Chapter 04: Patient-Focused Considerations
MULTIPLE CHOICE
1. During the last trimester of pregnancy, drug transfer to the fetus is more likely to occur. Which is a
reason for this possibility?
a. Fetal size
b. Decreased surface area
c. Enhanced placental blood flow
d. Increased amount of bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester, as a result of enhanced placental blood
flow, increased fetal surface area, and an increased amount of free drug in the mother’s circulation.
Increased, not decreased, fetal surface area affects drug transfer to the fetus. The placenta’s surface
area does not increase during this time. Drug transfer is increased due to an increased amount of free
drug, not protein-bound drug, in the mother’s circulation. “Fetal size” is incorrect because the first
trimester of pregnancy is the period of greatest danger of drug-induced developmental defects. During
this period, the fetus undergoes rapid cell proliferation. Gestational age is more important than fetal
size.
DIF: Cognitive Level: Comprehension
2. Which type of dosage calculation is used most commonly when calculating drug dosages for
children?
a. Fried’s rule
b. Clark’s rule
c. Young’s rule
d. The mg/kg formula
ANS: D
The body weight method, using the mg/kg formula, is the most common and reliable method for
calculating doses for young patients. Fried’s rule, Clark’s rule, and Young’s rule are not methods used for
calculating drug dosages for young patients.
, DIF: Cognitive Level: Knowledge
3. While assessing an 82-year-old woman, the nurse determines that the patient is experiencing
polypharmacy. What is this experience most likely to indicate?
a. The patient has a lower risk of drug interactions.
b. The patient takes medications for one illness several times a day.
c. The patient risks problems only if she also takes over-the-counter medications.
d. The patient takes multiple medications for several different illnesses.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of
them, medications possibly prescribed by different specialists who may be unaware of the patient’s
other treatments. This situation puts the patient at increased risk of drug interactions and adverse
reactions. Polypharmacy means that the patient has a higher, not lower, risk of drug interactions, and
that the patient is taking several different medications, not just one. Polypharmacy can include
prescription drugs, over-the-counter medications, and natural health products.
DIF: Cognitive Level: Application
4. For accurate medication administration to young patients, the nurse must take into account which
information?
a. Weight, height, age, and organ maturity
b. Age, glomerular filtration rate, and weight
c. Weight, height, body temperature, and age
d. Weight, height, and total body water content
ANS: A
To accurately administer medications to young patients, their weight, height, age, physical condition,
metabolism and organ maturity must be taken into account. Glomerular filtration rate, body
temperature, and total body water content are not considerations when administering medications to
young patients.
DIF: Cognitive Level: Comprehension
5. Which statement is true in regard to children?
a. Their levels of microsomal enzymes are decreased compared to those of adults.
b. Their total body water content is much less than that of adults.
c. Their first-pass elimination is increased because of higher portal circulation.
d. Gastric emptying is more rapid than that of adults because of increased peristaltic activity.
ANS: A
MULTIPLE CHOICE
1. During the last trimester of pregnancy, drug transfer to the fetus is more likely to occur. Which is a
reason for this possibility?
a. Fetal size
b. Decreased surface area
c. Enhanced placental blood flow
d. Increased amount of bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester, as a result of enhanced placental blood
flow, increased fetal surface area, and an increased amount of free drug in the mother’s circulation.
Increased, not decreased, fetal surface area affects drug transfer to the fetus. The placenta’s surface
area does not increase during this time. Drug transfer is increased due to an increased amount of free
drug, not protein-bound drug, in the mother’s circulation. “Fetal size” is incorrect because the first
trimester of pregnancy is the period of greatest danger of drug-induced developmental defects. During
this period, the fetus undergoes rapid cell proliferation. Gestational age is more important than fetal
size.
DIF: Cognitive Level: Comprehension
2. Which type of dosage calculation is used most commonly when calculating drug dosages for
children?
a. Fried’s rule
b. Clark’s rule
c. Young’s rule
d. The mg/kg formula
ANS: D
The body weight method, using the mg/kg formula, is the most common and reliable method for
calculating doses for young patients. Fried’s rule, Clark’s rule, and Young’s rule are not methods used for
calculating drug dosages for young patients.
, DIF: Cognitive Level: Knowledge
3. While assessing an 82-year-old woman, the nurse determines that the patient is experiencing
polypharmacy. What is this experience most likely to indicate?
a. The patient has a lower risk of drug interactions.
b. The patient takes medications for one illness several times a day.
c. The patient risks problems only if she also takes over-the-counter medications.
d. The patient takes multiple medications for several different illnesses.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of
them, medications possibly prescribed by different specialists who may be unaware of the patient’s
other treatments. This situation puts the patient at increased risk of drug interactions and adverse
reactions. Polypharmacy means that the patient has a higher, not lower, risk of drug interactions, and
that the patient is taking several different medications, not just one. Polypharmacy can include
prescription drugs, over-the-counter medications, and natural health products.
DIF: Cognitive Level: Application
4. For accurate medication administration to young patients, the nurse must take into account which
information?
a. Weight, height, age, and organ maturity
b. Age, glomerular filtration rate, and weight
c. Weight, height, body temperature, and age
d. Weight, height, and total body water content
ANS: A
To accurately administer medications to young patients, their weight, height, age, physical condition,
metabolism and organ maturity must be taken into account. Glomerular filtration rate, body
temperature, and total body water content are not considerations when administering medications to
young patients.
DIF: Cognitive Level: Comprehension
5. Which statement is true in regard to children?
a. Their levels of microsomal enzymes are decreased compared to those of adults.
b. Their total body water content is much less than that of adults.
c. Their first-pass elimination is increased because of higher portal circulation.
d. Gastric emptying is more rapid than that of adults because of increased peristaltic activity.
ANS: A
