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