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