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VISOVSKY INTRODUCTION TO CLINICAL PHARMACOLOGY, 10TH EDITION TESTBANK

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VISOVSKY INTRODUCTION TO CLINICAL PHARMACOLOGY, 10TH EDITION TESTBANK Chapter 09: Drugs Affecting the Renal/Urinary and Cardiovascular Systems Visovsky: Introduction to Clinical Pharmacology, 10th Edition MULTIPLE CHOICE 1. Which body system works with the renal/urinary system to maintain fluid balance and remove waste products from the body? a. Biliary system b. Cardiovascular system c. CNS d. Gastrointestinal system ANS: B The renal/urinary system works together with the cardiovascular system to maintain adequate circulation to all parts of the body. The interactions between these two systems help maintain fluid balance, delivery of nutrients, and removal of waste products from cells, tissues, and organs. Most drugs that affect one system have an effect on the functioning of the other system. DIF: Cognitive Level: Remembering REF: p. 134 2. A patient with newly diagnosed hypertension is prescribed a thiazide diuretic. The patient asks how thiazide diuretic drugs reduce high blood pressure. What is your best response? a. “Thiazide diuretics reduce blood volume and relax vascular smooth muscle in the arterioles, reducing blood pressure.” b. “Thiazide diuretics increase potassium excretion and slow heart contractions, reducing blood pressure.” c. “Thiazide diuretics release sodium from cellular storage sites to reduce blood pressure.” d. “Thiazide diuretics increase the reabsorption of sodium, potassium and chlorides, reducing blood pressure.” ANS: A Blood pressure is maintained by fluid volume in circulation, the force of heart contractions, and the constriction of blood vessels that provide resistance. All diuretics help lower blood pressure by reducing the amount of fluid (volume) in the blood. Thiazide and thiazide-like diuretics also relax blood vessel smooth muscle, which decrease vascular resistance to blood flow. The reduced volume and decreased resistance result in lower blood pressure. DIF: Cognitive Level: Applying REF: p. 134 3. You are teaching a patient about the side effects of diuretics. Which health problem is a potential side effect or adverse reaction of any class of diuretic drug? a. Dehydration b. Heart failure c. Blurred vision d. Urinary tract infection ANS: A Diuretics work by increasing the excretion of water through urination. When water loss is excessive, dehydration of the circulatory system or even the whole body can occur. Diuretic therapy helps improve the symptoms of heart failure and do not cause blurred vision. Although a urinary tract infection can occur in a patient taking a diuretic, the drug is not the direct cause. DIF: Cognitive Level: Understanding REF: p. 134 4. A patient has been prescribed furosemide (Lasix) for the treatment of heart failure. Which statement made by the patient indicates the need for more teaching? a. “Since I work at night, I take my drug when I first wake up rather than in the morning.” b. “If my hearing decreases, I will notify my healthcare provider.” c. “I make sure to space my fluid intake evenly throughout the day.” d. “When I travel long distances, I will plan to skip my diuretic that day.” ANS: D Although taking the time to urinate while traveling is inconvenient, the patient needs to understand that the drug must be taken every day. Often, patients are told to take the drug in the morning; it should be taken at the time furthest away from when the patient usually goes to bed so there is less interference with his or her normal sleep patterns. Spacing fluid intake evenly throughout the day helps prevent dehydration. Loop diuretics can cause hearing loss and the patient should notify the healthcare provider if this develops even though his or her health problem may require that the drug be continued. DIF: Cognitive Level: Applying REF: p. 138 5. The LPN is caring for a patient who has recently been prescribed nitrate drug. The patient reports a throbbing headache. Which response is the most appropriate? a. “Throbbing headache is a symptom of an allergic response to the drug.” b. “Throbbing headache is a symptom of developing tolerance to the drug.” c. “Throbbing headache is a temporary symptom that should disappear within a few weeks.” d. “Throbbing headache is a symptom of interaction with your other drugs.” ANS: C Throbbing headache is a transient side effect of nitrate drugs that should disappear. This symptom does not indicate an allergic response, development of tolerance to the drug, or interaction with the patient’s other drugs. DIF: Cognitive Level: Applying

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VISOVSKY: INTRODUCTION TO CLI
PHARMACOLOGY, 10TH EDITIO
TESTBANK

,Chapter 01: Pharmacology and the Nursing Process in LPN Practice
Visovsky: Introduction to Clinical Pharmacology, 10th Edition


MULTIPLE CHOICE

1. The LPN is collecting data for the initial assessment of a patient upon admission to a long-term care fa
patient’s prescribed drugs. Which action should the LPN consider to be the highest priority?
a. Obtain any special equipment that will be needed to give the patient’s drug.
b. Monitor the patient for a response to the drug given.
c. Collect data about the patient and the patient’s health condition.
d. Review the nursing care plan to verify that it is accurate.
ANS: C
Collecting and documenting data about the patient and the patient’s health condition is a critical step b
Information regarding the present illness, any signs and symptoms, review of medical records, drug his
needed before drugs are given. Deciding on special equipment that will be needed to give the patient’s
phase of the nursing process. Monitoring the patient for his response to given drug is part of the evalua
process. Reviewing the nursing care plan to verify that it is being followed accurately is part of the imp
nursing process.

DIF: Cognitive Level: Applying REF: p. 2

2. The LPN is working with a patient in the planning stage of the nursing process related to the patient’s p
action should the LPN take during this stage?
a. Develop a nursing goal to plan the procedures needed to give drug.
b. Develop a teaching plan for the patient regarding the drug’s actions.
c. Determine that the patient is experiencing the expected response to his drug.
d. Determine how much the patient understands about his drug.
ANS: D
Determining how much the patient understands about his drug is part of the diagnosis phase of the nurs
nursing goal to plan the procedures needed to give drug and developing a teaching plan for the patient
are part of the planning phase of the nursing process.

DIF: Cognitive Level: Applying REF: p. 2

3. You are teaching a patient with depression about the potential adverse effects of a prescribed drug. Wh
related to drug therapy are you engaging in at this point of the teaching plan?
a. Assessment
b. Implementation
c. Evaluation
d. Diagnosis
ANS: C
In the evaluation phase of the nursing process, the LPN understands and teaches to the patient the drug
expected side effects, and potential adverse effects.

DIF: Cognitive Level: Remembering REF: p. 2

4. Which of the following is an example of subjective data?
a. The patient states she has pain in her left arm.
b. The medical chart has a recorded blood pressure of 128/88.
c. The serum potassium level is 3.8 mmol/L.
d. The patient’s ECG shows normal sinus rhythm.
ANS: A
Reports from the patient or patient’s caregiver are considered subjective data. Symptoms such as pain,
examples of symptoms that cannot be “seen” and are data collected from the patient, caregiver, or othe
results, or vital sign data from a medical chart are examples of objective data.

,6. The LPN/VN is assessing a patient before giving a drug for blood pressure management. The nurse not
90/50 mm Hg. What is the nurse’s best action?
a. Hold the drug and report the blood pressure to the RN.
b. Give the patient a full glass of water before giving the drug.
c. Come back in 30 minutes and recheck the blood pressure.
d. Have the patient perform pursed lip breathing before giving the drug.
ANS: A
The best action is to hold the drug and contact the RN. The patient may need an adjustment to the dose
or switching to another drug. Giving water with the drug is not contraindicated but does not recognize
hypotension. Pursed lip breathing has no role in this situation.

DIF: Cognitive Level: Remembering REF: p. 4

7. The LPN is collecting objective data for inclusion in the nursing assessment. Which piece of informatio
a clear understanding of objective assessment data?
a. A patient’s rating of chest pain as 8 on a 1 to 10 scale.
b. Family members report that patient has been experiencing pain for 1 month.
c. Detailed history of the patient’s current illness upon admission.
d. Compilation of past laboratory results and x-ray reports.
ANS: D
The patient’s past laboratory and x-ray results are examples of objective data. A pain rating of 8/10, a f
of the patient’s pain, and history of current illness are examples of subjective data.

DIF: Cognitive Level: Remembering REF: p. 3

8. A patient recently began a taking blood pressure drug and presents for a follow-up appointment. The o
patient’s daily blood pressure recordings. Which stage of the nursing process corresponds to this review
a. Assessment
b. Planning
c. Diagnosis
d. Evaluation
ANS: D
The evaluation phase involves examining the results that occur when the plan is implemented. Review
pressure recording examines the patient’s response to the drug. The assessment phase provides initial i
the problem, and anything that may change the choice of treatment. The planning phase involves using
diagnoses to set goals and write care plans. The diagnosis phase involves decision-making about the pa
medical diagnoses made by the healthcare provider and nursing diagnoses developed through the North
Diagnosis Association (NANDA).

DIF: Cognitive Level: Remembering REF: p. 2

9. After receiving report, the LPN gives drugs to her assigned patients on the evening shift. With which s
does this activity correspond?
a. Implementation
b. Assessment
c. Planning
d. Diagnosis
ANS: A
The implementation phase involves actively following the plan of care and accurately giving ordered d
assessment phase involves obtaining initial information about the patient, the problem, and anything th
treatment. The planning phase involves using patient assessment data and diagnoses to set goals and w
phase involves decision-making about the patient’s problems, including medical diagnoses made by th
nursing diagnoses developed through the North American Nursing Diagnosis Association (NANDA).

DIF: Cognitive Level: Remembering REF: p. 5

, 11. A patient is receiving an antibiotic for pneumonia. On the third day of the treatment regimen, a rash ap
reports itching and shortness of breath. Which term describes the effect that has occurred?
a. Therapeutic effect
b. Adverse effect
c. Side effect
d. Overdose effect
ANS: B
An itchy rash with shortness of breath that develops in response to drug is an example of an allergic re
the antibiotic. Therapeutic effects occur when an antibiotic fights infection without causing any advers
drugs are known potential effects of the antibiotic that range from mild to moderate. An overdose occu
much of a drug.

DIF: Cognitive Level: Understanding REF: p. 9

12. An LPN enters a patient’s room to give a scheduled drug. Before administration, the patient states, “I c
allergic to it.” What should the nurse do first?
a. Reassure the patient that the drug is needed and observations regarding possible
allergic symptoms will be made.
b. Review the patient record and encourage the patient to take the drug if no
allergies have been documented.
c. Assess the patient’s allergic history and notify the healthcare provider to
determine a course of action.
d. Document patient refusal and leave a note on the patient chart for the healthcare
provider.
ANS: C
The patient has shared information that indicates the potential for the ordered drug to cause adverse eff
the nurse should investigate further by obtaining a more detailed drug history and notifying the healthc
order. Although the order may be accurately written, determining whether the drug’s benefits outweigh
within the legal scope of the nurse’s practice. The nurse should not offer false reassurance and as an ad
should investigate further before giving the drug. The patient has raised concerns regarding the drug th
brought to the provider’s attention. A note on the chart leaves potential for information to be missed.

DIF: Cognitive Level: Applying REF: p. 4

13. The LPN is preparing to give the initial dose of an antibiotic to a patient diagnosed with an infection. T
in a rash the last time I took that pill.” What action should the LPN take next?
a. Give the drug and check the patient in 30 minutes for a rash.
b. Document that the patient refused the drug per agency policy.
c. Leave the drug at the bedside while checking the chart for the patient’s allergies.
d. Notify the registered nurse or healthcare provider.
ANS: D
This is a possible adverse reaction, and the RN or healthcare provider should be notified immediately.
drug to see if it does cause a rash. Drug should never be left at the bedside. The patient did not refuse t

DIF: Cognitive Level: Applying REF: p. 9

14. Which priority assessment must you make before giving any patient a drug by mouth?
a. Quiz the patient about the action of each drug.
b. Make sure the patient can swallow.
c. Find out whether the patient prefers cold or room temperature liquids.
d. Ask the patient to repeat his or her name and birthdate.
ANS: B
Before the patient can take any drug by mouth, they must be able to swallow. Asking the patient to rep
may be part of using two identifiers but this is important with all patients. Preferences are also importa
patient be able to swallow the drug.

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