Pathopharm exam 1 review | Complete Solutions (Verified Answers)

Pathopharm exam 1 review | Complete Solutions (Verified Answers) The medical use of drugs a. Therapeutics b. Drug c. Pharmacology d. Clinical pharmacology The study of drugs and their interactions with the living systems a. Therapeutics b. Drug c. Pharmacology d. Clinical pharmacology Any chemical that can affect living processes a. Therapeutics b. Drug c. Pharmacology d. Clinical pharmacology The study of drugs in humans a. Therapeutics b. Drug c. Pharmacology d. Clinical pharmacology The property of an ideal drug: Tthe nurse teaches a patient to avoid engaging in hazardous activities when taking an antihistamine for allergy symptoms. Selectivity The property of an ideal drug: The nurse explains that a generic form of a newly prescribed drug is available to a patient who has limited insurance coverage for drugs Low cost The property of an ideal drug: The nurse researches if an antidote is available when administering drugs that have the potential to cause significant harm or death Reversible action The property of an ideal drug: The nurse administers ciprofloxacin through a second intravenous line separate from all other drugs Freedom from interactions The property of an ideal drug: The nurse explains that quinapril and accupril are names for the same drug Possession of a simple generic name The property of an ideal drug: The nurse reassesses the patient 20-30 minutes after administering an opiate analgesic Effectiveness The property of an ideal drug: During discharge teaching, the nurse assesses if the patient will be able to take a prescribed drug four times a day as ordered Ease of administration The property of an ideal drug: When a patient is, or could be pregnant, the nurse researches the pregnancy and lactation information for every drug administered Safety The property of an ideal drug: The nurse teaches the patient that the medicine cabinet is a bad place to store medications because the heat and humidity can damage the drug Chemical stability The property of an ideal drug: The nurse is aware that African Americans often do not respond as well as Caucasian to angiotensin-converting enzyme inhibitors (aceis) prescribed for hypertension Predictably Knowing the major adverse reactions of a drug, when they are likely to occur, early signs of development, and interventions to minimize discomfort and harm. a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity The rights of drug administration coupled with the knowledge of pharmacology a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity Knowing the reason for drug use and being able to assess the patients medication needs a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity Knowing the early signs of toxicity and the proper intervention when it occurs a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity Enhancing drug therapy through non-pharmacologic measures a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity Collecting baseline data, identifying high-risk patients, and determining the patients capacity for self-care a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity Taking a thorough drug history, advising the patient to avoid drugs that may interact with prescribed medication, and monitoring for adverse reactions a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity The process to determine if a drug is beneficial or causes harm a. Pre-administration assessment b. Dosage and administration c. Promoting therapeutic effects d. Minimizing adverse effects e. Minimizing adverse interactions f. Making as-needed (prn) decisions g. Evaluating responses to medication h. Managing toxicity A description of a drug using the nomenclature of chemistry Chemical name A drugs non-propriety name Generic name The names under which a drug is marketed Brand name Products that have similar or identical brand names that can contain different drugs and can be purchased without a prescription Over-the-counter (otc) drugs What are some examples of professional sources of drug information? Newsletters, reference books, and the internet Freedom from accidental injury Safety A safe environment reduces the risk of possible illness and injury Underlying theory of safety Rights of medication administration 1. Right patient 2. Right medication 3. Right dose 4. Right route 5. Right time 6. Right documentation 7. Right indication Mechanisms of medication action 1. Absorption 2. Distribution 3. Metabolism 4. Excretion Expected physiological response Therapeutic effects Unintended, undesirable, and often unpredictable severe responses to medication Adverse effects Predictable, unavoidable secondary effect Side effects When a medication accumulates in the blood due to impaired metabolism or excretion; excess amounts of medication within the body Toxic effects Factors that effect pharmacokinetics Age, gender, weight, diet, genetics Change in drug structure a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics Change in drug structure and movement out of the body a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics Movement from blood into tissue and cells a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics Movement into and out of the body a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics Movement into the blood a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics Movement out of the body a. Absorption b. Distribution c. Elimination d. Excretion e. Metabolism f. Pharmacokinetics May require energy or pores a. Passage through channels b. Direct penetration of the membrane c. Passage with the aid of a transport system Requires small size a. Passage through channels b. Direct penetration of the membrane c. Passage with the aid of a transport system Requires lipid solubility a. Passage through channels b. Direct penetration of the membrane c. Passage with the aid of a transport system True or false: cell membranes are composed of fat with phosphate True True or false: most drugs enter cells through channels or pores False True or false: p-glycoprotein transports many drugs out of the cell True True or false: a transport mechanism is needed for water-soluble drugs to enter a cell True True or false: ionization is a process that allows a drug to enter a cell False True or false: if a quaternary ammonium compound drug is injected into a vein it will produce effects, but it will not if taken orally True True or false: polar drugs can enter fetal circulation and breast milk False True or false: aspirin, like most drugs, is primarily absorbed in the small intestine False True or false: enteric drugs should not be crushed because crushing these preparations can cause stomach distress or cause the acid in the stomach to alter the drug True True or false: a depot intramuscular (im) injection of an antibiotic to treat syphilis will be completely effective within 24 hours after administration False True or false: the protein-bound portion of a drug in circulation is not able to exert its action True True or false: first-pass effect means most of the drug is activated by the liver, so it must be administered orally False True or false: a drug with extensive first-pass effect may be given sublingually to allow the drug to be absorbed directly into the systemic circulation True True or false: adding a drug to a patients drug regimen can cause the other drugs to be metabolized more slowly or more rapidly True True or false: intestinal enzymes can release drugs from bile in the duodenum, causing the drug to be reabsorbed True True or false: the nurse would expect that an intravenous (iv) antibiotic prescribed for bacterial meningitis would most likely get to the site of infection if the drug is water soluble False True or false: chemotherapy is administered through a central intravenous line because chemotherapy is caustic to the vein and a large central vein has rapid blood flow, which dilutes and moves the medication quickly True True or false: pharmacodynamics includes the study of how drugs work True True or false: phase 2 of the dose-response relationship starts at the point when the therapeutic effect does not increase with increasing the dose False True or false: maximal efficacy is defined as the largest effect that a drug can produce True True or false: potency is defined as the dose of drug needed to get the desired effect True True or false: two drugs in the same therapeutic class with different recommended doses can have equal effects True True or false: a drug that stimulates the transcription factor receptors may not reach a peak therapeutic effect until taken regularly for days to weeks True True or false: a drug that is selective for specific receptors will produce more unintended effects than a nonselective drug False True or false: if a drug is selective for specific receptors, it is safe False True or false: affinity is the strength of attraction between a drug and its receptor True True or false: drugs with high intrinsic activity cause an intense response True True or false: an agonist drug blocks the stimulation of a receptor False True or false: if a receptor is constantly bombarded by a drug, the cell can down-regulate and decrease the response to the drug True True or false: a patient who suddenly stops taking an antagonist drug may experience hypersensitivity of the receptor and overstimulation True True or false: the ed50 is usually the recommended dose for the drug True True or false: a prescriber may prescribe a drug solely because of its interaction with another drug True True or false: powdered drugs can be mixed once they are dissolved in a liquid False True or false: alcohol, bananas, cigarette smoking, chewing tobacco, chocolate candy, garlic, and grapefruit juice can interact with drugs and cause adverse effects True True or false: antacids increase urinary excretion of alkaline drugs False True or false: adding potassium clavulanate to amoxicillin prevents the body's beta-lactamase enzyme from destroying the amoxicillin False True or false: the nurse should consult with the prescriber regarding adequate blood levels of oral drugs when a patient has persistent diarrhea True Clay-colored stool with nausea and vomiting a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Egfr 50 ml/min and urinary output 750 ml/day; fluid intake 1500 ml/day a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Fatigue and hemoglobin/hematocrit 9.2%/28 mg/dl a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Numbness and tingling around the mouth and respiratory distress a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Frequent infections or infection with rare microbe and wbc count fewer than 5000/mm3 a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Pulse 52 beats/min and unexplained fainting a. Anaphylaxis b. Hemolytic anemia c. Hepatotoxicity d. Qt prolongation e. Nephrotoxicity f. Neutropenia Withdrawal reactions occur when a drug is stopped when a person is _____ ____ on the drug Physically dependent A(n) ____ reaction is an immune response Allergic _____ means cancer-causing Carcinogenic Drugs that are _____ can harm a fetus if the patient takes the drug while she is pregnant Teratogenic Effects that are nearly unavoidable secondary drug effects at therapeutic doses are called ______ ______ Side effects Genetic differences can cause uncommon drug responses. These are called ______ reactions Idiosyncratic ____ disease is when a drug causes symptoms closely resembling a disease Iatrogenic ____ is the detrimental physiologic effects caused by excessive drug dosing Toxicity Dose requirements for drugs with a narrow therapeutic range are more precisely calculated based on the patients _____ Body surface area When a patient take a drug for a long time and becomes tolerant, the nurse would expect the prescriber to _______ the dose to achieve the desired effect. Increase ____ is the ability of a drug to reach the systemic circulation from its site of administration Bioavalibility ____ is the reduction in drug responsiveness brought on by repeated dosing over a short time Tachyphylaxis If the nurse is administering warfarin to a malnourished patient with a serum protein level of 2.9 g/dl, the nurse would expect the patient to be at increased risk for _____ Bleeding Based on differences in metabolism of alcohol, if both a man and woman consume the same amount of alcohol (on a weight-adjusted basis) and take the drug metronidazole, the disulfiram-like reaction between alcohol and the drug in the woman should be more ____ and last ____than for the man. Intense; longer An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage Pain Has a sudden onset as a result of an identifiable tissue injury Acute pain Originates from nociceptors located in the skin; usually localized and described as being sharp Somatic pain Originates from the internal body organs and the linings of body cavities; described as dull, deep, or aching Visceral pain Is sensed in a region other than the site of origin Referred pain Pain that lasts beyond the expected time of healing; usually at-least 6 months Chronic pain Intense episodes of pain interspersed with periods of no pain Chronic recurrent pain Chronic pain that is always present, but varies in intensity Chronic intractable benign pain Pain associated with a chronic condition that worsens over time Chronic progressive pain Predictable pain that accompanies a movement or activity Incident pain Pain that is not associated with any known cause Idiopathic pain Pain caused by damage to the nerves Central pain Pain associated with psychological factors (emotional or mental) as opposed to physiological factors (injury or disease) Psychogenic pain True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic allows for the use of less anesthetic True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic causes local vasoconstriction True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic can cause adverse effects from the systemic absorption of the vasoconstrictor True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic causes local vasodilation False True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic delays the onset of anesthesia False True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic delays systemic absorption True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic improves blood flow to the affected area False True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic increases the risk of toxicity False True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic reduces blood flow to the affected area True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic reduces the risk of toxicity True True or false: using a vasoconstrictor, such as epinephrine, with a local anesthetic requires the use of a larger dose of anesthetic False High risk of bacterial infection a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Hypotension can occur from peripheral vasodilation a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Can induce seizures a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Delirium and unpleasant psychologic reactions can occur postoperatively a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Can produce heat and fire in administration apparatus a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Prolongs qt interval a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Tachycardia and hypertension can occur in response to abrupt increase in blood levels a. Desflurane b. Enflurane c. Droperidol d. Isoflurane e. Ketamine f. Propofol g. Sevoflurane Tue or false: an opiate is a drug that contains compounds found in opium, while an opioid may be a laboratory-created compound True True or false: activation of delta receptors is responsible for the delusions and delirium that are seen with certain opioids False True or false: enkephalins, endorphins, and dynorphins are body substances with opioid properties True True or false: the respiratory depression, physical dependence, and euphoria that occur with opioid analgesics are related to activation of mu opioid receptors True True or false: buprenorphine has less constipation and sedative effects than morphine False True or false: an agonist-antagonist blocks pain when taken alone but improves the pain-relieving effect of another opioid if in the blood at the same time False True or false: the dose of oral morphine is higher than the intravenous (iv) dose because hepatic first pass metabolizes some of the drug before it reaches the central nervous system True The half-life of aspirin is 15-20 minutes, but the anti-platelet effects last ______ 8 days Preoperative teaching for knee replacement surgery should include that the patient should discontinue high-dose aspirin therapy for _____ before surgery 1 week When taking aspirin for its anti-platelet action, other non-steroidal anti-inflammatory drugs (NSAIDS) should be given at least ______ hours before aspirin 2 Aspirin should not be taken by children, especially for symptoms of viral illness, because of the risk of _____ Reye's syndrome The nurse should instruct patients to dispose of aspirin tablets if they develop an odor that smells like _____ Vinegar Chronic alcohol use interferes with the metabolism of excessive doses of _____ Acetaminophen ____ is the antidote for acetaminophen overdose Acetylcysteine The recommended maximum dose of acetaminophen for individuals who regularly consume alcohol is ___ 2000mg The primary nurse, leaving the unit for lunch, provides a verbal report for the covering nurse. The report included one clients prescription for morphine:2mg intravenously (iv) every 3 hours for abdominal pain secondary to major abdominal surgery that morning. During the primary nurse's lunch, the client complains of pain at a level of 8 out of 10 on the pain scale. Which action would the covering nurse perform first? a. Determine the documented time of the last administration of pain medication b. Verify that the written prescription matches the administration record c. Encourage non pharmacological measures initially to relieve the pain d. Explain that the primary nurse will be back from lunch in a few minutes Which response by the nurse asked "how will they 'knock me out' for this colonoscopy?" describes the route of administration for conscious sedation? a. "the medicine will be injected into your spine" b. "you will receive the anesthesia through a face mask" c. "you will receive medication through an intravenous (iv) catheter" d. "we will give you an oral medication about 1 hour before the procedure" Based on the information in this chart, which adolescent may require a modified treatment plan? Client 1: menorrhea; treatment: chaste tree fruit client 2: endometriosis; treatment: oral contraceptive pills client 3: breast pain; treatment: ibuprofen client 4: dysmenorrhea; treatment: acetaminophen Which nursing interventions would the nurse implement for a child undergoing treatment with opioid analgesics? Select all that apply 1. Assessing the child’s level of pain 2. Administering oral medications with meals or snacks 3. Assessing the child’s verbal and nonverbal behaviors 4. Documenting the child’s age, weight, and height before treatment 5. Monitoring and documenting the child’s vital signs before they start therapy A client with inflamed sciatic nerve is to have a conventional transcutaneous electrical nerve stimulation (tens) device applied to the painful nerve pathway. When operating the tens unit, which nursing action is appropriate? A. Maintain the settings programs by the health care provider b. Turn the machine on several times a day for 10 to 20 minutes c. Adjust the dial on the unit until the client states that the pain is relieved d. Apply the color-coded electrodes on the client where they are most comfortable Which group of clients who were in a bus accident and admitted to the emergency department with injuries is considered urgent according to the three-tier triage system? A. Sprains b. Simple fractures c. Severe abdominal pain d. Chest pain with diaphoresis Which is the most reliable indicator of a 2.5-year-old child's pain? A. Crying and sobbing b. Changes in behavior c. Verbal exclamations of pain d. Changes in pulse and respiratory rate After an amputation of a limb, a client reports extreme discomfort in the area where the limb once was. Which goal would the nurse plan to focus interventions? A. Identifying actions to decrease pain in the lost limb b. Reversing feelings of hopelessness about the future c. Promoting mobility in the residual limb d. Facilitating the grieving process for the lost limb Which client would need a correction in the nursing intervention? A. Client 1: 11 yrs old; distraction and creative imagery during administration of medication b. Client 2: 9 yrs old; administration of analgesics only when pain intensifies c. Client 3: 7 yrs old; administration of opioids (po) along with medications d. Client 4: 14 yrs old; administration of half the adult dose in case suppositories should not be done A client with a history of osteoporosis and vertebral compression has been coming to the clinic more frequently for prescription refills of hydrocodone/acetaminophen. Which interference will the nurse make? A. The half-life of the medication has decreased b. An idiosyncratic reaction has occurred c. Higher doses are needed to achieve pain relief d. An emotional dependence on the medication has developed Which action would the nurse take when caring for a client using a patient-controlled analgesia pump who identifies attempts to self-administer the analgesic 10 times because the client is still experiencing pain? A. Monitor the client's pain level for another hour b. Determine the integrity of the intravenous delivery system c. Reprogram the pump to deliver a bolus dose every 8 minutes d. Arrange for the client to be evaluated by the health care provider Which pain description would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer? A. An ache radiating to mcburney point b. An intermittent, colicky right-flank pain c. A gnawing sensation in the epigastric area d. A generalized abdominal pain intensified by movement