusitis. The client experienced symptoms relief after three days and stopped taking the antibiotic at that time. What is a priority nursing diagnosis for this client? A. Acute Confusion B. Deficient knowledge C. Risk for injury D. Noncompliance

A client with a migraine took a prescribed dose of eletriptan (Relpax), and one hour later the headache is still intense. The client's husband calls the clinic and asks the nurse what they should do. What is an appropriate nursing response? a. "Tell her to lie down in a quiet cool room and just wait it out. It will subside." b. "Give her a dose of an ergot drug if you have it. It will decrease the intensity of the pain." c. "Ibuprofen may increase the action of the triptan." d. "She can take another dose of the drug 2 hours after the initial dose if the headache continues."

A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client? a. no general anesthesia, because general anesthesia should not be given to a client with her history b. the same dose of the general anesthetic as another female of her age and medical history c. a smaller-than-normal dose of the general anesthetic d. a larger-than-normal dose of the general anesthetic

A nurse has administered narcotics to a client. Which intervention should the nurse perform immediately after administering the drug? A. Monitor the vital signs of the client. B. Inform the client about the type of drug. C. Update the health care provider regarding the client's condition. D. Document administration of the drug.

A nurse is caring for a client with migraines. The prescriber orders subcutaneous sumatriptan. What type of treatment is this medication considered? a. Precautionary b. Addictive c. Preventative d. Abortive

A nurse is required to administer subcutaneous injections to a patient regularly. Which of the following interventions should the nurse perform in order to minimize tissue damage? A. Ensure that there is no hair on the injection site. B. Insert the needle at the appropriate angle. C. Select the needle length based on the patient's weight. D. Rotate the injection site regularly.

A patient who is the administrator of a large healthcare agency reports constant stress on the job, causing "tension headaches." What therapy will the nurse teach the patient to use? A. Running hands under cold water B. Oxygen therapy C. IV medication D. Nonsteroidal anti-inflammatory agents

A patient with migraine headaches has changed his diet and stopped drinking soda and coffee. The patient is seen in the emergency department with increased headaches. What is the nurse's best action? A. Keep the patient in a dark room. B. Have the patient drink coffee. C. Administer caffeine in pill form. D. Administer medication to help abort the migraine.

A question on a pharmacology test asks the students to define poisoning. What would be the best response? a. excessive responsiveness to either the primary or the secondary effects of a drug b. a primary action to a drug c. infections caused by the destruction of bacteria of the normal flora by certain drugs d. formation of antibodies to a drug or drug protein; causing an immune response

Both categories of migraine abortive drugs (ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and also have what potential? A. Manage hypertension B. Manage hypotension C. Lower blood pressure D. Raise blood pressure

The PCP orders amoxicillin 250 mg by mouth two times a day. The drug label reads "Amoxicillin 125 mg/5 ml." How much will the nurse administer? A. 2.5 mL B. 5 mL C. 7.5 mL D. 10 mL

The nurse administers almotriptan to a client because it is not contraindicated with what category of medications? A. Benzodiazepines B. SSRIs C. Phenothiazines D. MAOIs

The nurse at a campus medical clinic is administering a new medication to a 22-year-old female client. The nurse should educate the client about what potential risk of drug therapy? a. poisoning b. primary effects c. secondary effects d. teratogenicity

The nurse is administering medications and knows that there is a longer distribution time when the drug is intended for what area? a. kidney b. liver c. heart d. skin

The nurse is assessing the patient receiving chlorpromazine hydrochloride (Thorazine) as part of his therapy for migraines. What assessment indicates a therapeutic effect of this therapy? A. The patient is drowsy. B. The patient has amnesia about the pain. C. The patient has not had a seizure. D. The patient does not have nausea.

The nurse is caring for a patient with a migraine. What nursing diagnosis is a priority? A. Knowledge deficit B. Activity intolerance C. Anxiety D. Acute pain

The nurse multiplies and divides simple fractions when calculating drug doses for clients. Which fraction is a result of multiplying 2/5 by 5/8? A. 4 B. 16/25 C. 2/5 D. 1/4

The nurse observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize? A. Assessing the client for respiratory depression B. Assessing the client's lying, sitting and standing blood pressure C. Assessing the client for narcotic withdrawal syndrome D. Assessing the client for migraine pain

The patient asks how caffeine will help a migraine headache. How should the nurse respond? a. "Caffeine helps block prostaglandin." b. "Caffeine increases neurological function." c. "Caffeine helps you cope with the pain." d. "Caffeine causes constriction of blood vessels."

What client should not receive a nonsteroidal anti-inflammatory medication as ordered for migraine relief? a. The client who takes one aspirin per day for the prevention of heart disease b. The client who drinks 10 cups of coffee a day c. The client who has arthritis d. The client with a gastric ulcer

Which nursing intervention would the nurse expect to do during implementation? A. Developing statements about a client's actual problem. B. Obtaining baseline information about the client's pattern of health care. C. Identifying the client's social support network. D. Providing client teaching about a drug therapy regimen.

While providing care to a client who is prescribed a medication, the nurse identifies which client statement supports the diagnosis of Effective Self-Health Management? A. "I can afford my medications now." B. "I need to try to remember to take my medications every day." C. "I will take my medications only when I feel badly." D. "I will learn how to give myself this injection daily."

PHARM CHAPTER 3

A 57-year-old client is given morphine for myocardial ischemic pain. The nurse needs to monitor the client frequently for which adverse effect? a. Decreased respiratory rate b. Sweating c. Dizziness d. Urinary retention

A client is prescribed zolmitriptan for migraine headaches. The nurse should instruct the client to administer this drug by which route? A. Oral B. Intranasal C. Subcutaneous D. Sublingual

A nurse caring for a patient is describing steps for carrying out nursing activities that will assist in achieving patient goals. At which step of the nursing process is the nurse? a. Planning b. Implementation c. Evaluation d. Assessment

A patient reports feeling dizzy and anxious after taking sumatriptan (Imitrex) for a migraine. What is the nurse's best response? a. Have the patient sit down and wait for the dizziness to pass. b. Tell the patient to stop taking the medication. c. Call the healthcare provider. d. Instruct the patient to take an anti-anxiety medication with the Imitrex.

A patient with a cluster headache reports that the health care provider did not prescribe anything but "air." What is the nurse's best response to this statement? a. "Oxygen therapy has been shown to help relieve cluster headaches." b. "Drugs are not the answer for all headaches or pain." c. "Oxygen is a drug." d. "Oxygen therapy requires a prescription."

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: A. administer epinephrine as prescribed. B. administer monoclonal antibodies as prescribed. C. provide supplementary oxygen by nasal cannula. D. perform cardiopulmonary resuscitation.

The nurse is caring for a client with a brain infection of bacterial etiology. When administering medications to this client, what should nurse understand about the medication delivery method required by the client's diagnisis? A. The client will require lipid-soluble antibiotics. B. Active infection may destroy the integrity of the blood-brain barrier. C. The client's blood-brain barrier will not allow medications to affect brain tissue. D. Antibiotics will have to be injected directly into brain tissue.

The nurse is preparing to administer a liquid medication and notes that liquid from the bottle has stained the medication label. What is the nurse's best response to this situation? a. Contact the pharmacy for a new bottle of medication. b. Attempt to wipe the label with a clean, wet paper towel. c. Use the medication administration record (MAR) to determine the amount of medication to pour. d. Ask another nurse if this is the correct medication

Whereas some drugs or metabolites are excreted in bile and then eliminated in feces, others are excreted in bile, reabsorbed from the small intestine, and then returned to the liver. What is the name of this process? A. Enterohepatic recirculation B. Interohepatic recirculation C. Interorenal recirculation D. Enterorenal recirculation

Which medication therapy is correctly prescribed for the patient's condition? a. A patient with cluster headaches receiving oxygen therapy b. A patient with tension headaches receiving opioid therapy c. A patient with migraine headaches receiving oxygen therapy d. A patient with tension headaches taking caffeine

Which should be administered intradermally? (Choose one) a. PPD skin test b. Influenza vaccine c. Tetanus vaccine d. NPH insulin

The nurse assesses the client who has frequent migraine headaches. The client reports that headaches seem to occur more frequently when he eats which foods? (Select all that apply.) a. Diet beverages b. American cheese c. Chocolate cake d. Fried chicken e. Chinese food

a, c, e

A client reports nausea with a severe headache. On assessment, the nurse learns the client has vomited several times this hour. What is the best way to treat the client's migraine? A. Administer an antacid. B. Administer a subcutaneous triptan. C. Give the client dry crackers or pretzels prior to taking medication. D. Administer the oral medications, then assess to make certain the client retains the medication

A patient with frequent migraines has been prescribed valproic acid for her migraine. What should the nurse teach the patient? a. "Inject this medication subcutaneously." b. "This medication is taken daily." c. "This medication will prevent auras." d. "This medication is taken at the first sign of migraines."

The nurse is preparing to administer allergy skin testing. Through which parenteral route should the nurse administer drugs to the client to optimize results? a. intravenous b. intradermal c. subcutaneous d. interdermal

What statement indicates the patient needs more teaching about administering sumatriptan subcutaneously? a. "I can give the medication in my arm or leg." b. "I can take this medication safely when pregnant." c. "I will not drive after I take the medication." d. "I will not take more than two injections in 24 hours."

When describing the action of ergot derivatives, the nurse would incorporate understanding of: a. Inhibition of opioid receptors b. Blockage of alpha-adrenergic receptors c. Interference with dopamine d. Interference with cerebral enzyme systems

Which activity would a nurse do first? a. Teach a client about a drug's adverse effects. b. Ask the client about any chronic conditions. c. Identify a priority problem. d. Determine that drug has stabilized blood glucose levels.

A patient with frequent migraines is having her diet evaluated. What foods may precipitate the patient's migraines? Select all that apply. a. Salty meats b. Fermented foods c. Ice cream d. Diet soda with aspartame e. Aged cheese

b, d, e

A nurse is caring for a client diagnosed with migraine headaches. Which nursing intervention should be implemented during an acute headache? a. Administer diclofenac. b. Administer ergotamine subcutaneously. c. Administer subcutaneous sumatriptan succinate (Imitrex). d. Administer naproxen.

A nurse is caring for client who states, "I dislike hospitals because people die in them." What is the cause of 1 in 10,000 hospital deaths that occur each year in the United States? a. Bar coding systems b. Administration of a medication c. Calculating a medication dose d. Computerized medication order entry

A patient who self-administers garlic, St. John's wort, and echinacea is being evaluated for elective musculoskeletal surgery. What instructions should the patient receive to help minimize surgical complications? a. Continue only the garlic and echinacea. b. Maintain the current regimen c. Discontinue the herbal medications as instructed by the surgeon. d. Stop taking the herbal supplements immediately

During which phase of the nursing process would the nurse prepare and administer one or more drugs to a specific client? a. evaluation b. assessment c. implementation d. analysis

Identification of problems that can be solved or prevented by the nurse without involvement of the health care provider is known as which process? a. nursing evaluation b. nursing assessment c. nursing diagnosis d. nursing documentation

Opioids exert widespread pharmacologic effects, especially in the CNS and the gastrointestinal (GI) system. What are two major adverse effects of opioids that are potentially life threatening? a. constipation and restlessness b. Oliguria and restlessness c. Sedation and respiratory depression d. Hypertension and sedation

The nurse is providing discharge education for a frail older adult client who lives alone in an apartment. The client will soon be discharged from the hospital with several new prescriptions. What assessment should the nurse prioritize when determining the client's safety in the home setting? a. The client's financial status b. The client's education level c. The client's level of social support d. The client's plans and aspirations

When a drug is given at a stable dose, how many half-life periods are required to achieve steady-state concentrations and develop equilibrium between tissue and serum concentrations? A. 3 to 4 B. 2 to 3 C. 4 to 5 D. 5 to 6

When the nurse uses ratio and proportion to complete drug calculations, which formula would have the most potential for error? a. 1 L: 1,000 mL = X L: 895 mL b. 1000 g: 1 kg = X g: 1.7 kg c. 1 mg.: 1,0000 mcg = X mg: 0.620 mcg d. 1000 mL: 1 L = X mL: 0.85 L

Which of the following should be administered via subcutaneous injection? (Choose one) a. Influenza vaccine b. PPD skin test c. NPH insulin d. Tetanus vaccine

A nurse is caring for a client diagnosed with a migraine. The client received acetaminophen-aspirin-caffeine by mouth. Which method should be used to assess for the therapeutic effects of the medication? a. Subjective assessment b. Vital signs c. Glasgow coma scale d. Pain scale

A patient is prescribed naloxone for the treatment of postoperative acute respiratory depression after a kidney transplant operation. Which of the following should the nurse identify as the action of naloxone? a. Naloxone stops internal bleeding. b. Naloxone helps the patient overcome pain. c. Naloxone restores reflexes of limbs. d. Naloxone restores respiratory function.

A young mother asks the nurse why she cannot give her 2-year-old child an adult dose of acetaminophen. The nurse explains why this is unsafe. What statement would indicate that the mother needs further education? a. "There could be a time when my child may need a higher dose than normal." b. "My child's dose of acetaminophen should be based on her weight or age." c. "My baby can't handle a high dose of acetaminophen because her liver may be damaged." d. "My baby's dose of acetaminophen is based on a healthy adult male."

An 80-year-old male client presents to the emergency department with a fractured ankle and multiple abrasions and contusions. He is admitted to the hospital with an order for oxycodone for pain. Oxycodone may be prescribed for a geriatric client because the drug has which characteristic? a. It is metabolized by the liver. b. It has a long half-life and will manage bone pain more effectively. c. It is excreted by the kidney. d. It has a short half-life and is less likely to accumulate, causing toxicity or overdosage.

The client is having surgery this week. What information should the nurse give the client concerning the use of pain medication after surgery? a. Take as little pain medication as possible to prevent addiction. b. Wait as long as possible for pain medication; it will work more effectively. c. Request your pain medication whenever it is available to you. d. Ask for pain medication before the pain gets severe.

What is a priority nursing assessment of a client prescribed oral sumatriptan? a. Urinary output b. Glasgow coma scale c. Head to toe assessment d. Vital signs

What is a safety feature inherent in using the bar code method to administer drugs? a. The bar code on the drug label contains the client's name. b. When administering medications, the nurse is only required to scan the bar code on the drug label. c. A wireless computer network processes the scanned information and gives an error d. The bar code on the client's identification band contains the MAR.

Which client should not receive sumatriptan (Imitrex) as ordered? A. The client with urinary output of 30 mL/hour B. The client reporting nausea C. The client with a blood pressure of 140/95 mm Hg D. The client with an elevated BUN

Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids? A. hypotension B. insomnia C. drowsiness D. withdrawal symptoms

Which of the following would be least likely to occur during the assessment phase of the nursing process for drug therapy? a. Identifying the client's level of understanding b. Obtaining information about the client's drug use c. Determining relevant data about financial constraints d. Developing outcomes for effective response to drug therapy

The nurse is caring for a group of clients and is aware that which client may require a reduction in medication dosage? (Select all that apply.) a. client with cirrhosis of the liver b. client with meningitis c. client with cancer of the liver d. client with chronic hepatitis C e. client with a hip replacement

A, B, C

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? a. Provide supportive care to manage fever and inflammation. b. Administer naloxone as prescribed. c. Initiate emergency resuscitation measures. d. Administer subcutaneous epinephrine as prescribed.

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours? a. 31 mg b. 16 mg c. 125 mg d. 63 mg

A client's most recent laboratory result indicates an elevated potassium level. What drug in this client's medication regimen should the care team consider discontinuing? a. an antianxiety agent b. a narcotic c. an antipsychotic d. a diuretic

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention? A. serum drug level monitoring B. frequent administration of scheduled "drug holidays" C. regular changes to the administration route D. half-life analysis

A nurse has identified the half-life of drug that will be administered to a client for the first time. The nursing drug guide states the drug's half-life is 90 minutes. The nurse should identify what implication of this fact? A. Ninety minutes after drug levels peak, there will be 50% of the peak level B. In three hours, there will be no detectable levels of the drug presents in the client's body C. Drug levels will rise steadily after administration, reaching 50% of maximum concentration after 90 minutes D. Peak drug levels will be achieved 90 minutes after the drug is administered

According to Quality and Safety Education for Nurses (QSEN), what intervention will best help reduceH the risk of medication errors? a. Alerting other staff to minimize interrupting the nurse preparing medications b. Providing adequate lighting in the medication dispensing area c. Storing the drugs in alphabetical order to maximize organization d. Requiring staff to prepare all drugs for administration in areas away from patients and visitors

The nurse is caring for a client who is receiving Gentamycin, 250 mg, and Diflucan, 500 mg at the same time. What effect should the nurse anticipate if these two drugs compete with each other for protein binding sites? A. The effectiveness of both drugs will be altered B. Gentamycin will be metabolized faster than usual C. Potential positive benefits of each drug will cancel each other out D. Risks of adverse drug effects will increase

What statement describes a required characteristic of all generic drugs? a. Generic drugs must be therapeutically equivalent and less expensive than trade name drugs. b. Generic drugs are required to be protected by a current American patent. c. Generic drugs are designated and patented exclusively by the manufacturer. d. Generic drugs are categorized according to overall usefulness and potential for abuse.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean that the drug will: A. have a long duration of action. B. lead to toxicity when given. C. be released fairly quickly. D. be excreted quickly.

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? a. "Evidence is strong that the medication's benefits certainly outweigh any risks that have been noted." b. "The medication is now being prescribed for those diagnosed with acute depression." c. "I've found that there have been few post marketing reports of negative effects being submitted." d. "Volunteer recruitment for the study has been very successful."

A client is prescribed a combination of medications to treat the disease process. The client is exhibiting signs of toxicity related to the new drug regimen. A possible cause of the change in the absorption of the medications may be enzyme inhibition. What is true of enzyme inhibition? (Select all that apply.) a. It may necessitate the administration of smaller doses of the medication. e. It occurs within seconds or minutes of starting an inhibiting agent. b. It may occur with concurrent administration of two or more drugs that compete for the same metabolizing enzymes. c. It occurs within seconds or minutes of starting an inhibiting agent. d. It may occur with concurrent administration of two or more drugs that compete for different metabolizing enzymes. e. It may necessitate the administration of larger doses of the medication.

A & B

Absorption is the process by which a drug is made available for use in the body. What factors influence the rate of absorption? Select all that apply. A. route B. solubility of the drug C. conditions in the body D. dose E. first-pass effect

A, B, C, E

A nurse determines that medications are known by different names.What are the different classifications of names assigned to medications? Select all that apply. A. trade name B. chemical name C. off brand name D. generic name E. metabolic name

A, B, D

Which of the following are ways that drugs are classified? Select all that apply. A. Effects on body systems B. Dosage C. Chemical characteristics D. Method of manufacture E. Therapeutic uses

A, C, E

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? A. "If you were more ill with an infection last time, it's possible you confused an allergic reaction with your UTI symptoms." B. "Allergic reactions happen after your body has been sensitized to a drug in the past." C. "It's likely that you didn't have an allergic reaction last time because you had such a short course of treatment." D. "Allergic reactions are usually dose-dependent, so it could be that you were treated with a lower dose last year."

A nurse is administering digoxin to a client. To administer medications so that the drug is as effective as possible, the nurse should prioritize what factor? A. Educating the client about potential side effects B. The process of pharmacokinetics C. The client's culture and ethnicity D. The client's preferences

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? a. All elderly clients have dementia at some point in life, and the medication is making it worse. b. This may be coincidental, and the memory loss may be attributed to changes with aging. c. The client probably has the onset of Alzheimer disease. d. The nurse should not be concerned. Medication is not the cause of the client's confusion.

In response to the client's question about whether drugs are safe, the nurse explains that all medications in the United States undergo rigorous testing controlled by what organization? a. Drug Enforcement Agency (DEA) b. Food and Drug Administration (FDA) c. Joint Commission on Accreditation of Healthcare Organizations (JCAHO) d. Centers for Disease Control and Prevention (CDC)

One of the phases of drug development is the post-marketing surveillance phase. Which activity is carried out during this phase? a. The drug is given to clients with the disease. b. Health care providers report adverse effects to FDA. c. Healthy volunteers are involved in the test. d. In vitro tests are performed using human cells.

The Joint Commission requires performance measures related to safety in drug administration. Some of these performance measures require specific precautions when administering which drug? a. anesthetics b. anticoagulants c. analgesics d. antipsychotics

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: A. drug-drug interactions. B. cumulative drug effects. C. impaired absorption. D. drug tolerance.

The nurse has administered a client's medication. What action should the nurse perform next? a. Educate the client about the purpose of the drug. b. Assess for drug effects. c. Perform a head-to-toe assessment. d. Assess for preexisting conditions.

The nurse is assisting with a phase I drug study. What potential participant would be most appropriate? A. 17-year-old male who is in good health B 22-year-old male with an unremarkable health history C. 24-year-old female who takes oral contraceptives D. 49-year-old female who has completed menopause

The nurse is currently participating in phase IV of a clinical study of a chemotherapeutic drug. What action would the nurse be expected to perform during this phase of testing? A. Administering the drug to clients who have a diagnosis of cancer. B. Gathering data from clients taking the drug after it has been released to market. C. Recruiting a small number of healthy volunteers to take the drug. D. Publicizing the therapeutic benefits of the drug to cancer support groups.

What is included in FDA approval of a drug for OTC availability? a. analysis of the diagnoses for which the medication may be used by the consumer b. evaluation of evidence that the consumer can use the drug safely, using information on the product label c. analysis of the cost of the drug to the consumer d. studies involving the safe use of the medication by the consumer

What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease? A. pharmacology B. pharmacotherapeutics C. chemistry D. pharmacodynamics

What is the manufacturer's responsibility during phase IV of a drug trial? A. Determine if the drug is too toxic for human use. B. Continue to monitor the drug's effects while the drug is in general use. C. Match clients with similar characteristics to test drug effectiveness. D. Find healthy volunteers to test for adverse effects.

What term is used to describe drugs identified by their chemical or official name in order to be independent of any manufacturer's assigned name? A. trade B. generic C. prototype D. brand

Which client is most likely to experience the benefits of the the placebo effect? A. A client who expresses skepticism about the need for medications. B. A client with an infection who states, "I know this antibiotic is going to work for me C. A client with pain who says, "I hope this drug works faster than the first one you gave me." D. A client who states, "I'm not the type of person who likes to take pills."

While reviewing a package insert for a drug, what would the nurse identify as the drug's generic name? A. Synthroid B. Levothyroxine sodium C. Levothroid D. L-thyroxine

Why does the nurse need to be alert for any indication of an allergic reaction in clients? A. To increase the effectiveness of a specific medication B. To maintain the client's safety during drug therapy C. To obtain early warning of noncompliance in drug therapy D. To reduce the risk of adverse effects during drug therapy

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.) A. purines B. NSAIDs C. osmotic diuretics D. salicylates E. antacids

B, C, E

A client asks the nurse, "What is a Drug Enforcement Agency (DEA) number?" What is the nurse's best response? A. "DEA numbers standardized codes for each drug that is on the market in the United States." B. "DEA numbers are case numbers given when someone breaks the law involving a controlled substance." C. "DEA numbers are given to physicians and pharmacists when they register with the DEA to prescribe and dispense controlled substances." D. "Physicians must have a DEA number in order to prescribe any type of medication for clients."

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: A. basis for planning the medication regimen. B. prominent part of client teaching. C. contraindication for the use of certain medications. D. basis for the nursing care plan.

A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods? A. foods with vitamin C B. foods with niacin C. foods with vitamin K D. foods with vitamin B

A client is receiving 250 mg of a drug that has a half-life of 8 hours. How much drug would remain after 24 hours? A. 125 mg B. 62.5 mg C. 31.25 mg D. 15.625 mg

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: A. biotransformation. B. portal circulation. C. first-pass effect. D. liver metabolism.

A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance? a. schedule V (C-V) b. schedule IV (C-IV) c. schedule II (C-II) d. schedule III (C-III)

Mrs. Geonity is prescribed a medication, and the health care provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. The client asks the nurse what the rationale is for the dosage changes. How should the nurse respond? A. "Your generic drug does not work as efficiently, and the provider increased your dose." B. "Your HMO requires that we change the drug dose frequently." C. "Dosage determines whether the drug actions may be therapeutic or toxic." D. "Dosage varies based on the brand name."

Since 1962, newly developed drugs have been extensively tested before being marketed for general use. What do drug companies do to test drugs initially? A. Test the drugs with humans. B. Test the drugs in a controlled laboratory experiment. C. Test the drugs with animals. D. Test the drugs on volunteers.

The client is prescribed a medication that was just placed in phase IV study. The client tells the nurse, "This medication is too expensive. Could Dr. Smith order a generic form of this medication?" What is the nurse's best response? A. "You can request the generic form but the binder used may make the drug less effective for this medication." B. "The generic form of the medication would not be any less expensive because this is a relatively new medication." C. "Medications are not produced in generic form until the patent expires, which normally takes several years." D. "Generic medications are lower-quality drugs, and that would mean you would not be getting the best treatment available."

The nurse administers a loop diuretic to the client. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts? A. magnesium B. zinc C. potassium D. calcium

The nurse explains the Drug Enforcement Agency's (DEA's) schedule of controlled substances to the nursing assistant who asks, "Do you ever get a prescription for Schedule I medications?" What is the nurse's best response? A. "Schedule I medications have the lowest risk for abuse and do not require a prescription." B. "Schedule I medications are found in antitussives and antidiarrheals sold over the counter." C. "Schedule I medications have no medical use so they are not prescribed." D. "Schedule I medications are only prescribed in monitored units for client safety."

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. visual disturbances B. yellowing of the skin C. a decrease in urine output D. ringing noise in the ears

The nurse is caring for a patient who admits to having taken anabolic steroids to enhance his cycling ability. What schedule medication was this patient abusing? A. Schedule II B. Schedule I C. Schedule III D. Schedule IV

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? a. Absorption will be increased because of fluid accumulation. b. Excretion is likely to take place slowly. c. The client likely has impaired drug metabolism. d. Distribution will be delayed, increasing the risk of adverse effects

The nurse observes a Black Box warning on a chemotherapeutic agent that will be administered to a patient. What priority action should the nurse take? A. Call the pharmacy and report that the nurse is not allowed to administer drugs with Black Box warnings. B. Do not administer this drug to the patient; it is a dangerous medication. C. Administer the medication and assess for adverse effects. D. Call the prescriber and inform that the medication has a Black Box warning.

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration? A. protocols B. body system affected C. adverse effects D. route of administration

The telephone triage nurse receives a call from a client asking for a prescription for an opioid (narcotic) to manage the client's surgical pain. The nurse explains that opioid prescriptions must be written and cannot be called in to the pharmacy. The client says, "Why are opioids so difficult to get a prescription for?" What is the nurse's best response? A. "The Centers for Disease Control and Prevention (CDC) regulates use of controlled substances to reduce the risk of injury." B. "The increase in the number of drug addicts has made the rules stronger." C. "Controlled substances such as opioids are controlled by the FDA and the DEA." D. "The Drug Enforcement Agency (DEA) determines the risk for addiction and the Food and Drug Administration (FDA) enforces their control."

What does the Comprehensive Drug Abuse Prevention and Control Act regulate? A. Illegal sales of narcotics B. Acceptable diagnoses for prescription of narcotics C. Manufacture and distribution of narcotics D. Classifications of narcotics

What information should the nurse use to base his/her respond when asked what the outcome of biotechnology involves? A. The process that considers the influence a person's genetic heritage has on specific drug effectiveness B. The process that identifies the deoxyribonucleic acid (DNA) sequence in a gene C. The process involves the insertion of hybrid molecules into living organisms. D. The process involves an inert substance to affect a person's expectation of a drug's effect

What is not a responsibility of the nurse administering a controlled substance to a hospitalized client? A. administering them only to people for whom they are prescribed B. reporting discrepancies to the proper authorities C. renewing expired controlled substance prescriptions D. recording on agency narcotic sheets each dose given

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.) A. an 88-year-old client with chronic heart failure and peripheral edema B. a 51-year-old client who is immunocompromised following bone marrow transplant C. a 29-year-old client receiving prenatal care in her first trimester of pregnancy D. a 54-year-old client being treated in the intensive care unit for multi-organ dysfunction syndrome E. a 37-year-old client who is taking fertility drugs

C & E

Which are disadvantages of over-the-counter (OTC) medications? Select all that apply. A. Few visits to the pharmacy or supermarket to obtain the medication B. Earlier resumption of activities of daily living C. Development of adverse drug reactions and interactions D. Cost to consumers is reimbursed by insurance companies E. Inaccurate self-diagnosis

C, D, E

When considering controlled substances, what actions are considered nursing responsibilities? (Select all that apply.) A. Reporting discrepancies in the controlled substance inventory to the prescribing providers B. Determining appropriate alternative for medications that are not managing the signs and symptoms C. Assuring that the inventory of narcotics is accurate and sufficient for patient needs D. Assuring that the controlled substances in safely stored in locked containers E. Keeping accurate recordings of the administration of prescribed controlled substances

C,D,E

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? a. The man may be experiencing a paradoxical effect of aspirin b. The man may be allergic to aspirin c. The man may be experiencing liver toxicity from the aspirin d. The man may be experiencing nephrotoxic effects of aspirin

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should: A. educate the client about drug-drug interactions. B. review the client's electrolyte levels. C. assess the client for adverse effects. D. assess for factors that may reduce absorption.

A drug has been approved by the Food and Drug Administration. What study phase would occur next? A. phase I study B. phase III study C. phase II study D. phase IV study

A drug's ability to alter basic processes in body cells allows for what function? A. the stimulation or inhibit inhibition of normal cellular functions B. bring about local effects on body cells C. the control over body metabolism D. the alternation in specific cellular functions

A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics? A. metabolism B. elimination C. distribution D. absorption

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? a. the way that the client's body processes hormones b. safe and effective methods for drug administration c. the processes of absorption and elimination d. the effect of the drug on the client's body

A nurse working in radiology administers iodine to a client who is having a CAT scan. The nurse working on the oncology unit administers chemotherapy to clients who have cancer. At the Public Health Department, a nurse administers an MMR to a 14-month-old child as a routine immunization. Which branch of pharmacology describes the actions of all three nurses? A. pharmacoeconomics B. pharmacodynamics C. pharmacokinetics D. pharmacotherapeutics

A post-surgical client rates the pain at 10/10. The nurse confirms that there are standing orders for the administration of opioid analgesics as needed. What route of administration should the nurse choose to achieve the fastest effect? A. subcutaneous B. oral C. intramuscular D. intravenous

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? A. Many drugs are potentially harmless if used correctly. B. Most reactions occurring with present-day therapy are less severe than before. C. Any effect results from the alteration of several chemical factors. D. Drugs cause unexpected or unacceptable reactions despite screening and testing.

Before administering a macrolide antibiotic, the nurse should question the order for what client? A. a 51-year-old man after myocardial infarction B. an 82-year-old woman with hypertension C. a 30-year-old woman with irritable bowel syndrome D. a 12-year-old boy with hearing loss

The client with a history of ischemic heart disease is taking aspirin 81 mg daily. The nurse should explain that less than 81 mg actually reaches target tissue due to: a. slow distribution. b. adverse effects. c. reduced absorption. d. the first-pass effect.

The nurse is preparing to move to another state. What action should the nurse prioritize? A. Obtain local providers' Drug Enforcement Agency (DEA) number for prescribing controlled substances. B. Become familiar with pregnancy drug categorization system used in the new state. C. Learn about the particular OTC drugs that are for sale in the new state. D. Become familiar with the nurse practice act of the new state.

The nurse on a busy medical floor is caring for several clients whose medication regimens vary widely. What action best addresses a client's risk for adverse effects related to primary actions? a. Checking the potassium level of a client who is taking a loop diuretic b. Encouraging a client with osteoporosis to remain sitting upright after taking a bisphosphonate c. Assessing the nausea of a client with cancer who is receiving chemotherapy d. Monitoring the international normalized ratio (INR) of a client taking warfarin

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects? A. 60-year-old female client who is tetraplegic and who has developed a sacral pressure ulcer B. 6-year-old girl who has a urinary tract infection and who is accompanied by her parents C. 40-year-old male client who has a history of intravenous drug use and who has endocarditis D. 20-year-old female client who has been diagnosed with a chlamydial infection

The nurse's discussion of the role of cytochrome P450 (CYP) enzymes is focusing on what aspect of pharmacokinetics? A. elimination of drug proteins through the process of denaturing B. the role of the kidneys in pharmacokinetics C. drug transported through the cells of the GI tract D. drug metabolism that takes place in the liver

The processes involved in dynamic equilibrium are key elements in determining what? A. How long the client has to take the drug B. Timing of other drugs the client is taking C. Amount of solution for mixing parental drugs D. Dosage scheduling

What behavior demonstrates that a nurse is using knowledge for safe patient care under Quality and Safety Education for Nurses (QSEN) competencies when administering medications? A. Searches drug databases for effective patient education materials B. Consults with the pharmacist about possible adverse reactions to a newly approved drug C. Makes suggestion for feature to be included on a new drug dispensing system D. The nurse keeps the computer printout of medications to refer to when pulling out medications that are due.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body? A. decreased cognition. B. decreased gastric motility. C. decreased activity. D. decreased glomerular filtration rate.

What function is associated with metabolism? A. inhibiting cell function by occupying receptor sites B. aiding in the absorption of a drug C. converting fat-soluble drugs into water-soluble forms D. initiating the process of digestion

When involved in phase III drug evaluation studies, what action should the nurse perform? a. Work with animals who are given experimental drugs. b. Make decisions that will determine effectiveness of the drug. c. Select appropriate clients to be involved in the drug study. d. Monitor and observe clients closely for adverse effects.

Which agency is responsible for the enforcement of controlled substances? a. Department of Health and Human Services b. U.S. Department of Justice c. Food and Drug Administration d. Drug Enforcement Agency

Which client would a nurse expect to experience alterations in drug metabolism? A. 62-year-old woman in acute renal failure B. 41-year-old man with kidney stones C. 35-year-old woman with cervical cancer D. 50-year-old man with cirrhosis of the liver

While collecting a medication history, the client admits to doubling the recommended dosage of acetaminophen, saying "It's harmless or they would require a prescription." What is the nurse's best response? A. "Taking medications like that is careless and you could cause yourself serious harm if you keep doing it." B. "Did you notify your health care provider of the increased dosage you were taking?" C. "Sometimes you need to take more than the package directs to treat the symptoms. It's important not to do this frequently." D. "OTC drugs are serious medications and carry serious risks if not taken as directed."

Pharmacology Chapter 2 PrepU's

What would the nurse identify as the desired response of the combination of codeine and acetaminophen rather than each given separately? A. The analgesic effect of the drug will be decreased with the combined drugs. B. When the drugs are combined, the additive effect is better control of pain. C. The combination of the drugs will have an antagonistic effect, and the patient will have decreased pain control. D. The drugs will do the same thing given separately as they would with the combination.

Pharmacology PrepU's

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