INTRODUCTION TO CLINICAL PHARMACOLOGY 10TH EDITION
By Constance Visovsky, Cheryl Zambroski, Shirley Hosler
Chapter 01: Pharmacology and the Nursing Process in LPN Practice
Visovsky: Introduction to Clinical Pharmacology, 10th Edition
, MULTIPLE
CHOICE
1. The LPNiscollecting datafortheinitialassessment ofapatient uponadmission toalong-term carefacilitybeforegivingthe patient’s
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prescribeddrugs.WhichactionshouldtheLPNconsidertobethehighestpriority? J J J J J J J J J J J J
a. Obtainanyspecial equipment that will beneeded to givethepatient’s drug. J J J J J J J J J J J J
b. Monitor the patient for aresponse to the drug given. J J J J J J J J J
c. Collect data about thepatient and the patient’s health condition. J J J J J J J J J
d. Review the nursing care plan to verify that it isaccurate. J J J J J J J J J J
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Collectinganddocumentingdataaboutthepatientandthepatient’shealthconditionisacriticalstepbeforeanydrugs are given.
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Informationregardingthepresentillness,anysignsandsymptoms,reviewofmedicalrecords,drughistory,andvital signsare J J J J J J J J J J J J J J J J J J J
neededbeforedrugsaregiven. Deciding onspecialequipmentthat willbeneededtogivethepatient’s drugispart oftheplanning
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phaseofthenursingprocess.Monitoringthepatientforhisresponsetogivendrugispartoftheevaluation stageofthenursing
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process.Reviewingthenursingcareplantoverifythatitisbeingfollowedaccuratelyispartofthe implementation stage of the
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nursing process. J
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2. TheLPNisworkingwithapatientintheplanningstageofthenursingprocessrelatedtothepatient’sprescribeddrugs.Which action
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shouldtheLPNtakeduringthisstage? J J J J J J
a. Develop a nursing goal to plan theprocedures needed to givedrug. J J J J J J J J J J J
b. Develop a teaching plan for the patient regarding the drug’s actions. J J J J J J J J J J
c. Determinethat thepatient is experiencing theexpected responseto his drug. J J J J J J J J J J J
d. Determinehow much the patient understands abouthisdrug. J J J J J J J J
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Determining how muchthepatient understands about his drugis partof thediagnosis phaseof thenursing process. Developinga J J J J J J J J J J J J J J J J J J J J J
nursinggoaltoplantheprocedures neededtogivedrugand developingateachingplanforthepatient regarding the drug’s actions
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are part of the planning phase of the nursing process.
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3. Youareteachingapatientwithdepressionaboutthepotentialadverseeffects ofaprescribed drug.Whatpartofthenursing process
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related to drug therapy are you engaging in at this point of the teaching plan?
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a. Assessment
b. Implementation
c. Evaluation
d. Diagnosis
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Intheevaluationphaseofthenursingprocess,theLPNunderstandsandteachestothepatientthedrug’stherapeutic effects, expected side
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effects, and potential adverse effects. J J J J
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4. Whichof thefollowing isan example of subjectivedata?
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a. Thepatient statesshehaspaininherleftarm. J J J J J J J J J
b. The medical chart has a recorded blood pressure of 128/88.
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c. Theserum potassium level is 3.8 mmol/L. J J J J J J
d. Thepatient’s ECG showsnormal sinus rhythm. J J J J J J
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Reportsfromthepatientorpatient’scaregiverareconsideredsubjectivedata.Symptomssuchaspain,nausea,ordizziness are
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examplesofsymptomsthatcannotbe“seen”andaredatacollectedfromthepatient,caregiver,orothers.Laboratory values, ECG
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results, or vital sign data from a medical chart are examples of objective data.
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5. Which statement provides an example of objective data?
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a. The wifestatesthe patient wasconfused lastnight. J J J J J J J J
b. Grimacingwith movement ispresent during theexamination. J J J J J J J
c. The patient reports moderate alcohol consumption. J J J J J
d. The patient states pain is severe. J J J J J
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Measurabledataobtainedduringaphysicalexamsuchasgrimacingwithmovementisanexampleofobjectivedata. Subjective J J J J J J J J J J J J J J J J J J J
dataincludesinformationpresentedbythepatientorfamilythatcannotbesubstantiatedsuchasawife’sreport of a patient’s
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confusion, patient report of degree of alcohol consumption, and a patient’s pain rating. J J J J J J J J J J J J
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6. TheLPN/VNisassessingapatient beforegiving adrug forblood pressuremanagement. Thenursenotes theblood pressuretobe 90/50 mm
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Hg. Whatisthenurse’s bestaction?
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a. Hold the drug and report the blood pressureto theRN. J J J J J J J J J J
b. Givethe patient a full glass of water before giving the drug. J J J J J J J J J J J
c. Come back in 30 minutes and recheck the blood pressure. J J J J J J J J J
d. Havethe patient perform pursed lip breathing beforegiving the drug. J J J J J J J J J J
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The best action is to hold the drug and contact the RN. The patient may need an adjustment to the dose of the blood pressure drug or
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switchingtoanotherdrug.Giving waterwiththedrugisnotcontraindicatedbutdoesnotrecognizethepatient’s risk for hypotension.
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Pursed lip breathing has no role in this situation. J J J J J J J J
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7. TheLPNiscollecting objectivedataforinclusioninthenursingassessment.Whichpieceofinformation indicatesthatthe LPN
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hasa clear understanding of objective assessment data?
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a. Apatient’srating ofchestpainas8ona1 to10scale.
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b. Family members report that patient has been experiencing pain for1 month. J J J J J J J J J J J
c. Detailed history ofthe patient’s current illness upon admission. J J J J J J J J
d. Compilation of past laboratory resultsandx-ray reports. J J J J J J J
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Thepatient’spastlaboratoryandx-rayresultsareexamplesofobjectivedata. Apainratingof8/10,afamilymember’s descriptionof the
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patient’s pain, and history of current illness are examples of subjective data.
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8. Apatientrecentlybeganataking bloodpressuredrugandpresentsforafollow-upappointment.Theofficenursereviewsthe patient’s
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dailybloodpressurerecordings.Whichstageofthenursingprocesscorrespondstothisreview?
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a. Assessment
b. Planning
c. Diagnosis
d. Evaluation
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The evaluation phaseinvolves examining theresults that occurwhen theplan is implemented. Reviewing thepatient’s daily blood
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pressurerecording examines thepatient’s responseto thedrug. The assessment phaseprovides initial information about thepatient,the
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problem,andanythingthatmaychangethechoiceoftreatment.Theplanningphaseinvolvesusingpatient assessment data and
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diagnoses toset goals and write careplans. The diagnosis phase involves decision-making aboutthe patient’sproblems,including
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medicaldiagnosesmadebythehealthcareproviderandnursingdiagnosesdevelopedthroughthe North American Nursing Diagnosis
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Association(NANDA). J
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9. Afterreceivingreport,theLPNgives drugstoherassignedpatientsontheevening shift.With whichstageofthenursing process
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does this activity correspond?
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a. Implementation
b. Assessment
c. Planning
d. Diagnosis
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Theimplementation phaseinvolves activelyfollowing theplan of careand accurately givingordered drug tothepatients. The
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assessment phase involves obtaining initial information about the patient,theproblem, and anything that maychangethe choiceof
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treatment.Theplanningphaseinvolvesusingpatientassessmentdataanddiagnosestosetgoalsandwritecareplans. The diagnosis
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phaseinvolves decision-making aboutthepatient’s problems, including medical diagnoses made bythe healthcare provider and
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nursing diagnoses developed through the North American Nursing Diagnosis Association (NANDA).
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10. Youarereviewingapatient’snewantihypertensivedrugorder.Theorderaswrittenisunclearastothenumberoftimes per day
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the drug is to be given. What is your best action?
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a. Call the healthcare provider to clarify the order. J J J J J J J
b. Refer the question to the hospital pharmacy. J J J J J J
c. Givethe drug according to the information ina drug handbook. J J J J J J J J J J
d. Hold the drug until the healthcare provider returns the following day.J J J J J J J J J J
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Your responsibility as a nurse giving drugs is to apply knowledge about the specific drug and drug orders. No part of the drug
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order should be unclear. Any questions related to the drug, dose or appropriateness for the specific patient should be answered
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before the drug is given. J J J J
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11. Apatient isreceivingan antibiotic forpneumonia. On thethird dayofthetreatment regimen, arashappears onherchest, and
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shereports itching and shortness of breath. Which term describes the effect that has occurred? J J J J J J J J J J J J J
a. Therapeutic effect J
b. Adverse effect J
c. Sideeffect J
d. Overdose effect J
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Anitchyrashwithshortnessofbreaththatdevelopsinresponsetodrugisanexampleofanallergicreactionoradverse effect tothe
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antibiotic. Therapeutic effects occurwhen an antibiotic fights infection without causing any adverse effects. Side effectsofdrugs
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areknownpotentialeffectsoftheantibiotic thatrangefrommildtomoderate.Anoverdoseoccursif a patient receives too much of
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a drug.
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12. AnLPNentersapatient’sroomtogiveascheduleddrug.Beforeadministration,thepatientstates,“Ican’ttakethat drug;
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I’m allergic to it.” What should the nurse do first?
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a. Reassurethepatientthatthedrugisneededandobservationsregarding J J J J J J J J J J J
possibleallergic symptoms will be made. J J J J
b. Reviewthepatientrecordandencouragethepatient totakethedrugif J J J J J J J J J J J J J
noallergies have been documented. J J J
c. Assessthepatient’sallergichistoryandnotifythehealthcareproviderto J J J J J J J J J J J
determine a course of action. J J J J
d. Documentpatientrefusalandleaveanoteonthepatientchart for J J J J J J J J J J J J
thehealthcareprovider.
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Thepatienthassharedinformationthatindicatesthepotentialfortheordereddrugtocauseadverseeffects.Beforegiving the drug,the
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nurseshouldinvestigatefurtherbyobtainingamoredetaileddrughistoryandnotifyingthehealthcareproviderwho wrote theorder.
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Althoughtheorder may beaccurately written, determining whether thedrug’s benefits outweigh therisksis notanactionwithinthe
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legalscopeofthenurse’spractice.Thenurseshouldnotofferfalsereassuranceandasanadvocate forpatientsafety,should
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investigatefurtherbeforegivingthedrug.Thepatienthasraisedconcernsregardingthedrugthat should promptly be broughttothe J J J J J J J J J J J J J J J J J J J J J
provider’sattention.A noteon the chartleavespotential forinformation to be missed. J J J J J J J J J J J J J
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13. TheLPNispreparingtogivetheinitialdoseofanantibiotictoa patientdiagnosed withaninfection. Thepatientsays,“I broke
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outin a rash the last time I took that pill.” What action should the LPN take next?
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a. Givethedrugandcheckthepatientin30minutesforarash. J J J J J J J J J J J J
b. Document thatthe patient refused the drug peragency policy. J J J J J J J J J
c. Leavethe drug at the bedside whilechecking thechartfor the patient’s allergies. J J J J J J J J J J J J J
d. Notify theregistered nurse or healthcare provider. J J J J J J
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Thisisapossibleadversereaction,andtheRNorhealthcareprovidershouldbenotifiedimmediately.Youwouldnever give the
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drugtoseeifitdoescausearash.Drugshouldneverbeleftatthebedside.Thepatientdidnotrefusethedrug.
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14. Whichpriorityassessment must you makebeforegiving anypatient adrugby mouth?
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a. Quizthe patient about the action of each drug. J J J J J J J J
b. Makesurethe patient can swallow. J J J J J
c. Find out whether thepatient prefers cold or room temperature liquids. J J J J J J J J J J
d. Askthepatient to repeat his or her name and birthdate. J J J J J J J J J J
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Beforethepatientcantakeanydrugbymouth,theymustbeabletoswallow.Askingthepatienttorepeathisnameand birthdatemay
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bepartofusingtwoidentifiersbutthisisimportantwithallpatients.Preferencesarealsoimportant,butthe priority is that the patient
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be able to swallow the drug.
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MULTIPLE J
RESPONSE
1. Youarepreparingtogivethe morningdrugstoyourassignedpatients.Beforegiving eachdrug, whichsteps areconsideredto be “rights”of
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givingadrug?(Selectallthatapply.) J J J J J J
a. Therightplan J J
b. Therighttime J J
c. Therightdose J J
d. Theright patient J J
e. The right to self-administer J J J
f. The right drug J J
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Theninerightsassociatedwithgivingdrugsareasfollows:rightpatient,rightdrug,righttime,rightdose,rightroute,right documentation,
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right reason, right response, and right to refuse.
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