Pharmacology and the Nursing Process-Pharmacology Test Bank for NCLEX _RN

Chapter 01 The Nursing Process and Drug Therapy MULTIPLE CHOICE 1. The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis? A. Anxiety B. Anxiety related to new drug therapy C. Anxiety related to feelings about drug therapy as evidenced by statements such as ―I’m upset about having to give myself shots‖ D. Anxiety related to new drug therapy as evidenced by statements such as ―I’m upset about having to give myself shots‖ ANS: D 2. A patient is to receive oral digoxin (Lanoxin) daily; however, because he is unable to swallow, he cannot take it orally, as ordered. What type of problem does this represent? A. ―Right time‖ problem B. ―Right dose‖ problem C. ―Right route‖ problem D. ―Right medication‖ problem ANS: C 3. The nurse has been monitoring a patient’s progress on a new drug regimen since the first dose and documenting signs of possible adverse effects. This example illustrates which phase of the nursing process? A. Planning B. Evaluation C. Implementation D. Nursing diagnosis ANS: B 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 safe insulin self-administration technique. ANS: D 5. Which activity best reflects the implementation phase of the nursing process for a patient who is newly diagnosed with type 1 diabetes mellitus? A. Providing education regarding self-injection technique B. Setting goals and outcome criteria with the patient’s input C. D. Recording a drug history regarding over-the-counter medications used at home Formulating nursing diagnoses regarding knowledge deficit related to new treatment regimen ANS: A 3 6. The medication order reads, ―Give ondansetron 24 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. Giving the medication intravenously because it is for nausea prevention B. Giving the medication orally because the tablets are available in 24 mg doses C. Contacting the prescriber to clarify the route of the medication ordered D. Holding the medication until the prescriber returns to clarify the order ANS: C 7. When the nurse considers the timing of a drug dose, which of the factors listed below is appropriate to consider when deciding when to give a drug? A. The patient’s ability to swallow B. The patient’s weight C. The patient’s last meal D. The patient’s allergies ANS: C MULTIPLE RESPONSE 1. When giving medications, the nurse will follow the rights of medication administration, which include what rights? Select all that apply. A. Right drug B. Right route C. Right dose D. Right time E. Right patient F. Right documentation ANS: A, B, C, D, E, F OTHER 1. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. 1. Evaluation 2. Nursing Diagnoses 3. Assessment 4. Implementation 5. Planning ANS: 3, 2, 5, 4, 1 4 Chapter 02 Pharmacologic Principles MULTIPLE CHOICE 1. A patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Thus, because they have the same absorption rates, they are A. in a steady state. B. synergistic. C. compatible. D. bioequivalent. ANS: D 2. When given an intravenous (IV) medication, the patient says to the nurse, ―I usually take pills. Why does this medication have to be given in the arm?‖ What is the nurse’s best answer? A. ―The medication will cause fewer adverse effects when given intravenously.‖ B. ―The IV medication will be absorbed slowly into the tissues over time.‖ C. ―The action of the medication will begin sooner when given intravenously.‖ D. ―There is a lower chance of allergic reactions when drugs are given IV.‖ ANS: C 3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? A. Parenteral drugs bypass the first-pass effect. B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. C. Absorption of parenteral drugs is altered by the presence of food in the stomach. D. Parenteral drugs exert their effects while circulating in the bloodstream. ANS: A 4. When monitoring a patient on an insulin drip to reduce blood glucose levels, the nurse notes that the patient’s glucose level is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction? A. An adverse effect B. An allergic reaction C. An idiosyncratic reaction D. A pharmacologic reaction ANS: D 5. When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that a drug’s half-life is the time it takes for A. the drug to elicit half of its therapeutic response. B. one half of the original amount of a drug to reach the target cells. C. one half of the original amount of a drug to be removed from the body. D. one half of the original amount of a drug to be absorbed into the circulation. ANS: C 5 6. When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time it takes A. for a drug to elicit a therapeutic response. B. for a drug to achieve its maximum therapeutic response. C. to remove a drug from circulation. D. for a drug’s concentration to be sufficient to cause a therapeutic response. ANS: D 7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. This process occurs when the drug A. alters cell membrane permeability. B. is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. C. enhances its effectiveness within the cell walls of the target tissue. D. attracts enzymes to bind with it instead of the enzymes’ normal target cells, blocking the action of the enzymes. ANS: D 8. When administering a new medication to a patient, the nurse reads that it is highly proteinbound. The nurse should expect which result? A. Renal excretion will take longer. B. The length of time for drug metabolism will be shorter. C. The duration of action of the medication will be longer. D. The duration of action of the medication will be shorter. ANS: C 9. A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? A. Under the tongue B. In the space between the cheek and the gum inside the mouth C. At the back of the throat for easy swallowing D. On a nonhairy area of the chest ANS: A 10. The nurse is administering medications to a patient who is in liver failure resulting from endstage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase? A. Absorption B. Distribution C. Metabolism D. Excretion ANS: C 11. A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? 6 A. Palliative therapy B. Maintenance therapy C. Acute therapy D. Supplemental therapy ANS: A 12. The nurse gave a sleeping pill to an elderly patient at bedtime. Two hours later, the patient is irritable and restless and unable to sleep. The nurse recognizes that the patient’s response is reflective of which reaction? A. Allergic reaction B. Mutagenic effect C. Idiosyncratic reaction D. Teratogenic reaction ANS: C MULTIPLE RESPONSE 1. Of the drugs listed below, which would be affected by the first-pass effect? Select all that apply. A. morphine infusion through a patient-controlled analgesia pump B. nitroglycerin sublingual tablets C. diphenhydramine (Benadryl) elixir D. levothyroxine (Synthroid) tablets E. Transdermal nicotine patches F. nifedipine (Procardia) capsules G. penicillin given by IV piggyback infusion ANS: C, D, F 7 Chapter 03 Life Span Considerations MULTIPLE CHOICE 1. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason? A. Decreased fetal surface area B. Increased placental surface area C. Enhanced placental blood flow D. Increased amount of protein-bound drug in maternal circulation ANS: C 2. The nurse is monitoring a 22-year-old patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration (FDA) pregnancy safety category? A. Category B B. Category C C. Category D D. Category X ANS: C 3. When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations? A. West nomogram B. Clark rule C. Height-to-weight ratio D. Mg/kg formula ANS: D 4. The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? A. The patient has lower risk for drug interactions. B. The patient takes one medication for an illness several times a day. C. The patient risks problems only if over-the-counter medications are also taken. D. The patient takes multiple medications for several different illnesses. ANS: D 5. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses of an elderly patient who is taking which type of drug? A. Laxatives B. Anticoagulants C. Sedatives D. Diuretics ANS: C 8 6. For accurate medication administration to pediatric patients, the nurse must take into account which criteria? A. Weight and organ maturity B. Renal output and weight C. Weight, body temperature, and age D. Height and age ANS: A 7. It is not uncommon for an elderly patient to experience a reduction in the stomach’s ability to produce hydrochloric acid. This change may result in which effect? A. Delayed gastric emptying B. An increase in gastric acidity C. Decreased intestinal absorption of medications D. Altered absorption of weakly acidic drugs such as aspirin ANS: D 8. The nurse is administering drugs to neonates and should consider which factor that may contribute to drug toxicity? A. The lungs are immature. B. The kidneys are small. C. The liver is not fully developed. D. Excretion of the drug occurs quickly. ANS: C 9. An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems? A. Constipation and anorexia B. Fatigue and dehydration C. Daytime sedation and lethargy D. Edema, nausea, and blurred vision ANS: B 10. An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy? A. Drug therapy will be based on the patient’s weight. B. Drug therapy will be based on the patient’s age. C. The patient will receive the maximum dose that is expected to reduce the blood pressure. D. The patient will receive the lowest possible dose at first, and then the dose will be adjusted as needed. ANS: D 11. The nurse is trying to give a liquid medication to a -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child? 9 A. Give the medication with spoonfuls of sherbet. B. Add the medication to the child’s bottle. C. Tell the child you have candy for him. D. Add the medication to a cup of milk. ANS: A MULTIPLE RESPONSE 1. Which statements are true regarding pediatric patients and pharmacokinetics? Select all that apply. A. The levels of microsomal enzymes are decreased. B. Perfusion to the kidneys may be decreased and may result in reduced renal functio C. First-pass elimination is increased because of higher portal circulation. D. First-pass elimination is reduced because of the immaturity of the liver. E. Total body water content is much less than in adults. F. Gastric emptying is slowed because of slow or irregular peristalsis. G. Gastric emptying is more rapid because of increased peristaltic activity. ANS: A, B, D, F 2. Which statements are true regarding the elderly and pharmacokinetics? Select all that apply. A. The levels of microsomal enzymes are decreased. B. Fat content is increased because of decreased lean body mass. C. Fat content is decreased because of increased lean body mass. D. The number of intact nephrons is increased. E. The number of intact nephrons is decreased. F. Gastric pH is less acidic. G. Gastric pH is more acidic. ANS: A, B, E, F OTHER 1. A newborn infant needs a dose of acetaminophen. The order reads, ―Give acetaminophen, infant oral solution, 10 mg/kg/dose, every 4 hours as needed.‖ The infant weighs 7.8 pounds. How many milligrams will this infant receive per dose? Round to the nearest tenth. ANS: 35 mg 10 Chapter 04 Cultural, Legal, and Ethical Considerations MULTIPLE CHOICE 1. During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug’s usefulness? A. A placebo B. FDA approval C. Informed consent D. Efficacy information ANS: A 2. A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study? A. Phase I B. Phase II C. Phase III D. Phase IV ANS: A 3. During discharge patient-teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III? A. No prescription refills are permitted. B. Refills are allowed only by written prescription. C. The patient may have no more than 5 refills in a 6-month period. D. The patient may have no more than 6 refills in a 12-month period. ANS: C 4. A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates that the patient A. has been informed of the possible benefits of the new therapy. B. will be informed of the details of the study as the research continues. C. will not be sure to receive the actual drug during the experiment. D. has had the study’s purpose, procedures, and the risks involved explained to him. ANS: D 5. For which cultural group must the health care provider respect the value placed on harmony with nature and the belief that disease is the result ill spirits? A. Hispanics B. Asian Americans C. Native Americans D. African Americans ANS: C 11 6. The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects? A. The patient should be discouraged from using folk remedies and rituals. B. The nurse should expect the patient to value protective bracelets and ―root workers‖ as healers. C. The nurse should remember that the balance among body, mind, and environment would be important for this patient’s health beliefs. D. The nurse’s assessment should include information regarding religious practices and beliefs regarding medication, treatment, and healing. ANS: D 7. When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs? A. Drugs with high potential for abuse that have accepted medical use B. Drugs with high potential for abuse that do not have accepted medical use C. Medically accepted drugs that may cause moderate physical or psychologic dependence D. Medically accepted drugs with very limited potential for causing mild physical or psychologic dependence ANS: A 8. The nurse is reviewing facts about pharmacology. The term legend drug refers to which item? A. Over-the-counter drugs B. Prescription drugs C. Orphan drugs D. Herbal products ANS: B 9. Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as? A. Justice B. Veracity C. Beneficence D. Nonmaleficence ANS: B 10. The nurse is performing an admission assessment. Which findings would reflect a component of a cultural assessment? A. The patient uses aspirin as needed for pain. B. The patient has a history of hypertension. C. The patient is allergic to shellfish. D. The patient does not eat pork products for religious reasons. ANS: D 12 MULTIPLE RESPONSE 1. Which factors contribute to drug polymorphism? Select all that apply. A. The number of drugs ordered by the physician B. Inherited factors C. The patient’s diet and nutrition status D. Different dosage forms of the same drug E. The patient’s values and beliefs F. The patient’s drug history G. The various available forms of a drug ANS: B, C, E