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Care Practice 4th Edition SEALOCK Chapter 1-58
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Chapter 01: Nursing Practice in Canada and Drug Therapy
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
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MULTIPLE CHOICE SW
1. Which is a judgement about a particular patient’s potential need or problem?
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a. A goal SW
b. An assessment SW
c. Subjective data SW
d. A nursing diagnosis SW SW
ANS: D SW
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about how a patient responds to hea
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th conditions and life processes or vulnerability for that response.
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DIF: Cognitive Level: Knowledge SW SW
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to swallow, he cannot take
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medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
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a. A “right time” problem SW SW SW
b. A “right dose” problem SW SW SW
c. A “right route” problem SW SW SW
d. A “right medication” problem SW SW SW
ANS: C SW
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the prescriber. This is not a “right
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time” problem because the ordered frequency has not changed. This is not a “right dose” problem because the dose is not related to
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an inability to swallow. This is not a “right medication” problem because the medication ordered will not change, just the route.
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DIF: Cognitive Level: Application SW SW
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and has been documenting signs o
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f possible adverse effects. What nursing process phase is the nurse practising?
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a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis SW
ANS: B SW
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated
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by this example.
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DIF: Cognitive Level: Application SW SW
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an o
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utcome criterion for this patient? SW SW SW SW
a. The patient will follow instructions. SW SW SW SW
b. The patient will not experience complications.
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c. The patient adheres to the new insulin treatment regimen.
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d. The patient demonstrates safe insulin self-administration technique.
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ANS: D SW
Having the patient demonstrate safe insulin self-
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administration technique is a specific and measurable outcome criterion. Following instructions and avoiding complications are not
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specific criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
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DIF: Cognitive Level: Application SW SW
5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with type 1
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diabetes mellitus? SW
a. Providing education regarding self-injection technique SW SW SW SW
b. Setting goals and outcome criteria with the patient’s input SW SW SW SW SW SW SW SW
c. Recording a history of over-the-counter medications used at home SW SW SW SW SW SW SW SW
d. Formulating nursing diagnoses regarding knowledge deficits related to the new t SW SW SW SW SW SW SW SW SW SW
reatment regimen SW
ANS: A SW
Education is an intervention that occurs during the implementation phase. Setting goals and outcome criteria reflects the planning ph
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ase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit reflects
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analysis of data as part of the planning phase.
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DIF: Cognitive Level: Analysis SW SW
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6. The nurse is working during a very busy night shift, and the health care provider has just given the nurse a medication order over t
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he telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication errors?
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a. Recopy the order neatly on the order sheet, with the most common route indicated
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b. Consult with the pharmacist for clarification about the most common route
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c. Call the health care provider to clarify the route of administration
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d. Withhold the drug until the health care provider visits the patient SW SW SW SW SW SW SW SW SW SW
ANS: C SW
If a medication order does not include the route, the nurse must ask the health care provider to clarify it. Never assume the route of administrat
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ion.
DIF: Cognitive Level: Application | Cognitive Level: Analysis
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7. Which constitutes the traditional Five Rights of medication administration?
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a. Right drug, right route, right dose, right time, and right patient
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b. Right drug, the right effect, the right route, the right time, and the right patient
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c. Right patient, right strength, right diagnosis, right drug, and right route
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d. Right patient, right diagnosis, right drug, right route, and right time
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ANS: A SW
The traditional Five Rights of medication administration were considered to be Right drug, Right route, Right dose, Right time, and R
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ight patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
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DIF: Cognitive Level: Comprehension SW SW
8. What correctly describes the nursing process?
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a. Diagnosing, planning, assessing, implementing, and finally evaluating SW SW SW SW SW SW
b. Assessing, then diagnosing, implementing, and ending with evaluating SW SW SW SW SW SW SW
c. A linear direction that begins with assessing and continues through diagnosing,
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planning, and finally implementing SW SW SW
d. An ongoing process that begins with assessing and continues with diagnosing,
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planning, implementing, and evaluating SW SW SW
ANS: D SW
The nursing process is an ongoing, flexible, adaptable, and adjustable five-
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step process that begins with assessing and continues through diagnosing, planning, implementing, and finally evaluating, which
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may then lead back to any of the other phases.
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DIF: Cognitive Level: Application SW SW
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
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a. The patient’s identification SW SW
b. The patient’s weight SW SW
c. The patient’s last meal SW SW SW
d. Any drug or food allergies SW SW SW SW
ANS: C SW
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to any drug–
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food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timin
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g.
DIF: Cognitive Level: Application SW SW
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis?
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a. Anxiety
b. Anxiety related to new drug therapy SW SW SW SW SW
c. Anxiety related to anxious feelings about drug therapy, as evidenced by s
S
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tatements such as “I’m upset about having to give myself shots”
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d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m
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upset about having to give myself shots”
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ANS: D SW
Formulation of nursing diagnoses is usually a three- SW SW SW SW SW SW SW
step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m upset ab
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out having to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions. The answer “
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Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The “related to” section in
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“Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as ‘I’m upset about having to give myself
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shots’” is simply a restatement of the problem “anxiety,” not a separate factor related to the response.
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DIF: Cognitive Level: Analysis SW SW
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
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DIF: Cognitive Level: Analysis SW SW
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Chapter 02: Pharmacological Principles
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
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MULTIPLE CHOICE SW
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circulation in i
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dentical amounts. Which term best denotes that the drugs have the same absorption rates?
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a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D SW
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, they are
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bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption.
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“Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the
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effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicate that two substances
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do not have a chemical reaction when mixed (or given, in the case of drugs) together.
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DIF: S W S W Cognitive Level: Comprehension SW SW
2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education?
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a. The medication will cause fewer adverse effects when given intravenously.
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b. The medication will be absorbed slowly into the tissues over time.
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c. The medication’s action will begin faster when given intravenously.
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d. Most of the drug is inactivated by the liver before it reaches the target area.
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ANS: C SW
Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effects, the i
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ntravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver
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before it reaches the target area.SW SW SW SW SW
DIF: S W S W Cognitive Level: Comprehension SW SW
3. Which is true regarding parenteral drugs?
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a. They bypass the first-pass effect. SW SW SW SW
b. They decrease blood flow to the stomach. SW SW SW SW SW SW
c. They are altered by the presence of food in the stomach.
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d. They exert their effects while circulating in the bloodstream.
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ANS: A SW
Drugs given by the parenteral route bypass the first-
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pass effect, but they still must be absorbed into cells and tissues before they can exert their effects. Enteral drugs (drugs taken orally)
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, not parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral drugs
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must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while
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circulating in the bloodstream. SW SW SW
DIF: S W S W Cognitive Level: Analysis SW SW
4. A drug’s half-life is best defined as
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a. The time it takes for the drug to elicit half its therapeutic response.
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b. The time it takes one- SW SW SW SW
half of the original amount of a drug to reach the target cells.
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c. The time it takes one- SW SW SW SW
half of the original amount of a drug to be removed from the body.
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d. The time it takes one- SW SW SW SW
half of the original amount of a drug to be absorbed into the circulation.
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ANS: C SW
A drug’s half-life is the time it takes for one-
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half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed from the
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body. Answers A, B, and D are not correct definitions of a drug’s half-life.
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DIF: S W S W Cognitive Level: Comprehension SW SW
5. The term “duration of action” is best defined as
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a. The time it takes for the drug to elicit a therapeutic response.
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b. The time it takes a drug to reach its maximum therapeutic response.
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c. The length of time it takes to remove a drug from circulation.
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d. The time during which drug concentration is sufficient to elicit a therapeutic r
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esponse.
ANS: D SW
Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it takes for a
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drug to elicit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximum therapeutic res
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ponse is a drug’s “peak effect.” “The length of time it takes to remove a drug from circulation” defines a drug’s elimination and doe
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s not correctly define a drug’s duration of action.
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DIF: S W S W Cognitive Level: Comprehension SW SW
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