Pharmacology
A Patient-Centered Nursing
Process Approach
11th Edition
• Author(s)Linda McCuistion
TEST BANK
,Question 1
Difficulty: Moderate
Question Type: Multiple Choice (MCQ)
Question:
A nurse is reviewing a client's electronic health record prior to
administering a newly prescribed dose of digoxin. Which action
by the nurse represents the "Recognize Cues" phase of the
Clinical Judgment Measurement Model (CJMM)?
A. Checking the client's apical pulse for 60 seconds and noting a
rate of 52 beats/min.
B. Concluding that the client is experiencing digitalis toxicity due
to hypokalemia.
C. Holding the medication and notifying the primary healthcare
provider.
D. Documenting the heart rate and the decision to withhold the
medication in the nursing notes.
Correct Answer: A
Rationale: Checking the apical pulse and finding it to be 52
beats/min is the collection of clinical data, which directly
corresponds to the "Recognize Cues" (Assessment) phase.
Concluding toxicity is analyzing cues, holding the medication is
,taking action, and documenting is part of
implementation/evaluation.
Question 2
Difficulty: Difficult
Question Type: Select All That Apply (SATA)
Question:
The nurse is caring for a client who was recently started on
gentamycin therapy. Which of the following clinical findings
should the nurse "Analyze Cues" to identify a high-priority risk
for adverse drug reactions? Select all that apply.
A. Serum creatinine increased from 0.9 mg/dL to 1.8 mg/dL
over 48 hours.
B. Client reports a new onset of high-pitched ringing in both
ears.
C. White blood cell count is 7,500/mm³.
D. Total daily urine output has decreased to 250 mL.
E. Trough serum drug level is within the established therapeutic
range.
Correct Answer: A, B, D
Rationale: Gentamicin is highly nephrotoxic and ototoxic. An
elevated creatinine level (A), new-onset tinnitus (B), and
, oliguria (D) are critical clinical cues that indicate acute kidney
injury and ototoxicity, requiring immediate intervention.
Normal WBC and therapeutic trough levels do not indicate
adverse events.
Question 3
Difficulty: Moderate
Question Type: Multiple Choice (MCQ)
Question:
A nurse is preparing a teaching plan for a client who is being
discharged home on warfarin therapy. During the "Generate
Solutions" phase of the CJMM, which nursing activity is most
appropriate?
A. Assessing the client's literacy level and access to
transportation for lab checks.
B. Developing SMART goals emphasizing that the client will
state vitamin K food sources before discharge.
C. Providing the client with a color-coded calendar highlighting
daily dosing schedules.
D. Drawing a venous blood sample to check the client's
international normalized ratio (INR).
Correct Answer: B
A Patient-Centered Nursing
Process Approach
11th Edition
• Author(s)Linda McCuistion
TEST BANK
,Question 1
Difficulty: Moderate
Question Type: Multiple Choice (MCQ)
Question:
A nurse is reviewing a client's electronic health record prior to
administering a newly prescribed dose of digoxin. Which action
by the nurse represents the "Recognize Cues" phase of the
Clinical Judgment Measurement Model (CJMM)?
A. Checking the client's apical pulse for 60 seconds and noting a
rate of 52 beats/min.
B. Concluding that the client is experiencing digitalis toxicity due
to hypokalemia.
C. Holding the medication and notifying the primary healthcare
provider.
D. Documenting the heart rate and the decision to withhold the
medication in the nursing notes.
Correct Answer: A
Rationale: Checking the apical pulse and finding it to be 52
beats/min is the collection of clinical data, which directly
corresponds to the "Recognize Cues" (Assessment) phase.
Concluding toxicity is analyzing cues, holding the medication is
,taking action, and documenting is part of
implementation/evaluation.
Question 2
Difficulty: Difficult
Question Type: Select All That Apply (SATA)
Question:
The nurse is caring for a client who was recently started on
gentamycin therapy. Which of the following clinical findings
should the nurse "Analyze Cues" to identify a high-priority risk
for adverse drug reactions? Select all that apply.
A. Serum creatinine increased from 0.9 mg/dL to 1.8 mg/dL
over 48 hours.
B. Client reports a new onset of high-pitched ringing in both
ears.
C. White blood cell count is 7,500/mm³.
D. Total daily urine output has decreased to 250 mL.
E. Trough serum drug level is within the established therapeutic
range.
Correct Answer: A, B, D
Rationale: Gentamicin is highly nephrotoxic and ototoxic. An
elevated creatinine level (A), new-onset tinnitus (B), and
, oliguria (D) are critical clinical cues that indicate acute kidney
injury and ototoxicity, requiring immediate intervention.
Normal WBC and therapeutic trough levels do not indicate
adverse events.
Question 3
Difficulty: Moderate
Question Type: Multiple Choice (MCQ)
Question:
A nurse is preparing a teaching plan for a client who is being
discharged home on warfarin therapy. During the "Generate
Solutions" phase of the CJMM, which nursing activity is most
appropriate?
A. Assessing the client's literacy level and access to
transportation for lab checks.
B. Developing SMART goals emphasizing that the client will
state vitamin K food sources before discharge.
C. Providing the client with a color-coded calendar highlighting
daily dosing schedules.
D. Drawing a venous blood sample to check the client's
international normalized ratio (INR).
Correct Answer: B
