,Chapter01:NursingPracticeinCanadaandDrugTherapy
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
m& m& m & m& m& m& m& m& m&
MULTIPLE CHOICE m&
1. Whichisajudgement about aparticularpatient’s potentialneed orproblem?
d* m& m& m& m&
a. Agoal
b. Anassessment
c. Subjectivedata
d. Anursingdiagnosis
ANS: D m&
Nursing diagnosis isthe phase ofthenursingprocessduring whichaclinicaljudgementis made abouthowa patient responds to heath co nditi
d* m& d* m& m& m& xv m& d* d* m& d* m &
o ns and life processes or vulnerability for that response.
m & m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Knowledge d* m&
2. The patient isto receiveoralfurosemide(Lasix)everyday;however,becausethepatientis unabletoswallow,hecannottakemedi cat
m& xv d* m& d* d* d* m& d* m & m
& ion orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
m& m& m& m& m& d* m& m& d* m& m& m& m& m& m& m&
a. A “right time” problem
m& m& m&
b. A“right dose” problem m& m&
c. A “right route” problem
m& m& m
&
d. A “right medication” problem xv m &
ANS: C m&
This is a “right route”problem: thenursecannotassumethe route and must clarifythe routewith the prescriber. This is not a “right time” pro bl
d* m& d* m& m
& m& m
& d* d* d* d* d* m
& m
& d* d* m
& m& m&
em because the ordered frequencyhas notchanged. This is nota“rightdose” problem because thedose isnot related to an inabilit y to sw al
m& m& m& m& m& m& xm & m& m& m& m& m& m& m& m
& d* m& m& m& m&
low. This is not a“right medication” problem because the medication ordered will not change, just the route.
m& m& m& xm & m& m& m& m& m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Application d* m&
3. Thenursehasbeen monitoringthepatient’sprogress on his newdrugregimensincethefirstdoseand hasbeen documentingsigns of po ssi
d* m& d* xv d* d* m& m& m& m& m
ble adverse effects. What nursing process phase is the nurse practising?
& m& m& m& m& m& m& m& m& m& m&
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis d*
ANS: B m&
Monitoringthepatient’s progress ispart oftheevaluation phase.Planning, implementation, and nursingdiagnosis arenot illustrated by th
m& m& m& d* m& m& d* m& m & m & m & m
isexample.
&
DIF: CognitiveLevel: Application m &
4. The nurse iscaring fora patientwhohasbeennewlydiagnosedwithtype1diabetesmellitus.Whichstatementbestillustratesan outco m
m& d* d* m& d* d* d* m&
e criterion for this patient?
m& m& m& m&
a. Thepatient willfollowinstructions. m&
b. Thepatient will not experience complications. m& xm & m &
c. Thepatient adheres tothenewinsulin treatment regimen. m& m& m& m&
d. Thepatient demonstratessafeinsulinself-administrationtechnique. m&
ANS: D m&
Having the patient demonstrate safeinsulinself-
m& x m& m& m&
administrationtechnique is aspecific and measurable outcomecriterion. Following instructions and avoiding complications are not spe
d* d* d* m
& m
& m& d* m& m& m& m& m& m& m&
ci fic criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
m& m& m& m& m& m& m& m& m& d* m& m& m& m& d* m& m& m&
DIF: Cognitive Level: Application xv m &
5. Whichactivitybestreflects the implementation phaseofthe nursing process forthepatient who isnewlydiagnosed with type 1 diab
d* m& m& m& d* d* m& m& xm & m& d* m& m& m&
m & et es mellitus?
m& m&
a. Providingeducation regardingself-injection technique d* m&
b. Setting goals and outcomecriteriawith thepatient’s input
m& m& m& m& m&
c. Recording ahistoryofover-the-countermedications used at home m& d* d* d* m&
d. Formulatingnursingdiagnosesregardingknowledgedeficitsrelatedtothenew tr m&
e atment regimen
m& m&
ANS: A m&
Education is an intervention thatoccursduringthe implementation phase. Settinggoals and outcomecriteriareflects theplanning phase
m& xv m& m& m& m& m& m& m& m& m &
. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analy si
m& m& m& m& m& m& m& m& m& m& m
& m& m& d* m& m& m& m&
s of data as part of the planning phase.
m& m& m& m& m& m& m& m&
DIF: CognitiveLevel: Analysis m &
1
, 6. The nurse i s working d uringa verybusynight shift,andthe health careproviderhas just giventhenursea medication orderover thetel
m& d* d* d* x m& m& m& xm & xm & m & m& d* m& m
&ep hone, but the nursedoes not recall the route. What is the best way for the nurse to avoid medication errors?
m& m& xm & m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
a. Recopythe order neatlyon theordersheet, with the m ost common routeindicated
d* m& m& m& xm & d* m& d*
b. Consultwiththe pharmacist forclarification about themostcommon route m& m & m& d* m&
c. Callthe health care provider toclarifythe routeof administration
m& m& m& m& xm & m&
d. Withholdthe drug until the health care provider visits the patient m& d* m& m& m& m& m& m& m&
ANS: C m&
If a medication order doesnot include theroute, the nurse must ask thehealthcareprovider toclarifyit. Never assumethe routeof administration.
m & xm & m& m& m& m& d* m& m& xv m& m& m& m& m& m &
DIF: Cognitive Level: Application |Cognitive Level: Analysis
m& m& xv xm & m&
7. Whichconstitutesthetraditional Five Rights ofmedication administration? m& d* m& m&
a. Rightdrug,rightroute, right dose,right time,and right patient m& m& xm & m& m&
b. Rightdrug, therighteffect, theright route,theright time, and theright patient
m& m& xm & xm & d* m& m&
c. Rightpatient, right strength, right diagnosis,right drug, and right route d* xv m& d* m& m& d* m&
d. Rightpatient, right diagnosis, right drug,right route, and right time m& xv m& m& xm & d* d* m&
ANS: A m&
ThetraditionalFiveRightsofmedicationadministrationwereconsideredto be Right drug,Right route,Right dose,Righttime,and Right pa d* d* m& xv d* m& d* xm & d* m&
ti ent. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Comprehension d* m&
8. What correctlydescribes the nursing process?
d* d* m& d*
a. Diagnosing,planning,assessing,implementing, andfinallyevaluating m&
b. Assessing,thendiagnosing, implementing, andendingwithevaluating m& d* d*
c. Alineardirectionthatbeginswithassessingandcontinuesthroughdiagnosing, pla d* m&
nning, and finally implementing
m& m& m& m&
d. Anongoingprocessthatbegins withassessingandcontinues withdiagnosing, pla m
& m& m& m&
nning, implementing, and evaluating
m& m& m&
ANS: D m&
Thenursingprocess isan ongoing, flexible,adaptable,andadjustablefive- m& d* m & d*
step processthat begins withassessingandcontinues through diagnosing, planning, implementing, and finally evaluating, whichmay the
xv d* m& xv m& m& m& m& m& m& m& m& m &
n lead back to any of the other phases.
m& m& m& m& m& m& m& m&
DIF: CognitiveLevel: Application m &
9. Whenthenurseis consideringthetiming ofa drug dose, which ismost important toassess?d* d* m& d* m
& d* m&
a. Thepatient’s identification m&
b. Thepatient’s weight m&
c. Thepatient’slast meal m&
d. Anydrug or food allergies m
& m& m&
ANS: C m&
Thepharmacokineticand pharmacodynamicproperties ofthedrugneed tobeassessed with regard to anydrug– m& m& m& m& d* xv m&
food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timing.
x m& m& m& m& m& m& m& m& m& xv m& m& xv m& m& d* m& m& m& m&
DIF: Cognitive Level: Application xv m &
10. Thenurseis writing nursingdiagnoses for aplan ofcare. Which reflects the correct format forher nursing diagnosis?
m& d* d* m& d* m& m& m& m& d* d* m& m& m
&
a. Anxiety
b. Anxietyrelated to new drug therapy m& m& m& m&
c. Anxietyrelated to anxious feelings aboutdrugtherapy, as evidenced by sta t xv x xv m& m& d* m& m&
ements such as “I’m upset about having to give myself shots”
m& m& m& m& m& m& xm & m& m& m& m&
d. Anxietyrelatedtonewdrugtherapy, asevidenced bystatementssuchas“I’m ups m
& m& m&
et about having to give myself shots”
m& m& m& m& m& m& m&
ANS: D m&
Formulation of nursing diagnoses is usually a three- d* m& m& m& m& m& d*
step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m upset abou
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
t h av ing to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions. The answer “Anx
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
iety re lated to new drug therapy” is missing the “as evidenced by” portion ofdefining characteristics. The“related to”sectio
m& m& m& m& m& m& m & x m& m& m& m & m & m& m& m& m& m&
n in“Anxietyrelat e d to anxious feelings about drugtherapy, as evidenced by statements such as ‘I’m upset about having to give mys
m& m& m& m& xv m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
elf shots’” is simply a rest atement of the problem “anxiety,” not a separate factor related to the response.
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: m & m & Cognitive Level: Analysis m& m&
OTHER
1. Placethephases of the nursingprocess inthecorrect order, startingwith the first phase.
m& d* d* m& d* m& m& d* m&
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A,D,B m
& m&
DIF: m & m & Cognitive Level: Analysis m& m&
2
, Chapter02:Pharmacological Principles xv
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
m& m& m & m& m& m& m& m& m&
MULTIPLE CHOICE m&
1. Apatientisreceivingtwodifferent drugs,which, at theircurrentdose formsand dosages,arebothabsorbedinto thecirculation in identi cal m& m& m& m& xv d* m& d* m& m &
m & amounts. Which term best denotes that the drugs have the same absorption rates?
m& m& m& m& m& d* m& m& m& m& m& m&
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D m&
Two drugs absorbed into the circulation at thesameamount (in specific dosage forms) havethesame bioavailability; thus, they are bi
m& x m& m& m& m& m& m& m& x m& m& m& m& m& m& m& m& m&
oe qui valent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption.
m& m& m& m& m& m& m& m& m& m& d* m& d* m& m& m& m& m&
“Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the ef
m& m& d* m& m& m& m& m& m& m& d* m& d* m& m& m& m& m& m& m& m& m&
fe ct s of each drug given alone. “Compatible” is incorrect because this term is ageneral term used to indicate that two substances d
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
o not ha ve a chemical reaction when mixed (or given, in the case of drugs) together.
m& m& m& m& m& m& m& m& m& m& m& d* m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
2. Apatientisreceivingmedicationviaintravenous injection. Whichinformation shouldthenurseprovideforpatient education?
d* d* m& d* m& d* d* d* m &
a. Themedication will causefewer adverse effects when given intravenously. m& m& m& m& m& m& m&
b. Themedication willbeabsorbed slowlyinto thetissues overtime. m& m& m
& m&
c. Themedication’s action will begin fasterwhen given intravenously. d* m& m& m& m& m&
d. Mostofthedrugis inactivated bytheliverbefore itreaches thetarget area. m& m& d* m& m& d*
ANS: C m&
Intravenous injections arethe fastest route of absorption. Theintravenous routedoes not affect the number of adverse effects, the int
m& m& m& x m& m& m& m& m& m& xv m& m& m& m& m& m& m&
ra ve nous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver b
m& m& m& m& m& m& d* m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
efore it r eac hes the target area.
m& m& m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
3. Which is trueregarding parenteral drugs?
d* m& m& m&
a. Theybypass thefirst-pass effect. m
& m&
b. Theydecrease blood flowto thestomach. m
& m
& m&
c. Theyarealtered bythe presence of foodin thestomach. m& d* m& d*
d. Theyexert their effects while circulating in the bloodstream. m& m& m& m& m& m& m&
ANS: A m&
Drugs givenbytheparenteral routebypassthefirst-
m& d* m&
pass effect, but theystill must beabsorbedinto cells andtissues before theycan exert their effects. Enteral drugs (drugs taken orally), n
m& m& m& m& m& x m& m& m& m& m& m& m& m& m& m& m& m&
ot par enteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral drugs
m& m& m& m& m& m& m& m& m& m& m& xm & m& m& m& m& m& m& m& m& m& m& m&
must be a bsor bed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
circulating in t he blo odstream. m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Analysis
4. Adrug’shalf-lifeisbest defined as m& d*
a. Thetime it t akes forthe drug to elicit halfitstherapeutic response.
x m& d* m
& d* d* m
& m& d*
b. Thetimeittakes one- x
half oftheoriginal amountofa drug to reach thetarget cells.
m& xv m& d* m&
c. Thetimeittakesone-
half oftheoriginal amount of a drugto be removedfromthe body.
m& xm & d* x d* m&
d. Thetimeittakesone-
half oftheoriginal amount ofadrugto beabsorbed intothe circulation.
m& m& xm & m& d* m &
ANS: C m&
Adrug’shalf-lifeis thetimeittakesforone- m&
half of the originalamount of a drugtobe removed from the body. It is ameasure of the rate at which drugs are removed from the b
m& m& m& m& m& m& xv m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
ody. A nswers A, B, and D are not correct definitions of a drug’s half-life.
m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
5. Theterm“durationof action”isbest defined as m& d* m&
a. Thetimeit takes forthedrug to elicitatherapeuticresponse. xm & m& d* m& d*
b. Thetimeittakes adrugto reach itsmaximumtherapeutic response. d* d* m& m& m&
c. Thelength of time it takes to removeadrugfrom circulation. m
& d* m& xm & d* m& d* m&
d. Thetimeduringwhichdrugconcentrationis sufficient toelicitatherapeutic res d* x m& m& m& m
& ponse.
ANS: D m&
Duration ofaction isthetimeduringwhich drugconcentration is sufficient to elicit a therapeutic response. The timeit takes foradrug t
m& m& d* m& d* m& m& xm & m & d* d* m& d* m& d* m &
o el icit a therapeutic response is the drug’s “onset of action.” Thetimeittakes adrugto reachitsmaximum therapeutic responseisad
m& m& d* m& d* m& m& d* m& m& d* m& m& m& m &
rug’s “p eakeffect.”“Thelengthoftimeit takes toremovea drug from circulation”definesa drug’s eliminationand does notcorrectly d
d* m& d* xm & m& m& d* m& xm & d* xm & m& m& m &
efine a dru g’s duration of action.
m & m & m & m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
1
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
m& m& m & m& m& m& m& m& m&
MULTIPLE CHOICE m&
1. Whichisajudgement about aparticularpatient’s potentialneed orproblem?
d* m& m& m& m&
a. Agoal
b. Anassessment
c. Subjectivedata
d. Anursingdiagnosis
ANS: D m&
Nursing diagnosis isthe phase ofthenursingprocessduring whichaclinicaljudgementis made abouthowa patient responds to heath co nditi
d* m& d* m& m& m& xv m& d* d* m& d* m &
o ns and life processes or vulnerability for that response.
m & m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Knowledge d* m&
2. The patient isto receiveoralfurosemide(Lasix)everyday;however,becausethepatientis unabletoswallow,hecannottakemedi cat
m& xv d* m& d* d* d* m& d* m & m
& ion orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
m& m& m& m& m& d* m& m& d* m& m& m& m& m& m& m&
a. A “right time” problem
m& m& m&
b. A“right dose” problem m& m&
c. A “right route” problem
m& m& m
&
d. A “right medication” problem xv m &
ANS: C m&
This is a “right route”problem: thenursecannotassumethe route and must clarifythe routewith the prescriber. This is not a “right time” pro bl
d* m& d* m& m
& m& m
& d* d* d* d* d* m
& m
& d* d* m
& m& m&
em because the ordered frequencyhas notchanged. This is nota“rightdose” problem because thedose isnot related to an inabilit y to sw al
m& m& m& m& m& m& xm & m& m& m& m& m& m& m& m
& d* m& m& m& m&
low. This is not a“right medication” problem because the medication ordered will not change, just the route.
m& m& m& xm & m& m& m& m& m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Application d* m&
3. Thenursehasbeen monitoringthepatient’sprogress on his newdrugregimensincethefirstdoseand hasbeen documentingsigns of po ssi
d* m& d* xv d* d* m& m& m& m& m
ble adverse effects. What nursing process phase is the nurse practising?
& m& m& m& m& m& m& m& m& m& m&
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis d*
ANS: B m&
Monitoringthepatient’s progress ispart oftheevaluation phase.Planning, implementation, and nursingdiagnosis arenot illustrated by th
m& m& m& d* m& m& d* m& m & m & m & m
isexample.
&
DIF: CognitiveLevel: Application m &
4. The nurse iscaring fora patientwhohasbeennewlydiagnosedwithtype1diabetesmellitus.Whichstatementbestillustratesan outco m
m& d* d* m& d* d* d* m&
e criterion for this patient?
m& m& m& m&
a. Thepatient willfollowinstructions. m&
b. Thepatient will not experience complications. m& xm & m &
c. Thepatient adheres tothenewinsulin treatment regimen. m& m& m& m&
d. Thepatient demonstratessafeinsulinself-administrationtechnique. m&
ANS: D m&
Having the patient demonstrate safeinsulinself-
m& x m& m& m&
administrationtechnique is aspecific and measurable outcomecriterion. Following instructions and avoiding complications are not spe
d* d* d* m
& m
& m& d* m& m& m& m& m& m& m&
ci fic criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
m& m& m& m& m& m& m& m& m& d* m& m& m& m& d* m& m& m&
DIF: Cognitive Level: Application xv m &
5. Whichactivitybestreflects the implementation phaseofthe nursing process forthepatient who isnewlydiagnosed with type 1 diab
d* m& m& m& d* d* m& m& xm & m& d* m& m& m&
m & et es mellitus?
m& m&
a. Providingeducation regardingself-injection technique d* m&
b. Setting goals and outcomecriteriawith thepatient’s input
m& m& m& m& m&
c. Recording ahistoryofover-the-countermedications used at home m& d* d* d* m&
d. Formulatingnursingdiagnosesregardingknowledgedeficitsrelatedtothenew tr m&
e atment regimen
m& m&
ANS: A m&
Education is an intervention thatoccursduringthe implementation phase. Settinggoals and outcomecriteriareflects theplanning phase
m& xv m& m& m& m& m& m& m& m& m &
. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analy si
m& m& m& m& m& m& m& m& m& m& m
& m& m& d* m& m& m& m&
s of data as part of the planning phase.
m& m& m& m& m& m& m& m&
DIF: CognitiveLevel: Analysis m &
1
, 6. The nurse i s working d uringa verybusynight shift,andthe health careproviderhas just giventhenursea medication orderover thetel
m& d* d* d* x m& m& m& xm & xm & m & m& d* m& m
&ep hone, but the nursedoes not recall the route. What is the best way for the nurse to avoid medication errors?
m& m& xm & m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
a. Recopythe order neatlyon theordersheet, with the m ost common routeindicated
d* m& m& m& xm & d* m& d*
b. Consultwiththe pharmacist forclarification about themostcommon route m& m & m& d* m&
c. Callthe health care provider toclarifythe routeof administration
m& m& m& m& xm & m&
d. Withholdthe drug until the health care provider visits the patient m& d* m& m& m& m& m& m& m&
ANS: C m&
If a medication order doesnot include theroute, the nurse must ask thehealthcareprovider toclarifyit. Never assumethe routeof administration.
m & xm & m& m& m& m& d* m& m& xv m& m& m& m& m& m &
DIF: Cognitive Level: Application |Cognitive Level: Analysis
m& m& xv xm & m&
7. Whichconstitutesthetraditional Five Rights ofmedication administration? m& d* m& m&
a. Rightdrug,rightroute, right dose,right time,and right patient m& m& xm & m& m&
b. Rightdrug, therighteffect, theright route,theright time, and theright patient
m& m& xm & xm & d* m& m&
c. Rightpatient, right strength, right diagnosis,right drug, and right route d* xv m& d* m& m& d* m&
d. Rightpatient, right diagnosis, right drug,right route, and right time m& xv m& m& xm & d* d* m&
ANS: A m&
ThetraditionalFiveRightsofmedicationadministrationwereconsideredto be Right drug,Right route,Right dose,Righttime,and Right pa d* d* m& xv d* m& d* xm & d* m&
ti ent. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: Cognitive Level: Comprehension d* m&
8. What correctlydescribes the nursing process?
d* d* m& d*
a. Diagnosing,planning,assessing,implementing, andfinallyevaluating m&
b. Assessing,thendiagnosing, implementing, andendingwithevaluating m& d* d*
c. Alineardirectionthatbeginswithassessingandcontinuesthroughdiagnosing, pla d* m&
nning, and finally implementing
m& m& m& m&
d. Anongoingprocessthatbegins withassessingandcontinues withdiagnosing, pla m
& m& m& m&
nning, implementing, and evaluating
m& m& m&
ANS: D m&
Thenursingprocess isan ongoing, flexible,adaptable,andadjustablefive- m& d* m & d*
step processthat begins withassessingandcontinues through diagnosing, planning, implementing, and finally evaluating, whichmay the
xv d* m& xv m& m& m& m& m& m& m& m& m &
n lead back to any of the other phases.
m& m& m& m& m& m& m& m&
DIF: CognitiveLevel: Application m &
9. Whenthenurseis consideringthetiming ofa drug dose, which ismost important toassess?d* d* m& d* m
& d* m&
a. Thepatient’s identification m&
b. Thepatient’s weight m&
c. Thepatient’slast meal m&
d. Anydrug or food allergies m
& m& m&
ANS: C m&
Thepharmacokineticand pharmacodynamicproperties ofthedrugneed tobeassessed with regard to anydrug– m& m& m& m& d* xv m&
food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timing.
x m& m& m& m& m& m& m& m& m& xv m& m& xv m& m& d* m& m& m& m&
DIF: Cognitive Level: Application xv m &
10. Thenurseis writing nursingdiagnoses for aplan ofcare. Which reflects the correct format forher nursing diagnosis?
m& d* d* m& d* m& m& m& m& d* d* m& m& m
&
a. Anxiety
b. Anxietyrelated to new drug therapy m& m& m& m&
c. Anxietyrelated to anxious feelings aboutdrugtherapy, as evidenced by sta t xv x xv m& m& d* m& m&
ements such as “I’m upset about having to give myself shots”
m& m& m& m& m& m& xm & m& m& m& m&
d. Anxietyrelatedtonewdrugtherapy, asevidenced bystatementssuchas“I’m ups m
& m& m&
et about having to give myself shots”
m& m& m& m& m& m& m&
ANS: D m&
Formulation of nursing diagnoses is usually a three- d* m& m& m& m& m& d*
step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m upset abou
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
t h av ing to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions. The answer “Anx
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
iety re lated to new drug therapy” is missing the “as evidenced by” portion ofdefining characteristics. The“related to”sectio
m& m& m& m& m& m& m & x m& m& m& m & m & m& m& m& m& m&
n in“Anxietyrelat e d to anxious feelings about drugtherapy, as evidenced by statements such as ‘I’m upset about having to give mys
m& m& m& m& xv m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
elf shots’” is simply a rest atement of the problem “anxiety,” not a separate factor related to the response.
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: m & m & Cognitive Level: Analysis m& m&
OTHER
1. Placethephases of the nursingprocess inthecorrect order, startingwith the first phase.
m& d* d* m& d* m& m& d* m&
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A,D,B m
& m&
DIF: m & m & Cognitive Level: Analysis m& m&
2
, Chapter02:Pharmacological Principles xv
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
m& m& m & m& m& m& m& m& m&
MULTIPLE CHOICE m&
1. Apatientisreceivingtwodifferent drugs,which, at theircurrentdose formsand dosages,arebothabsorbedinto thecirculation in identi cal m& m& m& m& xv d* m& d* m& m &
m & amounts. Which term best denotes that the drugs have the same absorption rates?
m& m& m& m& m& d* m& m& m& m& m& m&
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D m&
Two drugs absorbed into the circulation at thesameamount (in specific dosage forms) havethesame bioavailability; thus, they are bi
m& x m& m& m& m& m& m& m& x m& m& m& m& m& m& m& m& m&
oe qui valent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption.
m& m& m& m& m& m& m& m& m& m& d* m& d* m& m& m& m& m&
“Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the ef
m& m& d* m& m& m& m& m& m& m& d* m& d* m& m& m& m& m& m& m& m& m&
fe ct s of each drug given alone. “Compatible” is incorrect because this term is ageneral term used to indicate that two substances d
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
o not ha ve a chemical reaction when mixed (or given, in the case of drugs) together.
m& m& m& m& m& m& m& m& m& m& m& d* m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
2. Apatientisreceivingmedicationviaintravenous injection. Whichinformation shouldthenurseprovideforpatient education?
d* d* m& d* m& d* d* d* m &
a. Themedication will causefewer adverse effects when given intravenously. m& m& m& m& m& m& m&
b. Themedication willbeabsorbed slowlyinto thetissues overtime. m& m& m
& m&
c. Themedication’s action will begin fasterwhen given intravenously. d* m& m& m& m& m&
d. Mostofthedrugis inactivated bytheliverbefore itreaches thetarget area. m& m& d* m& m& d*
ANS: C m&
Intravenous injections arethe fastest route of absorption. Theintravenous routedoes not affect the number of adverse effects, the int
m& m& m& x m& m& m& m& m& m& xv m& m& m& m& m& m& m&
ra ve nous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver b
m& m& m& m& m& m& d* m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
efore it r eac hes the target area.
m& m& m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
3. Which is trueregarding parenteral drugs?
d* m& m& m&
a. Theybypass thefirst-pass effect. m
& m&
b. Theydecrease blood flowto thestomach. m
& m
& m&
c. Theyarealtered bythe presence of foodin thestomach. m& d* m& d*
d. Theyexert their effects while circulating in the bloodstream. m& m& m& m& m& m& m&
ANS: A m&
Drugs givenbytheparenteral routebypassthefirst-
m& d* m&
pass effect, but theystill must beabsorbedinto cells andtissues before theycan exert their effects. Enteral drugs (drugs taken orally), n
m& m& m& m& m& x m& m& m& m& m& m& m& m& m& m& m& m&
ot par enteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral drugs
m& m& m& m& m& m& m& m& m& m& m& xm & m& m& m& m& m& m& m& m& m& m& m&
must be a bsor bed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while
m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
circulating in t he blo odstream. m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Analysis
4. Adrug’shalf-lifeisbest defined as m& d*
a. Thetime it t akes forthe drug to elicit halfitstherapeutic response.
x m& d* m
& d* d* m
& m& d*
b. Thetimeittakes one- x
half oftheoriginal amountofa drug to reach thetarget cells.
m& xv m& d* m&
c. Thetimeittakesone-
half oftheoriginal amount of a drugto be removedfromthe body.
m& xm & d* x d* m&
d. Thetimeittakesone-
half oftheoriginal amount ofadrugto beabsorbed intothe circulation.
m& m& xm & m& d* m &
ANS: C m&
Adrug’shalf-lifeis thetimeittakesforone- m&
half of the originalamount of a drugtobe removed from the body. It is ameasure of the rate at which drugs are removed from the b
m& m& m& m& m& m& xv m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m& m&
ody. A nswers A, B, and D are not correct definitions of a drug’s half-life.
m& m& m& m& m& m& m& m& m& m& m& m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
5. Theterm“durationof action”isbest defined as m& d* m&
a. Thetimeit takes forthedrug to elicitatherapeuticresponse. xm & m& d* m& d*
b. Thetimeittakes adrugto reach itsmaximumtherapeutic response. d* d* m& m& m&
c. Thelength of time it takes to removeadrugfrom circulation. m
& d* m& xm & d* m& d* m&
d. Thetimeduringwhichdrugconcentrationis sufficient toelicitatherapeutic res d* x m& m& m& m
& ponse.
ANS: D m&
Duration ofaction isthetimeduringwhich drugconcentration is sufficient to elicit a therapeutic response. The timeit takes foradrug t
m& m& d* m& d* m& m& xm & m & d* d* m& d* m& d* m &
o el icit a therapeutic response is the drug’s “onset of action.” Thetimeittakes adrugto reachitsmaximum therapeutic responseisad
m& m& d* m& d* m& m& d* m& m& d* m& m& m& m &
rug’s “p eakeffect.”“Thelengthoftimeit takes toremovea drug from circulation”definesa drug’s eliminationand does notcorrectly d
d* m& d* xm & m& m& d* m& xm & d* xm & m& m& m &
efine a dru g’s duration of action.
m & m & m & m& m& m&
DIF: m & m & m & CognitiveLevel:Comprehension
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