Pharmacology exam 1 questions and Answers,100% CORRECT

Pharmacology exam 1 questions and Answers Ch 1-5 PPT Questions 1. The nurse answers a patient’s call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first? a. Check the orders and give the patient the requested pain medication. b. Provide comfort measures to the patient. c. Assess the patient’s pain and pain level. d. Evaluate the effectiveness of previous pain medications. 2. The patient’s medication administration record lists two antiepileptic medications that are due at 0900, but the patient is NPO for a barium study. The nurse’s coworker suggests giving the medications via IV because the patient is NPO. What will the nurse do? a. Give the medications PO with a small sip of water. b. Give the medications via the IV route because the patient is NPO. c. Hold the medications until after the test is completed. d. Call the health care provider to clarify the instructions. 3. The day shift charge nurse is making rounds. A patient tells the nurse that the night shift nurse never gave him his medication, which was due at 2100. What will the nurse do first to determine whether the medication was given? a. Call the night nurse at home. b. Check the medication administration record. c. Call the pharmacy. d. Review the nurse’s documentation. 4. A nurse makes an error when administering medications to a patient. Which action by the nurse requires the supervising nurse to intervene? a. The nurse completes an incident report. b. The nurse informs the prescriber of the error. c. The nurse documents adverse effects to the medication error. d. The nurse records completion of an incident report in the medical record. 5. A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow pills. What will the nurse do? a. Crush the tablets and mix them with applesauce or pudding. b. Call the pharmacy and ask for the liquid form of the medication. c. Call the pharmacy and ask for the IV form of the medication. d. Encourage the patient to try to swallow the tablets. 6. The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do? a. Remove the old medication patch and notify the health care provider. b. Apply the new patch without removing the old one. c. Remove the old patch and apply the new patch in the same spot. d. Remove the old patch and apply the new patch to a different, clean area. 7. The nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from PO to IV. What can the nurse expect with the IV dose? a. The IV dose will be higher because of the first-pass effect. b. The IV dose will be lower because of the first-pass effect. c. The IV dose will be the same as the PO dose. d. The rate of IV infusion must be faster due to first-pass effect. 8. A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route? a. IV b. IM c. Subcutaneous d. PO 9. When teaching a pregnant woman about the use of drugs during pregnancy, which statement will the nurse include? a. Exposure of the fetus to drugs is most detrimental during the second trimester of pregnancy. b. Pregnant women must never take drugs to control high blood pressure. c. Drug transfer to a fetus is most likely to occur during the last trimester of pregnancy. d. A fetus is at greatest risk for drug-induced developmental defects during the second trimester of pregnancy. 10. When administering medications to pediatric patients, the nurse understands that the dosage calculations for pediatric patients are different than for adults because pediatric patients a. are more likely to develop edema. b. have more stomach acid. c. have skin that is less permeable. d. have immature liver and kidney function, resulting in impaired drug metabolism and excretion. 11. Bruno is a 6-month-old male who is being admitted for the treatment of pneumonia. The unit where Bruno is admitted is a combined adult and pediatric medical unit. The nurse assigned has little pediatric experience and has sought the advice of the experienced charge nurse. a. What age-related considerations should the nurse take into account when preparing medications for Bruno? 12. The nurse reviews the prescriber’s orders and notes the following: Administer acetaminophen 10 mg/kg/dose every 4 hours for fever greater than 102.6 temporal. The nurse needs to administer a dose. a. What important data would the nurse need to verify? 13. The nurse verifies the child’s weight on admission: 18.5 pounds. a. Using the prescribed dose: 10mg/kg/dose b. Calculate the mg of medication Bruno will receive per dose. 14. The acetaminophen unit dose label reads: Acetaminophen 160 mg/5 ml. a. How many ml will the nurse prepare for one dose of acetaminophen for Bruno? 15. The nurse caring for a pediatric patient calculates the safe range for the prescribed medication. Based on the nurses calculations, the dose ordered exceeds the high limit. What is the nurse’s next action? a. Contact the prescriber immediately. b. Administer only half the ordered dose. c. Proceed with administration of the prescribed dose. d. Contact pharmacy to substitute the prescribed medication with one that will calculate in the safe range. 16. What does the nurse identify as a pharmacokinetic change that occurs in older adults? a. Gastric pH is more acidic. b. Fat content is decreased because of increased lean body mass. c. There is increased production of proteins by the liver. d. The number of intact nephrons is decreased. 17. Which racial group is predicted to be nearly one in three U.S. residents in 2050? a. African American b. Asian c. Hispanic d. White 18. Which of the following statements regarding African Americans’ responses to antihypertensive medication therapy is true? a. African Americans respond better to diuretics than to beta blockers. b. African Americans do not respond to diltiazem. c. Single-drug therapy is effective for African Americans. d. Hypertension is uncommon in the African-American population. 19. A research group is conducting an investigational drug study on a promising new drug for osteoporosis. It has been difficult to find research participants who meet the criteria. Just before the conclusion of the study, four participants approach the researchers and express their desire to withdraw from the study. What is the researcher’s priority intervention? a. Inform them that they waited too long to withdraw from the study. b. Explore with them the reasons for withdrawing from the study. c. Acknowledge that they can withdraw at any time from the study. d. Request that they try to remain with the study until it is completed. 20. A nurse does not notice that a patient’s IV site is swollen, red, painful, and warm to touch nor that the IV has quit infusing properly. What ethical principle does this involve? a. Breach of duty b. Duty c. Causation d. Damage 21. A nurse has been asked to participate in an elective procedure that violates the nurse’s personal ethical principles. What is the nurse’s best action? a. Refuse to participate. b. Ask to switch assignments with another nurse. c. Speak to the manager or supervisor. d. Perform the procedure. 22. In a 2006 IOM study, it was estimated that some form of medication error resulted in harm to how many patients? a. 400,000 b. 800,000 c. 1 million d. 1.5 million 23. What is the most common point in the process at which medications errors occur? a. Prescribing b. Dispensing c. Administering d. Monitoring 24. The nurse is administering a drug that has been ordered as follows: “Give 10 mg on odd-numbered days and 5 mg on even-numbered days.” When the date changes from May 31 to June 1, what should the nurse do? a. Give 10 mg because June 1 is an odd-numbered day. b. Hold the dose until the next odd-numbered day. c. Change the order to read: “Give 10 mg on even-numbered days and 5 mg on odd-numbered days.” d. Consult the prescriber to verify that the dose should alternate each day, no matter whether the day is odd or even numbered 25. The nursing student realizes that she has given a patient a double dose of an antihypertensive medication. The tablet was supposed to be cut in half, but the student forgot and administered the entire tablet. The patient’s blood pressure just before the dose was 146/98 mm Hg. What should the student nurse do first? a. Notify the patient’s physician. b. Notify the clinical faculty. c. Take the patient’s blood pressure. d. Continue to monitor the patient. Answers to Ch 1-5 PPT Questions: 1. ANS: C a. The nurse should always assess a patient before any intervention. Although the nurse will check the orders and possibly give the medication (and possibly even perform the actions in responses B and D), the first priority is assessment. 2. ANS: D a. The dosage for the IV route would not be the same as for the PO route. Holding the medications may cause drug levels to drop and result in seizure activity, and giving the medications PO without consent may alter the test results. The nurse must never assume the route of medication administration and should consult the physician for clarification of the orders. 3. ANS: B a. The medication administration record is the legal documentation that the professional nurse uses to sign off medications that are given, so it should be checked first. 4. ANS: D a. If there is a medication error, the nurse should complete an incident report with the entire event, surrounding circumstances, therapeutic response, adverse effects, and notification of the prescriber described in detail. However, the nurse should not record completion of an incident report in the medical record. 5. ANS: B a. The liquid form is appropriate because it is also given via the oral route. Enteric-coated tablets should not be crushed, and the patient should not be forced to take the tablets. This medication does not have an IV form, but even if it did, the routes cannot be changed without a health care provider’s order. 6. ANS: D a. Transdermal drugs should be placed on alternating sites, on a clean and nonirritating area, and only after the previously applied patch has been removed. 7. ANS: B a. The first-pass effect is the metabolism of a drug before it becomes systemically available, and it reduces the bioavailability of the drug. This primarily occurs with oral medications. Therefore, IV doses need to be lower than PO doses because of the first-pass effect. 8. ANS: D a. Parenteral routes result in the fastest absorption and therefore also the fastest effects. 9. ANS: C a. Drug transfer to the fetus is most likely to occur during the last trimester of pregnancy. Exposure of a fetus to drugs is most detrimental during the first trimester of pregnancy, and fetuses are at greatest risk for drug-induced developmental defects during the first trimester of pregnancy. Pregnant women need to take medications to control situations such as high blood pressure. 10. ANS: D a. In pediatric patients, body temperature is less well regulated, and dehydration occurs easily; pediatric patients lack stomach acid to kill bacteria and have skin that is thinner and more permeable. It is true that pediatric patients have immature liver and kidney function, resulting in impaired drug metabolism and excretion. 11. The nurse must consider the age and weight of the child for safe medication administration. A 6-month-old cannot swallow pills therefore, liquid preparation of medications must be available. High risk medications should be verified by a second RN. Pediatric medications have safe ranges and these should be calculated for all medications. If the drug dose raises concerns or varies from the safe range, contact the prescriber immediately. The nurse will have to consider how to safely administer the medication. Oral syringes are common methods to instill the medication in the mouth of the young child. 12. The nurse needs to verify an accurate weight. Children of this age should be weighed nude or with as little clothing as possible (diaper and t-shirt). The weight should be calculated in kilograms. 13. 18.5 pounds equals 8.4 kg. 10 mg x 8.4 kg = 84 mg. 14. 84 mg/160 mg x 5 ml = 2.6 ml. 15. ANS: A a. The nurse should contact the prescriber immediately and before administering the medications. Giving only half the prescribed dose is making a prescribed order which is not within the scope of practice for the nurse. Pharmacy cannot make treatment changes without the direction of the prescriber. 16. ANS: D a. In older adults, the gastric pH is less acidic because of a gradual reduction in the production of hydrochloric acid in the stomach, fat content is increased because of decreased lean body mass, and there is decreased production of proteins by the aging liver and reduced protein intake. It is correct that the number of intact nephrons decreases in older adults. 17. ANS: C a. It is predicted that by 2050, nearly one third of the U.S. population will be Hispanic. The non-Hispanic, single-race white population is projected to be only slightly larger in 2050. The African-American population is projected to increase from 41 million (about 14%) to about 66 million (or 15%) by 2050. The Asian population is projected to increase from 15 million to about 40 million, rising from a current 5.1% to 9.2% of the total population. 18. ANS: A a. African Americans respond less effectively to beta blockers. African Americans respond best to calcium channel blockers, especially diltiazem. African Americans respond less effectively to single-drug therapy. 19. ANS: C a. The researcher may try to find the reasons for withdrawal and request that the participants try to remain with the study, but the individuals must know that their participation is truly voluntary and that they can quit the study at any time. 20. ANS: A a. Refer to Teamwork and Collaboration: Legal and Ethical Principles: Elements of Liability for Nursing Malpractice box on page 58 in the textbook. 21. ANS: C a. The nurse has a right to refuse to participate in any treatment or aspect of patient care that violates the nurse’s personal ethical principles. However, this should be done without deserting the patient. The matter should be discussed with the manager or supervisor so that a change in assignment can be approved. 22. ANS: D a. In a 2006 IOM study, it was estimated that some form of medication error resulted in harm to 1.5 million patients per year, including 400,000 in hospitals and up to 800,000 in long-term care settings. 23. ANS: A a. Nearly 50% of preventable errors occur at the point of prescribing. The next most common error point is administration of medications. 24. ANS: D a. Although option C seems reasonable, the nurse does not have prescriptive authority to change the order. Therefore, the prescriber should be consulted to verify the order, which can be written in clearer terms. The other options would result in a change in the alternating dose schedule. 25. ANS: B a. The patient’s blood pressure will need to be monitored, but it was just taken, and the medication dose will not have an immediate effect. The student should notify the clinical instructor immediately. Ch 6-9 PPT Questions 1. The nurse is caring for an 85-year-old patient in the hospital and teaching him how to use an inhaler. His 84-year-old wife attends the teaching sessions, and their daughter comes in to visit in the evenings. The patient is having trouble remembering the steps. What is the nurse’s best approach? a. Provide the package insert that comes with the medication for the patient to read. b. Focus the teaching sessions on the patient’s wife. c. Provide small amounts of information at a time, repeating information frequently. d. Wait until the daughter comes in and teach the daughter instead. 2. A patient with newly diagnosed type 1 diabetes mellitus has completed a diabetes education program. One month later, the patient confesses at a follow-up appointment that he “just didn’t feel like” giving himself the insulin injections. Which nursing diagnosis will the nurse assign the patient? a. Deficient knowledge b. Noncompliance c. Impaired memory d. Sleep deprivation 3. A nurse is providing patient teaching for a community health center that serves a primarily Portuguese population. How would this nurse best serve this patient population? a. By learning Portuguese b. Always using interpreter services c. Using the family member interpreter the patient provides d. Finding a job in a different setting 4. After providing education regarding medications to a patient who has been newly diagnosed with type 2 diabetes mellitus, the nurse would use which part of the nursing process to determine whether the patient understands these new instructions? a. Assessment b. Diagnosis c. Implementation d. Evaluation 5. OTC medications now account for about what percent of all medications used in the United States? a. 5% b. 15% c. 30% d. 60% 6. A 56-year-old man is taking OTC antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for more than 1 month because “it works for me.” What is the nurse’s primary concern? a. This self-treatment is expensive. b. This self-treatment may be delaying treatment of a more serious problem. c. This self-treatment may be the best treatment of his indigestion. d. The long-term use of antacids may make the indigestion worse. 7. The nurse associates use of which OTC medication with the development of hepatotoxicity? a. Acetylsalicylic acid (Aspirin) b. Ibuprofen (Motrin) c. Pseudoephedrine (Sudafed) d. Acetaminophen (Tylenol) 8. A patient tells the nurse that he wants to stop taking his antilipemic drugs and start taking garlic to lower his cholesterol. What is the nurse’s best reply? a. “That decision is up to you.” b. “You have every right to switch to herbal remedies.” c. “You should not go against what the doctor has prescribed for you.” d. “Let’s explore the evidence that supports the use of garlic to lower your cholesterol.” 9. A nurse has been asked to provide teaching at a community health fair on the topic of use of herbs and dietary products. a. A participant tells the nurse, “I have high blood pressure and hardening of my arteries. I go to the doctor and take prescription pills, but I have added herbs because they are natural and totally safe.” b. The nurse understands use of herbal products in patients with cardiovascular disease has what significance? 10. A participant tells the nurse that she is seeing her family physician for treatment of depression and that she has been taking a serotonergic drug. The participant tells the nurse that she wants to start to take St. John’s wort because she has heard that this herb will help her depression get better faster. a. The nurse bases his response based on the fact that use of St. John’s wort with serotonergic drugs has what effect? 11. A participant tells the nurse that she would like to start taking gingko. a. Before starting this herb, it is most important for the nurse to ask the patient if she is taking which type of medication? 12. Which statement regarding gene therapy is accurate? a. Gene therapy is commonly used for the treatment of disease. b. During gene therapy, segments of RNA are injected into the patient’s body. c. Bacteria are used for gene transfer. d. The majority of the world’s insulin supply has been produced by recombinant gene technology. 13. A patient’s daughter asks the nurse, “What did the test results show? I know they were doing genetic testing on my mother.” How should the nurse respond? a. Refer the daughter to the patient’s physician. b. Review the patient’s medical record with the daughter. c. Ask the patient about the test results when the daughter enters the room. d. Remind the daughter that private information cannot be discussed without the patient’s permission. 14. The nurse’s instructions to a patient who is to take an orally disintegrating tablet would include what statement? a. “Place the tablet on the tongue and let it dissolve there.” b. “After it starts dissolving, chew the medication.” c. “Place the tablet on your tongue and then take a sip of water.” d. “This tablet will take several minutes to fully dissolve.” 15. A patient is ordered to receive two different types of insulin. How will the nurse prepare the insulin? a. Draw each insulin into an insulin syringe and administer two injections. b. Draw the cloudy insulin into the insulin syringe first and then the clear insulin into the same syringe. c. Call the prescriber to question the order. d. Draw the clear insulin into the insulin syringe and then the cloudy insulin into the same syringe. 16. A patient is to receive a 0.5-mL injection of iron dextran, which can be very irritating to the body’s tissues. What is the proper technique for administration of this drug? a. IM injection using the Z-track technique b. IM injection into the deltoid muscle c. Subcutaneous injection into the abdomen d. Intradermal injection into the forearm 17. Which is the safest site for administration of an intramuscular injection to an adult? a. Deltoid b. Dorsogluteal c. Vastus lateralis d. Ventrogluteal 18. When administering eyedrops, where will the nurse place the drop? a. On the pupil b. On the sclera c. In the conjunctival sac d. In the inner canthus Answers to Ch 6-9 PPT Questions 1. ANS: C a. Providing small amounts of information at a time and repeating information frequently are appropriate educational strategies for an older adult patient who may be having trouble with short-term memory. Written instructions should also be provided, but they should be in a format that the patient can easily read. The package insert may contain small lettering. Family members should be included if possible. 2. ANS: B a. Deficient knowledge differs from noncompliance in that the latter occurs when the patient does not take the medication as prescribed or at all—in other words, the patient does not comply with or adhere to the instructions given about the medication. Noncompliance (also called nonadherence) is usually a patient’s choice. 3. ANS: A a. The nurse should communicate with the patient in the patient’s native language if at all possible. If the nurse is not able to speak the patient’s native language, then a professional translator should be hired. It is best to avoid family members as translators, if possible, because of issues with bias, misinterpretation, and potential confidentiality issues. 4. ANS: D a. The nurse would evaluate the effectiveness of the teaching session and look for areas where the patient needs reinforcement. 5. ANS: D a. OTC medications now account for about 60% of all medications used in the United States. 6. ANS: B a. Normally, over-the-counter medications should be used only for short-term treatment of common minor illnesses. Their use may postpone effective management of chronic disease states and may delay treatment. 7. ANS: D a. Acetaminophen (Tylenol) is associated with the development of hepatotoxicity. 8. ANS: D a. The nurse can provide patient education regarding potential risks and adverse drug reactions that are possible with herbal products. 9. A state-of-the-art paper published in the Journal of the American College of Cardiology in 2010 suggests that many herbal products are best avoided in patients with cardiovascular diseases (Tachjian et al., 2010). Herbal products can increase bleeding risk with warfarin, potentiate digoxin toxicity, increase the effects of antihypertensive agents, and cause heart block or dysrhythmias. 10. Use of St. John’s wort with serotonergic drugs may lead to serotonin syndrome. Patients should inform their health care providers of all OTC medications as well as herbal and dietary supplements they are taking. 11. Use of gingko may increase risk of bleeding in patients who are taking anticoagulants such as warfarin and heparin as well as antiplatelet drugs such as aspirin and clopidogrel. 12. ANS: D a. The majority of the world’s medical insulin supply has been produced by this method for well over a decade. Gene therapy is not commonly used. During gene therapy, segments of DNA are injected into the patient’s body, and viruses are used for gene transfer. 13. ANS: D a. Nurses must protect against improper disclosure of information to other family members, friends of the family, other health care providers, and insurance providers. Nurses share the responsibility with other health care providers to protect patients and their families against the misuse of the patients’ genetic information. 14. ANS: A a. Orally disintegrating medications, either in tablet or medicated strip form, dissolve in the mouth without water in about a minute. These medications are placed on the tongue, not under the tongue, as in the sublingual route. The patient must be instructed to allow the medication to dissolve on the tongue and not to chew or swallow the medication. 15. ANS: D a. When two different types of insulin are ordered for a patient, the same syringe is used. The clear insulin is drawn up into the syringe first followed by the cloudy insulin. There is no need to administer two separate injections. 16. ANS: A a. The Z-track method is used for administration of irritating substances. This technique forms a “Z-track” in the tissue that prevents the irritating medication from leaking through the more sensitive subcutaneous tissue. 17. ANS: D a. The ventrogluteal site is considered the safest of all sites because the muscle is deep and away from major blood vessels. 18. ANS: C a. To avoid trauma to the eye and systemic absorption, the eyedrop should be placed in the conjunctival sac. Ch 1 Questions 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 anxious feelings about new drug therapy, as evidenced by statements such as “I’m upset about having to test my blood sugars.” d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m upset about having to test my blood sugars.” 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” 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. Nursing diagnosis b. Planning c. Implementation d. Evaluation 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 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 OTC used at home d. Formulating nursing diagnoses regarding deficient knowledge related to the new treatment regimen 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. 7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? a. The patient’s ability to swallow b. The patient’s height c. The patient’s last meal d. The patient’s allergy 8. The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data? a. Blood pressure 158/96 mm Hg b. Weight 255 pounds c. The patient reports that he uses the herbal product ginkgo. d. The patient’s laboratory work includes a complete blood count and urinalysis. 9. When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient’s right to refuse. Which of these are additional rights? (Select all that apply.) a. Right drug b. Right route c. Right dose d. Right diagnosis e. Right time f. Right patient 10. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.) a. Planning b. Evaluation c. Assessment d. Implementation e. Nursing diagnosis Ch 1 Answers 1. ANS: D a. Formulation of nursing diagnosis is usually a three-step process. “Anxiety” is missing the “related to” and “as evidenced” portions of defining characteristics. “Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The statement beginning “Anxiety related to anxious feelings” is incorrect because the “related to” section is simply a restatement of the problem “anxiety,” not a separate factor related to the response. 2. ANS: A 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. 3. ANS: D a. Monitoring the patient’s progress, including the patient’s response to the medication, is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by this example. 4. ANS: D a. “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. 5. ANS: A 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 nursing diagnoses reflects analysis of data as part of planning. 6. ANS: C a. 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. 7. ANS: C a. The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may be affected by the timing of the last meal. The patient’s ability to swallow, height, and allergies are not factors to consider regarding the timing of the drug’s administration. 8. ANS: C a. Subjective data include information shared through the spoken word by any reliable source, such as the patient. Objective data may be defined as any information gathered through the senses or that which is seen, heard, felt, or smelled. A patient’s blood pressure, weight, and laboratory tests are all examples of objective data. 9. ANS: A, B, C, E, F a. Additional rights of medication administration must always include the right drug, right dose, right time, right route, and right patient. The right diagnosis is incorrect. 10. ANS: A, B, C, D, E a. The nursing process is an ongoing process that begins with assessing and continues with diagnosing, planning, implementing, and evaluating. Ch 2 Questions 1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Which term is used to identify this principle? a. Bioequivalent b. Synergistic c. Prodrugs d. Steady state 2. When given an intravenous 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 intravenous medication will have delayed absorption into the body’s tissues.” 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 intravenously.” 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 faster when the stomach is empty. d. Parenteral drugs exert their effects while circulating in the bloodstream 4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction? a. Adverse effect b. Allergic reaction c. Idiosyncratic reaction d. Pharmacologic reaction 5. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug’s half-life? a. The time it takes for the drug to cause half of its therapeutic response b. The time it takes for one half of the original amount of a drug to reach the target cells c. The time it takes for one half of the original amount of a drug to be removed from the body d. The time it takes for one half of the original amount of a drug to be absorbed into the circulation 6. When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these? a. The time it takes for a drug to elicit a therapeutic response b. The amount of time needed to remove a drug from circulation c. The time it takes for a drug to achieve its maximum therapeutic response d. The time period at which a drug’s concentration is sufficient to cause a therapeutic response 7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction? a. The drug alters cell membrane permeability. b. The drug’s effectiveness within the cell walls of the target tissue is enhanced. c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme’s action with the normal target cell. 8. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient’s albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound? a. Renal excretion will be faster. b. The drug will be metabolized quickly. c. The duration of action of the medication will be shorter. d. The duration of action of the medication will be longer. 9. The 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. On top of the tongue c. At the back of the throat d. In the space between the cheek and the gum 10. The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase? a. Absorption b. Distribution c. Metabolism d. Excretion 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? a. Palliative therapy b. Maintenance therapy c. Empiric therapy d. Supplemental therapy 12. The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest? a. A capsule b. A tablet c. An enteric-coated tablet d. A powder 13. The nurse will be injecting a drug into the fatty tissue of the patient’s abdomen. Which route does this describe? a. Intradermal b. Subcutaneous c. Intramuscular d. Transdermal 14. Which drugs would be affected by the first-pass effect (Select all that apply) a. Morphine given by IV push injection b. Sublingual nitroglycerin tablets c. Diphenhydramine (Benadryl) elixir d. Levothyroxine (Synthroid) tablets e. Transdermal nicotine patches f. Esomeprazole (Nexium) capsules g. Penicillin given by IV piggyback infusion 15. A drug dose that delivers 250 mg has a half life of 5 hours. Identify how much drug will remain in the body after one half life. Ch 2 Answers 1. ANS: A a. Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug’s steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body. 2. ANS: C a. An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions. 3. ANS: A a. Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream. 4. ANS: D a. A pharmacologic reaction is an extension of a drug’s normal effects in the body. In this case, the antihypertensive drug lowered the patient’s blood pressure levels too much. The other options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of a drug. 5. ANS: C a. A drug’s half-life is the time it takes for one half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed from the body. The other options are incorrect definitions of half-life. 6. ANS: D a. Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug’s onset of action is the time it takes for the drug to elicit a therapeutic response. A drug’s peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation. 7. ANS: D a. With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells. As a result, the target cells are protected from the action of the enzymes. This results in a drug effect. The actions described in the other options do not occur with selective enzyme interactions. 8. ANS: D a. Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter. 9. ANS: A a. Drugs administered via the sublingual route are placed under the tongue. Drugs administered via the buccal route are placed in the space between the cheek and the gum; oral drugs are swallowed. The other options are incorrect. 10. ANS: D a. The kidneys are the organs that are most responsible for drug excretion. Renal function does not affect the absorption and distribution of a drug. Renal function may affect metabolism of drugs to a small extent. 11. ANS: A a. The goal of palliative therapy is to make the patient as comfortable as possible. It is typically used in the end stages of illnesses when all attempts at curative therapy have failed. Maintenance therapy is used for the treatment of chronic illnesses such as hypertension. Empiric therapy is based on clinical probabilities and involves drug administration when a certain pathologic condition has an uncertain but high likelihood of occurrence based on the patient’s initial presenting symptoms. Supplemental (or replacement therapy) supplies the body with a substance needed to maintain normal function. 12. ANS: D a. Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order. 13. ANS: B a. Injections into the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections. Injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as intradermal injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch. 14. ANS: C, D, F a. Orally administered drugs (elixirs, tablets, capsules) undergo the first-pass effect because they are metabolized in the liver after being absorbed into the portal circulation from the small intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal patches also enter the bloodstream without going directly to the liver, thus avoiding the first-pass effect. 15. ANS: 125 mg a. A drug’s half-life is the time required for one half of an administered dose of a drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%. Therefore, one half of 250 mg equals 125 mg. Ch 3 Questions 1. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason? a. Decreased fetal surface b. Increased placental surface area c. Enhanced blood flow to the fetus d. Increased amount of protein-bound drug in maternal circulation 2. The nurse is monitoring a 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 pregnancy safety category? a. Category X b. Category B c. Category C d. Category D 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. Milligram per kilogram of body weight formula 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 is experiencing multiple illnesses b. The patient uses one medication for an illness several times per day c. The patient uses OTC drugs for an illness d. The patient uses multiple medications simultaneously 5. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug? a. Laxatives b. Anticoagulants c. Sedatives d. Antidepressants 6. For accurate medication administration to pediatric patients, the nurse must take into account which criteria? a. Organ maturity b. Renal output c. Body temperature d. Height 7. The nurse recognizes that 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. Increased gastric acidity c. Decreased intestinal absorption of medications d. Altered absorption of weakly acidic drugs 8. The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity? a. The lungs are immature b. The kidneys are small c. The liver is not fully developed d. Excretions of the drug occurs quickly 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, leg cramps, and dehydration c. Daytime sedation and lethargy d. Edema, nausea, and blurred vision 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 increased as needed. 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? a. Give the medication with a spoonful of ice cream. 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. 12. The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child? a. Give the injection without any advanced preparation. b. Give the injection, and then explain the reason for the procedure afterward. c. Offer a brief, concrete explanation of the procedure at the patient’s level and with the parent or caregiver present. d. Prepare the child in advance with details about the procedure without the parent or caregiver present. 13. 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 function. 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. 14. 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. 15. A 7-year-old child will be receiving amoxicillin (Amoxil) 80 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 50 mg/mL. Identify how many milliliters will the child receive per dose. Ch 3 Answers 1. ANS: C a. Drug transfer to the fetus is more likely during the last trimester as a result of enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta’s surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not protein-bound drug, in the mother’s circulation. 2. ANS: D a. Pregnancy category D fits the description given. Category B indicates no risk to animal fetus; information for humans is not available. Category C indicates adverse effects reported in animal fetus; information for humans is not available. Category X consists of drugs that should not be used in pregnant women because of reports of fetal abnormalities and positive evidence of fetal risk in humans. 3. ANS: D a. The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. The other options are available methods but are not the most commonly used. Height-to-weight ratio is not used. 4. ANS: D a. Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. The other options are incorrect. Polypharmacy addresses the medications taken, not just the illnesses. Polypharmacy means the patient is taking several different medications, not just one, and can include prescription drugs, over-the-counter medications, and herbal products. 5. ANS: C a. Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and antidepressants may cause adverse effects in the elderly, but not the ones specified in the question. 6. ANS: A a. To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. The other options are incorrect; renal output and body temperature are not considerations, and height alone is not sufficient. 7. ANS: D a. Reduction in the stomach’s ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of weakly acidic drugs. The other options are not results of reduced hydrochloric acid production. 8. ANS: C a. A neonate’s liver is not fully developed and cannot detoxify many drugs. The other options are incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renal excretion is slow, not fast, because of organ immaturity, but this is not the factor that contributes the most to drug toxicity. 9. ANS: B a. Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe complications that occur when these drugs are given to the elderly. 10. ANS: D a. As a general rule, dosing for elderly patients should follow the admonition, “Start low, and go slow,” which means to start with the lowest possible dose (often less than an average adult dose) and increase the dose slowly, if needed, based on patient response. The other responses are incorrect. 11. ANS: A a. Ice cream or another nonessential food disguises the taste of the medication. The other options are incorrect. If the child does not drink the entire contents of the bottle, medication is wasted and the full dose is not administered. Using the word candy with drugs may lead to the child thinking that drugs are actually candy. If the medication is mixed with a cup of milk, the child may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse milk in the future. 12. ANS: C a. For a 4-year-old child, offering a brief, concrete explanation about a procedure just beforehand, with the parent or caregiver present, is appropriate. The other options are incorrect for any age group. 13. ANS: A, B, D, F a. In children, first-pass elimination by the liver is reduced because of the immaturity of the liver, and microsomal enzymes are decreased. In addition, gastric emptying is reduced because of slow or irregular peristalsis. Perfusion to the kidneys may be decreased, resulting in reduced renal function. The other options are incorrect. In addition, remember that total body water content is greater in children than in adults. 14. ANS: A, B, E, F a. In the elderly, levels of microsomal enzymes are decreased because the aging liver is less able to produce them; fat content is increased because of decreased lean body mass; the number of intact nephrons is decreased as the result of aging; and gastric pH is less acidic because of a gradual reduction of the production of hydrochloric acid. The other options are incorrect statements. 15. ANS: 20 mL a. Convert pounds to kilograms: 55 pounds = 25 kg. b. To get the amount per dose, divide 2000 by 2, which equals 1000 mg/dose. Ch 4 Questions 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. Safety information 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 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 prescriptions refill are permitted b. Refills are allowed by only written prescriptions c. The patient may have no more than five refills in a 6 month period d. Written prescriptions expire in 12 months 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 which of these? a. The patient has been informed of the possible benefits of the new therapy. b. The patient will be informed of the details of the study as the research continues. c. The patient will receive the actual drug during the experiment. d. The patient has had the study’s purpose, procedures, and the risks involved explained to him. 5. For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits? a. Hispanics b. Asian Americans c. Native Americans d. African Americans 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 will expect the patient to value protective bracelets and “root workers” as healers. c. The nurse will remember that the balance among body, mind, and environment is important for this patient’s health beliefs. d. The nurse’s assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing. 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 psychological dependence d. Medically accepted drugs with limited potential for causing physical or psychological dependence 8. The nurse is reviewing facts about pharmacology for a review course. The term legend drug refers to which item? a. Over-the-counter drugs b. Prescription drugs c. Orphan drugs d. Older drugs 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. Autonomy 10. A patient is undergoing major surgery and asks the nurse about a living will. He states, “I don’t want anybody else making decisions for me. And I don’t want to prolong my life.” The patient is demonstrating which ethical term? a. Autonomy b. Beneficence c. Justice d. Veracity 11. The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on the list. Which is a characteristic of Schedule C-I drugs? a. No refills are permitted. b. They may be obtained over-the-counter with a signature. c. They are available only by written prescription. d. They are used only with approved protocols. 12. During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these? a. Medical negligence b. Nursing negligence c. Nonmaleficence d. Autonomy 13. The nurse is reviewing the concept of drug polymorphism. 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 nutritional status d. Different dosage forms of the same drug e. The patient’s health beliefs and practices f. The patient’s drug history g. The various available forms of a drug 14. The nurse is performing an admission assessment. Which findings reflect components of a cultural assessment? (Select all that apply.) a. The patient uses aspirin as needed for pain. b. The patient has a history of hypertension. c. The patient uses herbal tea to relax in the evenings. d. The patient does not speak English. e. The patient is allergic to shellfish. f. The patient does not eat pork products for religious reasons. Ch 4 Answers 1. ANS: A a. To prevent bias that may occur as a result of unrealistic expectations of an investigational new drug, a placebo is incorporated into the study. The other options are incorrect. FDA approval, if given, does not occur until after phase III. Informed consent is required in all drug studies. Safety information is not determined until the study is under way. 2. ANS: A a. Phase I studies involve small numbers of healthy volunteers to determine optimal dosage range and the pharmacokinetics of the drug. The other phases progressively involve volunteers who have the disease or ailment that the drug is designed to diagnose or treat. 3. ANS: C a. Schedule C-III medications may be refilled no more than five times in a 6-month period. The patient should be informed of this regulation. No prescription refills are permitted for Schedule C-II drugs. Requiring refills by written prescription only applies to Schedule C-II drugs. Schedule C-III prescriptions (written or oral) expire in 6 months. 4. ANS: D a. Informed consent involves the careful explanation of the purpose of the study, the procedures to be used, and the risks involved. The other options do not describe informed consent. 5. ANS: C a. Some Native Americans believe in preserving harmony with nature and that disease is a result of ill spirits. The groups listed in the other options do not typically reflect these practices. 6. ANS: D a. All beliefs need to be considered clearly so as to prevent a conflict from arising between the goals of nursing and health care and the dictates of a patient’s cultural background. Assessing religious practices and beliefs is part of a thorough cultural assessment. The other options are incorrect. The nurse should not ignore a patient’s cultural practices. The concept of balance among body, mind, and environment and the valuing of protective bracelets and root workers reflect beliefs or practices that usually do not apply to the Hispanic cultural group. 7. ANS: A a. Schedule II drugs are those with high potential for abuse but that have accepted medical use. Drugs that have high potential for abuse but do not have accepted medical use are Schedule I drugs. Medically accepted drugs that may cause moderate physical or psychologic dependence are Schedule III drugs. Medically accepted drugs with limited potential for causing physical or psychologic dependence are Schedule IV and V drugs. 8. ANS: B a. The term legend drug refers to prescription drugs, which were differentiated from over-the-counter drugs by the 1951 Durham-Humphrey Amendment. Orphan drugs are drugs that are developed for rare diseases. The other options are not examples of legend drugs. 9. ANS: B a. Veracity is defined as the duty to tell the truth. Justice is the ethical principle of being fair or equal in one’s actions. Beneficence is the ethical principle of doing or actively promoting good. Autonomy is self-determination, or the ability to make one’s own decisions. 10. ANS: A a. Autonomy includes self-determination, or the ability to act on one’s own, including making one’s own decisions about health care. Veracity is defined as the duty to tell the truth. Justice is the ethical principle of being fair or equal in one’s actions. Beneficence is the ethical principle of doing or actively promoting good. 11. ANS: D a. Schedule C-I drugs are used only with approved protocols. Schedule C-II drugs are available only by written prescription, and refills are not permitted. Being available over-the-counter with a signature may be true of Schedule C-V drugs in certain states. 12. ANS: B a. Negligence is the failure to act in a reasonable and prudent manner or failure of the nurse to give the care that a reasonably prudent (cautious) nurse would render or use under similar circumstances. In this case, nursing negligence applies to nurses, not medical negligence. Nonmaleficence is defined as the duty to do no harm; autonomy is defined as the right to make one’s own decisions, or self-determination. 13. ANS: B, C, E a. Inherited factors, diet and nutritional status, and health beliefs and practices are some of the factors that contribute to drug polymorphism. The other options are not factors that contribute to drug polymorphism. 14. ANS: A, C, D, F a. The past use of medicines, use of herbal treatments, languages spoken, and religious practices and beliefs are components of a cultural assessment. The other options reflect components of a general medication assessment or health history. Ch 5 Questions 1. The nurse is reviewing medication errors. Which situation is an example of a medication error? a. A patient refuses her morning medications. b. A patient receives a double dose of a medication because the nurse did not cut the pill in half. c. A pati