A drug is effective if it produces the intended effects, even if it also produces side effects.
Test Bank Lehne's Pharmacology for Nursing Care, 11th Because no drug is completely safe, the level of toxicity does not determine effectiveness. All
Edition by Jacqueline Burchum, Laura Rosenthal drugs have side effects and many react with other substances; these do not affect the drug’s
effectiveness. Ease of administration is independent of a drug’s effectiveness.
Chapter 1: Orientation to Pharmacology DIF: Cognitive Level: Comprehension REF: Properties of an Ideal Drug
Test Bank TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
MULTIPLE CHOICE MULTIPLE RESPONSE
1. The nurse is teaching a patient how a medication works to treat an illness. To do this, the 1. What are the properties of an ideal drug? (Select all that apply.)
nurse will rely on knowledge of: a. Irreversible action
a. clinical pharmacology. b. Predictability
b. drug efficacy. c. Ease of administration
c. pharmacokinetics. d. Chemical stability
d. pharmacotherapeutics. e. A simple trade name
ANS: D ANS: B, C, D
Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent In addition to predictability, ease of administration, and chemical stability, other properties
conditions. Clinical pharmacology is concerned with all aspects of drug–human interactions. include a reversible action so that any harm the drug may cause can be undone and a simple
Drug efficacy measures the extent to which a given drug causes an intended effect. generic name, because generic names are usually complex and difficult to remember and
Pharmacokinetics is the study of the impact of the body on a drug. pronounce.
DIF: Cognitive Level: Comprehension REF: Four Basic Terms DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation REF: Properties of an Ideal Drug | Additional Properties of an Ideal Drug
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. What does it mean when a drug is described as easy to administer?
a. It can be stored indefinitely without need for refrigeration. 2. Before administering a medication, what does the nurse need to know to evaluate how
b. It does not interact significantly with other medications. individual patient variability might affect the patient’s response to the medication? (Select all
c. It enhances patient adherence to the drug regimen. that apply.)
d. It is usually relatively inexpensive to produce. a. Chemical stability of the medication
ANS: C b. Ease of administration
A major benefit of drugs that are easy to administer is that patients taking them are more c. Family medical history
likely to comply with the drug regimen. Drugs that are easy to give may have the other d. Patient’s age
attributes listed, but those properties are independent of ease of administration. e. Patient’s diagnosis
ANS: C, D, E
DIF: Cognitive Level: Comprehension
The family medical history can indicate genetic factors that may affect a patient’s response to
REF: Additional Properties of an Ideal Drug: Ease of Administration
TOP: Nursing Process: Assessment
a medication. Patients of different ages can respond differently to medications. The patient’s
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies illness can affect how drugs are metabolized. The chemical stability of the medication and the
ease of administration are properties of drugs.
3. A patient tells the nurse that he was told by the prescriber that the analgesic he is taking is
very effective. Which statement by the patient demonstrates an understanding of the drug’s DIF: Cognitive Level: Analysis REF: Sources of Individual Variation
TOP: Nursing Process: Implementation
effectiveness?
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
a. “I don’t have to worry about toxicity, since it takes a large amount of this drug to
cause an overdose.”
b. “It has no side effects and doesn’t interact with other drugs.”
c. “I only have to take it every 12 hours.”
d. “It might make me sleepy, and it lessens pain for several hours at a time.”
ANS: D
,Chapter 2: Application of Pharmacology in Nursing Practice 3. The nurse is preparing to care for a patient who will be taking an antihypertensive medication.
Test Bank Which action by the nurse is part of the assessment step of the nursing process?
a.Asking the prescriber for an order to monitor serum drug levels
b.Monitoring the patient for drug interactions after giving the medication
MULTIPLE CHOICE c.Questioning the patient about over-the-counter medications
d.Taking the patient’s blood pressure throughout the course of treatment
1. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication
label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or ANS: C
wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she The assessment part of the nursing process involves gathering information before beginning
doesn’t feel that the medication is always effective. Which is not an appropriate nursing treatment, and this includes asking about other medications the patient may be taking.
intervention for this patient? Monitoring serum drug levels, watching for drug interactions, and checking vital signs after
a. Asking the patient to demonstrate use of the inhaler giving the medication are all part of the evaluation phase.
b. Assessing the patient’s exposure to tobacco smoke
DIF: Cognitive Level: Application REF: Preadministration Assessment
c. Auscultating lung sounds and obtaining vital signs
TOP: Nursing Process: Assessment
d. Suggesting that the patient use one puff to reduce side effects MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: D
It is not within the nurse’s scope of practice to change the dose of a medication without an 4. A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10
order from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to (10 being the most extreme pain). The prescriber has ordered acetaminophen (Tylenol) 650
evaluate the patient’s ability to administer the medication properly and is part of the nurse’s mg PO every 6 hours PRN pain. What will the nurse do?
a. Ask the patient what medications have helped with pain in the past.
evaluation. Assessing tobacco smoke exposure helps the nurse determine whether nondrug
b. Contact the provider to request a different analgesic medication.
therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a
c. Give the pain medication and reposition the patient to promote comfort.
physical assessment helps the nurse evaluate the patient’s response to the medication.
d. Request an order to administer the medication every 4 hours.
DIF: Cognitive Level: Application ANS: B
REF: Applying the Nursing Process in Drug Therapy: Preadministration Assessment [and all The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to
subsections under this heading] TOP: Nursing Process: Implementation
moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication.
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
Asking the patient to tell the nurse what has helped in the past is a part of an initial assessment
2. A postoperative patient is being discharged home with acetaminophen/hydrocodone (Lortab) and should be done preoperatively and not when the patient is having severe pain. Because the
for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the patient is having severe pain, acetaminophen combined with nondrug therapies will not be
nurse is correct? sufficient. Increasing the frequency of the dose of a medication for mild pain will not be
a. “It is not safe to take over-the-counter drugs with prescription medications.” effective.
b. “Taking the two medications together poses a risk of drug toxicity.”
DIF: Cognitive Level: Analysis REF: Analysis and Nursing Diagnosis
c. “There are no known drug interactions, so this will be safe.”
TOP: Nursing Process: Diagnosis
d. “Tylenol and Lortab are different drugs, so there is no risk of overdose.”
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
ANS: B
Tylenol is the trade name and acetaminophen is the generic name for the same medication. It 5. A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse
is important to teach patients to be aware of the different names for the same drug to minimize teaching this patient about home management should begin by doing what?
the risk of overdose. Over-the-counter (OTC) medications and prescription medications may a. Asking the patient to demonstrate how to measure and administer insulin
be taken together unless significant harmful drug interactions are possible. Even though no b. Discussing methods of storing insulin and discarding syringes
drug interactions are at play in this case, both drugs contain acetaminophen, which could lead c. Giving information about how diet and exercise affect insulin requirements
to toxicity. d. Teaching the patient about the long-term consequences of poor diabetes control
ANS: A
DIF: Cognitive Level: Application
REF: Application of Pharmacology in Patient Education: Dosage and Administration
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
, Because insulin must be given correctly to control symptoms and because an overdose can be MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
fatal, it is most important for the patient to know how to administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood 8. A nurse is preparing to administer medications. Which patient would the nurse consider to
the teaching. When a patient is receiving a lot of new information, the information presented have the greatest predisposition to an adverse reaction?
first is the most likely to be remembered. The other teaching points are important as well, but a. A 30-year-old man with kidney disease
they are not as critical and can be taught later. b. A 75-year-old woman with cystitis
c. A 50-year-old man with an upper respiratory tract infection
DIF: Cognitive Level: Application REF: Planning TOP: Nursing Process: Planning d. A 9-year-old boy with an ear infection
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: A
6. The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action The individual with impaired kidney function would be at risk of having the drug accumulate
is not part of the six rights of drug administration? to a toxic level because of potential excretion difficulties. Cystitis is an infection of the
a. Assessing the patient’s pain level 15 to 30 minutes after giving the medication bladder and not usually the cause of excretion problems that might lead to an adverse reaction
b. Checking the medication administration record to see when the last dose was from a medication. A respiratory tract infection would not predispose a patient to an adverse
administered reaction, because drugs are not metabolized or excreted by the lungs. A 9-year-old boy would
c. Consulting a drug manual to determine whether the amount the prescriber ordered not have the greatest predisposition to an adverse reaction simply because he is a child; nor
is appropriate does an ear infection put him at greater risk.
d. Documenting the reason the medication was given in the patient’s electronic
DIF: Cognitive Level: Analysis REF: Minimizing Adverse Reactions
medical record TOP: Nursing Process: Planning
ANS: A MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
Assessing the patient’s pain after administering the medication is an important part of the
nursing process when giving medications, but it is not part of the six rights of drug 9. A nurse consults a drug manual before giving a medication to an 80-year-old patient. The
administration. Checking to see when the last dose was given helps ensure that the medication manual states that elderly patients are at increased risk for hepatic side effects. Which action
is given at the right time. Consulting a drug manual helps ensure that the medication is given by the nurse is correct?
in the right dose. Documenting the reason for a pain medication is an important part of the a. Contact the provider to discuss an order for pretreatment laboratory work.
right documentation—the sixth right. b. Ensure that the drug is given in the correct dose at the correct time to minimize the
risk of adverse effects.
DIF: Cognitive Level: Application c. Notify the provider that this drug is contraindicated for this patient.
REF: Evolution of Nursing Responsibilities Regarding Drugs | Implementation d. Request an order to give the medication intravenously so that the drug does not
TOP: Nursing Process: Implementation pass through the liver.
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: A
7. A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not The drug manual indicates that this drug should be given with caution to elderly patients.
working. What will the nurse do? Getting information about liver function before giving the drug establishes baseline data that
a. Ask the patient about the number and frequency of tablets taken. can be compared with post-treatment data to determine whether the drug is affecting the liver.
b. Assess the patient’s headache pain on a scale from 1 to 10. Giving the correct dose at the correct interval helps to minimize risk, but without baseline
c. Report the patient’s complaint to the prescriber. information, the effects cannot be determined. The drug is not contraindicated.
d. Suggest biofeedback as an adjunct to drug therapy.
DIF: Cognitive Level: Analysis REF: Minimizing Adverse Effects
ANS: A TOP: Nursing Process: Implementation
When evaluating the effectiveness of a drug, it is important to determine whether the patient is MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
using the drug as ordered. Asking the patient to tell the nurse how many tablets are taken and
how often helps the nurse determine compliance. Assessing current pain does not yield 10. A patient has been receiving intravenous penicillin for pneumonia for several days and begins
information about how well the medication is working unless the patient is currently taking it. to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a
The nurse should gather as much information about compliance, symptoms, and drug temperature of 38.5° C (101° F). Which is the correct action by the nurse?
effectiveness as possible before contacting the prescriber. Biofeedback may be an effective a. Administer the next dose and continue to evaluate the patient’s symptoms.
adjunct to treatment, but it should not be recommended without complete information about b. Ask the prescriber if an antihistamine can be given to relieve the itching.
drug effectiveness. c. Contact the prescriber to request an order for a chest radiograph.
d. Hold the next dose and notify the prescriber of the symptoms.
DIF: Cognitive Level: Application REF: Evaluation TOP: Nursing Process: Evaluation
ANS: D
, Pruritus and wheezing are signs of a possible allergic reaction, which can be fatal; therefore, Chapter 3: Drug Regulation, Development, Names, and Information
the medication should not be given and the prescriber should be notified. When patients are Test Bank
having a potentially serious reaction to a medication, the nurse should not continue giving the
medication. Antihistamines may help the symptoms of an allergic reaction, but the first
priority is to stop the medication. Obtaining a chest radiograph is not helpful. MULTIPLE CHOICE
DIF: Cognitive Level: Application 1. A nurse educator is conducting a continuing education class on pharmacology. To evaluate
REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in the learning of the nurses in the class, the nurse educator asks, “Which drug name is a generic
Patient Care: Identifying High-Risk Patients TOP: Nursing Process: Evaluation drug name?” Which is the correct response?
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential a. Acetaminophen
b. Tylenol
MULTIPLE RESPONSE c. Cipro
d. Motrin
1. A nurse is reviewing a patient’s medical record before administering a medication. Which
ANS: A
factor(s) can alter the patient’s physiologic response to the drug? (Select all that apply.)
a.
Acetaminophen is the generic name. Tylenol, Cipro, and Motrin are all trade names.
Ability to swallow pills
b. Age DIF: Cognitive Level: Comprehension REF: Table 3-3: The Three Types of Drug Names
c. Genetic factors TOP: Nursing Process: Diagnosis
d. Gender MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
e. Height
2. The FDA Amendments Act (FDAAA) was passed in 2007 to address which aspect of drug
ANS: B, C, D
Age, genetic factors, and gender all influence an individual patient’s ability to absorb, safety?
a. Allowing pharmaceutical companies to identify off-label uses of medications
metabolize, and excrete drugs; therefore, these factors must be assessed before a medication is
administered. A patient’s ability to swallow pills, although it may determine the way a drug is approved for other uses
b. Evaluating drug safety information that emerges after a drug has been approved
administered, does not affect the physiologic response. Height does not affect response;
weight and the distribution of adipose tissue can affect the distribution of drugs. and is in use
c. Expediting the approval process of the U.S. Food and Drug Administration (FDA)
DIF: Cognitive Level: Analysis so that needed drugs can get to market more quickly
REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in d. Requiring manufacturers to notify patients before removing a drug from the market
Patient Care: Preadministration Assessment
ANS: B
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
The FDAAA was passed to enable the Food and Drug Administration to continue oversight of
a drug after granting it approval so that changes in labeling could be made as necessary and
postmarketing risks could be tracked and identified. A provision of the FDA Modernization
Act (FDAMA), passed in 1997, allows drug companies to promote their products for off-label
uses as long as they promise to conduct studies to support their claims. Regulations to permit
accelerated approval of drugs for life-threatening diseases were adopted in 1992 by the FDA.
The requirement that drug companies notify patients 6 months before removing a drug from
the market is a provision of the FDAMA.
DIF: Cognitive Level: Comprehension REF: Landmark Drug Legislation
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. A nursing student asks a nurse about pharmaceutical research and wants to know the purpose
of randomization in drug trials. The nurse explains that randomization is used to:
a. ensure that differences in outcomes are the result of treatment and not differences
in subjects.
b. compare the outcome caused by the treatment to the outcome caused by no
treatment.
Test Bank Lehne's Pharmacology for Nursing Care, 11th Because no drug is completely safe, the level of toxicity does not determine effectiveness. All
Edition by Jacqueline Burchum, Laura Rosenthal drugs have side effects and many react with other substances; these do not affect the drug’s
effectiveness. Ease of administration is independent of a drug’s effectiveness.
Chapter 1: Orientation to Pharmacology DIF: Cognitive Level: Comprehension REF: Properties of an Ideal Drug
Test Bank TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
MULTIPLE CHOICE MULTIPLE RESPONSE
1. The nurse is teaching a patient how a medication works to treat an illness. To do this, the 1. What are the properties of an ideal drug? (Select all that apply.)
nurse will rely on knowledge of: a. Irreversible action
a. clinical pharmacology. b. Predictability
b. drug efficacy. c. Ease of administration
c. pharmacokinetics. d. Chemical stability
d. pharmacotherapeutics. e. A simple trade name
ANS: D ANS: B, C, D
Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent In addition to predictability, ease of administration, and chemical stability, other properties
conditions. Clinical pharmacology is concerned with all aspects of drug–human interactions. include a reversible action so that any harm the drug may cause can be undone and a simple
Drug efficacy measures the extent to which a given drug causes an intended effect. generic name, because generic names are usually complex and difficult to remember and
Pharmacokinetics is the study of the impact of the body on a drug. pronounce.
DIF: Cognitive Level: Comprehension REF: Four Basic Terms DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation REF: Properties of an Ideal Drug | Additional Properties of an Ideal Drug
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. What does it mean when a drug is described as easy to administer?
a. It can be stored indefinitely without need for refrigeration. 2. Before administering a medication, what does the nurse need to know to evaluate how
b. It does not interact significantly with other medications. individual patient variability might affect the patient’s response to the medication? (Select all
c. It enhances patient adherence to the drug regimen. that apply.)
d. It is usually relatively inexpensive to produce. a. Chemical stability of the medication
ANS: C b. Ease of administration
A major benefit of drugs that are easy to administer is that patients taking them are more c. Family medical history
likely to comply with the drug regimen. Drugs that are easy to give may have the other d. Patient’s age
attributes listed, but those properties are independent of ease of administration. e. Patient’s diagnosis
ANS: C, D, E
DIF: Cognitive Level: Comprehension
The family medical history can indicate genetic factors that may affect a patient’s response to
REF: Additional Properties of an Ideal Drug: Ease of Administration
TOP: Nursing Process: Assessment
a medication. Patients of different ages can respond differently to medications. The patient’s
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies illness can affect how drugs are metabolized. The chemical stability of the medication and the
ease of administration are properties of drugs.
3. A patient tells the nurse that he was told by the prescriber that the analgesic he is taking is
very effective. Which statement by the patient demonstrates an understanding of the drug’s DIF: Cognitive Level: Analysis REF: Sources of Individual Variation
TOP: Nursing Process: Implementation
effectiveness?
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
a. “I don’t have to worry about toxicity, since it takes a large amount of this drug to
cause an overdose.”
b. “It has no side effects and doesn’t interact with other drugs.”
c. “I only have to take it every 12 hours.”
d. “It might make me sleepy, and it lessens pain for several hours at a time.”
ANS: D
,Chapter 2: Application of Pharmacology in Nursing Practice 3. The nurse is preparing to care for a patient who will be taking an antihypertensive medication.
Test Bank Which action by the nurse is part of the assessment step of the nursing process?
a.Asking the prescriber for an order to monitor serum drug levels
b.Monitoring the patient for drug interactions after giving the medication
MULTIPLE CHOICE c.Questioning the patient about over-the-counter medications
d.Taking the patient’s blood pressure throughout the course of treatment
1. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication
label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or ANS: C
wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she The assessment part of the nursing process involves gathering information before beginning
doesn’t feel that the medication is always effective. Which is not an appropriate nursing treatment, and this includes asking about other medications the patient may be taking.
intervention for this patient? Monitoring serum drug levels, watching for drug interactions, and checking vital signs after
a. Asking the patient to demonstrate use of the inhaler giving the medication are all part of the evaluation phase.
b. Assessing the patient’s exposure to tobacco smoke
DIF: Cognitive Level: Application REF: Preadministration Assessment
c. Auscultating lung sounds and obtaining vital signs
TOP: Nursing Process: Assessment
d. Suggesting that the patient use one puff to reduce side effects MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: D
It is not within the nurse’s scope of practice to change the dose of a medication without an 4. A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10
order from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to (10 being the most extreme pain). The prescriber has ordered acetaminophen (Tylenol) 650
evaluate the patient’s ability to administer the medication properly and is part of the nurse’s mg PO every 6 hours PRN pain. What will the nurse do?
a. Ask the patient what medications have helped with pain in the past.
evaluation. Assessing tobacco smoke exposure helps the nurse determine whether nondrug
b. Contact the provider to request a different analgesic medication.
therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a
c. Give the pain medication and reposition the patient to promote comfort.
physical assessment helps the nurse evaluate the patient’s response to the medication.
d. Request an order to administer the medication every 4 hours.
DIF: Cognitive Level: Application ANS: B
REF: Applying the Nursing Process in Drug Therapy: Preadministration Assessment [and all The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to
subsections under this heading] TOP: Nursing Process: Implementation
moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication.
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
Asking the patient to tell the nurse what has helped in the past is a part of an initial assessment
2. A postoperative patient is being discharged home with acetaminophen/hydrocodone (Lortab) and should be done preoperatively and not when the patient is having severe pain. Because the
for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the patient is having severe pain, acetaminophen combined with nondrug therapies will not be
nurse is correct? sufficient. Increasing the frequency of the dose of a medication for mild pain will not be
a. “It is not safe to take over-the-counter drugs with prescription medications.” effective.
b. “Taking the two medications together poses a risk of drug toxicity.”
DIF: Cognitive Level: Analysis REF: Analysis and Nursing Diagnosis
c. “There are no known drug interactions, so this will be safe.”
TOP: Nursing Process: Diagnosis
d. “Tylenol and Lortab are different drugs, so there is no risk of overdose.”
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
ANS: B
Tylenol is the trade name and acetaminophen is the generic name for the same medication. It 5. A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse
is important to teach patients to be aware of the different names for the same drug to minimize teaching this patient about home management should begin by doing what?
the risk of overdose. Over-the-counter (OTC) medications and prescription medications may a. Asking the patient to demonstrate how to measure and administer insulin
be taken together unless significant harmful drug interactions are possible. Even though no b. Discussing methods of storing insulin and discarding syringes
drug interactions are at play in this case, both drugs contain acetaminophen, which could lead c. Giving information about how diet and exercise affect insulin requirements
to toxicity. d. Teaching the patient about the long-term consequences of poor diabetes control
ANS: A
DIF: Cognitive Level: Application
REF: Application of Pharmacology in Patient Education: Dosage and Administration
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
, Because insulin must be given correctly to control symptoms and because an overdose can be MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
fatal, it is most important for the patient to know how to administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood 8. A nurse is preparing to administer medications. Which patient would the nurse consider to
the teaching. When a patient is receiving a lot of new information, the information presented have the greatest predisposition to an adverse reaction?
first is the most likely to be remembered. The other teaching points are important as well, but a. A 30-year-old man with kidney disease
they are not as critical and can be taught later. b. A 75-year-old woman with cystitis
c. A 50-year-old man with an upper respiratory tract infection
DIF: Cognitive Level: Application REF: Planning TOP: Nursing Process: Planning d. A 9-year-old boy with an ear infection
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: A
6. The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action The individual with impaired kidney function would be at risk of having the drug accumulate
is not part of the six rights of drug administration? to a toxic level because of potential excretion difficulties. Cystitis is an infection of the
a. Assessing the patient’s pain level 15 to 30 minutes after giving the medication bladder and not usually the cause of excretion problems that might lead to an adverse reaction
b. Checking the medication administration record to see when the last dose was from a medication. A respiratory tract infection would not predispose a patient to an adverse
administered reaction, because drugs are not metabolized or excreted by the lungs. A 9-year-old boy would
c. Consulting a drug manual to determine whether the amount the prescriber ordered not have the greatest predisposition to an adverse reaction simply because he is a child; nor
is appropriate does an ear infection put him at greater risk.
d. Documenting the reason the medication was given in the patient’s electronic
DIF: Cognitive Level: Analysis REF: Minimizing Adverse Reactions
medical record TOP: Nursing Process: Planning
ANS: A MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
Assessing the patient’s pain after administering the medication is an important part of the
nursing process when giving medications, but it is not part of the six rights of drug 9. A nurse consults a drug manual before giving a medication to an 80-year-old patient. The
administration. Checking to see when the last dose was given helps ensure that the medication manual states that elderly patients are at increased risk for hepatic side effects. Which action
is given at the right time. Consulting a drug manual helps ensure that the medication is given by the nurse is correct?
in the right dose. Documenting the reason for a pain medication is an important part of the a. Contact the provider to discuss an order for pretreatment laboratory work.
right documentation—the sixth right. b. Ensure that the drug is given in the correct dose at the correct time to minimize the
risk of adverse effects.
DIF: Cognitive Level: Application c. Notify the provider that this drug is contraindicated for this patient.
REF: Evolution of Nursing Responsibilities Regarding Drugs | Implementation d. Request an order to give the medication intravenously so that the drug does not
TOP: Nursing Process: Implementation pass through the liver.
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
ANS: A
7. A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not The drug manual indicates that this drug should be given with caution to elderly patients.
working. What will the nurse do? Getting information about liver function before giving the drug establishes baseline data that
a. Ask the patient about the number and frequency of tablets taken. can be compared with post-treatment data to determine whether the drug is affecting the liver.
b. Assess the patient’s headache pain on a scale from 1 to 10. Giving the correct dose at the correct interval helps to minimize risk, but without baseline
c. Report the patient’s complaint to the prescriber. information, the effects cannot be determined. The drug is not contraindicated.
d. Suggest biofeedback as an adjunct to drug therapy.
DIF: Cognitive Level: Analysis REF: Minimizing Adverse Effects
ANS: A TOP: Nursing Process: Implementation
When evaluating the effectiveness of a drug, it is important to determine whether the patient is MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
using the drug as ordered. Asking the patient to tell the nurse how many tablets are taken and
how often helps the nurse determine compliance. Assessing current pain does not yield 10. A patient has been receiving intravenous penicillin for pneumonia for several days and begins
information about how well the medication is working unless the patient is currently taking it. to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a
The nurse should gather as much information about compliance, symptoms, and drug temperature of 38.5° C (101° F). Which is the correct action by the nurse?
effectiveness as possible before contacting the prescriber. Biofeedback may be an effective a. Administer the next dose and continue to evaluate the patient’s symptoms.
adjunct to treatment, but it should not be recommended without complete information about b. Ask the prescriber if an antihistamine can be given to relieve the itching.
drug effectiveness. c. Contact the prescriber to request an order for a chest radiograph.
d. Hold the next dose and notify the prescriber of the symptoms.
DIF: Cognitive Level: Application REF: Evaluation TOP: Nursing Process: Evaluation
ANS: D
, Pruritus and wheezing are signs of a possible allergic reaction, which can be fatal; therefore, Chapter 3: Drug Regulation, Development, Names, and Information
the medication should not be given and the prescriber should be notified. When patients are Test Bank
having a potentially serious reaction to a medication, the nurse should not continue giving the
medication. Antihistamines may help the symptoms of an allergic reaction, but the first
priority is to stop the medication. Obtaining a chest radiograph is not helpful. MULTIPLE CHOICE
DIF: Cognitive Level: Application 1. A nurse educator is conducting a continuing education class on pharmacology. To evaluate
REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in the learning of the nurses in the class, the nurse educator asks, “Which drug name is a generic
Patient Care: Identifying High-Risk Patients TOP: Nursing Process: Evaluation drug name?” Which is the correct response?
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential a. Acetaminophen
b. Tylenol
MULTIPLE RESPONSE c. Cipro
d. Motrin
1. A nurse is reviewing a patient’s medical record before administering a medication. Which
ANS: A
factor(s) can alter the patient’s physiologic response to the drug? (Select all that apply.)
a.
Acetaminophen is the generic name. Tylenol, Cipro, and Motrin are all trade names.
Ability to swallow pills
b. Age DIF: Cognitive Level: Comprehension REF: Table 3-3: The Three Types of Drug Names
c. Genetic factors TOP: Nursing Process: Diagnosis
d. Gender MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
e. Height
2. The FDA Amendments Act (FDAAA) was passed in 2007 to address which aspect of drug
ANS: B, C, D
Age, genetic factors, and gender all influence an individual patient’s ability to absorb, safety?
a. Allowing pharmaceutical companies to identify off-label uses of medications
metabolize, and excrete drugs; therefore, these factors must be assessed before a medication is
administered. A patient’s ability to swallow pills, although it may determine the way a drug is approved for other uses
b. Evaluating drug safety information that emerges after a drug has been approved
administered, does not affect the physiologic response. Height does not affect response;
weight and the distribution of adipose tissue can affect the distribution of drugs. and is in use
c. Expediting the approval process of the U.S. Food and Drug Administration (FDA)
DIF: Cognitive Level: Analysis so that needed drugs can get to market more quickly
REF: Evolution of Nursing Responsibilities Regarding Drugs | Application of Pharmacology in d. Requiring manufacturers to notify patients before removing a drug from the market
Patient Care: Preadministration Assessment
ANS: B
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
The FDAAA was passed to enable the Food and Drug Administration to continue oversight of
a drug after granting it approval so that changes in labeling could be made as necessary and
postmarketing risks could be tracked and identified. A provision of the FDA Modernization
Act (FDAMA), passed in 1997, allows drug companies to promote their products for off-label
uses as long as they promise to conduct studies to support their claims. Regulations to permit
accelerated approval of drugs for life-threatening diseases were adopted in 1992 by the FDA.
The requirement that drug companies notify patients 6 months before removing a drug from
the market is a provision of the FDAMA.
DIF: Cognitive Level: Comprehension REF: Landmark Drug Legislation
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. A nursing student asks a nurse about pharmaceutical research and wants to know the purpose
of randomization in drug trials. The nurse explains that randomization is used to:
a. ensure that differences in outcomes are the result of treatment and not differences
in subjects.
b. compare the outcome caused by the treatment to the outcome caused by no
treatment.
