Test Bank for Lehne's Pharmacology for Nursing Care, 9th Edition

1. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jittery sometimes when takingthe medication, and she doesn’t feel that the medication is always effective. Which action is outside the nurse’s scope of practice? a. Asking the patient to demonstrate use of the inhaler b. Assessing the patient’s exposure to tobacco smoke c. Auscultating lung sounds and obtaining vital signs Suggesting that the patient use one puff to reduce side d. effects ANS: D It is not within the nurse’s scope of practice to change the dose of a medication without an order from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to evaluate the patient’s ability to administer the medication properly and is part of the nurse’s evaluation. Assessing tobacco smoke exposure helps the nurse determine whether nondrug therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a physical assessment helps the nurse evaluatethe patient’s response to the medication. PTS: 1 DIF: Cognitive Level: Application REF: pp. 9-10 TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 2. A postoperative patient is being discharged home with acetaminophen/hydrocodone[Lortab] for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct? “It is not safe to take over-the-counter drugs with a. prescription medications.” “Taking the two medications together poses a risk of b. drug toxicity.” “There are no known drug interactions, so this will be c. safe.” “Tylenol and Lortab are different drugs, so there is no d. risk of overdose.” ANS: B Tylenol is the trade name and acetaminophen is the generic name for the same medication. It is important to teach patients to be aware of the different names for the same drug to minimize the risk of overdose. Over-the-counter (OTC) medications and prescription medications may be taken together unless significant harmful drug interactions are possible. Even though no drug interactions are at play in this case, both drugs contain acetaminophen, which could lead to toxicity. PTS: 1 DIF: Cognitive Level: Application REF: p. 8 TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential