Question 1
In which of the following patients would a nurse expect to experience
alterations in drug metabolism?
Response The liver is the most important site for drug metabolism. If the
Feedback: liver is not functioning effectively, as with cirrhosis, drugs will
not be metabolized normally and toxic levels could develop.
Drug dosage will have to be altered to ensure normal levels in the
body. The patient with kidney stones and the patient in acute
renal failure would most likely have alterations in drug excretion.
If there are no complications with the cervical cancer patient,
there should be no alterations in drug therapy.
Question 2
A nurse is instructing a patient concerning a newly prescribed drug. Which of
the following should be included to help improve patient compliance and
safety?
Response If patients are aware of certain adverse effects and how to
Feedback: alleviate or decrease the discomfort, they are more likely to
continue taking the medication and providing for safe
administration. A list of pharmacies can be useful information,
but will not improve safety or compliance. Knowing the cost of
the brand versus the generic could also be helpful to the patient.
However, a substitution may not be allowed, and the cost of a
drug does not improve patient safety. Most patients are not
concerned with statistics regarding drug testing, and the testing is
usually not discussed with patients.
Question 3
An elderly postsurgical patient has developed postoperative pneumonia in the
days following abdominal surgery and is being treated with a number of
medications. Which of the following medications that the nurse will administer
has the slowest absorption?
, Response Absorption of drugs is dependent primarily on the route of
Feedback: administration. IV, IM, and sublingual administration results in
faster absorption than drugs that are given orally.
Question 4
The nurse's assessment of a community-dwelling adult suggests that the client
may have drug allergies that have not been previously documented. What
statement by the client would confirm this?
Response True allergic reactions include formation of rash or hives,
Feedback: itching, redness, swelling, difficulty breathing, and anaphylactic
shock. Nausea and vomiting, however, are adverse effects of
drug therapy. Similarly, an unsafe drop in blood pressure and
gastric bleeding from aspirin use are adverse drug effects, not
allergic reactions.
Question 5
For which of the following patients would a nasogastric tube most likely be
considered to aid in the administration of medications?
Response The use of an NG tube for medication administration requires a
Feedback: functioning GI tract. An NG tube would not be used if a patient
is vomiting frequently or has had recent bowel surgery.
Similarly, an NG tube would not be used in the case of a
competent adult who wishes to discontinue his or her
medications.
Question 6
A nurse has been administering a drug to a patient intramuscularly (IM). The
physician discontinued the IM dose and wrote an order for the drug to be given
orally. The nurse notices that the oral dosage is considerably higher than the
parenteral dose and understands that this due to