Pharmacology 11th Edition McCuistion
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,Chapter 01: The Nursing Process and Patient-Centered Care
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th
Edition
MULTIPLE CHOICE
1. All of the following would be considered subjective data, EXCEPT:
a. Patient-reported health history
b. Patient-reported signs and symptoms of their illness
c. Financial barriers reported by the patient’s caregiver
d. Vital signs obtained from the medical record
ANS: D
Subjective data is based on what patients or family members communicate to the nurse.
Patient-reported health history, signs and symptoms, and caregiver reported financial barriers
would be considered subjective data. Vital signs obtained from the medical record would be
considered objective data.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Management of Client Care
2. The nurse is using data collected to define a set of interventions to achieve the most desirable
outcomes. Which of the following steps is the nurse applying?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Generate solutions (planning)
d. Take action (nursing interventions)
ANS: C
When generating solutions (planning), the nurse identifies expected outcomes and uses the
patient’s problem(s) to define a set of interventions to achieve the most desirable outcomes.
Recognizing cues (assessment) involves the gathering of cues (information) from the patient
about their health and lifestyle practices, which are important facts that aid the nurse in
making clinical care decisions. Prioritizing hypothesis is used to organize and rank the patient
problem(s) identified. Finally, taking action involves implementation of nursing interventions
to accomplish the expected outcomes.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
3. A 5-year-old child with type 1 diabetes mellitus has had repeated hospitalizations for episodes
of hyperglycemia. The parents tell the nurse that they can’t keep track of everything that has
to be done to care for their child. The nurse reviews medications, diet, and symptom
management with the parents and draws up a daily checklist for the family to use. These
activities are completed in which step of the nursing process?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Generate solutions (planning)
d. Take action (nursing interventions)
, ANS: D
Taking action through nursing interventions is where the nurse provides patient health
teaching, drug administration, patient care, and other interventions necessary to assist the
patient in accomplishing expected outcomes.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
4. The nurse is preparing to administer a medication and reviews the patient’s chart for drug
allergies, serum creatinine, and blood urea nitrogen (BUN) levels. The nurse’s actions are
reflective of which of the following?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Take action (nursing interventions)
d. Generate solutions (planning)
ANS: A
Recognizing cues (assessment) involves gathering subjective and objective information about
the patient and the medication. Laboratory values from the patient’s chart would be
considered collection of objective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care
5. Which of the following would be correctly categorized as objective data?
a. A list of herbal supplements regularly used provided by the patient.
b. Lab values associated with the drugs the patient is taking.
c. The ages and relationship of all household members to the patient.
d. Usual dietary patterns and food intake.
ANS: B
Objective data are measured and detected by another person and would include lab values.
The other examples are subjective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care
6. The nurse reviews a patient’s database and learns that the patient lives alone, is forgetful, and
does not have an established routine. The patient will be sent home with three new
medications to be taken at different times of the day. The nurse develops a daily medication
chart and enlists a family member to put the patient’s pills in a pill organizer. This is an
example of which element of the nursing process?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Take action (nursing interventions)
d. Generate solutions (planning)
ANS: C
Taking action (nursing interventions) involves education and patient care in order to assist the
patient to accomplish the goals of treatment.
, DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
7. A patient who is hospitalized for chronic obstructive pulmonary disease (COPD) wants to go
home. The nurse and the patient discuss the patient’s situation and decide that the patient may
go home when able to perform self-care without dyspnea and hypoxia. This is an example of
which phase of the nursing process?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Take action (nursing interventions)
d. Generate solutions (planning)
ANS: D
Generating solutions (planning) involves defining a set of interventions to achieve the most
desirable outcomes, which, for this patient, means being able to perform self-care activities
without dyspnea and hypoxia.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Management of Client Care
8. A patient will be sent home with a metered-dose inhaler, and the nurse is providing teaching.
Which is a correctly written expected outcome for this process?
a. The nurse will demonstrate the correct use of a metered-dose inhaler to the patient.
b. The nurse will teach the patient how to administer medication with a metered-dose
inhaler.
c. The patient will know how to self-administer the medication using the metered-
dose inhaler.
d. The patient will independently administer the medication using the metered-dose
inhaler at the end of the session.
ANS: D
Expected outcomes must be patient-centered and clearly state the outcome with a reasonable
deadline and should identify components for evaluation.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Management of Client Care
9. The nurse is generating solutions (planning) for a patient who has chronic lung disease and
hypoxia. The patient has been admitted for increased oxygen needs above a baseline of 2
L/min. The nurse generates an expected outcomes stating, “The patient will have oxygen
saturations of >95% on room air at the time of discharge from the hospital.” What is wrong
with this goal?
a. It cannot be evaluated.
b. It is not measurable.
c. It is not patient-centered.
d. It is not realistic.
ANS: D
The expected outcome is not realistic because the patient is not usually on room air and
should not be expected to attain that expected outcome by discharge from this hospitalization.
, DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Management of Client Care
10. The nurse is developing a teaching plan for an elderly patient who will begin taking an
antihypertensive drug that causes dizziness and orthostatic hypotension. Which hypothesis
(problem) documented by the nurse is appropriate for this patient?
a. Deficient knowledge related to drug side effects.
b. Ineffective health maintenance related to age.
c. Readiness for enhanced knowledge related to medication side effects.
d. Risk for injury related to side effects of the medication.
ANS: D
This patient has an increased risk for injury because of drug side effects, so this is an
appropriate hypothesis (problem) to direct the type of care and follow-up the patient will
receive.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Nursing Diagnosis
MSC: NCLEX: Management of Client Care
11. An older patient must learn to administer a medication using a device that requires manual
dexterity. The patient becomes frustrated and expresses lack of self-confidence in performing
this task. Which action will the nurse perform next?
a. Ask the patient to keep trying until the skill is learned.
b. Provide written instructions with illustrations showing each step of the skill.
c. Schedule multiple sessions and practice each step separately.
d. Teach the procedure to family members who can administer the medication for the
patient.
ANS: C
Nurses should be sensitive to patient’s level of frustration when teaching skills. In this case,
breaking the steps down into individual parts will help with this patient’s frustration level.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Management of Client Care
12. A school-age child will begin taking a medication to be administered at 5 mL three times
daily. The child’s parent tells the nurse that, with a previous use of the drug, the child
repeatedly forgot to bring the medication home from school, resulting in missed evening
doses. What will the nurse recommend?
a. Encourage the child to be more responsible and that it is important to take the
medication as prescribed.
b. Putting a note on the child’s locker to encourage the child to take responsibility for
medication administration.
c. Asking the provider if 7.5 mL may be taken in the morning and 7.5 mL may be
taken in the evening so that the correct amount is given daily.
d. Taking the noon dose to school every day and giving it to the school nurse to
administer.
ANS: C
, For busy families with school-age children, it may be necessary to adjust the medication
schedule to one that fits their schedule. The nurse should ask the provider if a revised schedule
is possible. In this case, the most effective revised schedule would involve not taking the
medication while at school. Putting a note on the locker is not likely to be effective. It is not
correct to adjust the dose.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Nursing Intervention | Nursing Process: Planning
MSC: NCLEX: Management of Client Care
13. A high-school student regularly forgets to use a twice-daily inhaled corticosteroid to prevent
asthma flares and is repeatedly admitted to the hospital. The child’s parent tells the nurse that
the child has been told that forgetting to take the medication causes frequent hospitalizations.
The nurse will
a. encourage the child to take responsibility for taking the medication.
b. reinforce the need to take prescribed medications to avoid hospitalizations.
c. suggest putting the inhaler with the child’s toothbrush to use before brushing teeth.
d. suggest that the child’s parents administer the medication to increase compliance.
ANS: C
It is important to empower patients to take responsibility for managing medications. Putting
the medication with the toothbrush can help this child remember to use it. Telling the child to
take medications and reminding the child that failure to do so results in hospitalization is not
working. Asking the child’s parents to administer the medication does not empower the
adolescent to take responsibility.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Planning | Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
14. An adolescent patient who has acne is given a regimen of topical medications and an oral
antibiotic that generally clears up lesions to fewer than 10 within 6 to 8 weeks. At a 2-month
follow-up, the patient continues to have more than 25 lesions. The child’s parent affirms that
the child is using the medications as prescribed. Which statement below is correct for this
patient to evaluate the outcome?
a. “Goal of fewer than 10 lesions in 6 to 8 weeks is not met.”
b. “Goal that the medication will be effective is not met.”
c. “Goal that the patient will take medications as prescribed is not met.”
d. “Goal that the patient understands the medication regimen is not met.”
ANS: A
All indications are that this patient is taking the medications and they are not effective. The
first statement is correct because it identifies a measurable desired outcome and a specific
time frame.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Management of Client Care
15. Which of the following would not be considered an important element of health teaching in
drug therapy?
a. Assess the patients’ health literacy skills.
,b. Assess all of the drugs on the patients’ profile for possible drug interactions.
c. Avoid discussing potential side effects and adverse reactions with the patient to
avoid nonadherence.
d. Determine if the patient needs laboratory monitoring.
ANS: C
Potential side effects and adverse reactions should always be discussed with the patient so
they know what to report to their health care team should they occur. All other factors
considerations listed are important elements of health teaching.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment | Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
,Chapter 02: Drug Development and Ethical Considerations
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th
Edition
MULTIPLE CHOICE
1. The nurse is obtaining consent from a subject newly recruited for a clinical drug trial that will
last for 6 months. All subjects will be given gift certificates for participating. One subject
says, “Well, I guess if the drug doesn’t work, I’ll just have to put up with the symptoms for 6
months.” What will the nurse tell the subject?
a. “Participation for the duration of the study is required.”
b. “Participation may end at any time without penalty.”
c. “Withdrawal from the study may end at any time, but the gift certificate will not be
given.”
d. “You can request placement in the treatment group.”
ANS: B
All participants have the right to autonomy, which is the right to self-determination. Patients
have the right to refuse to participate or to withdraw from a study at any time without penalty.
Patients generally are not allowed to choose participation in either the treatment or the control
group.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Management of Client Care
2. The nurse is assisting with a clinical drug trial in which the side effects of two effective drugs
are being compared. A patient who would benefit from either drug has elected to withdraw
from the study, and the nurse assists with the paperwork to facilitate this. This is an example
of
a. autonomy.
b. beneficence.
c. justice.
d. veracity.
ANS: A
All participants have the right to autonomy, which is the right to self-determination. Patients
have the right to refuse to participate or to withdraw from a study at any time without penalty
even if the health care provider disagrees with that choice.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: N/A
MSC: NCLEX: Management of Client Care
3. During a clinical drug trial for a new medication, researchers note a previously unknown
serious adverse effect occurring in more than 50% of subjects. The study is discontinued.
Which ethical principle is being exercised?
a. Beneficence
b. Justice
c. Respect for persons
d. Veracity
, ANS: A
Beneficence is the duty to protect subjects from harm. Once a serious adverse effect is noted
and it is determined that the benefits do not outweigh the risks of the study, researchers have
an ethical obligation to stop the study.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: N/A
MSC: NCLEX: Management of Client Care
4. In a 5-year clinical trial investigating a new cancer treatment, researchers note overwhelming
improvement in almost all of the subjects in the treatment group during the second year of the
trial. It is decided to stop the trial early and report the findings due to the overwhelmingly
beneficial effects. This decision was made based on which ethical principle?
a. Beneficence
b. Justice
c. Respect for persons
d. Veracity
ANS: B
The principle of justice requires that all people be treated fairly. Because the findings were
overwhelmingly positive, an ethical decision was made to stop the study early and report
findings so that additional people could gain benefit from the treatment.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: N/A
MSC: NCLEX: Management of Client Care
5. The nurse is enrolling subjects for a double-blind experimental study. One patient asks the
nurse to explain the role of the experimental group. The nurse will explain that subjects in the
experimental group in this type of study
a. are selected for participation in that group.
b. have unique baseline characteristics.
c. receive a placebo.
d. receive the experimental treatment being evaluated.
ANS: D
In a double-blind experimental study, subjects in the experimental group receive the treatment
or drug under study. They are randomly assigned and not selected. They should have similar
baseline characteristics to those in the control group. They do not receive a placebo.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Management of Client Care
6. The nurse is obtaining signatures on consent forms for participation in a clinical drug trial.
One patient says, “I’m not sure I want to do this, but I need the cash.” The nurse will take
which action?
a. Ask the patient to clarify concerns.
b. Reinforce that cash is given to all subjects equally.
c. Report this statement to the lead investigator.
d. Review the elements of the study and obtain consent.
ANS: C