lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
lOMoARcPSD|301 380 4
TABLE OF CONTENTS
TEST BANK - Lilleys Pharmacology for
Canadian Health Care Practice, 4th Edition
(Sealock), Chapters 1 - 58 | All Chapters
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
Copyright © 2021, Elsevier Inc. All rights reserved. 1
Chapter 01: Nursing Practice in Canada and Drug Therapy
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. Which is a judgement about a particular patient’s potential need or problem?
a. A goal
b. An assessment
c. Subjective data
d. A nursing diagnosis
ANSWER: D
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about how a patient responds to
heath conditions and life processes or vulnerability for that response.
DIF: Cognitive Level: Knowledge
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to swallow, he cannot take
medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
a. A “right time” problem
b. A “right dose” problem
c. A “right route” problem
d. A “right medication” problem
ANSWER: C
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the prescriber. This is not a “right
time” problem because the ordered frequency has not changed. This is not a “right dose” problem because the dose is not related to
an inability to swallow. This is not a “right medication” problem because the medication ordered will not change, just the route.
DIF: Cognitive Level: Application
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and has been documenting signs
of possible adverse effects. What nursing process phase is the nurse practising?
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis
ANSWER: B
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not
illustrated by this example.
DIF: Cognitive Level: Application
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an
outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient adheres to the new insulin treatment regimen.
d. The patient demonstrates safe insulin self-administration technique.
ANSWER: D
Having the patient demonstrate safe insulin self-administration technique is a specific and measurable outcome criterion. Following
instructions and avoiding complications are not specific criteria. Adherence to the new insulin treatment regimen is not objective
and would be difficult to measure.
DIF: Cognitive Level: Application
5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with type 1
diabetes mellitus?
a. Providing education regarding self-injection technique
b. Setting goals and outcome criteria with the patient’s input
c. Recording a history of over-the-counter medications used at home
d. Formulating nursing diagnoses regarding knowledge deficits related to the new
treatment regimen
ANSWER: A
Education is an intervention that occurs during the implementation phase. Setting goals and outcome criteria reflects the planning
phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit
reflects analysis of data as part of the planning phase.
DIF: Cognitive Level: Analysis
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
6. The nurse is working during a very busy night shift, and the health care provider has just given the nurse a medication order over Chapter 02: Pharmacological Principles
the telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication errors? Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
a. Recopy the order neatly on the order sheet, with the most common route indicated
b. Consult with the pharmacist for clarification about the most common route
c. Call the health care provider to clarify the route of administration MULTIPLE CHOICE
d. Withhold the drug until the health care provider visits the patient
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circulation in
ANSWER: C identical amounts. Which term best denotes that the drugs have the same absorption rates?
If a medication order does not include the route, the nurse must ask the health care provider to clarify it. Never assume the route of a. Equivalent
administration. b. Synergistic
c. Compatible
DIF: Cognitive Level: Application | Cognitive Level: Analysis
d. Bioequivalent
7. Which constitutes the traditional Five Rights of medication administration? ANSWER: D
a. Right drug, right route, right dose, right time, and right patient Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, they are
b. Right drug, the right effect, the right route, the right time, and the right patient bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption.
c. Right patient, right strength, right diagnosis, right drug, and right route “Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the
d. Right patient, right diagnosis, right drug, right route, and right time effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicate that two substances
ANSWER: A do not have a chemical reaction when mixed (or given, in the case of drugs) together.
The traditional Five Rights of medication administration were considered to be Right drug, Right route, Right dose, Right time, and
DIF: Cognitive Level: Comprehension
Right patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education?
DIF: Cognitive Level: Comprehension
a. The medication will cause fewer adverse effects when given intravenously.
8. What correctly describes the nursing process? b. The medication will be absorbed slowly into the tissues over time.
a. Diagnosing, planning, assessing, implementing, and finally evaluating c. The medication’s action will begin faster when given intravenously.
b. Assessing, then diagnosing, implementing, and ending with evaluating d. Most of the drug is inactivated by the liver before it reaches the target area.
c. A linear direction that begins with assessing and continues through diagnosing, ANSWER: C
planning, and finally implementing Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effects, the
d. An ongoing process that begins with assessing and continues with diagnosing, intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver
planning, implementing, and evaluating before it reaches the target area.
ANSWER: D
DIF: Cognitive Level: Comprehension
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that begins with assessing and continues
through diagnosing, planning, implementing, and finally evaluating, which may then lead back to any of the other phases. 3. Which is true regarding parenteral drugs?
a. They bypass the first-pass effect.
DIF: Cognitive Level: Application
b. They decrease blood flow to the stomach.
9. When the nurse is considering the timing of a drug dose, which is most important to assess? c. They are altered by the presence of food in the stomach.
a. The patient’s identification d. They exert their effects while circulating in the bloodstream.
b. The patient’s weight ANSWER: A
c. The patient’s last meal Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed into cells and tissues before they can
d. Any drug or food allergies exert their effects. Enteral drugs (drugs taken orally), not parenteral drugs, decrease blood flow to the stomach and are altered by
ANSWER: C the presence of food in the stomach. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to any drug–food interactions or exert their effects; they do not exert their effects while circulating in the bloodstream.
compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timing.
DIF: Cognitive Level: Analysis
DIF: Cognitive Level: Application
4. A drug’s half-life is best defined as
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis? a. The time it takes for the drug to elicit half its therapeutic response.
a. Anxiety b. The time it takes one-half of the original amount of a drug to reach the target
b. Anxiety related to new drug therapy cells.
c. Anxiety related to anxious feelings about drug therapy, as evidenced by c. The time it takes one-half of the original amount of a drug to be removed from the
statements such as “I’m upset about having to give myself shots” body.
d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m d. The time it takes one-half of the original amount of a drug to be absorbed into the
upset about having to give myself shots” circulation.
ANSWER: D ANSWER: C
Formulation of nursing diagnoses is usually a three-step process. The only complete answer is “Anxiety related to new drug A drug’s half-life is the time it takes for one-half of the original amount of a drug to be removed from the body. It is a measure of
therapy, as evidenced by statements such as ‘I’m upset about having to give myself shots.’” The answer “Anxiety” is missing the the rate at which drugs are removed from the body. Answers A, B, and D are not correct definitions of a drug’s half-life.
“related to” and “as evidenced by” portions. The answer “Anxiety related to new drug therapy” is missing the “as evidenced by”
DIF: Cognitive Level: Comprehension
portion of defining characteristics. The “related to” section in “Anxiety related to anxious feelings about drug therapy, as evidenced
by statements such as ‘I’m upset about having to give myself shots’” is simply a restatement of the problem “anxiety,” not a 5. The term “duration of action” is best defined as
separate factor related to the response. a. The time it takes for the drug to elicit a therapeutic response.
b. The time it takes a drug to reach its maximum therapeutic response.
DIF: Cognitive Level: Analysis
c. The length of time it takes to remove a drug from circulation.
d. The time during which drug concentration is sufficient to elicit a therapeutic
OTHER response.
1. Place the phases of the nursing process in the correct order, starting with the first phase. ANSWER: D
a. Planning Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it takes for a
b. Evaluation drug to elicit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximum therapeutic
c. Assessment response is a drug’s “peak effect.” “The length of time it takes to remove a drug from circulation” defines a drug’s eliminat ion and
d. Implementation does not correctly define a drug’s duration of action.
e. Diagnosing
DIF: Cognitive Level: Comprehension
ANSWER:
C, E, A, D, B
DIF: Cognitive Level: Analysis
Copyright © 2021, Elsevier Inc. All rights reserved. 2 Copyright © 2021, Elsevier Inc. All rights reserved. 1
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
6. A drug interacts with enzymes by Chapter 03: Legal and Ethical Considerations
a. altering cell membrane permeability. Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
b. “fooling” a receptor on the cell wall.
c. enhancing the drug’s effectiveness within the cells.
d. “fooling” the enzyme into binding with it instead of its normal target cell. MULTIPLE CHOICE
ANSWER: D 1. In the development of a new drug by a pharmaceutical company, the researcher must ensure that the participants in experimental
When drugs interact with enzymes, they inhibit the action of a specific enzyme by “fooling” the enzyme into binding to it instead drug studies do not have unrealistic expectations of the new drug’s usefulness. What will the researcher include in the design of the
of to its normal target cell. Thus, the target cells are protected from the action of the enzymes to result in a drug effect. The study to prevent bias that may occur?
alteration of cell membrane permeability, the “fooling” of a receptor on the cell wall, and the enhancement of the effectiveness of a. A placebo
drugs within cells do not occur with selective enzyme interactions. b. Health Canada approval
c. Informed consent
DIF: Cognitive Level: Comprehension
d. Efficacy information
7. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Which consequence will result ANSWER: A
from this protein binding? To prevent bias that may occur as a result of unrealistic expectations of an investigational new drug, a placebo will be incorporated
a. Renal excretion will take longer. into the study. Health Canada approval, if given, does not be obtained until after phase III of the study. Informed consent is
b. The drug will be metabolized quickly. required in all drug studies. Efficacy information is not determined until the study is under way.
c. The duration of action of the medication will be longer.
d. The duration of action of the medication will be shorter. DIF: Cognitive Level: Comprehension
ANSWER: C 2. A member of an investigational drug study team is working with healthy volunteers whose participation will help determine the
Drugs that are bound to plasma proteins are characterized by a longer duration of action. Protein binding does not make renal optimal dosage range and pharmacokinetics of the drug. In what type of study is the team member participating?
excretion longer and does not increase metabolism of the drug. Protein binding of a drug means that the duration of action is a. Phase I
longer, not shorter. b. Phase II
c. Phase III
DIF: Cognitive Level: Application
d. Phase IV
8. When monitoring a patient on an insulin drip to reduce blood glucose levels, the nurse notes that the patient’s glucose level is ANSWER: A
extremely low, and the patient is lethargic and difficult to awaken. Which adverse drug reaction is the nurse observing? Phase I studies involve small numbers of healthy volunteers to determine the optimal dosage range and the pharmacokinetics of the
a. An adverse effect drug. Phases II, III, and IV involve progressively larger numbers of volunteers who have the disease or ailment that the drug is
b. An allergic reaction designed to diagnose or treat.
c. An idiosyncratic reaction
d. A pharmacological reaction DIF: Cognitive Level: Application
ANSWER: D
3. A patient has a prescription for a drug classified as Schedule F. What important information should the nurse give this patient about
A pharmacological reaction is an extension of the drug’s normal effects in the body. In this case, the insulin lowered the patient’s obtaining refills for this medication?
blood glucose levels too much. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no a. No prescription refills are permitted.
changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune b. Refills may be obtained via telephone order.
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of c. Refills are indicated by the prescriber.
a drug.
d. The patient may have no more than six refills in a 12-month period.
DIF: Cognitive Level: Comprehension ANSWER: C
Schedule F contains a list of drugs that can be sold and refilled only on prescription; prescriptions can be refilled as often as
9. A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where should the nurse tell the patient to indicated by the prescriber.
place the tablet?
a. Under the tongue DIF: Cognitive Level: Analysis
b. In the space between the cheek and gum
c. At the back of the throat, for easy swallowing 4. A patient has been chosen to be a recipient of an investigational drug for heart failure and has given informed consent. Which is
d. On a non-hairy area on the chest indicated by the patient’s informed consent?
a. The patient has been informed of the possible benefits of the new therapy.
ANSWER: A b. The patient will be informed of the details of the study as the research continues.
Drugs taken by the sublingual route are placed under the tongue. Placing the tablet in the space between the cheek and gum is done c. The patient will not be assured of receiving the actual drug during the experiment.
for the buccal route; placing the tablet at the back of the throat (for easy swallowing) is done in the oral route; and placing the tablet d. The patient has received an explanation of the study’s purpose, procedures, and
on a non-hairy area on the chest is done in the topical or transdermal route. the benefits and risks involved.
DIF: Cognitive Level: Comprehension ANSWER: D
Informed consent involves the careful explanation of the purpose of the study, procedures to be used, and the possible benefits and
10. The nurse is administering medications to a patient who is in liver failure due to end-stage cirrhosis. The nurse is aware that risks involved. Being informed of the possible benefits of the new therapy, being informed of the study details as research
patients with liver failure are most likely to have problems with which pharmacokinetic phase? continues, and being assured of receiving the actual drug during the experiment do not describe informed consent.
a. Absorption
b. Distribution DIF: Cognitive Level: Comprehension
c. Metabolism
d. Excretion 5. Which is the most significant part of legislation in regard to professional nursing practice?
a. Canada Health Act
ANSWER: C b. Nursing Practice Act
The liver is the organ that is most responsible for drug metabolism. Decreased liver function will most affect a drug’s metabolism. c. Controlled Drugs and Substances Act
The absorption of a drug is not affected by liver function, and distribution is not affected by liver function. Excretion is affected d. Personal Information Protection and Electronic Documents Act
only because decreased liver function may not transform drugs into water-soluble substances for elimination via the kidneys, but
this is not the best answer to this question. ANSWER: B
Nurse practice acts (NPAs) are regulatory laws that are instrumental in defining the scope of nursing practice and that protect
DIF: Cognitive Level: Application public health, safety, and welfare. Nursing practice in Canada is regulated by separate acts in each of the 10 provinces and 3
territories. These acts grant self-governance to the nursing profession, direct entry into nursing practice, define the scopes of
practice, and identify disciplinary actions. NPAs are the most significant part of legislation in regard to professional nursing
practice.
DIF: Cognitive Level: Comprehension
Copyright © 2021, Elsevier Inc. All rights reserved. 2 Copyright © 2021, Elsevier Inc. All rights reserved. 1
lOMoARcPSD|301 380 4
TABLE OF CONTENTS
TEST BANK - Lilleys Pharmacology for
Canadian Health Care Practice, 4th Edition
(Sealock), Chapters 1 - 58 | All Chapters
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
Copyright © 2021, Elsevier Inc. All rights reserved. 1
Chapter 01: Nursing Practice in Canada and Drug Therapy
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
MULTIPLE CHOICE
1. Which is a judgement about a particular patient’s potential need or problem?
a. A goal
b. An assessment
c. Subjective data
d. A nursing diagnosis
ANSWER: D
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about how a patient responds to
heath conditions and life processes or vulnerability for that response.
DIF: Cognitive Level: Knowledge
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to swallow, he cannot take
medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
a. A “right time” problem
b. A “right dose” problem
c. A “right route” problem
d. A “right medication” problem
ANSWER: C
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the prescriber. This is not a “right
time” problem because the ordered frequency has not changed. This is not a “right dose” problem because the dose is not related to
an inability to swallow. This is not a “right medication” problem because the medication ordered will not change, just the route.
DIF: Cognitive Level: Application
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and has been documenting signs
of possible adverse effects. What nursing process phase is the nurse practising?
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis
ANSWER: B
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not
illustrated by this example.
DIF: Cognitive Level: Application
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an
outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient adheres to the new insulin treatment regimen.
d. The patient demonstrates safe insulin self-administration technique.
ANSWER: D
Having the patient demonstrate safe insulin self-administration technique is a specific and measurable outcome criterion. Following
instructions and avoiding complications are not specific criteria. Adherence to the new insulin treatment regimen is not objective
and would be difficult to measure.
DIF: Cognitive Level: Application
5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with type 1
diabetes mellitus?
a. Providing education regarding self-injection technique
b. Setting goals and outcome criteria with the patient’s input
c. Recording a history of over-the-counter medications used at home
d. Formulating nursing diagnoses regarding knowledge deficits related to the new
treatment regimen
ANSWER: A
Education is an intervention that occurs during the implementation phase. Setting goals and outcome criteria reflects the planning
phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge deficit
reflects analysis of data as part of the planning phase.
DIF: Cognitive Level: Analysis
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
6. The nurse is working during a very busy night shift, and the health care provider has just given the nurse a medication order over Chapter 02: Pharmacological Principles
the telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication errors? Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
a. Recopy the order neatly on the order sheet, with the most common route indicated
b. Consult with the pharmacist for clarification about the most common route
c. Call the health care provider to clarify the route of administration MULTIPLE CHOICE
d. Withhold the drug until the health care provider visits the patient
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circulation in
ANSWER: C identical amounts. Which term best denotes that the drugs have the same absorption rates?
If a medication order does not include the route, the nurse must ask the health care provider to clarify it. Never assume the route of a. Equivalent
administration. b. Synergistic
c. Compatible
DIF: Cognitive Level: Application | Cognitive Level: Analysis
d. Bioequivalent
7. Which constitutes the traditional Five Rights of medication administration? ANSWER: D
a. Right drug, right route, right dose, right time, and right patient Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, they are
b. Right drug, the right effect, the right route, the right time, and the right patient bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption.
c. Right patient, right strength, right diagnosis, right drug, and right route “Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the
d. Right patient, right diagnosis, right drug, right route, and right time effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicate that two substances
ANSWER: A do not have a chemical reaction when mixed (or given, in the case of drugs) together.
The traditional Five Rights of medication administration were considered to be Right drug, Right route, Right dose, Right time, and
DIF: Cognitive Level: Comprehension
Right patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education?
DIF: Cognitive Level: Comprehension
a. The medication will cause fewer adverse effects when given intravenously.
8. What correctly describes the nursing process? b. The medication will be absorbed slowly into the tissues over time.
a. Diagnosing, planning, assessing, implementing, and finally evaluating c. The medication’s action will begin faster when given intravenously.
b. Assessing, then diagnosing, implementing, and ending with evaluating d. Most of the drug is inactivated by the liver before it reaches the target area.
c. A linear direction that begins with assessing and continues through diagnosing, ANSWER: C
planning, and finally implementing Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effects, the
d. An ongoing process that begins with assessing and continues with diagnosing, intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver
planning, implementing, and evaluating before it reaches the target area.
ANSWER: D
DIF: Cognitive Level: Comprehension
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that begins with assessing and continues
through diagnosing, planning, implementing, and finally evaluating, which may then lead back to any of the other phases. 3. Which is true regarding parenteral drugs?
a. They bypass the first-pass effect.
DIF: Cognitive Level: Application
b. They decrease blood flow to the stomach.
9. When the nurse is considering the timing of a drug dose, which is most important to assess? c. They are altered by the presence of food in the stomach.
a. The patient’s identification d. They exert their effects while circulating in the bloodstream.
b. The patient’s weight ANSWER: A
c. The patient’s last meal Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed into cells and tissues before they can
d. Any drug or food allergies exert their effects. Enteral drugs (drugs taken orally), not parenteral drugs, decrease blood flow to the stomach and are altered by
ANSWER: C the presence of food in the stomach. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to any drug–food interactions or exert their effects; they do not exert their effects while circulating in the bloodstream.
compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the drug’s timing.
DIF: Cognitive Level: Analysis
DIF: Cognitive Level: Application
4. A drug’s half-life is best defined as
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis? a. The time it takes for the drug to elicit half its therapeutic response.
a. Anxiety b. The time it takes one-half of the original amount of a drug to reach the target
b. Anxiety related to new drug therapy cells.
c. Anxiety related to anxious feelings about drug therapy, as evidenced by c. The time it takes one-half of the original amount of a drug to be removed from the
statements such as “I’m upset about having to give myself shots” body.
d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m d. The time it takes one-half of the original amount of a drug to be absorbed into the
upset about having to give myself shots” circulation.
ANSWER: D ANSWER: C
Formulation of nursing diagnoses is usually a three-step process. The only complete answer is “Anxiety related to new drug A drug’s half-life is the time it takes for one-half of the original amount of a drug to be removed from the body. It is a measure of
therapy, as evidenced by statements such as ‘I’m upset about having to give myself shots.’” The answer “Anxiety” is missing the the rate at which drugs are removed from the body. Answers A, B, and D are not correct definitions of a drug’s half-life.
“related to” and “as evidenced by” portions. The answer “Anxiety related to new drug therapy” is missing the “as evidenced by”
DIF: Cognitive Level: Comprehension
portion of defining characteristics. The “related to” section in “Anxiety related to anxious feelings about drug therapy, as evidenced
by statements such as ‘I’m upset about having to give myself shots’” is simply a restatement of the problem “anxiety,” not a 5. The term “duration of action” is best defined as
separate factor related to the response. a. The time it takes for the drug to elicit a therapeutic response.
b. The time it takes a drug to reach its maximum therapeutic response.
DIF: Cognitive Level: Analysis
c. The length of time it takes to remove a drug from circulation.
d. The time during which drug concentration is sufficient to elicit a therapeutic
OTHER response.
1. Place the phases of the nursing process in the correct order, starting with the first phase. ANSWER: D
a. Planning Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it takes for a
b. Evaluation drug to elicit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximum therapeutic
c. Assessment response is a drug’s “peak effect.” “The length of time it takes to remove a drug from circulation” defines a drug’s eliminat ion and
d. Implementation does not correctly define a drug’s duration of action.
e. Diagnosing
DIF: Cognitive Level: Comprehension
ANSWER:
C, E, A, D, B
DIF: Cognitive Level: Analysis
Copyright © 2021, Elsevier Inc. All rights reserved. 2 Copyright © 2021, Elsevier Inc. All rights reserved. 1
, lOMoARcPSD|301 380 4 lOMoARcPSD|301 380 4
6. A drug interacts with enzymes by Chapter 03: Legal and Ethical Considerations
a. altering cell membrane permeability. Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
b. “fooling” a receptor on the cell wall.
c. enhancing the drug’s effectiveness within the cells.
d. “fooling” the enzyme into binding with it instead of its normal target cell. MULTIPLE CHOICE
ANSWER: D 1. In the development of a new drug by a pharmaceutical company, the researcher must ensure that the participants in experimental
When drugs interact with enzymes, they inhibit the action of a specific enzyme by “fooling” the enzyme into binding to it instead drug studies do not have unrealistic expectations of the new drug’s usefulness. What will the researcher include in the design of the
of to its normal target cell. Thus, the target cells are protected from the action of the enzymes to result in a drug effect. The study to prevent bias that may occur?
alteration of cell membrane permeability, the “fooling” of a receptor on the cell wall, and the enhancement of the effectiveness of a. A placebo
drugs within cells do not occur with selective enzyme interactions. b. Health Canada approval
c. Informed consent
DIF: Cognitive Level: Comprehension
d. Efficacy information
7. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Which consequence will result ANSWER: A
from this protein binding? To prevent bias that may occur as a result of unrealistic expectations of an investigational new drug, a placebo will be incorporated
a. Renal excretion will take longer. into the study. Health Canada approval, if given, does not be obtained until after phase III of the study. Informed consent is
b. The drug will be metabolized quickly. required in all drug studies. Efficacy information is not determined until the study is under way.
c. The duration of action of the medication will be longer.
d. The duration of action of the medication will be shorter. DIF: Cognitive Level: Comprehension
ANSWER: C 2. A member of an investigational drug study team is working with healthy volunteers whose participation will help determine the
Drugs that are bound to plasma proteins are characterized by a longer duration of action. Protein binding does not make renal optimal dosage range and pharmacokinetics of the drug. In what type of study is the team member participating?
excretion longer and does not increase metabolism of the drug. Protein binding of a drug means that the duration of action is a. Phase I
longer, not shorter. b. Phase II
c. Phase III
DIF: Cognitive Level: Application
d. Phase IV
8. When monitoring a patient on an insulin drip to reduce blood glucose levels, the nurse notes that the patient’s glucose level is ANSWER: A
extremely low, and the patient is lethargic and difficult to awaken. Which adverse drug reaction is the nurse observing? Phase I studies involve small numbers of healthy volunteers to determine the optimal dosage range and the pharmacokinetics of the
a. An adverse effect drug. Phases II, III, and IV involve progressively larger numbers of volunteers who have the disease or ailment that the drug is
b. An allergic reaction designed to diagnose or treat.
c. An idiosyncratic reaction
d. A pharmacological reaction DIF: Cognitive Level: Application
ANSWER: D
3. A patient has a prescription for a drug classified as Schedule F. What important information should the nurse give this patient about
A pharmacological reaction is an extension of the drug’s normal effects in the body. In this case, the insulin lowered the patient’s obtaining refills for this medication?
blood glucose levels too much. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no a. No prescription refills are permitted.
changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune b. Refills may be obtained via telephone order.
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of c. Refills are indicated by the prescriber.
a drug.
d. The patient may have no more than six refills in a 12-month period.
DIF: Cognitive Level: Comprehension ANSWER: C
Schedule F contains a list of drugs that can be sold and refilled only on prescription; prescriptions can be refilled as often as
9. A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where should the nurse tell the patient to indicated by the prescriber.
place the tablet?
a. Under the tongue DIF: Cognitive Level: Analysis
b. In the space between the cheek and gum
c. At the back of the throat, for easy swallowing 4. A patient has been chosen to be a recipient of an investigational drug for heart failure and has given informed consent. Which is
d. On a non-hairy area on the chest indicated by the patient’s informed consent?
a. The patient has been informed of the possible benefits of the new therapy.
ANSWER: A b. The patient will be informed of the details of the study as the research continues.
Drugs taken by the sublingual route are placed under the tongue. Placing the tablet in the space between the cheek and gum is done c. The patient will not be assured of receiving the actual drug during the experiment.
for the buccal route; placing the tablet at the back of the throat (for easy swallowing) is done in the oral route; and placing the tablet d. The patient has received an explanation of the study’s purpose, procedures, and
on a non-hairy area on the chest is done in the topical or transdermal route. the benefits and risks involved.
DIF: Cognitive Level: Comprehension ANSWER: D
Informed consent involves the careful explanation of the purpose of the study, procedures to be used, and the possible benefits and
10. The nurse is administering medications to a patient who is in liver failure due to end-stage cirrhosis. The nurse is aware that risks involved. Being informed of the possible benefits of the new therapy, being informed of the study details as research
patients with liver failure are most likely to have problems with which pharmacokinetic phase? continues, and being assured of receiving the actual drug during the experiment do not describe informed consent.
a. Absorption
b. Distribution DIF: Cognitive Level: Comprehension
c. Metabolism
d. Excretion 5. Which is the most significant part of legislation in regard to professional nursing practice?
a. Canada Health Act
ANSWER: C b. Nursing Practice Act
The liver is the organ that is most responsible for drug metabolism. Decreased liver function will most affect a drug’s metabolism. c. Controlled Drugs and Substances Act
The absorption of a drug is not affected by liver function, and distribution is not affected by liver function. Excretion is affected d. Personal Information Protection and Electronic Documents Act
only because decreased liver function may not transform drugs into water-soluble substances for elimination via the kidneys, but
this is not the best answer to this question. ANSWER: B
Nurse practice acts (NPAs) are regulatory laws that are instrumental in defining the scope of nursing practice and that protect
DIF: Cognitive Level: Application public health, safety, and welfare. Nursing practice in Canada is regulated by separate acts in each of the 10 provinces and 3
territories. These acts grant self-governance to the nursing profession, direct entry into nursing practice, define the scopes of
practice, and identify disciplinary actions. NPAs are the most significant part of legislation in regard to professional nursing
practice.
DIF: Cognitive Level: Comprehension
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