CarePractice5thEditionSEALOCKChapter1-58
g x gx
Chapter01:NursingPracticeinCanadaandDrugTherapy Sealock:Lilley’s Pharmac v
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ology forCanadianHealthCarePractice, 5th Edition
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MULTIPLE CHOICE xv
1. Whichis a judgement about a particular patient‘s potential need or problem?
xv gx xv gx gx gx gx gx gx gx gx
a. A goal gx
b. Anassessment gx
c. Subjective data gx
d. A nursing diagnosis gx gx
ANS: D g x
Nursingdiagnosisisthe phase ofthenursingprocessduringwhich aclinical judgement is made about howapatient responds to h eath co nditio
gx xv gx gx gx xv xv xv xv gx gx xv gx gx gx
ns and life processes or vulnerability for that response.
gx xv gx gx gx gx gx gx
DIF: Cognitive Level: Knowledge xv gx
2. The patientistoreceive oral furosemide(Lasix)everyday; however,becausethepatient isunableto swallow,hecannot take medi cat
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ion orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx
a. A―right time‖problem xv gx
b. A―right dose‖problem xv gx
c. A―right route‖ problem gx xv
d. A―right medication‖ problem gx gx
ANS: C g x
This isa ―right route‖ problem: thenursecannot assumetherouteand must clarifythe route withtheprescriber. This is not a―righ t time‖ proble
xv gx xv gx gx gx gx xv xv gx gx gx gx gx gx gx
m because the ordered frequencyhas not changed. This is not a ―right dose‖ problem because the dose is not related to an inabilit y to
gx gx gx gx gx gx gx gx gx xv gx xv gx gx gx gx gx xv gx xv gx gx gx gx x
swallow. This is not a ―right medication‖ problem because the medication ordered will not change, just the route
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.
DIF: g x g x Cognitive Level: Application gx gx
3. Thenursehas been monitoringthepatient‘s progress onhis newdrug regimensincethefirst doseand hasbeen documentingsigns of pos si
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ble adverse effects. What nursing process phase is the nurse practising?
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a. Planning
b. Evaluation
c. Implementation
d. Nursingdiagnosis
ANS: B g x
Monitoringthepatient‘s progress ispart of theevaluation phase. Planning, implementation, andnursing diagnosis arenot illustrate d by t hi
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s example.
gx
DIF: g x g x Cognitive Level: Application xv gx
4. The nurseiscaringfora patient whohas beennewlydiagnosed with type 1 diabetes mellitus.Whichstatementbestillustrates an outco
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me criterion for this patient?
gx gx gx gx
a. Thepatient will follow instructions. gx gx gx
b. Thepatient will not experience complications. gx gx gx gx
c. Thepatient adheres to thenew insulin treatment regimen. gx gx xv gx gx gx
d. Thepatient demonstrates safeinsulinself-administration technique. gx gx gx
ANS: D g x
Havingthepatient demonstrate safeinsulinself- gx gx xv
administration techniqueisa specificand measurableoutcomecriterion. Following instructions and avoiding complications are not specific cr it
xv gx xv gx xv gx gx gx gx gx gx gx xv xv gx
eria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
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DIF: g x g x Cognitive Level: Application xv gx
5. Whichactivitybestreflects theimplementation phaseofthenursing process forthepatient who isnewlydiagnosed with type 1 diab e gx xv gx gx gx gx gx gx gx xv gx xv gx gx gx gx
tes mellitus? gx
a. Providingeducation regarding self-injection technique gx gx g x
b. Settinggoals and outcome criteria with thepatient‘s input gx gx gx gx gx gx
c. Recordinga historyof over-the-counter medications used at home xv gx gx gx gx gx
d. Formulatingnursingdiagnoses regardingknowledge deficits related to thenew tre xv gx gx xv gx gx gx
atment regimen gx
ANS: A g x
Educationis an intervention thatoccursduring the implementationphase. Settinggoalsand outcome criteria reflects theplanning p hase.
xv gx xv xv gx gx xv gx xv gx gx gx gx
Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit refle cts analys i
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s of data as part of the planning phase.
gx gx gx gx gx gx gx g x
DIF: g x g x Cognitive Level: Analysis xv gx
1
, 6. The nurse is workingduringaverybusynight shift, andthehealth care provider has just given thenurse amedication order over the tel
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ephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication errors?
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a. Recopytheorder neatlyon the order sheet, with themost common route indicated gx gx gx gx gx gx gx gx gx gx gx
b. Consultwith thepharmacist forclarification about the most common route gx gx gx gx xv gx gx
c. Callthe health care provider to clarifythe routeof administration gx gx gx gx xv gx gx gx
d. Withholdthe druguntil the health care provider visits the patient gx gx gx gx gx gx gx gx
ANS: C g x
If a medication order does not include the route,thenursemust ask thehealth careprovider toclarifyit.Never assumethe routeof administr ation.
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DIF: Cognitive Level:Application |Cognitive Level:Analysis gx gx xv gx gx
7. Which constitutes thetraditional FiveRights ofmedication administration?
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a. Rightdrug, right route, right dose, righttime, and right patient gx xv gx gx gx gx gx gx
b. Rightdrug, the right effect, the right route, the right time,and theright patient gx gx xv gx gx gx gx gx gx gx gx
c. Rightpatient,rightstrength, right diagnosis,right drug, and right route gx gx gx xv gx gx gx gx gx
d. Rightpatient, right diagnosis, right drug,right route, and right time gx xv gx xv gx gx gx xv gx
ANS: A g x
ThetraditionalFive Rights ofmedication administrationwereconsidered to be Right drug, Rightroute,Right dose,Right time,and Right pati
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ent. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
gx gx gx gx gx gx xv gx gx gx xv gx gx gx gx
DIF: Cognitive Level: Comprehension gx gx
8. What correctlydescribes the nursingprocess?
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a. Diagnosing,planning, assessing,implementing, andfinallyevaluating gx gx gx
b. Assessing,thendiagnosing, implementing, and endingwith evaluating gx gx gx gx gx
c. Alineardirectionthatbegins withassessingandcontinues throughdiagnosing, pla xv xv gx gx
nning, and finally implementing gx gx gx
d. Anongoing processthatbegins withassessingand continues withdiagnosing, plagx gx gx xv xv gx gx
nning, implementing, and evaluating gx gx gx
ANS: D g x
Thenursingprocessisan ongoing, flexible, adaptable,and adjustablefive-
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step processthat begins withassessing andcontinues through diagnosing, planning, implementing, and finally evaluating, which may th
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en lead back to any of the other phases.
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DIF: Cognitive Level: Application xv gx
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
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a. Thepatient‘s identification gx
b. Thepatient‘s weight gx
c. Thepatient‘slast meal gx
d. Anydrug or food allergies gx gx gx
ANS: C g x
Thepharmacokinetic and pharmacodynamic properties ofthedrugneed to beassessed with regard to anydrug–
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food interactions or compatibility issues. The patient‘s identification, weight, and drug or food allergies are not affected by the drug‘s timi ng.
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DIF: Cognitive Level: Application xv gx
10. Thenurseis writingnursingdiagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis?
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a. Anxiety
b. Anxietyrelated to new drug therapy gx gx gx gx
c. Anxietyrelatedtoanxiousfeelings about drugtherapy,as evidenced by sta t v
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ements such as ―I‘m upset about having to give myself shots‖
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d. Anxietyrelated tonewdrug therapy, asevidenced bystatementssuch as ―I‘m up xv gx gx gx xv xv gx gx
set about having to give myself shots‖
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ANS: D g x
Formulation of nursing diagnoses is usually a three- gx gx gx gx gx gx gx
step process. The only complete answer is ―Anxiety related to new drug therapy, as evidenced by statements such as ‗I‘m upset a bout
xv gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx xvg x
having to give myself shots.‘‖ Theanswer ―Anxiety‖ ismissing the ―related to‖ and ―as evidenced by‖ portions. Theanswer
gx xv xv gx gx gx gx gx xv xv gx xv gx gx gx gx
―Anxietyrelatedtonewdrugtherapy‖ismissing the―as evidenced by‖portionofdefiningcharacteristics. The―relatedto‖sectio nin ― g x xv gx gx gx xv g
Anxietyrelatedtoanxiousfeelingsabout drugtherapy,asevidenced by statements such as ‗I‘m upset about having to givem yself shot
x xv xv g x gx g x gx gx gx gx g x gx gx g x g x
s‘‖ is simply a restatement of the problem ―anxiety,‖ not a separate factor related to the response.
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DIF: Cognitive Level: Analysis xv gx
OTHER
1. Placethe phases ofthenursing process inthe correct order, startingwith thefirst phase.
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E,A,D, B
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DIF: Cognitive Level: Analysis xv gx
2
, Chapter02:Pharmacological Principles xv
Sealock:Lilley’s Pharmacology for Canadian Health Care Practice, 5th Edition xv g x gx gx gx gx xv gx
MULTIPLE CHOICE xv
1. Apatient is receivingtwodifferent drugs, which, attheir current doseforms anddosages, arebothabsorbed into the circulationin
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cal amounts. Which term best denotes that the drugs have the same absorption rates?
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a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D g x
Two drugs absorbed into thecirculation at thesame amount (in specific dosage forms) havethesame bioavailability; thus, theyare bioeq uiv
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alent. ―Equivalent‖ is incorrect because the term ―bioavailability‖ is used to express the extent of drug absorption.
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―Synergistic‖ is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of th e eff ec
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ts of each drug given alone. ―Compatible‖ is incorrect because this term is a general term used toindicate that two substanc es do not ha
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ve a chemical reaction when mixed (or given, in the case of drugs) together.
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DIF: g x g x g x Cognitive Level:Comprehension gx
2. Apatient is receivingmedication via intravenous injection. Whichinformation should the nurse provide forpatient education?
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a. Themedication willcausefewer adverseeffects when given intravenously. gx gx gx gx gx gx gx
b. Themedication will be absorbed slowlyinto the tissues over time. gx gx gx gx gx gx gx gx
c. Themedication‘saction will begin faster when given intravenously. gx gx gx gx gx gx gx
d. Mostofthe drugis inactivated bytheliver before it reaches the target area. gx gx gx gx gx gx gx gx gx gx
ANS: C g x
Intravenous injections arethefastest route of absorption. Theintravenous route does notaffect thenumberof adverseeffects, the intra ven
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ous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug bythe liv er before it reac
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hes the target area. gx gx gx
DIF: g x g x g x Cognitive Level:Comprehension gx
3. Whichistrueregarding parenteral drugs? gx gx gx
a. Theybypass thefirst-pass effect. gx gx gx
b. Theydecrease blood flow to the stomach. gx gx gx gx gx
c. Theyare altered bythe presence of food in the stomach. gx gx gx gx gx gx gx gx
d. Theyexert their effects while circulating in the bloodstream. gx gx gx gx gx gx gx
ANS: A g x
Drugs givenbytheparenteral routebypass thefirst-
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pass effect, but theystill mustbeabsorbedinto cells and tissues before theycan exert their effects. Enteral drugs (drugs taken orall y),
gx gx gx gx xv xv gx gx gx gx gx gx gx g x gx gx gx gx gx
no t parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral dr ugs must b
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e absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulatin
gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx xv gx gx
g in the bloodstream.
gx gx gx
DIF: g x g x Cognitive Level: Analysis gx gx
4. Adrug‘shalf-life isbest defined as gx gx gx gx
a. Thetimeit takes forthe drugto elicit halfits therapeutic response. gx gx gx gx gx x vgx gx gx gx gx
b. Thetimeittakes one- xv xv
halfof the original amount ofa drugto reach the target cells.
xv xv xv xv gx xv xv xv gx
c. Thetimeit takes one- xv xv gx
half oftheoriginal amountofa drugtoberemoved fromthe body.
gx gx gx gx xv gx xv gx gx
d. Thetimeit takes one- xv xv gx
halfofthe original amountofadrug tobeabsorbed into the circulation. xv gx xv g x xv g x gx
ANS: C g x
Adrug‘s half-life isthetimeit takes forone- xv gx gx gx gx
half ofthe original amount ofa drug to be removed from thebody. It isa measure of the rate at which drugs are removed from th e body
gx gx xv gx gx gx xv xv gx gx gx gx gx gx gx xv gx gx gx gx gx gx gx gx gx gx gx gx
. Answers A, B, and D are not correct definitions of a drug‘s half-life.
gx gx gx gx gx gx gx xv gx gx gx gx gx
DIF: g x g x Cognitive Level: Comprehension gx gx
5. Theterm―durationofaction‖is best definedas
xv xv xv
a. Thetimeit takes forthe drugto elicit a therapeutic response. xvgx gx gx gx gx gx gx gx gx
b. Thetime it takes adrugto reach its maximum therapeutic response. xv gx gx gx gx gx gx gx gx
c. Thelength oftimeit takes to remove a drug from circulation.
gx gx gx gx gx gx gx xv gx gx
d. The timeduringwhich drug concentration issufficient to elicit a therapeutic res
xv gx gx xv gx gx xv xv xv xv gx
ponse.
ANS: D g x
Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it takes for a dr ug
gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx gx
to elicit a therapeutic response is the drug‘s ―onset of action.‖ The time it takes a drug to reach its maximum therapeutic response isa d
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rug‘s ―peak effect.‖ ―Thelength of timeit takes to remove a drugfromcirculation‖ defines adrug‘s eliminationand does not correc tly de
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fine a drug‘s duration of action.
gx xv gx gx gx
DIF: g x g x Cognitive Level: Comprehension gx gx
1