Pharmacology and the Nursing
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Question 1 – MCQ
Clinical Scenario: A 72-year-old patient with chronic kidney
disease receives a medication that is primarily eliminated by the
kidneys.
Question Stem: Which nursing action is the priority before
administering the medication?
Answer Options:
• Assess the patient’s hearing
• Review the patient’s serum creatinine and estimated
glomerular filtration rate (eGFR)
• Encourage the patient to increase fluid intake
• Administer the medication with food
Correct Answer: B. Review the patient’s serum creatinine and
estimated glomerular filtration rate (eGFR)
Comprehensive Rationale
Renal function directly affects drug excretion. Reduced kidney
function can lead to drug accumulation, increased serum
,concentrations, and toxicity. Reviewing serum creatinine and
eGFR helps determine whether dosage adjustment or
withholding the medication is necessary.
Pharmacologic Principles:
• Pharmacokinetics: Excretion is impaired in chronic kidney
disease.
• Therapeutic Outcome: Prevent drug accumulation and
toxicity.
• Monitoring: Renal laboratory values and signs of adverse
effects.
Distractor Analysis
• A: Hearing assessment is important for certain ototoxic
drugs but is not the priority here.
• C: Increasing fluids may be inappropriate in some patients
with renal disease.
• D: Administering with food affects absorption, not renal
clearance.
Nursing Process Integration
Primary: Assessment
Other Steps: Planning includes dosage adjustments;
Implementation includes safe administration; Evaluation
includes monitoring for toxicity.
, NCJMM Competencies
• Recognize Cues
• Analyze Cues
• Take Action
Difficulty: Moderate
Bloom’s Level: Apply
NCLEX Category: Pharmacological and Parenteral Therapies
Key Learning Objective: Apply pharmacokinetic principles to
prevent medication toxicity in patients with impaired renal
function.
Question 2 – SATA
Clinical Scenario: A nurse is preparing to administer a high-alert
medication.
Question Stem: Which actions are appropriate to reduce the
risk of medication error? Select all that apply.
Answer Options:
• Verify the medication with a second licensed nurse if
required by policy.
• Use two patient identifiers.
• Document administration before giving the medication.
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Question 1 – MCQ
Clinical Scenario: A 72-year-old patient with chronic kidney
disease receives a medication that is primarily eliminated by the
kidneys.
Question Stem: Which nursing action is the priority before
administering the medication?
Answer Options:
• Assess the patient’s hearing
• Review the patient’s serum creatinine and estimated
glomerular filtration rate (eGFR)
• Encourage the patient to increase fluid intake
• Administer the medication with food
Correct Answer: B. Review the patient’s serum creatinine and
estimated glomerular filtration rate (eGFR)
Comprehensive Rationale
Renal function directly affects drug excretion. Reduced kidney
function can lead to drug accumulation, increased serum
,concentrations, and toxicity. Reviewing serum creatinine and
eGFR helps determine whether dosage adjustment or
withholding the medication is necessary.
Pharmacologic Principles:
• Pharmacokinetics: Excretion is impaired in chronic kidney
disease.
• Therapeutic Outcome: Prevent drug accumulation and
toxicity.
• Monitoring: Renal laboratory values and signs of adverse
effects.
Distractor Analysis
• A: Hearing assessment is important for certain ototoxic
drugs but is not the priority here.
• C: Increasing fluids may be inappropriate in some patients
with renal disease.
• D: Administering with food affects absorption, not renal
clearance.
Nursing Process Integration
Primary: Assessment
Other Steps: Planning includes dosage adjustments;
Implementation includes safe administration; Evaluation
includes monitoring for toxicity.
, NCJMM Competencies
• Recognize Cues
• Analyze Cues
• Take Action
Difficulty: Moderate
Bloom’s Level: Apply
NCLEX Category: Pharmacological and Parenteral Therapies
Key Learning Objective: Apply pharmacokinetic principles to
prevent medication toxicity in patients with impaired renal
function.
Question 2 – SATA
Clinical Scenario: A nurse is preparing to administer a high-alert
medication.
Question Stem: Which actions are appropriate to reduce the
risk of medication error? Select all that apply.
Answer Options:
• Verify the medication with a second licensed nurse if
required by policy.
• Use two patient identifiers.
• Document administration before giving the medication.
