RNSG 1301 EXAM 2 QUESTIONS AND
ANSWERS ALL CORRECT
A patient in severe pain is unable to swallow and does not have intravenous (IV)
access. Which prescription would the nurse request from the health care provider?
Morphine by mouth (PO)
Morphine by rectum (PR)
Acetaminophen PO
Acetaminophen PR - Answer- Morphine by rectum (PR) - A patient in severe pain with
no IV access who is not able to swallow should have morphine administered rectally.
This will allow for fast absorption and pain relief while ensuring patient safety.
Which pharmacokinetic trait is important to consider with oral morphine administration?
Has a long half-life
Does not cross the placenta
Undergoes first hepatic pass
Does not cross the blood-brain barrier - Answer- Undergoes first hepatic pass - Oral
morphine undergoes first hepatic pass, meaning it must be metabolized by the liver
before it becomes available to the rest of the body. This results in a higher dose for oral
administration compared with parenteral administration.
Which questions would the nurse ask a patient who is taking acetaminophen?
Do you take nonsteroidal antiinflammatory drugs (NSAIDs)?
How often do you drink alcohol?
How often do you smoke cigarettes?
Do you have any history of liver disease?
Do you have any history of renal disease? - Answer- How often do you drink alcohol? -
Asking a patient taking acetaminophen about alcohol intake is necessary, as both
substances affect the liver. The risk for hepatotoxicity is increased when acetaminophen
is combined with alcohol.
Do you have any history of liver disease? - Asking a patient taking acetaminophen
about a history of liver disease is appropriate given the drug's effect on the liver.
Patients with a history of liver disease may require a decreased dose of acetaminophen
or an alternative medication.
A patient in the emergency department has mild pain and asks for acetaminophen.
Which intervention by the nurse is appropriate?
,Suggest that the patient take intravenous (IV) morphine instead.
Ask the patient how many cigarettes he or she smokes every day.
Tell the patient that acetaminophen does not help with mild pain.
Ask the patient if he or she has taken any acetaminophen earlier in the day. - Answer-
Ask the patient if he or she has taken any acetaminophen earlier in the day. - Asking a
patient about his or her use of acetaminophen earlier in the day is important before
administering the drug again, as there is a limit to how much can safely be taken in 1
day.
A patient has been taking morphine frequently after a recent surgery. The nurse would
suggest monitoring of which laboratory test?
Liver function panel
Basic metabolic panel
Complete blood count (CBC)
Complete metabolic panel - Answer- Liver function panel - The transaminases aspartate
aminotransferase (AST) and alanine aminotransferase (ALT) may become elevated with
morphine use and should be monitored via liver function panel. If liver function is
impaired, the metabolism of morphine may be slowed, and the dose would be reduced
to avoid toxicity.
A patient is on a continuous infusion of morphine after surgery. Which interventions will
the nurse perform?
Monitor urinary output
Monitor respiratory rate
Assess for epigastric pain
Auscultate bowel sounds
Assess for peripheral edema - Answer- Monitor urinary output - Urinary output should
be monitored in patients on continuous morphine infusions because urinary retention
may occur.
Monitor respiratory rate - Respiratory rate should be monitored in patients on
continuous morphine infusions because respiratory suppression or distress may occur.
Assess for epigastric pain
Auscultate bowel sounds - The nurse would auscultate bowel tones in patients on
continuous morphine infusions because decreased peristalsis and/or constipation may
occur.
A patient presents to the emergency department with nausea, vomiting, abdominal pain,
and yellow sclera. The patient's liver function tests are elevated, and the serum
acetaminophen level is 10. Which conclusion will the nurse draw?
Acetaminophen is not likely playing a role.
, The patient is probably an alcoholic with liver disease.
The patient most likely took an overdose of acetaminophen.
Acetaminophen has likely caused the liver function test elevation. - Answer-
Acetaminophen is not likely playing a role. - A serum acetaminophen level of 10 is
within the normal range of 5 to 25. The nurse can conclude that acetaminophen is not
the likely cause of the patient's condition.
An 18-month-old patient has been started on chemotherapy. Which means are used to
adjust the drug dosages?
Therapeutic response
Drug dosage calculator
Plasma drug concentrations
Body surface area calculation
Extrapolated from adult dosage - Answer- Therapeutic response - Drug therapy must be
adjusted based on therapeutic response to chemotherapy.
Plasma drug concentrations - Drug therapy must be adjusted based on plasma drug
concentrations.
Which family-centered education techniques would the nurse use when teaching the
parents of a 12-month-old infant how to administer oral antibiotics?
Administer the drug all at once
Have parent soothe the 12-month-old patient
Disguise the drug taste with grape juice
Use an oral syringe to administer the drug
Allow the 12-month-old patient to suck on a pacifier - Answer- Have parent soothe the
12-month-old patient - The parent should maintain safe and secure positioning of the
infant (e.g., holding, rocking, cuddling, soothing).
Use an oral syringe to administer the drug - The parents should use a calibrated
dropper or an oral syringe.
Allow the 12-month-old patient to suck on a pacifier - The parents should allow self-
comforting measures as age-appropriate (e.g., use of pacifier or sucking on fingers).
Which factors increase the incidence of older adults experiencing adverse drug effects
(ADEs) from drug therapy?
Polypharmacy
Cognitive impairment
Use of drugs with wide therapeutic index
Kidney dysfunction
Intact hepatic function - Answer- Polypharmacy - Polypharmacy contributes to the
increased incidence of ADEs experienced by older adults.
ANSWERS ALL CORRECT
A patient in severe pain is unable to swallow and does not have intravenous (IV)
access. Which prescription would the nurse request from the health care provider?
Morphine by mouth (PO)
Morphine by rectum (PR)
Acetaminophen PO
Acetaminophen PR - Answer- Morphine by rectum (PR) - A patient in severe pain with
no IV access who is not able to swallow should have morphine administered rectally.
This will allow for fast absorption and pain relief while ensuring patient safety.
Which pharmacokinetic trait is important to consider with oral morphine administration?
Has a long half-life
Does not cross the placenta
Undergoes first hepatic pass
Does not cross the blood-brain barrier - Answer- Undergoes first hepatic pass - Oral
morphine undergoes first hepatic pass, meaning it must be metabolized by the liver
before it becomes available to the rest of the body. This results in a higher dose for oral
administration compared with parenteral administration.
Which questions would the nurse ask a patient who is taking acetaminophen?
Do you take nonsteroidal antiinflammatory drugs (NSAIDs)?
How often do you drink alcohol?
How often do you smoke cigarettes?
Do you have any history of liver disease?
Do you have any history of renal disease? - Answer- How often do you drink alcohol? -
Asking a patient taking acetaminophen about alcohol intake is necessary, as both
substances affect the liver. The risk for hepatotoxicity is increased when acetaminophen
is combined with alcohol.
Do you have any history of liver disease? - Asking a patient taking acetaminophen
about a history of liver disease is appropriate given the drug's effect on the liver.
Patients with a history of liver disease may require a decreased dose of acetaminophen
or an alternative medication.
A patient in the emergency department has mild pain and asks for acetaminophen.
Which intervention by the nurse is appropriate?
,Suggest that the patient take intravenous (IV) morphine instead.
Ask the patient how many cigarettes he or she smokes every day.
Tell the patient that acetaminophen does not help with mild pain.
Ask the patient if he or she has taken any acetaminophen earlier in the day. - Answer-
Ask the patient if he or she has taken any acetaminophen earlier in the day. - Asking a
patient about his or her use of acetaminophen earlier in the day is important before
administering the drug again, as there is a limit to how much can safely be taken in 1
day.
A patient has been taking morphine frequently after a recent surgery. The nurse would
suggest monitoring of which laboratory test?
Liver function panel
Basic metabolic panel
Complete blood count (CBC)
Complete metabolic panel - Answer- Liver function panel - The transaminases aspartate
aminotransferase (AST) and alanine aminotransferase (ALT) may become elevated with
morphine use and should be monitored via liver function panel. If liver function is
impaired, the metabolism of morphine may be slowed, and the dose would be reduced
to avoid toxicity.
A patient is on a continuous infusion of morphine after surgery. Which interventions will
the nurse perform?
Monitor urinary output
Monitor respiratory rate
Assess for epigastric pain
Auscultate bowel sounds
Assess for peripheral edema - Answer- Monitor urinary output - Urinary output should
be monitored in patients on continuous morphine infusions because urinary retention
may occur.
Monitor respiratory rate - Respiratory rate should be monitored in patients on
continuous morphine infusions because respiratory suppression or distress may occur.
Assess for epigastric pain
Auscultate bowel sounds - The nurse would auscultate bowel tones in patients on
continuous morphine infusions because decreased peristalsis and/or constipation may
occur.
A patient presents to the emergency department with nausea, vomiting, abdominal pain,
and yellow sclera. The patient's liver function tests are elevated, and the serum
acetaminophen level is 10. Which conclusion will the nurse draw?
Acetaminophen is not likely playing a role.
, The patient is probably an alcoholic with liver disease.
The patient most likely took an overdose of acetaminophen.
Acetaminophen has likely caused the liver function test elevation. - Answer-
Acetaminophen is not likely playing a role. - A serum acetaminophen level of 10 is
within the normal range of 5 to 25. The nurse can conclude that acetaminophen is not
the likely cause of the patient's condition.
An 18-month-old patient has been started on chemotherapy. Which means are used to
adjust the drug dosages?
Therapeutic response
Drug dosage calculator
Plasma drug concentrations
Body surface area calculation
Extrapolated from adult dosage - Answer- Therapeutic response - Drug therapy must be
adjusted based on therapeutic response to chemotherapy.
Plasma drug concentrations - Drug therapy must be adjusted based on plasma drug
concentrations.
Which family-centered education techniques would the nurse use when teaching the
parents of a 12-month-old infant how to administer oral antibiotics?
Administer the drug all at once
Have parent soothe the 12-month-old patient
Disguise the drug taste with grape juice
Use an oral syringe to administer the drug
Allow the 12-month-old patient to suck on a pacifier - Answer- Have parent soothe the
12-month-old patient - The parent should maintain safe and secure positioning of the
infant (e.g., holding, rocking, cuddling, soothing).
Use an oral syringe to administer the drug - The parents should use a calibrated
dropper or an oral syringe.
Allow the 12-month-old patient to suck on a pacifier - The parents should allow self-
comforting measures as age-appropriate (e.g., use of pacifier or sucking on fingers).
Which factors increase the incidence of older adults experiencing adverse drug effects
(ADEs) from drug therapy?
Polypharmacy
Cognitive impairment
Use of drugs with wide therapeutic index
Kidney dysfunction
Intact hepatic function - Answer- Polypharmacy - Polypharmacy contributes to the
increased incidence of ADEs experienced by older adults.
