Chapter 01: Nursing Practice in Canada and Drug Therapy
t t t t t t t t
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
t t t t t t t t t
MULTIPLE CHOICE t
1. Which is a judgement about a particular patient‘s potential need or
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problem?
t
a. A goal t
b. An assessment t
c. Subjective data t
d. A nursing diagnosis t t
ANS: D t
Nursing diagnosis is the phase of the nursing process during which
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a clinical judgement is made about how a patient responds to heath conditions and life processes
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or vulnerability forthat response.
t t t t
DIF: Cognitive Level: Knowledge t t REF: p. 11 t t
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is
t t t t t t t t t t t t t t
unable to swallow, he cannot take medication orally, as ordered. The nurse needs to contact
t t t t t t t t t t t t t t t
the physician. What type of problem is this?
t t t t t t t t
a. A ―right time‖ problem t t t
b. A ―right dose‖ problem t t t
c. A ―right route‖ problem t t t
d. A ―right medication‖ problem t t t
ANS: C t
This is a ―right route‖ problem: the nurse cannot assume the route and must clarify the route
t t t t t t t t t t t t t t t t
with the prescriber. This is not a ―right time‖ problem because the ordered frequency has not
t t t t t t t t t t t t t t t
changed. This is not a ―right dose‖ problem because the dose is not related to an inability to
t t t t t t t t t t t t t t t t t t
swallow. This is not a ―right medication‖ problem because the medication ordered will not
t t t t t t t t t t t t t t
change, just the route.
t t t t
DIF: Cognitive Level: Application t t REF: p. 14 t t
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first
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dose and has been documenting signs of possible adverse effects. What nursing process phase is
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the nurse practising?
t t t
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis t
ANS: B t
Monitoring the patient‘s progress is part of the evaluation phase. Planning, implementation, and
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nursing diagnosis are not illustrated by this example.
t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 19 t t
,4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus.
t t t t t t t t t t t t t t t t
Which statement best illustrates an outcome criterion for this patient?
t t t t t t t t t t
a. The patient will follow instructions. t t t t
b. The patient will not experience complications.
t t t t t
c. The patient adheres to the new insulin treatment regimen.
t t t t t t t t
d. The patient demonstrates safe insulin self-administration technique.
t t t t t t
ANS: D t
Having the patient demonstrate safe insulin self-administration technique is a specific and
t t t t t t t t t t t
measurable outcome criterion. Following instructions and avoiding complications are not
t t t t t t t t t t
specific criteria. Adherence to the new insulin treatment regimen is not objective and would be
t t t t t t t t t t t t t t t
difficult to measure.
t t t
DIF: Cognitive Level: Application t t REF: p. 13 t t
5. Which activity best reflects the implementation phase of the nursing process for the patient
t t t t t t t t t t t t t
twho is newly diagnosed with type 1 diabetes mellitus?
t t t t t t t t
a. Providing education regarding self-injection technique t t t t
b. Setting goals and outcome criteria with the patient‘s input t t t t t t t t
c. Recording a history of over-the-counter medications used at home t t t t t t t t
d. Formulating nursing diagnoses regarding knowledge deficits related to the new t t t t t t t t t
treatment regimen
t t
ANS: A t
Education is an intervention that occurs during the implementation phase. Setting goals and
t t t t t t t t t t t t
outcome criteria reflects the planning phase. Recording a drug history reflects the assessment
t t t t t t t t t t t t t
phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analysis of data as
t t t t t t t t t t t t t
part of the planning phase.N
t t t t t
DIF: Cognitive Level: Analysis t t REF: p. 8 | p. 13 t t t t t
6. The nurse is working during a very busy night shift, and the health care provider has just given
t t t t t t t t t t t t t t t t t
the nurse a medication order over the telephone, but the nurse does not recall the route. What is
t t t t t t t t t t t t t t t t t t
the best way for the nurse to avoid medication errors?
t t t t t t t t t t
a. Recopy the order neatly on the order sheet, with the most common route indicated
t t t t t t t t t t t t t
b. Consult with the pharmacist for clarification about the most common route t t t t t t t t t t
c. Call the health care provider to clarify the route of administration
t t t t t t t t t t
d. Withhold the drug until the health care provider visits the patient t t t t t t t t t t
ANS: C t
If a medication order does not include the route, the nurse must ask the health care provider to
t t t t t t t t t t t t t t t t t
clarify it. Never assume the route of administration.
t t t t t t t t
DIF: Cognitive Level: Application | Cognitive Level: Analysis REF: p. 17 t t t t t t t t t
7. Which constitutes the traditional Five Rights of medication administration?
t t t t t t t t
a. Right drug, right route, right dose, right time, and right patient
t t t t t t t t t t
b. Right drug, the right effect, the right route, the right time, and the right patient
t t t t t t t t t t t t t t
c. Right patient, right strength, right diagnosis, right drug, and right route
t t t t t t t t t t
d. Right patient, right diagnosis, right drug, right route, and right time
t t t t t t t t t t
ANS: A t
, The traditional Five Rights of medication administration were considered to be Right drug,
t t t t t t t t t t t t
Right route, Right dose, Right time, and Right patient. Right effect, right strength, and right
t t t t t t t t t t t t t t t
diagnosis are not part of the traditional Five Rights.
t t t t t t t t t
DIF: t t Cognitive Level: Comprehension t t t t t REF: t p. 13 t
8. What correctly describes the nursing process?
t t t t t
a. Diagnosing, planning, assessing, implementing, and finally evaluating t t t t t t
b. Assessing, then diagnosing, implementing, and ending with evaluating t t t t t t t
c. A linear direction that begins with assessing and continues through diagnosing,
t t t t t t t t t t
planning, and finally implementing
t t t t
d. An ongoing process that begins with assessing and continues with diagnosing,
t t t t t t t t t t
planning, implementing, and evaluating
t t t t
ANS: D t
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that
t t t t t t t t t t t t
begins with assessing and continues through diagnosing, planning, implementing, and finally
t t t t t t t t t t t
evaluating, which may then lead back to any of the other phases.
t t t t t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 8 t t
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
t t t t t t t t t t t t t t t t
a. The patient‘s identification t t
b. The patient‘s weight t t
c. The patient‘s last meal t t t
d. Any drug or food allergies t t t t
ANS: C t
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with
t t t t t t t t t t t t
regard to any drug–food interactions or compatibility issues. The patient‘s identification,
t t t t t t t t t t
weight, and drug or food allergies are not affected by the drug‘s timing.
t t t t t t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 17 t t
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her
t t t t t t t t t t t t t t t t t
nursing diagnosis?
t t
a. Anxiety
b. Anxiety related to new drug therapy t t t t t
c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements
t t t t t t t t t t t
such as ―I‘m upset about having to give myself shots‖
t t t t t t t t t t
d. Anxiety related to new drug therapy, as evidenced by statements such as ―I‘m
t t t t t t t t t t t t
upset about having to give myself shots‖
t t t t t t t
ANS: D t
, Formulation of nursing diagnoses is usually a three-step process. The only complete answer is
t t t t t t t t t t t t t
―Anxiety related to new drug therapy, as evidenced by statements such as ‗I‘m upset about
t t t t t t t t t t t t t t
having to give myself shots.‘‖ The answer ―Anxiety‖ is missing the ―related to‖ and ―as
t t t t t t t t t t t t t t t
evidenced by‖ portions. The answer ―Anxiety related to new drug therapy‖ is missing the ―as
t t t t t t t t t t t t t t t
evidenced by‖ portion of defining characteristics. The ―related to‖ section in ―Anxiety related to
t t t t t t t t t t t t t t
anxious feelings about drug therapy, as evidenced by statements such as ‗I‘m upset about
t t t t t t t t t t t t t t
having to give myself shots‘‖ is simply a restatement of the problem ―anxiety,‖ not a separate
t t t t t t t t t t t t t t t t
factor related to the response.
t t t t t
DIF: Cognitive Level: Analysis t t REF: p. 9 t t
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
t t t t t t t t t t t t t t t
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
t t t t
DIF: Cognitive Level: Analysis t t REF: p. 9 t t
t t t t t t t t
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
t t t t t t t t t
MULTIPLE CHOICE t
1. Which is a judgement about a particular patient‘s potential need or
t t t t t t t t t t
problem?
t
a. A goal t
b. An assessment t
c. Subjective data t
d. A nursing diagnosis t t
ANS: D t
Nursing diagnosis is the phase of the nursing process during which
t t t t t t t t t t
a clinical judgement is made about how a patient responds to heath conditions and life processes
t t t t t t t t t t t t t t t
or vulnerability forthat response.
t t t t
DIF: Cognitive Level: Knowledge t t REF: p. 11 t t
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is
t t t t t t t t t t t t t t
unable to swallow, he cannot take medication orally, as ordered. The nurse needs to contact
t t t t t t t t t t t t t t t
the physician. What type of problem is this?
t t t t t t t t
a. A ―right time‖ problem t t t
b. A ―right dose‖ problem t t t
c. A ―right route‖ problem t t t
d. A ―right medication‖ problem t t t
ANS: C t
This is a ―right route‖ problem: the nurse cannot assume the route and must clarify the route
t t t t t t t t t t t t t t t t
with the prescriber. This is not a ―right time‖ problem because the ordered frequency has not
t t t t t t t t t t t t t t t
changed. This is not a ―right dose‖ problem because the dose is not related to an inability to
t t t t t t t t t t t t t t t t t t
swallow. This is not a ―right medication‖ problem because the medication ordered will not
t t t t t t t t t t t t t t
change, just the route.
t t t t
DIF: Cognitive Level: Application t t REF: p. 14 t t
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first
t t t t t t t t t t t t t t t
dose and has been documenting signs of possible adverse effects. What nursing process phase is
t t t t t t t t t t t t t t t
the nurse practising?
t t t
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis t
ANS: B t
Monitoring the patient‘s progress is part of the evaluation phase. Planning, implementation, and
t t t t t t t t t t t t
nursing diagnosis are not illustrated by this example.
t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 19 t t
,4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus.
t t t t t t t t t t t t t t t t
Which statement best illustrates an outcome criterion for this patient?
t t t t t t t t t t
a. The patient will follow instructions. t t t t
b. The patient will not experience complications.
t t t t t
c. The patient adheres to the new insulin treatment regimen.
t t t t t t t t
d. The patient demonstrates safe insulin self-administration technique.
t t t t t t
ANS: D t
Having the patient demonstrate safe insulin self-administration technique is a specific and
t t t t t t t t t t t
measurable outcome criterion. Following instructions and avoiding complications are not
t t t t t t t t t t
specific criteria. Adherence to the new insulin treatment regimen is not objective and would be
t t t t t t t t t t t t t t t
difficult to measure.
t t t
DIF: Cognitive Level: Application t t REF: p. 13 t t
5. Which activity best reflects the implementation phase of the nursing process for the patient
t t t t t t t t t t t t t
twho is newly diagnosed with type 1 diabetes mellitus?
t t t t t t t t
a. Providing education regarding self-injection technique t t t t
b. Setting goals and outcome criteria with the patient‘s input t t t t t t t t
c. Recording a history of over-the-counter medications used at home t t t t t t t t
d. Formulating nursing diagnoses regarding knowledge deficits related to the new t t t t t t t t t
treatment regimen
t t
ANS: A t
Education is an intervention that occurs during the implementation phase. Setting goals and
t t t t t t t t t t t t
outcome criteria reflects the planning phase. Recording a drug history reflects the assessment
t t t t t t t t t t t t t
phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analysis of data as
t t t t t t t t t t t t t
part of the planning phase.N
t t t t t
DIF: Cognitive Level: Analysis t t REF: p. 8 | p. 13 t t t t t
6. The nurse is working during a very busy night shift, and the health care provider has just given
t t t t t t t t t t t t t t t t t
the nurse a medication order over the telephone, but the nurse does not recall the route. What is
t t t t t t t t t t t t t t t t t t
the best way for the nurse to avoid medication errors?
t t t t t t t t t t
a. Recopy the order neatly on the order sheet, with the most common route indicated
t t t t t t t t t t t t t
b. Consult with the pharmacist for clarification about the most common route t t t t t t t t t t
c. Call the health care provider to clarify the route of administration
t t t t t t t t t t
d. Withhold the drug until the health care provider visits the patient t t t t t t t t t t
ANS: C t
If a medication order does not include the route, the nurse must ask the health care provider to
t t t t t t t t t t t t t t t t t
clarify it. Never assume the route of administration.
t t t t t t t t
DIF: Cognitive Level: Application | Cognitive Level: Analysis REF: p. 17 t t t t t t t t t
7. Which constitutes the traditional Five Rights of medication administration?
t t t t t t t t
a. Right drug, right route, right dose, right time, and right patient
t t t t t t t t t t
b. Right drug, the right effect, the right route, the right time, and the right patient
t t t t t t t t t t t t t t
c. Right patient, right strength, right diagnosis, right drug, and right route
t t t t t t t t t t
d. Right patient, right diagnosis, right drug, right route, and right time
t t t t t t t t t t
ANS: A t
, The traditional Five Rights of medication administration were considered to be Right drug,
t t t t t t t t t t t t
Right route, Right dose, Right time, and Right patient. Right effect, right strength, and right
t t t t t t t t t t t t t t t
diagnosis are not part of the traditional Five Rights.
t t t t t t t t t
DIF: t t Cognitive Level: Comprehension t t t t t REF: t p. 13 t
8. What correctly describes the nursing process?
t t t t t
a. Diagnosing, planning, assessing, implementing, and finally evaluating t t t t t t
b. Assessing, then diagnosing, implementing, and ending with evaluating t t t t t t t
c. A linear direction that begins with assessing and continues through diagnosing,
t t t t t t t t t t
planning, and finally implementing
t t t t
d. An ongoing process that begins with assessing and continues with diagnosing,
t t t t t t t t t t
planning, implementing, and evaluating
t t t t
ANS: D t
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that
t t t t t t t t t t t t
begins with assessing and continues through diagnosing, planning, implementing, and finally
t t t t t t t t t t t
evaluating, which may then lead back to any of the other phases.
t t t t t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 8 t t
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
t t t t t t t t t t t t t t t t
a. The patient‘s identification t t
b. The patient‘s weight t t
c. The patient‘s last meal t t t
d. Any drug or food allergies t t t t
ANS: C t
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with
t t t t t t t t t t t t
regard to any drug–food interactions or compatibility issues. The patient‘s identification,
t t t t t t t t t t
weight, and drug or food allergies are not affected by the drug‘s timing.
t t t t t t t t t t t t t
DIF: Cognitive Level: Application t t REF: p. 17 t t
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her
t t t t t t t t t t t t t t t t t
nursing diagnosis?
t t
a. Anxiety
b. Anxiety related to new drug therapy t t t t t
c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements
t t t t t t t t t t t
such as ―I‘m upset about having to give myself shots‖
t t t t t t t t t t
d. Anxiety related to new drug therapy, as evidenced by statements such as ―I‘m
t t t t t t t t t t t t
upset about having to give myself shots‖
t t t t t t t
ANS: D t
, Formulation of nursing diagnoses is usually a three-step process. The only complete answer is
t t t t t t t t t t t t t
―Anxiety related to new drug therapy, as evidenced by statements such as ‗I‘m upset about
t t t t t t t t t t t t t t
having to give myself shots.‘‖ The answer ―Anxiety‖ is missing the ―related to‖ and ―as
t t t t t t t t t t t t t t t
evidenced by‖ portions. The answer ―Anxiety related to new drug therapy‖ is missing the ―as
t t t t t t t t t t t t t t t
evidenced by‖ portion of defining characteristics. The ―related to‖ section in ―Anxiety related to
t t t t t t t t t t t t t t
anxious feelings about drug therapy, as evidenced by statements such as ‗I‘m upset about
t t t t t t t t t t t t t t
having to give myself shots‘‖ is simply a restatement of the problem ―anxiety,‖ not a separate
t t t t t t t t t t t t t t t t
factor related to the response.
t t t t t
DIF: Cognitive Level: Analysis t t REF: p. 9 t t
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
t t t t t t t t t t t t t t t
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
t t t t
DIF: Cognitive Level: Analysis t t REF: p. 9 t t
