Rasmussen College - NUR 339 Pharmacology and the Nursing Pro-
cess, 8th Edition
Chapter 01: The Nursing Process and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly
diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing
diagnosis?
d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m
upset about having to test my blood sugars.”
ANS: D
Formulation of nursing diagnoses is usually a three-step process. “Anxiety” is missing the
“related to” and “as evidenced by” portions of defining characteristics. “Anxiety related to
new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The
statement beginning “Anxiety related to anxious feelings” is incorrect because the “related to”
section is simply a restatement of the problem “anxiety,” not a separate factor related to the
response.
2. The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy
and gave the medication 2 hours after the scheduled dose was due. What type of problem does
this represent?
a. “Right time”
ANS: A
“Right time” is correct because the medication was given more than 30 minutes after the
scheduled dose was due. “Dose” is incorrect because the dose is not related to the time the
medication administration is scheduled. “Route” is incorrect because the route is not affected.
“Medication” is incorrect because the medication ordered will not change.
3. The nurse has been monitoring the patient’s progress on a new drug regimen since the first
dose and documenting the patient’s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
d. Evaluation
ANS: D
Monitoring the patient’s progress, including the patient’s response to the medication, is part of
the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by
this example.
1 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
,4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
d. The patient will demonstrate correct blood glucose testing technique.
ANS: D
“Demonstrating correct blood glucose testing technique” is a specific and measurable
outcome criterion. “Following instructions” and “not experiencing complications” are not
specific criteria. “Adhering to new regimen” would be difficult to measure.
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?
a. Providing education on keeping a journal of blood pressure readings
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcomes reflects the planning phase. Recording a drug history reflects the assessment phase.
Formulating nursing diagnoses reflects analysis of data as part of planning.
6. The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning
chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order.
What is the nurse’s best action?
c. Contact the prescriber to clarify the route of the medication ordered.
ANS: C
A complete medication order includes the route of administration. If a medication order does
not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral
routes are not interchangeable. Holding the medication until the prescriber returns would
mean that the patient would not receive a needed medication.
7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider
when deciding when to give a drug?
c. The patient’s last meal
ANS: C
The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may
be affected by the timing of the last meal. The patient’s ability to swallow, height, and
allergies are not factors to consider regarding the timing of the drug’s administration.
8. The nurse is performing an assessment of a newly admitted patient. Which is an example of
subjective data?
c. The patient reports that he uses the herbal product ginkgo.
ANS: C
Subjective data include information shared through the spoken word by any reliable source,
such as the patient. Objective data may be defined as any information gathered through the
senses or that which is seen, heard, felt, or smelled. A patient’s blood pressure, weight, and
laboratory tests are all examples of objective data.
2 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
,MULTIPLE RESPONSE
1. When giving medications, the nurse will follow the rights of medication administration. The
rights include the right documentation, the right reason, the right response, and the patient’s
right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
e. Right time
f. Right patient
ANS: A, B, C, E, F
Additional rights of medication administration must always include the right drug, right dose,
right time, right route, and right patient. The right diagnosis is incorrect.
2. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as
the last phase. (Select all that apply.)
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Nursing Diagnoses
ANS: A, B, C, D, E
The nursing process is an ongoing process that begins with assessing and continues with
diagnosing, planning, implementing, and evaluating.
Chapter 02: Pharmacologic Principles
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs
are absorbed into the circulation in identical amounts. Which term is used to identify this
principle?
a. Bioequivalent
ANS: A
Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. A drug’s steady state is the physiologic
state in which the amount of drug removed via elimination is equal to the amount of drug
absorbed from each dose. The term synergistic refers to two drugs, given together, with a
resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug
is an inactive drug dosage form that is converted to an active metabolite by various
biochemical reactions once it is inside the body.
3 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
, 2. When given an intravenous medication, the patient says to the nurse, “I usually take pills.
Why does this medication have to be given in the arm?” What is the nurse’s best answer?
c. “The action of the medication will begin sooner when given intravenously.”
ANS: C
An intravenous (IV) injection provides the fastest route of absorption. The IV route does not
affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in
faster absorption). The IV route does not affect the number of allergic reactions.
3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral
drugs?
a. Parenteral drugs bypass the first-pass effect.
ANS: A
Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the
stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to
parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation
before they can exert their effects; they do not exert their effects while circulating in the
bloodstream.
4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the
nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and
difficult to awaken. This would be classified as which type of adverse drug reaction?
d. Pharmacologic reaction
ANS: D
A pharmacologic reaction is an extension of a drug’s normal effects in the body. In this case,
the antihypertensive drug lowered the patient’s blood pressure levels too much. The other
options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-
known adverse drug reaction that results in minor or no changes in patient management. An
allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined
abnormal response to normal dosages of a drug.
5. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which
sentence defines a drug’s half-life?
c. The time it takes for one half of the original amount of a drug to be removed from
the body
ANS: C
A drug’s half-life is the time it takes for one half of the original amount of a drug to be
removed from the body. It is a measure of the rate at which drugs are removed from the body.
The other options are incorrect definitions of half-life.
6. When administering drugs, the nurse remembers that the duration of action of a drug is
defined as which of these?
4 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
cess, 8th Edition
Chapter 01: The Nursing Process and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly
diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing
diagnosis?
d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m
upset about having to test my blood sugars.”
ANS: D
Formulation of nursing diagnoses is usually a three-step process. “Anxiety” is missing the
“related to” and “as evidenced by” portions of defining characteristics. “Anxiety related to
new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The
statement beginning “Anxiety related to anxious feelings” is incorrect because the “related to”
section is simply a restatement of the problem “anxiety,” not a separate factor related to the
response.
2. The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy
and gave the medication 2 hours after the scheduled dose was due. What type of problem does
this represent?
a. “Right time”
ANS: A
“Right time” is correct because the medication was given more than 30 minutes after the
scheduled dose was due. “Dose” is incorrect because the dose is not related to the time the
medication administration is scheduled. “Route” is incorrect because the route is not affected.
“Medication” is incorrect because the medication ordered will not change.
3. The nurse has been monitoring the patient’s progress on a new drug regimen since the first
dose and documenting the patient’s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
d. Evaluation
ANS: D
Monitoring the patient’s progress, including the patient’s response to the medication, is part of
the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by
this example.
1 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
,4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
d. The patient will demonstrate correct blood glucose testing technique.
ANS: D
“Demonstrating correct blood glucose testing technique” is a specific and measurable
outcome criterion. “Following instructions” and “not experiencing complications” are not
specific criteria. “Adhering to new regimen” would be difficult to measure.
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?
a. Providing education on keeping a journal of blood pressure readings
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcomes reflects the planning phase. Recording a drug history reflects the assessment phase.
Formulating nursing diagnoses reflects analysis of data as part of planning.
6. The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning
chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order.
What is the nurse’s best action?
c. Contact the prescriber to clarify the route of the medication ordered.
ANS: C
A complete medication order includes the route of administration. If a medication order does
not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral
routes are not interchangeable. Holding the medication until the prescriber returns would
mean that the patient would not receive a needed medication.
7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider
when deciding when to give a drug?
c. The patient’s last meal
ANS: C
The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may
be affected by the timing of the last meal. The patient’s ability to swallow, height, and
allergies are not factors to consider regarding the timing of the drug’s administration.
8. The nurse is performing an assessment of a newly admitted patient. Which is an example of
subjective data?
c. The patient reports that he uses the herbal product ginkgo.
ANS: C
Subjective data include information shared through the spoken word by any reliable source,
such as the patient. Objective data may be defined as any information gathered through the
senses or that which is seen, heard, felt, or smelled. A patient’s blood pressure, weight, and
laboratory tests are all examples of objective data.
2 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
,MULTIPLE RESPONSE
1. When giving medications, the nurse will follow the rights of medication administration. The
rights include the right documentation, the right reason, the right response, and the patient’s
right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
e. Right time
f. Right patient
ANS: A, B, C, E, F
Additional rights of medication administration must always include the right drug, right dose,
right time, right route, and right patient. The right diagnosis is incorrect.
2. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as
the last phase. (Select all that apply.)
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Nursing Diagnoses
ANS: A, B, C, D, E
The nursing process is an ongoing process that begins with assessing and continues with
diagnosing, planning, implementing, and evaluating.
Chapter 02: Pharmacologic Principles
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs
are absorbed into the circulation in identical amounts. Which term is used to identify this
principle?
a. Bioequivalent
ANS: A
Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. A drug’s steady state is the physiologic
state in which the amount of drug removed via elimination is equal to the amount of drug
absorbed from each dose. The term synergistic refers to two drugs, given together, with a
resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug
is an inactive drug dosage form that is converted to an active metabolite by various
biochemical reactions once it is inside the body.
3 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
, 2. When given an intravenous medication, the patient says to the nurse, “I usually take pills.
Why does this medication have to be given in the arm?” What is the nurse’s best answer?
c. “The action of the medication will begin sooner when given intravenously.”
ANS: C
An intravenous (IV) injection provides the fastest route of absorption. The IV route does not
affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in
faster absorption). The IV route does not affect the number of allergic reactions.
3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral
drugs?
a. Parenteral drugs bypass the first-pass effect.
ANS: A
Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the
stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to
parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation
before they can exert their effects; they do not exert their effects while circulating in the
bloodstream.
4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the
nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and
difficult to awaken. This would be classified as which type of adverse drug reaction?
d. Pharmacologic reaction
ANS: D
A pharmacologic reaction is an extension of a drug’s normal effects in the body. In this case,
the antihypertensive drug lowered the patient’s blood pressure levels too much. The other
options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-
known adverse drug reaction that results in minor or no changes in patient management. An
allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined
abnormal response to normal dosages of a drug.
5. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which
sentence defines a drug’s half-life?
c. The time it takes for one half of the original amount of a drug to be removed from
the body
ANS: C
A drug’s half-life is the time it takes for one half of the original amount of a drug to be
removed from the body. It is a measure of the rate at which drugs are removed from the body.
The other options are incorrect definitions of half-life.
6. When administering drugs, the nurse remembers that the duration of action of a drug is
defined as which of these?
4 FORMULATION OF NURSING DIAGNOSES IS USUALLY A THREE-STEP PROCESS. “ANXIETY” IS MISSING THE “RELATED TO” AND “AS EVIDENCED BY” PORTIONS OF DEFINING CHARACTERISTICS. “ANXIETY RELATED TO NEW DRUG THERAPY” IS MISSING THE “AS EVIDENCED BY” PORTION OF DEFINING CHARACTERISTICS. THE STATEMENT BEGINNING “ANXIETY RELATED TO
ANXIOUS FEELINGS” IS INCORRECT BECAUSE THE “RELATED TO” SECTION IS SIMPLY A RESTATEMENT OF THE PROBLEM “ANXIETY,” NOT A SEPARATE FACTOR RELATED TO THE RESPONSE.(*@#)@@@@@__####################@@@@@@@@@@@@@@@@@@@@@
