Adams, Pharmacology for Nurses: A Pathophysiologic Approach, 5/E Chapter 4

The nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement? 1. "We can safely take the drug for at least 6 months beyond the expiration date." 2. "We don't need to worry about storage of the drug, it won't lose potency." 3. "We should not take our medications with milk or dairy products." 4. "We need to be careful about taking the medication with certain foods." Correct Answer: 4 Rationale 1: Patients should be taught to avoid taking medications beyond the expiration date. Rationale 2: Storage can affect the medication's strength and may affect how it responds in the body. Rationale 3: There are many more foods that will alter the absorption of medications other than milk and dairy products. Rationale 4: Food can alter the absorption of many medications. Global Rationale: Food can alter the absorption of many medications. Storage can affect the medication's strength and may affect how it responds in the body. There are many more foods that will alter the absorption of medications other than milk and dairy products. Patients should be taught to avoid taking medications beyond the expiration date. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essentials Competencies: 111.1 Explain the interrelationships among theory, practice, and research. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 4.4 Discuss factors affecting drug absorption. MNL Learning Outcome 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. Page Number: 41 Question 2 Type: MCSA The physician ordered a loading dose of medication for the patient; it is to be followed by a lower dose. When the patient receives the lower dose, she says to the nurse, "I think my doctor made a mistake; my medication dose is too low." What is the best response by the nurse? 1. "The initial dose shortened the half-life, so the medication would work more quickly." 2. "We always give medications this way; the doctor did not make a mistake." 3. "You had a larger dose initially so that the medication would work more quickly." 4. "Giving a larger dose initially will reduce the chance of side effects." Correct Answer: 3 Rationale 1: Loading doses do not shorten the half-life of a drug. Rationale 2: Not all medications are initiated with a loading dose. Rationale 3: Loading doses of medications are used to quickly induce a therapeutic response. Rationale 4: Loading doses do not reduce the occurrence of side effects. Global Rationale: Loading doses of medications are used to quickly induce a therapeutic response. Loading doses do not shorten the half-life of a drug. Not all medications are initiated with a loading dose. Loading doses do not reduce the occurrence of side effects. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essentials Competencies: 111.1 Explain the interrelationships among theory, practice, and research. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4-12 Differentiate between loading and maintenance doses. MNL Learning Outcome 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. Page Number: 47 Question 3 Type: MCSA The patient has meningitis. The physician initially prescribed a water-soluble drug. Another physician changed the order to a lipid-soluble drug. The patient is confused about this. Which plan best resolves the patient's concern? 1. Teach the patient that lipid-soluble drugs are better because of protein binding. 2. Teach the patient that lipid-soluble drugs are more effective in treating his illness. 3. Teach the patient that lipid-soluble drugs are better because they have fewer side effects. 4. Teach the patient that lipid-soluble drugs are more effective because they are excreted at a slower rate. Correct Answer: 2 Rationale 1: Not all lipid-soluble drugs are protein bound. Rationale 2: Drug molecules that are lipid soluble will usually pass through plasma membranes by simple diffusion and more easily reach their target cells. Rationale 3: Lipid-soluble drugs do not necessarily have fewer side effects. Not all lipid-soluble drugs are protein bound. Rationale 4: Lipid solubility does not affect drug excretion. Global Rationale: Drug molecules that are lipid soluble will usually pass through plasma membranes by simple diffusion and more easily reach their target cells. Lipid-soluble drugs do not necessarily have fewer side effects. Not all lipid-soluble drugs are protein bound. Lipid solubility does not affect drug excretion. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essentials Competencies: 111.1 Explain the interrelationships among theory, practice, and research. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 4-6 Discuss factors affecting drug absorption. MNL Learning Outcome 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. Page Number: 41 Question 4 Type: MCSA The patient is malnourished and has a low serum albumin. The physician has ordered aspirin, a highly proteinbound drug, for the patient. Which evaluation by the nurse best describes the effect this will have on the patient? 1. The patient will be at risk to experience a decreased effectiveness of the drug. 2. The patient will be at risk to experience toxic effects of the drug. 3. The patient's kidneys will excrete the drug at a faster rate. 4. The patient's serum globulin is more important than serum album