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,Chapter01:NursingPracticeinCanadaandDrugTherapy
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition xv d* d* xv d* xv xv d*




MULTIPLE CHOICE d*




1. Whichisajudgement about a particular patient’s potentialneed or problem?
d* d* xv d* d* d* d* d* d*



a. A goal d*



b. Anassessment d*



c. Subjectivedata
d. A nursing diagnosis d* d*




ANS: D d*



Nursingdiagnosis isthephase ofthenursingprocessduring which aclinicaljudgementis made about howa patient respondsto heath co nditio
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ns and life processes or vulnerability for that response.
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DIF: Cognitive Level: Knowledge d* d*




2. The patient isto receive oral furosemide (Lasix) everyday; however,becausethepatientis unableto 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?
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a. A “right time” problem xv d*



b. A“right dose” problem d* d*



c. A “right route” problem xv d*



d. A “right medication” problem xv d*




ANS: C d*



This is a “right route” problem: the nursecannot assume the route and must clarifythe route with the prescriber. This is not a “right time” pro
d* xv d* xv d* d* d* d* d* d* xv d* d* d* d* d* d* d* d* d* d* d* d* d* d* d*



blem because the ordered frequencyhas not changed. This is not a “right dose” problem because the dose is not related to an inabilit y to sw
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allow. This is not a “right medication” problem because the medication ordered will not change, just the route.
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DIF: Cognitive Level: Application d* d*




3. The nursehasbeen monitoring thepatient’s progress on his newdrugregimen sincethe first doseand hasbeen documenting signs of po ssi
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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. Nursing diagnosis d*




ANS: B d*



Monitoringthepatient’s progress is partoftheevaluation phase. Planning, implementation, and nursingdiagnosis are not illustrated by th xv d* xv d* d* d* d* d* xv d* d* d* d*



is example.
d*




DIF: Cognitive Level: Application xv d*




4. The nurseiscaringfora patientwhohasbeennewlydiagnosed with type1diabetesmellitus.Whichstatementbestillustratesan outco me
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criterion for this patient? d* d* d*



a. Thepatient will follow instructions. d* xv d* d*



b. Thepatient will not experience complications. d* d* xv d*



c. Thepatient adheres tothenew insulin treatment regimen. d* d* d* d* d*



d. Thepatient demonstrates safeinsulinself-administration technique. xv d* d* d* d*




ANS: D d*



Having the patient demonstrate safeinsulinself- d* xv xv d*



administration technique is a specific and measurable outcomecriterion. Following instructions and avoiding complications are not spe ci
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fic criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
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DIF: Cognitive Level: Application xv d*




5. Whichactivitybestreflects the implementation phase ofthe nursing process forthe patient who isnewlydiagnosed with type 1 diab et
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es mellitus?
d*



a. Providingeducation regardingself-injection technique d* d* xv




b. Setting goals and outcomecriteria with thepatient’s input xv d* d* d* d* d*



c. Recording a historyofover-the-counter medications used at home xv d* d* d* d* d* d*



d. Formulatingnursingdiagnosesregardingknowledgedeficitsrelatedtothenew tre d* d* d*



atment regimen d*




ANS: A d*



Education is anintervention thatoccursduringthe implementation phase. Settinggoals and outcomecriteriareflects theplanning phase
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. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analy sis
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of data as part of the planning phase.
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DIF: Cognitive Level: Analysis xv d*




1

, 6. The nurseisworkingduringa verybusynight shift,andthe health careprovider has just given thenurse a medication order over the tel ep
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hone, 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 neatly on the order sheet, with themost common routeindicated d* d* d* d* d* d* d* xv d* d* d* d*



b. Consultwith the pharmacist forclarification about themost common route d* xv d* d* d* d* d* d*



c. Callthe health care provider toclarifythe route of administration d* d* d* d* d* xv d* d*



d. Withholdthe druguntil the health care provider visits the patient d* xv d* d* d* d* d* d* d* d*




ANS: C d*



If a medication order does not include theroute, the nurse must ask thehealthcareprovider toclarifyit. Never assumethe route of administration.
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DIF: Cognitive Level: Application |Cognitive Level: Analysis xv d* xv xv d*




7. Whichconstitutes thetraditional FiveRights ofmedication administration? d* d* d* d* d* d*



a. Rightdrug, rightroute, right dose, right time, and right patient d* d* d* d* xv d* d* d*



b. Rightdrug, the right effect, the right route, the right time, and theright patient d* d* d* d* d* xv d* d* xv d* d* d*



c. Right patient, right strength, right diagnosis, right drug, and right route
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d. Rightpatient, right diagnosis, right drug,right route, and right time d* xv d* d* d* xv d* d* d*




ANS: A d*



ThetraditionalFiveRights ofmedication administrationwereconsidered to be Right drug,Right route,Right dose,Righttime,and Right pati
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ent. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
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DIF: Cognitive Level: Comprehension d* d*




8. What correctlydescribes the nursing process?
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a. Diagnosing,planning, assessing,implementing, andfinallyevaluating d* d* d*



b. Assessing,thendiagnosing, implementing, and endingwith evaluating d* d* d* d* d* d*



c. Alineardirectionthatbegins withassessingand continuesthroughdiagnosing, pla d* d* d* d*



nning, and finally implementing d* d* d*



d. Anongoingprocess that begins withassessingandcontinues withdiagnosing, pla xv xv xv xv d* d*



nning, implementing, and evaluating d* d* d*




ANS: D d*



Thenursingprocess isan ongoing, flexible, adaptable, and adjustablefive- xv d* d* d* d* d*



step processthatbegins withassessingand continues through diagnosing, planning, implementing, and finally evaluating, which may then
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lead back to any of the other phases.
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DIF: Cognitive Level: Application xv d*




9. Whenthe nurseis considering thetimingof a drug dose, which is mostimportant to assess?
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a. Thepatient’s identification d*



b. Thepatient’s weight d*



c. Thepatient’slast meal d* d*



d. Anydrug or food allergies d* d* d*




ANS: C d*



Thepharmacokinetic and pharmacodynamic properties ofthedrugneed to be assessed with regard to anydrug– d* xv d* d* d* xv d* d* xv d*



food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timing.
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DIF: Cognitive Level: Application xv d*




10. The nurseis writing nursingdiagnoses for aplan of care. Which reflects the correct format for her nursing diagnosis?
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a. Anxiety
b. Anxietyrelated to new drug therapy xv d* d* d*



c. Anxietyrelated to anxious feelings aboutdrugtherapy, as evidenced by sta t xv xv xv d* d* xv d* d* d*



ements such as “I’m upset about having to give myself shots”
d* d* d* d* d* xv d* d* d* d*



d. Anxietyrelatedtonewdrugtherapy, as evidenced bystatementssuch as“I’m ups d* xv d* d* d* d* d* d*



et about having to give myself shots”
d* d* d* d* d* d*




ANS: D d*



Formulation of nursing diagnoses is usually a three- d* d* d* d* d* d* d*



step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m upset about h av
d* d* d* d* d* d* d* d* xv d* d* d* d* d* d* d* d* d* d* d* d* d* d*



ing to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions. The answer “Anxiety re lated
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to new drug therapy” is missing the “as evidenced by” portion ofdefining characteristics. The“related to”section in“Anxietyrelat e
d * d * d * d * d * xv d * d * d * d * d * d* d* d * d* d* d*



d to anxious feelings about drugtherapy, as evidenced by statements such as ‘I’m upset about having to give myself shots’” is simply a rest
d* xv d* xv d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d*



atement of the problem “anxiety,” not a separate factor related to the response.
xv d* d* d* d* d* d* d* d* d* d* d*




DIF: d * d * Cognitive Level: Analysis xv d*




OTHER

1. Placethe phases of thenursing process inthe correct order, starting with thefirst phase.
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing

ANS:
C, E, A, D, B
d* xv d* d*




DIF: d * d * Cognitive Level: Analysis xv d*




2

, Chapter02:Pharmacological Principles xv




Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
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MULTIPLE CHOICE d*




1. A patientisreceivingtwodifferent drugs, which, at their currentdose formsand dosages, arebothabsorbed into thecirculationin identi cal
d* d* xv d* d* xv d* d* xv d* xv d* d* d* d* xv d* d* d* d* d*



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 d*



Two drugs absorbed into the circulation at thesameamount (in specific dosage forms) havethesame bioavailability; thus, they are bioe qui
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valent. “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 the effe ct
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s of each drug given alone. “Compatible” is incorrect because this term is ageneral term used to indicate that two substances do not ha ve
d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* xv d* d* d* xv d* d*



a chemical reaction when mixed (or given, in the case of drugs) together.
d* d* d* d* d* d* d* d* d* d* d* d*




DIF: d * d * CognitiveLevel:Comprehension

2. Apatient is receivingmedication via intravenous injection. Which information shouldthenurseprovideforpatient education?
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a. Themedication will causefewer adverse effects when given intravenously. xv d* d* d* xv xv d*



b. Themedication will be absorbed slowlyinto the tissues over time. xv d* d* d* d* d* d* d*



c. Themedication’s action will begin faster when given intravenously. d* d* d* d* d* d* d*



d. Mostofthe drugis inactivated bytheliver before it reaches the target area.
d* d* d* d* d* d* d* d* d* d* d* d* d*




ANS: C d*



Intravenous injections are the fastest route of absorption. Theintravenous routedoes not affect the number of adverse effects, the intra ve
d* d* xv d* xv d* d* d* d* d* xv d* d* d* xv d* d* d* d*



nous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver before it r eac
d* d* d* xv d* d* d* d* d* d* d* d* d* d* xv d* d* d* d* d* d* d* d* d* d* d*



hes the target area.
d* d* d*




DIF: d * d * CognitiveLevel:Comprehension

3. Which is true regarding parenteral drugs?
d* xv d* d* d*



a. Theybypass the first-pass effect. d* d* d*



b. Theydecrease blood flow to the stomach. d* d* d* d* d*



c. Theyare altered bythe presence of food in the stomach. d* xv d* d* d* d* d* d* d*



d. Theyexert their effects while circulating in the bloodstream. d* d* d* d* d* xv d*




ANS: A d*



Drugs givenbytheparenteral routebypass thefirst-
d* d* d* d* d*



pass effect, but theystill must be absorbed into cells and tissues before theycan exert their effects. Enteral drugs (drugs taken orally), not par
d* d* d* d* xv xv d* xv d* d* d* d* d* d* d* d* d* d* d* d*



enteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral drugs must be a bsor
d* d* d* d* d* d* d* d* d* xv d* d* d* d* d* d* d* d* d* d* d* xv d* d*



bed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in t he blo
d* d* d* xv d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d*



odstream.

DIF: d * d * CognitiveLevel:Analysis

4. Adrug’shalf-life isbest defined as
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a. Thetime it takes forthe drugto elicit halfits therapeutic response. xv d* d* d* d* d* d* d* d* d* d*



b. Thetimeittakes one- d* xv




half oftheoriginal amount ofa drugto reachthetarget cells.
d* d* d* xv xv d* d*



c. Thetimeittakesone-
half oftheoriginal amount of a drugto beremoved from the body.
d* d* xv d* xv d* d* d* d*



d. Thetimeittakesone-
half oftheoriginal amount of adrugto be absorbed intothe circulation.
d* d* xv d* xv d* d* d*




ANS: C d*



Adrug’s half-life is thetimeittakes forone-
d* d* d* xv d* d* d*



half of the originalamount of a drugto be removed from the body. It is ameasure of the rate at which drugs are removed from the body. A
d* d* d* d* d* d* xv d* xv d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d* d*



nswers A, B, and D are not correct definitions of a drug’s half-life.
d* d* d* xv d* d* d* d* d* d* d* d*




DIF: d * d * CognitiveLevel:Comprehension

5. The term “duration of action”isbest defined as
xv d* d* xv d* d* d*



a. Thetime it takes forthe drugto elicit a therapeutic response. xv xv d* d* d* d* d* d* d* d*



b. Thetimeit takes a drugto reach its maximum therapeutic response. d* d* d* d* d* d* d* d* d*



c. The length oftime it takes to remove adrug from circulation.
d* d* d* xv d* d* d* d* d* d*



d. Thetimeduringwhich drugconcentrationis sufficient toelicitatherapeutic res d* d* xv xv d* d* d*



ponse.
ANS: D d*



Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. Thetime it takes for a drug to el
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icit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximum therapeutic responsei sad rug’s“p
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eakeffect.” “Thelengthof timeit takes toremove a drugfrom circulation” defines a drug’s eliminationand does not correctly d efine a dru
d* d* d* d* xv xv d* d* xv d* xv d* d* xv d* d* xv d* d* d* d* d* d*



g’s duration of action.
d* xv d*




DIF: d * d * CognitiveLevel:Comprehension




1