k k k k k k
Nurses k
Chapter 02: Basic Principles of Drug Action and Drug Interact
k k k k k k k k k
ions
Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition MULTIP k k k k k k k
LE CHOICE
k
1.The nurse assesses hives in a patient started on a new medication. What is the n
k k k k k k k k k k k k k k k
urse‟s priority action?
k k
a. Notify physician of allergic reaction.
k k k k
b.Notify physician of idiosyncratic reaction.
k k k k
c. Notify physician of potential teratogenicity.
k k k k
d.Notify physician of potential tolerance.
k k k k
ANS: A k
An allergic reaction is indicative of hypersensitivity and manifests with hives and/or
k k k k k k k k k k k k
urticaria, which are easily identified. An idiosyncratic reaction occurs when somethi
k k k k k k k k k k
ng unusual or abnormal happens when a drug is first administered. A teratogenic rea
k k k k k k k k k k k k k
ction refers to the occurrence of birth defects related to
k k k k k k k k k
,administration of the drug. Tolerance refers to the body‟s requirement for increasin
k k k k k k k k k k k
g dosages to achieve the same effects that a lower dose once did.
k k k k k k k k k k k k
DIF: Cognitive Level: Application REF: Page 17 OBJ: 4 TOP:Nu
k k k k k k k k k
rsing Process Step: Assessment
k k k
MSC:NCLEX Client Needs Category: Physiological Integrity NOT:CONCEPT(S)
k k k k k k
: Clinical Judgment; Safety
k k k
2.The nurse administers an initial dose of a steroid to a patient with asthma. Thirty m
k k k k k k k k k k k k k k k
inutes after administration, the nurse finds the patient agitated and stating that “ever
k k k k k k k k k k k k
yone is out to get me.” What is the term for this unusual reaction?
k k k k k k k k k k k k k
a. Desired action k
b.Adverse effect k
c. Idiosyncratic reaction k
d.Allergic reaction k
ANS: C k
Idiosyncratic reactions are unusual, abnormal reactions that occur when a drug is firs
k k k k k k k k k k k k
t administered. Patients typically exhibit an overresponsiveness to a medication relat
k k k k k k k k k k
ed to diminished metabolism. These reactions are believed to be related to genetic en
k k k k k k k k k k k k k
zyme deficiencies. Desired actions are expected responses to a medication. Adverse
k k k k k k k k k k k
effects are reactions that occur in another system of the body; they are usually predic
k k k k k k k k k k k k k k
table. Allergic reactions appear after repeated medication dosages.
k k k k k k k
DIF: Cognitive Level: Knowledge REF: Page 18 OBJ: 4 TOP:Nu
k k k k k k k k k
rsing Process Step: Evaluation
k k k
MSC:NCLEX Client Needs Category: Physiological Integrity k k k k k
NOT: CONCEPT(S): Patient Education; Clinical Judgment; Caregiving; Safety; S
k k k k k k k k
ensory Perception k
3.Which is the best description of when drug interactions occur? a
k k k k k k k k k k
.On administration of toxic dosages of a drug
k k k k k k k
, b.On an increase in the pharmacodynamics of bound drugs
k k k k k k k k
c. On the alteration of the effect of one drug by another drug
k k k k k k k k k k k
d.On increase of drug excretion
k k k k
ANS: C k
Drug interactions may be characterized by an increase or decrease in the effectiv
k k k k k k k k k k k k
eness of one or both of the drugs. Toxicity of one drug may or may not affect the
k k k k k k k k k k k k k k k k k k
metabolism of another one. Drug interactions may result from either increased o
k k k k k k k k k k k
r decreased pharmacodynamics. Drug interactions may result from either increa
k k k k k k k k k
sed or decreased excretion.
k k k
DIF: Cognitive Level: Comprehension REF: Page 18 OBJ: 5 TO
k k k k k k k k k
P:Nursing Process Step: Assessment k k k
MSC:NCLEX Client Needs Category: Physiological Integrity NOT:CONCEPTk k k k k k
(S): Safety; Patient Education; Clinical Judgment
k k k k k
4.What occurs when two drugs compete for the same receptor site, resulting in i
k k k k k k k k k k k k k
ncreased activity of the first drug? k k k k k
a. Desired action k
b.Synergistic effect k
c. Carcinogenicity
d.Displacement
ANS: D k
The displacement of the first drug from receptor sites by a second drug increases the
k k k k k k k k k k k k k k
amount of the first drug because more unbound drug is available. An expected resp
k k k k k k k k k k k k k k
onse of a drug is the desired action. A synergistic effect is the effect of two drugs bei
k k k k k k k k k k k k k k k k k
ng greater than the effect of each chemical individually or the sum of the individual
k k k k k k k k k k k k k k k
effects. Carcinogenicity is the ability of a drug to cause cells to mutate and become c
k k k k k k k k k k k k k k k
ancerous.
DIF: Cognitive Level: Comprehension REF: Page 19 OBJ: 6 TO
k k k k k k k k k
P:Nursing Process Step: Implementation k k k