Chapter 04 - The Nursing Process in Drug Therapy and Patient Safety |Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)

1. A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient? a. Noncompliance: Cost of the drug b. Deficient knowledge: Unfamiliar with drug therapy c. Risk for injury: Related to adverse effects of the drug d. Ineffective health maintenance: Need for medication Ans: C Feedback: Because of the patient’s age and that the medication causes sedation, the highest priority nursing diagnosis is related to maintaining the patient’s safety. Safety for the patient is the nurse’s number one concern. There is nothing indicated related to the cost of the drug or the risk of noncompliance for this patient. Deficient knowledge will need to be addressed but it is not the priority when compared with patient safety. There is no indication the patient’s need for this medication is related to an ineffective health maintenance issue. 2. What is the responsibility of the nurse related to the patient’s drug therapy? (Select all that apply.) a. Teaching the patient how to cope with therapy to ensure the best outcome b. Providing therapy as well as medications c. Evaluating the effectiveness of therapy d. Altering the drug regimen to optimize outcome e. Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapy Ans: A, B, C Feedback: A nurse is, therefore, a key health care provider who is in a position to assess the whole patient, to administer therapy as well as medications, to teach the patient how best to cope with the therapy to ensure the most favorable outcome, and to evaluate the effectiveness of the therapy. Nurses do not alter drug therapy or recommend over-the-counter medications because prescribing is outside the nurse’s scope of practice. 3. The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient? a. The medication history of the patient’s mother and/or father b. The name of the patient’s pharmacy c. Insurance, financial support, and stability for the patient and his family d. The last time the patient was hospitalized Ans: C Feedback: In this situation, insurance, financial support, and stability would be the most important data and may determine compliance with future drug therapy. The medication history of the patient’s parents could indicate a pattern of overall attitude about drug therapy but is not the priority concern. The last time the patient was hospitalized could indicate whether the patient seeks medical care when appropriate or if he self-medicates, contributing to the nurse’s knowledge of this individual but this is not the priority concern. The name of the pharmacy would be unnecessary unless the nurse anticipates having to call a prescription in to the pharmacy for the prescriber. 4. During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy? a. Assessment b. Nursing diagnosis c. Interventions d. Evaluation Ans: D Feedback: Evaluation allows the nurse to review what has changed since intervening to determine whether the nursing care has had a positive, therapeutic effect moving the patient toward a more healthful life. If outcomes have not improved, the nurse begins again at the assessment phase of the nursing process with the goal of changing the plan of care to improve outcomes. The patient’s response to the drug and occurrence of adverse drug effects indicate the effectiveness of the nursing interventions related to drug therapy. Assessment involves a systematic, organized collection of data concerning a patient. A nursing diagnosis indicates actual or potential alterations in patient function based on the assessment of the clinical situation. Interventions are actions taken to meet the patient’s needs, such as administration of drugs. 5. When the nurse reads in the drug handbook the section related to recommended dosage, it is important to remember that this suggested dosage is based on what? a. A 40-year-old man b. An average-sized adult c. A 150-pound adult male d. A healthy young adult Ans: C Feedback: Drug studies base the therapeutic dosage, or that dose needed to reach a critical concentration, on the physiology of a 150-pound healthy adult male. Testing is not routinely done in women because of the potential for unknown effects on the ova. Testing would not be done on an obese adult or older adult because of the potential for underlying disease, altered metabolism, or reactions to the drug. Children and adolescents are never used for testing due to ethical concerns. 6. A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?