lOMoARcPSD| 13728229
lOMoARcPSD| 13728229
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Chapter 01: Nursing Practice in Canada and Drug Therapy
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 5th Edition
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MULTIPLE CHOICE V$
1. Which is a judgement about a particular patient’s potential need or problem?
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a. A goal V$
b. An assessment V$
c. Subjective data V$
d. A nursing diagnosis V$ V$
ANS: D V$
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about how a patient respon
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ds to heath conditions and life processes or vulnerability for that response.
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DIF: Cognitive Level: Knowledge V$ V$
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to swallow, he cann
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ot take medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
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a. A “right time” problem V$ V$ V$
b. A “right dose” problem V$ V$ V$
c. A “right route” problemV$ V$ V$
d. A “right medication” problem
V$ V$ V$
ANS: C V$
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the prescriber. This is not
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a “right time” problem because the ordered frequency has not changed. This is not a “right dose” problem because the dos
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e is not related to an inability to swallow. This is not a “right medication” problem because the medication ordered will not
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change, just the route.
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DIF: Cognitive Level: Application V$ V$
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and has been documentin
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g signs of possible adverse effects. What nursing process phase is the nurse practising?
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a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis V$
ANS: B V$
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not ill
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ustrated by this example. V$ V$ V$
DIF: Cognitive Level: Application V$ V$
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which statement best illust
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rates an V$ V$ outcome criterion for this patient? V$ V$ V$ V$
a. The V$ patient will follow instructions.
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b. The V$ patient will not experience complications.
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c. The V$ patient adheres to the new insulin treatment regimen.
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d. The V$ patient demonstrates safe insulin self-administration technique.
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ANS: D V$
Having the patient demonstrate safe insulin self-
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administration technique is a specific and measurable outcome criterion. Following instructions and avoiding complications ar
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e not specific criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
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DIF: Cognitive Level: Application V$ V$
5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with
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type 1 diabetes mellitus?
$ V$ V$ V$
a. Providing education regarding self-injection technique V$ V$ V$ V$
b. Setting goals and outcome criteria with the patient’s input
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c. Recording a history of over-the-counter medications used at home
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d. Formulating nursing diagnoses regarding knowledge deficits related to the n
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ew treatment regimen V$ V$
ANS: A V$
Education is an intervention that occurs during the implementation phase. Setting goals and outcome criteria reflects the plan
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ning phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge d
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eficit reflects analysis of data as part of the planning phase.
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DIF: Cognitive Level: Analysis V$ V$
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6. The nurse is working during a very busy night shift, and the health care provider has just given the nurse a medication or
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der over the telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication er
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rors?
a. Recopy the order neatly on the order sheet, with the most common route indicated
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b. Consult with the pharmacist for clarification about the most common route
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c. Call the health care provider to clarify the route of administration
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d. Withhold the drug until the health care provider visits the patient
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ANS: C V$
If a medication order does not include the route, the nurse must ask the health care provider to clarify it. Never assume the rout
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e of administration.
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DIF: Cognitive Level: Application | Cognitive Level: Analysis
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7. Which constitutes the traditional Five Rights of medication administration?
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a. Right drug, right route, right dose, right time, and right patient
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b. Right drug, the right effect, the right route, the right time, and the right patient
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c. Right patient, right strength, right diagnosis, right drug, and right route
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d. Right patient, right diagnosis, right drug, right route, and right time
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ANS: A V$
The traditional Five Rights of medication administration were considered to be Right drug, Right route, Right dose, Right time, a
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nd Right patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
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DIF: Cognitive Level: Comprehension V$ V$
8. What correctly describes the nursing process?
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a. Diagnosing, planning, assessing, implementing, and finally evaluating
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b. Assessing, then diagnosing, implementing, and ending with evaluating
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c. A linear direction that begins with assessing and continues through diagnosi
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ng, planning, and finally implementing
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d. An ongoing process that begins with assessing and continues with diagnosi
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ng, planning, implementing, and evaluating
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ANS: D V$
The nursing process is an ongoing, flexible, adaptable, and adjustable five-
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step process that begins with assessing and continues through diagnosing, planning, implementing, and finally evaluating, w
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hich may then lead back to any of the other phases.
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DIF: Cognitive Level: Application V$ V$
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
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a. The patient’s identification
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b. The patient’s weight V$ V$
c. The patient’s last meal V$ V$ V$
d. Any drug or food allergies V$ V$ V$ V$
ANS: C V$
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to any drug–
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food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the d
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rug’s timing. V$
DIF: Cognitive Level: Application V$ V$
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis?
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a. Anxiety
b. Anxiety related to new drug therapy V$ V$ V$ V$ V$
c. Anxiety related to anxious feelings about drug therapy, as evidenced
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by statements such as “I’m upset about having to give myself shot
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s”
d. Anxiety related to new drug therapy, as evidenced by statements such as
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“I’m upset about having to give myself shots”
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ANS: D V$
Formulation of nursing diagnoses is usually a three-
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step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m u
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pset about having to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions.
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The answer “Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The
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“related to” section in “Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as ‘I’m upse
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t about having to give myself shots’” is simply a restatement of the problem “anxiety,” not a separate factor related to the r
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esponse.
DIF: Cognitive Level: Analysis V$ V$
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
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DIF: Cognitive Level: Analysis V$ V$
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Chapter 02: Pharmacological Principles
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 5th Edition
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MULTIPLE CHOICE V$
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circul
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ation in identical amounts. Which term best denotes that the drugs have the same absorption rates?
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a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D V$
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, th
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ey are bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absor
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ption. “Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than th
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e sum of the effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicat
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e that two substances do not have a chemical reaction when mixed (or given, in the case of drugs) together.
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DIF: Cognitive Level: Comprehension V$ V$
2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education?
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a. The medication will cause fewer adverse effects when given intravenously.
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b. The medication will be absorbed slowly into the tissues over time.
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c. The medication’s action will begin faster when given intravenously.
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d. Most of the drug is inactivated by the liver before it reaches the target area.
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ANS: C V$
Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effect
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s, the intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug
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$by the liver before it reaches the target area.
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DIF: Cognitive Level: Comprehension V$ V$
3. Which is V$ V$ true regarding parenteral drugs?
V$ V$ V$
a. They V$ bypass the first-pass effect. V$ V$ V$
b. They V$ decrease blood flow to the stomach. V$ V$ V$ V$ V$
c. They V$ are altered by the presence of food in the stomach.
V$ V$ V$ V$ V$ V$ V$ V$ V$
d. They V$ exert their effects while circulating in the bloodstream.
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ANS: A V$
Drugs given by the parenteral route bypass the first-
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pass effect, but they still must be absorbed into cells and tissues before they can exert their effects. Enteral drugs (drugs tak
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en orally), not parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach.
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Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not
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exert their effects while circulating in the bloodstream.
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DIF: Cognitive Level: Analysis V$ V$
4. A drug’s half-life is best defined as
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a. The time it takes for the drug to elicit half its therapeutic response.
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b. The time it takes one- V$ V$ V$ V$
half V$ of the original amount of a drug to reach the target cells.
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c. The V$ time it takes one-V$ V$ V$
half V$ of the original amount of a drug to be removed from the body.
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d. The V$ time it takes one-V$ V$ V$
half V$ of the original amount of a drug to be absorbed into the circulation.
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ANS: C V$
A drug’s half-life is the time it takes for one-
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half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed
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from the body. Answers A, B, and D are not correct definitions of a drug’s half-life.
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DIF: Cognitive Level: Comprehension V$ V$
5. The term “duration of action” is best defined as
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a. The time it takes for the drug to elicit a therapeutic response.
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b. The time it takes a drug to reach its maximum therapeutic response.
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c. The length of time it takes to remove a drug from circulation.
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d. The time during which drug concentration is sufficient to elicit a therape
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utic response. V$
ANS: D V$
Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it tak
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es for a drug to elicit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximu
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m therapeutic response is a drug’s “peak effect.” “The length of time it takes to remove a drug from circulation” defines a
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drug’s elimination and does not correctly define a drug’s duration of action.
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DIF: Cognitive Level: Comprehension V$ V$
6. A drug interacts with enzymes by
V$ V$ V$ V$ V$
a. altering cell membrane permeability. V$ V$ V$
b. “fooling” a receptor on the cell wall. V$ V$ V$ V$ V$ V$
c. enhancing the drug’s effectiveness within the cells. V$ V$ V$ V$ V$ V$
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Chapter 01: Nursing Practice in Canada and Drug Therapy
V$ V$ V$ V$ V$ V$ V$ V$
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 5th Edition
V$ V$ V$ V$ V$ V$ V$ V$ V$
MULTIPLE CHOICE V$
1. Which is a judgement about a particular patient’s potential need or problem?
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
a. A goal V$
b. An assessment V$
c. Subjective data V$
d. A nursing diagnosis V$ V$
ANS: D V$
Nursing diagnosis is the phase of the nursing process during which a clinical judgement is made about how a patient respon
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
ds to heath conditions and life processes or vulnerability for that response.
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
DIF: Cognitive Level: Knowledge V$ V$
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is unable to swallow, he cann
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
ot take medication orally, as ordered. The nurse needs to contact the physician. What type of problem is this?
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
a. A “right time” problem V$ V$ V$
b. A “right dose” problem V$ V$ V$
c. A “right route” problemV$ V$ V$
d. A “right medication” problem
V$ V$ V$
ANS: C V$
This is a “right route” problem: the nurse cannot assume the route and must clarify the route with the prescriber. This is not
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
a “right time” problem because the ordered frequency has not changed. This is not a “right dose” problem because the dos
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e is not related to an inability to swallow. This is not a “right medication” problem because the medication ordered will not
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change, just the route.
V$ V$ V$ V$
DIF: Cognitive Level: Application V$ V$
3. The nurse has been monitoring the patient’s progress on his new drug regimen since the first dose and has been documentin
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
g signs of possible adverse effects. What nursing process phase is the nurse practising?
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis V$
ANS: B V$
Monitoring the patient’s progress is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not ill
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
ustrated by this example. V$ V$ V$
DIF: Cognitive Level: Application V$ V$
4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus. Which statement best illust
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
rates an V$ V$ outcome criterion for this patient? V$ V$ V$ V$
a. The V$ patient will follow instructions.
V$ V$ V$
b. The V$ patient will not experience complications.
V$ V$ V$ V$
c. The V$ patient adheres to the new insulin treatment regimen.
V$ V$ V$ V$ V$ V$ V$
d. The V$ patient demonstrates safe insulin self-administration technique.
V$ V$ V$ V$ V$
ANS: D V$
Having the patient demonstrate safe insulin self-
V$ V$ V$ V$ V$ V$
administration technique is a specific and measurable outcome criterion. Following instructions and avoiding complications ar
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
e not specific criteria. Adherence to the new insulin treatment regimen is not objective and would be difficult to measure.
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
DIF: Cognitive Level: Application V$ V$
5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V
type 1 diabetes mellitus?
$ V$ V$ V$
a. Providing education regarding self-injection technique V$ V$ V$ V$
b. Setting goals and outcome criteria with the patient’s input
V$ V$ V$ V$ V$ V$ V$ V$
c. Recording a history of over-the-counter medications used at home
V$ V$ V$ V$ V$ V$ V$ V$
d. Formulating nursing diagnoses regarding knowledge deficits related to the n
V$ V$ V$ V$ V$ V$ V$ V$ V$
ew treatment regimen V$ V$
ANS: A V$
Education is an intervention that occurs during the implementation phase. Setting goals and outcome criteria reflects the plan
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
ning phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses regarding a knowledge d
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eficit reflects analysis of data as part of the planning phase.
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DIF: Cognitive Level: Analysis V$ V$
1
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6. The nurse is working during a very busy night shift, and the health care provider has just given the nurse a medication or
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der over the telephone, but the nurse does not recall the route. What is the best way for the nurse to avoid medication er
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rors?
a. Recopy the order neatly on the order sheet, with the most common route indicated
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b. Consult with the pharmacist for clarification about the most common route
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c. Call the health care provider to clarify the route of administration
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d. Withhold the drug until the health care provider visits the patient
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ANS: C V$
If a medication order does not include the route, the nurse must ask the health care provider to clarify it. Never assume the rout
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e of administration.
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DIF: Cognitive Level: Application | Cognitive Level: Analysis
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7. Which constitutes the traditional Five Rights of medication administration?
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a. Right drug, right route, right dose, right time, and right patient
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b. Right drug, the right effect, the right route, the right time, and the right patient
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c. Right patient, right strength, right diagnosis, right drug, and right route
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d. Right patient, right diagnosis, right drug, right route, and right time
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ANS: A V$
The traditional Five Rights of medication administration were considered to be Right drug, Right route, Right dose, Right time, a
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nd Right patient. Right effect, right strength, and right diagnosis are not part of the traditional Five Rights.
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DIF: Cognitive Level: Comprehension V$ V$
8. What correctly describes the nursing process?
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a. Diagnosing, planning, assessing, implementing, and finally evaluating
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b. Assessing, then diagnosing, implementing, and ending with evaluating
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c. A linear direction that begins with assessing and continues through diagnosi
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ng, planning, and finally implementing
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d. An ongoing process that begins with assessing and continues with diagnosi
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ng, planning, implementing, and evaluating
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ANS: D V$
The nursing process is an ongoing, flexible, adaptable, and adjustable five-
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step process that begins with assessing and continues through diagnosing, planning, implementing, and finally evaluating, w
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hich may then lead back to any of the other phases.
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DIF: Cognitive Level: Application V$ V$
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
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a. The patient’s identification
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b. The patient’s weight V$ V$
c. The patient’s last meal V$ V$ V$
d. Any drug or food allergies V$ V$ V$ V$
ANS: C V$
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with regard to any drug–
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food interactions or compatibility issues. The patient’s identification, weight, and drug or food allergies are not affected by the d
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rug’s timing. V$
DIF: Cognitive Level: Application V$ V$
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for her nursing diagnosis?
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a. Anxiety
b. Anxiety related to new drug therapy V$ V$ V$ V$ V$
c. Anxiety related to anxious feelings about drug therapy, as evidenced
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by statements such as “I’m upset about having to give myself shot
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s”
d. Anxiety related to new drug therapy, as evidenced by statements such as
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“I’m upset about having to give myself shots”
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ANS: D V$
Formulation of nursing diagnoses is usually a three-
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step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m u
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pset about having to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions.
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The answer “Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The
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“related to” section in “Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as ‘I’m upse
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t about having to give myself shots’” is simply a restatement of the problem “anxiety,” not a separate factor related to the r
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esponse.
DIF: Cognitive Level: Analysis V$ V$
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
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DIF: Cognitive Level: Analysis V$ V$
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Chapter 02: Pharmacological Principles
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 5th Edition
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MULTIPLE CHOICE V$
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circul
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ation in identical amounts. Which term best denotes that the drugs have the same absorption rates?
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a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D V$
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, th
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ey are bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absor
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ption. “Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than th
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e sum of the effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicat
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e that two substances do not have a chemical reaction when mixed (or given, in the case of drugs) together.
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DIF: Cognitive Level: Comprehension V$ V$
2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education?
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a. The medication will cause fewer adverse effects when given intravenously.
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b. The medication will be absorbed slowly into the tissues over time.
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c. The medication’s action will begin faster when given intravenously.
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d. Most of the drug is inactivated by the liver before it reaches the target area.
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ANS: C V$
Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effect
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s, the intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug
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$by the liver before it reaches the target area.
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DIF: Cognitive Level: Comprehension V$ V$
3. Which is V$ V$ true regarding parenteral drugs?
V$ V$ V$
a. They V$ bypass the first-pass effect. V$ V$ V$
b. They V$ decrease blood flow to the stomach. V$ V$ V$ V$ V$
c. They V$ are altered by the presence of food in the stomach.
V$ V$ V$ V$ V$ V$ V$ V$ V$
d. They V$ exert their effects while circulating in the bloodstream.
V$ V$ V$ V$ V$ V$ V$
ANS: A V$
Drugs given by the parenteral route bypass the first-
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pass effect, but they still must be absorbed into cells and tissues before they can exert their effects. Enteral drugs (drugs tak
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en orally), not parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach.
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Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not
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exert their effects while circulating in the bloodstream.
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DIF: Cognitive Level: Analysis V$ V$
4. A drug’s half-life is best defined as
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a. The time it takes for the drug to elicit half its therapeutic response.
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b. The time it takes one- V$ V$ V$ V$
half V$ of the original amount of a drug to reach the target cells.
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c. The V$ time it takes one-V$ V$ V$
half V$ of the original amount of a drug to be removed from the body.
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d. The V$ time it takes one-V$ V$ V$
half V$ of the original amount of a drug to be absorbed into the circulation.
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
ANS: C V$
A drug’s half-life is the time it takes for one-
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half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed
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from the body. Answers A, B, and D are not correct definitions of a drug’s half-life.
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DIF: Cognitive Level: Comprehension V$ V$
5. The term “duration of action” is best defined as
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a. The time it takes for the drug to elicit a therapeutic response.
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b. The time it takes a drug to reach its maximum therapeutic response.
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c. The length of time it takes to remove a drug from circulation.
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d. The time during which drug concentration is sufficient to elicit a therape
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utic response. V$
ANS: D V$
Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The time it tak
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es for a drug to elicit a therapeutic response is the drug’s “onset of action.” The time it takes a drug to reach its maximu
V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$ V$
m therapeutic response is a drug’s “peak effect.” “The length of time it takes to remove a drug from circulation” defines a
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drug’s elimination and does not correctly define a drug’s duration of action.
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DIF: Cognitive Level: Comprehension V$ V$
6. A drug interacts with enzymes by
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a. altering cell membrane permeability. V$ V$ V$
b. “fooling” a receptor on the cell wall. V$ V$ V$ V$ V$ V$
c. enhancing the drug’s effectiveness within the cells. V$ V$ V$ V$ V$ V$
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