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Lilley-Pharmacology and the Nursing Process, 9th Edition

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When evaluating a patient who is taking orlistat (Xenical), which is an intended therapeutic effect? a. Increased wakefulness b. Increased appetite c. Decreased weight d. Decreased hyperactivity ANS: C Orlistat (Xenical) is a nonstimulant drug that is used as part of a weight loss program. The other options are incorrect. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 7. The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching? a. “I will take this medication regularly to prevent a migraine headache from occurring.” b. “I will take this medication when I feel a migraine headache starting.” c. “This medication will not reduce the number of migraines I will have.” d. “I will keep a journal to record the headaches I have and how the injections are working.” ANS: A Although they may be taken during aura symptoms by patients who have auras with their headaches, these drugs are not indicated for preventive migraine therapy. The medication is intended to relieve the migraine and not to prevent it or to reduce the number of attacks. The triptans do not reduce the number of migraines a person will have. Journal recordings of headaches and the patient’s responses to the medication are helpful. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies MULTIPLE RESPONSE 1. The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.) a. Narcolepsy b. Depression c. Panic attacks d. Neonatal apnea e. Attention deficit hyperactivity disorder (ADHD) f. Appetite suppression ANS: A, D, E, F Central nervous system stimulants can be used for narcolepsy, neonatal apnea, ADHD, and appetite suppression in the treatment of obesity. They are not used for depression and panic attacks. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. A patient has a new prescription for phentermine (Ionamin) as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.) a. Take this medication after meals. b. Take this medication in the morning. c. This drug is taken along with supervised exercise and suitable diet. d. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth. e. Avoid foods that contain caffeine, such as coffee, tea, and colas. ANS: B, C, D, E This drug should be taken in the morning to avoid interference with sleep, and the patient should also be on a supervised exercise and dietary regime. Caffeine-containing products should be avoided because of possible additional stimulation. Dry mouth can be minimized by the use of mouth rinses, sugarless gum, or hard candy. The other option is incorrect. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies COMPLETION 1. The order reads, “Give atomoxetine (Strattera) 0.5 mg/kg/day once daily in the morning before school.” The child weighs 88 pounds. Identify how many milligrams will be administered per dose. ANS: 20 mg 88 pounds ÷ 2.2 = 40 kg 0.5 mg/kg/day 40 kg = 20 mg/day DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Chapter 14: Antiepileptic Drugs Lilley: Pharmacology and the Nursing Process, 9th Edition MULTIPLE CHOICE 1. The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing? a. Levetiracetam (Keppra) b. Phenobarbital c. Valproic acid (Depakote) d. Gabapentin (Neurontin) ANS: B Phenobarbital has the longest half-life of all standard AEDs, including those listed in the other options; therefore, it allows for once-a-day dosing. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding of the instructions? a. “I will need to take extra care of my teeth and gums while on this medication.” b. “I can go out for a beer while on this medication.” c. “I can skip doses if the side effects bother me.” d. “I will be able to stop taking this drug once the seizures stop.” ANS: A Thorough dental care is necessary to prevent gingival hypertrophy during therapy with phenytoin. Alcohol and other central nervous system depressants may cause severe sedation. Consistent dosing is important to maintain therapeutic drug levels. Therapy with AEDs usually must continue for life and must not be stopped once seizures stop. DIF: Cognitive Level: Analyzing (Analysis) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction? a. “Driving is allowed after 2 weeks of therapy.” b. “If seizures recur, take a double dose of the medication.” c. “Antacids can be taken with the AED to reduce gastrointestinal adverse effects.” d. “Take the drug at the same time every day.” ANS: D Consistent dosing, taken regularly at the same time of day, at the recommended dose, and with meals to reduce the common gastrointestinal adverse effects, is the key to successful management of seizures when taking AEDs. The other options are not correct statements. DIF: Cognitive Level: Applying

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LILLEY: PHARMACOLOGY AND THE NURSING
PROCESS, 9TH EDITION
ALL CHAPTERS COVERED

,Chapter 01: The Nursing Process and Drug Therapy

Lilley: Pharmacology and the Nursing Process, 9th Edition

MULTIPLE CHOICE

1. The nurse is developing a human needs statement for a patient who has a new diagnosis of
heart failure. Identification of human needs statements occur with which of these activities?

a. Collection of patient data

b. Administering interventions

c. Deciding on patient outcomes

d. Documenting the patient’s behavior

ANS: A

Identification of human needs occurs with the collection of patient data.



DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Human Needs
Statement

MSC: NCLEX: Safe and Effective Care Environment: Management of Care



2. The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and
gave the medication 2 hours after the scheduled dose was due. What type of problem does this
represent?

a. “Right time”

b. “Right dose”

c. “Right route”

d. “Right medication”

ANS: A

“Right time” is correct because the medication was given more than 30 minutes after the scheduled
dose was due. “Dose” is incorrect because the dose is not related to the time the medication
administration is scheduled. “Route” is incorrect because the route is not affected. “Medication” is
incorrect because the medication ordered will not change.



DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control

,3. The nurse has been monitoring the patient’s progress on a new drug regimen since the first
dose and documenting the patient’s therapeutic response to the medication. Which phase of the
nursing process do these actions illustrate?

a. Human needs statement

b. Planning

c. Implementation

d. Evaluation

ANS: D

Monitoring the patient’s progress, including the patient’s response to the medication, is part of the
evaluation phase. Planning, implementation, and human needs statement are not illustrated by this
example.



DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care



4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which
statement best illustrates an outcome criterion for this patient?

a. The patient will follow instructions.

b. The patient will not experience complications.

c. The patient will adhere to the new insulin treatment regimen.

d. The patient will demonstrate correct blood glucose testing technique.

ANS: D

“Demonstrating correct blood glucose testing technique” is a specific and measurable outcome
criterion. “Following instructions” and “not experiencing complications” are not specific criteria.
“Adhering to new regimen” would be difficult to measure.



DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning

MSC: NCLEX: Safe and Effective Care Environment: Management of Care



5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?

, a. Providing education on keeping a journal of blood pressure readings

b. Setting goals and outcome criteria with the patient’s input

c. Recording a drug history regarding over-the-counter medications used at home

d. Formulating human needs statements regarding insufficient knowledge related to the new
treatment regimen

ANS: A

Education is an intervention that occurs during the implementation phase. Setting goals and outcomes
reflects the planning phase. Recording a drug history reflects the assessment phase. Formulating human
needs statements reflects analysis of data as part of planning.



DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care



6. The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning
chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order. What is the
nurse’s best action?

a. Give the medication intravenously because the patient might vomit.

b. Give the medication orally because the tablets are available in 4-mg doses.

c. Contact the prescriber to clarify the route of the medication ordered.

d. Hold the medication until the prescriber returns to make rounds.

ANS: C

A complete medication order includes the route of administration. If a medication order does not
include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral routes are not
interchangeable. Holding the medication until the prescriber returns would mean that the patient would
not receive a needed medication.



DIF: Cognitive Level: Applying (Application)



TOP: Nursing Process: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

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