Chapter01:Nursing PracticeinCanadaandDrugTherapy
c c c c c c c c
Lilley:PharmacologyforCanadianHealthCarePractice,3rdCanadianEdition
c c c c c c c c c
MULTIPLECHOICE c
1. Whichis ajudgement about aparticularpatient‘s potential need or c c c c c c c c c c
problem?
c
a. A goal c
b. An assessment c
c. Subjectivedata c
d. Anursingdiagnosis c c
ANS: D c
Nursingdiagnosis is the phase of the nursing process during which c c c c c c c c c c
aclinical judgement is madeabout how apatient responds to heath conditions andlife processes or
c c c c c c c c c c c c c c c c
vulnerability forthat response.
c c c
DIF: CognitiveLevel:Knowledge c c REF: p. 11 c c
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable
c c c c c c c c c c c c c c c
to swallow, he cannot take medication orally, as ordered. The nurse needs to contact the physician.
c c c c c c c c c c c c c c c c
What type of problem is this?
c c c c c c
a. A―righttime‖problem c c c
b. A ―right dose‖ problem c c c
c. A―rightroute‖problem c c c
d. A―rightmedication‖problem c c c
ANS: C c
Thisisa―rightroute‖problem:thenursecannotassumetherouteandmustclarifytheroute
c c c c c c c c c c c c c c c c
withtheprescriber.Thisisnota―righttime‖problembecausetheorderedfrequencyhasnot changed.
c c c c c c c c c c c c c c c c
This is not a ―right dose‖ problem because the doseis not related to an inabilityto swallow. This is not
c c c c c c c c c c c c c c c c c c c c c
a ―right medication‖ problem because the medication ordered will not change, just the route.
c c c c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 14 c c
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first doseand
c c c c c c c c c c c c c c c c c
has been documentingsigns ofpossibleadverseeffects. What nursingprocess phase is the nurse
c c c c c c c c c c c c c c c
practising?
c
a. Planning
b. Evaluation
c. Implementation
d. Nursingdiagnosis c
ANS: B c
Monitoringthe patient‘s progressispart oftheevaluation phase. Planning, implementation, and c c c c c c c c c c c c
nursing diagnosis are not illustrated by this example.
c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 19 c c
,4. Thenurseis caringfor a patient who has been newlydiagnosed with type 1 diabetes mellitus. Which
c c c c c c c c c c c c c c c c c
statement best illustrates an outcome criterion for this patient?
c c c c c c c c c
a. Thepatient will follow instructions. c c c c
b. Thepatient will notexperience complications.
c c c c c
c. Thepatient adheres tothenewinsulin treatment regimen.
c c c c c c c c
d. Thepatient demonstrates safeinsulin self-administration technique.
c c c c c c
ANS: D c
Having the patient demonstrate safe insulin self-administration technique is a specific and
c c c c c c c c c c c
measurable outcome criterion. Following instructions and avoiding complications are not specific
c c c c c c c c c c c
criteria. Adherenceto thenew insulin treatment regimen is not objectiveand would be difficult to
c c c c c c c c c c c c c c c c
measure.
c
DIF: CognitiveLevel:Application c c REF: p. 13 c c
5. Whichactivitybest reflects theimplementation phaseof thenursingprocess forthe patient who is
c c c c c c c c c c c c c c c
c newly diagnosed with type 1 diabetes mellitus?
c c c c c c
a. Providingeducation regardingself-injection technique c c c c
b. Settinggoals and outcomecriteriawith thepatient‘s input c c c c c c c c
c. Recordingahistoryofover-the-countermedications used at home c c c c c c c c
d. Formulatingnursingdiagnoses regardingknowledgedeficits related to the new c c c c c c c c c
treatment regimen
c c
ANS: A c
Education is an intervention that occurs during the implementation phase. Setting goals and
c c c c c c c c c c c c
outcomecriteria reflects theplanningphase. Recordingadrughistoryreflects theassessment phase.
c c c c c c c c c c c c c c
Formulating nursingdiagnoses regarding a knowledgedeficit reflects analysis of data as part of the
c c c c c c c c c c c c c c c
planning phase.N
c c
DIF: CognitiveLevel:Analysis c c REF: p. 8 |p. 13 c c c c c
6. The nurse is working during a very busy night shift, and the health care provider has just giventhe
c c c c c c c c c c c c c c c c c c
nurse amedication orderover thetelephone, but thenursedoes not recall the route. What is the best
c c c c c c c c c c c c c c c c c c c
way for the nurse to avoid medication errors?
c c c c c c c c
a. Recopythe order neatlyon the order sheet, with the most common routeindicated c c c c c c c c c c c c c
b. Consult with thepharmacist forclarification about themost common route c c c c c c c c c c
c. Call the health careprovider to clarifythe routeof administration
c c c c c c c c c c
d. Withholdthe druguntil thehealth careprovider visits the patient c c c c c c c c c c
ANS: C c
If a medication order does not include the route, the nursemust ask the health careprovider to clarify it.
c c c c c c c c c c c c c c c c c c c
Never assume the route of administration.
c c c c c c
DIF: CognitiveLevel: Application |Cognitive Level:Analysis REF: p.17 c c c c c c c c c
7. Whichconstitutes thetraditionalFiveRights ofmedication administration?
c c c c c c c c
a. Rightdrug, rightroute, right dose, righttime, and right patient
c c c c c c c c c c
b. Rightdrug, theright effect, theright route,theright time, andtheright patient
c c c c c c c c c c c c c c
c. Rightpatient, right strength,right diagnosis,right drug, and right route
c c c c c c c c c c
d. Rightpatient, rightdiagnosis, rightdrug, right route,andright time
c c c c c c c c c c
ANS: A c
, The traditional Five Rights of medication administration were considered to be Right drug, Right
c c c c c c c c c c c c c
route, Right dose, Right time, and Right patient. Right effect, right strength, and right diagnosis are
c c c c c c c c c c c c c c c c
not part of the traditional Five Rights.
c c c c c c c
DIF: c c Cognitive Level: Comprehension c c c c c REF: p.13 c c
8. What correctlydescribes the nursingprocess?
c c c c c
a. Diagnosing, planning,assessing, implementing, andfinallyevaluating c c c c c c
b. Assessing,thendiagnosing, implementing, and endingwith evaluating c c c c c c c
c. Alinear direction that begins with assessingand continues through diagnosing,
c c c c c c c c c c
c planning, and finally implementing c c c
d. An ongoingprocess that begins with assessingand continues with diagnosing,
c c c c c c c c c c
c planning, implementing, and evaluating c c c
ANS: D c
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that begins
c c c c c c c c c c c c c
with assessingandcontinues throughdiagnosing,planning,implementing, andfinally evaluating,
c c c c c c c c c c c
which may then lead back to any of the other phases.
c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 8 c c
9. When the nurseis consideringthe timingof adrug dose, which is most important to assess?
c c c c c c c c c c c c c c c c
a. Thepatient‘s identification c c
b. Thepatient‘s weight c c
c. Thepatient‘s last meal c c c
d. Anydrugor food allergies c c c c
ANS: C c
Thepharmacokinetic and pharmacodynamic propertiesof thedrugneed to beassessed with
c c c c c c c c c c c c
regard to anydrug–food interactions or compatibilityissues. The patient‘s identification, weight,
c c c c c c c c c c c
and drug or food allergies are not affected by the drug‘s timing.
c c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 17 c c
10. Thenurseis writingnursingdiagnosesfora plan ofcare. Which reflects the correct format for her
c c c c c c c c c c c c c c c c c
c nursing diagnosis? c
a. Anxiety
b. Anxietyrelated to new drugtherapy c c c c c
c. Anxietyrelated toanxiousfeelings about drugtherapy, asevidenced bystatements such c c c c c c c c c c c c
c as ―I‘m upset about having to give myself shots‖
c c c c c c c c
d. Anxietyrelatedtonewdrugtherapy,asevidencedbystatementssuchas―I‘m upset c c c c c c c c c c c c c
c about having to give myself shots‖ c c c c c
ANS: D c
, Formulation of nursingdiagnoses is usuallya three-step process. The onlycomplete answer is
c c c c c c c c c c c c c
―Anxietyrelated to new drugtherapy, as evidenced bystatementssuch as ‗I‘m upset about having
c c c c c c c c c c c c c c c
togivemyselfshots.‘‖Theanswer―Anxiety‖ismissingthe―relatedto‖and―as evidencedby‖
c c c c c c c c c c c c c c c c
portions.Theanswer―Anxietyrelatedtonewdrugtherapy‖ismissingthe―as evidencedby‖portion
c c c c c c c c c c c c c c c c
ofdefiningcharacteristics.The―relatedto‖sectionin ―Anxietyrelated to anxious feelings about
c c c c c c c c c c c c c c
drug therapy, as evidenced by statements such as ‗I‘m upset about havingtogivemyselfshots‘‖is
c c c c c c c c c c c c c c c c c
simplyarestatementoftheproblem―anxiety,‖notaseparate factor related to the response.
c c c c c c c c c c c c c c c
DIF: CognitiveLevel:Analysis c c REF: p. 9 c c
OTHER
1. Placethe phases of thenursingprocess in the correct order,startingwith the first phase.
c c c c c c c c c c c c c c c
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
c c c c
DIF: CognitiveLevel:Analysis c c REF: p. 9 c c
c c c c c c c c
Lilley:PharmacologyforCanadianHealthCarePractice,3rdCanadianEdition
c c c c c c c c c
MULTIPLECHOICE c
1. Whichis ajudgement about aparticularpatient‘s potential need or c c c c c c c c c c
problem?
c
a. A goal c
b. An assessment c
c. Subjectivedata c
d. Anursingdiagnosis c c
ANS: D c
Nursingdiagnosis is the phase of the nursing process during which c c c c c c c c c c
aclinical judgement is madeabout how apatient responds to heath conditions andlife processes or
c c c c c c c c c c c c c c c c
vulnerability forthat response.
c c c
DIF: CognitiveLevel:Knowledge c c REF: p. 11 c c
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable
c c c c c c c c c c c c c c c
to swallow, he cannot take medication orally, as ordered. The nurse needs to contact the physician.
c c c c c c c c c c c c c c c c
What type of problem is this?
c c c c c c
a. A―righttime‖problem c c c
b. A ―right dose‖ problem c c c
c. A―rightroute‖problem c c c
d. A―rightmedication‖problem c c c
ANS: C c
Thisisa―rightroute‖problem:thenursecannotassumetherouteandmustclarifytheroute
c c c c c c c c c c c c c c c c
withtheprescriber.Thisisnota―righttime‖problembecausetheorderedfrequencyhasnot changed.
c c c c c c c c c c c c c c c c
This is not a ―right dose‖ problem because the doseis not related to an inabilityto swallow. This is not
c c c c c c c c c c c c c c c c c c c c c
a ―right medication‖ problem because the medication ordered will not change, just the route.
c c c c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 14 c c
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first doseand
c c c c c c c c c c c c c c c c c
has been documentingsigns ofpossibleadverseeffects. What nursingprocess phase is the nurse
c c c c c c c c c c c c c c c
practising?
c
a. Planning
b. Evaluation
c. Implementation
d. Nursingdiagnosis c
ANS: B c
Monitoringthe patient‘s progressispart oftheevaluation phase. Planning, implementation, and c c c c c c c c c c c c
nursing diagnosis are not illustrated by this example.
c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 19 c c
,4. Thenurseis caringfor a patient who has been newlydiagnosed with type 1 diabetes mellitus. Which
c c c c c c c c c c c c c c c c c
statement best illustrates an outcome criterion for this patient?
c c c c c c c c c
a. Thepatient will follow instructions. c c c c
b. Thepatient will notexperience complications.
c c c c c
c. Thepatient adheres tothenewinsulin treatment regimen.
c c c c c c c c
d. Thepatient demonstrates safeinsulin self-administration technique.
c c c c c c
ANS: D c
Having the patient demonstrate safe insulin self-administration technique is a specific and
c c c c c c c c c c c
measurable outcome criterion. Following instructions and avoiding complications are not specific
c c c c c c c c c c c
criteria. Adherenceto thenew insulin treatment regimen is not objectiveand would be difficult to
c c c c c c c c c c c c c c c c
measure.
c
DIF: CognitiveLevel:Application c c REF: p. 13 c c
5. Whichactivitybest reflects theimplementation phaseof thenursingprocess forthe patient who is
c c c c c c c c c c c c c c c
c newly diagnosed with type 1 diabetes mellitus?
c c c c c c
a. Providingeducation regardingself-injection technique c c c c
b. Settinggoals and outcomecriteriawith thepatient‘s input c c c c c c c c
c. Recordingahistoryofover-the-countermedications used at home c c c c c c c c
d. Formulatingnursingdiagnoses regardingknowledgedeficits related to the new c c c c c c c c c
treatment regimen
c c
ANS: A c
Education is an intervention that occurs during the implementation phase. Setting goals and
c c c c c c c c c c c c
outcomecriteria reflects theplanningphase. Recordingadrughistoryreflects theassessment phase.
c c c c c c c c c c c c c c
Formulating nursingdiagnoses regarding a knowledgedeficit reflects analysis of data as part of the
c c c c c c c c c c c c c c c
planning phase.N
c c
DIF: CognitiveLevel:Analysis c c REF: p. 8 |p. 13 c c c c c
6. The nurse is working during a very busy night shift, and the health care provider has just giventhe
c c c c c c c c c c c c c c c c c c
nurse amedication orderover thetelephone, but thenursedoes not recall the route. What is the best
c c c c c c c c c c c c c c c c c c c
way for the nurse to avoid medication errors?
c c c c c c c c
a. Recopythe order neatlyon the order sheet, with the most common routeindicated c c c c c c c c c c c c c
b. Consult with thepharmacist forclarification about themost common route c c c c c c c c c c
c. Call the health careprovider to clarifythe routeof administration
c c c c c c c c c c
d. Withholdthe druguntil thehealth careprovider visits the patient c c c c c c c c c c
ANS: C c
If a medication order does not include the route, the nursemust ask the health careprovider to clarify it.
c c c c c c c c c c c c c c c c c c c
Never assume the route of administration.
c c c c c c
DIF: CognitiveLevel: Application |Cognitive Level:Analysis REF: p.17 c c c c c c c c c
7. Whichconstitutes thetraditionalFiveRights ofmedication administration?
c c c c c c c c
a. Rightdrug, rightroute, right dose, righttime, and right patient
c c c c c c c c c c
b. Rightdrug, theright effect, theright route,theright time, andtheright patient
c c c c c c c c c c c c c c
c. Rightpatient, right strength,right diagnosis,right drug, and right route
c c c c c c c c c c
d. Rightpatient, rightdiagnosis, rightdrug, right route,andright time
c c c c c c c c c c
ANS: A c
, The traditional Five Rights of medication administration were considered to be Right drug, Right
c c c c c c c c c c c c c
route, Right dose, Right time, and Right patient. Right effect, right strength, and right diagnosis are
c c c c c c c c c c c c c c c c
not part of the traditional Five Rights.
c c c c c c c
DIF: c c Cognitive Level: Comprehension c c c c c REF: p.13 c c
8. What correctlydescribes the nursingprocess?
c c c c c
a. Diagnosing, planning,assessing, implementing, andfinallyevaluating c c c c c c
b. Assessing,thendiagnosing, implementing, and endingwith evaluating c c c c c c c
c. Alinear direction that begins with assessingand continues through diagnosing,
c c c c c c c c c c
c planning, and finally implementing c c c
d. An ongoingprocess that begins with assessingand continues with diagnosing,
c c c c c c c c c c
c planning, implementing, and evaluating c c c
ANS: D c
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that begins
c c c c c c c c c c c c c
with assessingandcontinues throughdiagnosing,planning,implementing, andfinally evaluating,
c c c c c c c c c c c
which may then lead back to any of the other phases.
c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 8 c c
9. When the nurseis consideringthe timingof adrug dose, which is most important to assess?
c c c c c c c c c c c c c c c c
a. Thepatient‘s identification c c
b. Thepatient‘s weight c c
c. Thepatient‘s last meal c c c
d. Anydrugor food allergies c c c c
ANS: C c
Thepharmacokinetic and pharmacodynamic propertiesof thedrugneed to beassessed with
c c c c c c c c c c c c
regard to anydrug–food interactions or compatibilityissues. The patient‘s identification, weight,
c c c c c c c c c c c
and drug or food allergies are not affected by the drug‘s timing.
c c c c c c c c c c c c
DIF: CognitiveLevel:Application c c REF: p. 17 c c
10. Thenurseis writingnursingdiagnosesfora plan ofcare. Which reflects the correct format for her
c c c c c c c c c c c c c c c c c
c nursing diagnosis? c
a. Anxiety
b. Anxietyrelated to new drugtherapy c c c c c
c. Anxietyrelated toanxiousfeelings about drugtherapy, asevidenced bystatements such c c c c c c c c c c c c
c as ―I‘m upset about having to give myself shots‖
c c c c c c c c
d. Anxietyrelatedtonewdrugtherapy,asevidencedbystatementssuchas―I‘m upset c c c c c c c c c c c c c
c about having to give myself shots‖ c c c c c
ANS: D c
, Formulation of nursingdiagnoses is usuallya three-step process. The onlycomplete answer is
c c c c c c c c c c c c c
―Anxietyrelated to new drugtherapy, as evidenced bystatementssuch as ‗I‘m upset about having
c c c c c c c c c c c c c c c
togivemyselfshots.‘‖Theanswer―Anxiety‖ismissingthe―relatedto‖and―as evidencedby‖
c c c c c c c c c c c c c c c c
portions.Theanswer―Anxietyrelatedtonewdrugtherapy‖ismissingthe―as evidencedby‖portion
c c c c c c c c c c c c c c c c
ofdefiningcharacteristics.The―relatedto‖sectionin ―Anxietyrelated to anxious feelings about
c c c c c c c c c c c c c c
drug therapy, as evidenced by statements such as ‗I‘m upset about havingtogivemyselfshots‘‖is
c c c c c c c c c c c c c c c c c
simplyarestatementoftheproblem―anxiety,‖notaseparate factor related to the response.
c c c c c c c c c c c c c c c
DIF: CognitiveLevel:Analysis c c REF: p. 9 c c
OTHER
1. Placethe phases of thenursingprocess in the correct order,startingwith the first phase.
c c c c c c c c c c c c c c c
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
c c c c
DIF: CognitiveLevel:Analysis c c REF: p. 9 c c
