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