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Chapter 01: Nursing Practice in Canada and Drug Therapy
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
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MULTIPLEnCHOICE
1. Whichnisnanjudgementnaboutnanparticularnpatient’snpotentialnneednornproblem?
a. Angoal
b. Annassessment
c. Subjectivendata
d. Annursingndiagnosis
ANS:nnD
Nursingndiagnosisnisnthenphasenofnthennursingnprocessnduringnwhichnanclinicalnjudgementnisnmadenaboutnh
eathnconditionsnandnlifenprocessesnornvulnerabilitynfornthatnresponse.
DIF: CognitivenLevel:nKnowledge
2. Thenpatientnisntonreceivenoralnfurosemiden(Lasix)neverynday;nhowever,nbecausenthenpatientnisnunablentonsw
medicationnorally,nasnordered.nThennursenneedsntoncontactnthenphysician.nWhatntypenofnproblemnisnthis?
a. An“rightntime”nproblem
b. An“rightndose”nproblem
c. An“rightnroute”nproblem
d. An“rightnmedication”nproblem
ANS:nnC
Thisnisnan“rightnroute”nproblem:nthennursencannotnassumenthenroutenandnmustnclarifynthenroutenwithnthenpre
me”nproblemnbecausenthenorderednfrequencynhasnnotnchanged.nThisnisnnotnan“rightndose”nproblemnbecause
nabilityntonswallow.nThisnisnnotnan“rightnmedication”nproblemnbecausenthenmedicationnorderednwillnnotnch
DIF: CognitivenLevel:nApplication
3. Thennursenhasnbeennmonitoringnthenpatient’snprogressnonnhisnnewndrugnregimennsincenthenfirstndosenandnha
fnpossiblenadverseneffects.nWhatnnursingnprocessnphasenisnthennursenpractising?
a. Planning
b. Evaluation
c. Implementation
d. Nursingndiagnosis
ANS:nnB
Monitoringnthenpatient’snprogressnisnpartnofnthenevaluationnphase.nPlanning,nimplementation,nandnnursing
ednbynthisnexample.
DIF: CognitivenLevel:nApplication
4. Thennursenisncaringnfornanpatientnwhonhasnbeennnewlyndiagnosednwithntypen1ndiabetesnmellitus.nWhichnstat
utcomencriterionnfornthisnpatient?
a. Thenpatientnwillnfollowninstructions.
b. Thenpatientnwillnnotnexperiencencomplications.
c. Thenpatientnadheresntonthennewninsulinntreatmentnregimen.
d. Thenpatientndemonstratesnsafeninsulinnself-administrationntechnique.
ANS:nnD
Havingnthenpatientndemonstratensafeninsulinnself-
administrationntechniquenisnanspecificnandnmeasurablenoutcomencriterion.nFollowingninstructionsnandnavo
pecificncriteria.nAdherencentonthennewninsulinntreatmentnregimennisnnotnobjectivenandnwouldnbendifficultnto
DIF: CognitivenLevel:nApplication
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6. Thennursenisnworkingnduringnanverynbusynnightnshift,nandnthenhealthncarenprovidernhasnjustngivennthennurse
entelephone,nbutnthennursendoesnnotnrecallnthenroute.nWhatnisnthenbestnwaynfornthennursentonavoidnmedicatio
a. Recopynthenordernneatlynonnthenordernsheet,nwithnthenmostncommonnroutenindicated
b. Consultnwithnthenpharmacistnfornclarificationnaboutnthenmostncommonnroute
c. Callnthenhealthncarenproviderntonclarifynthenroutenofnadministration
d. Withholdnthendrugnuntilnthenhealthncarenprovidernvisitsnthenpatient
ANS:nC
Ifnanmedicationnorderndoesnnotnincludenthenroute,nthennursenmustnasknthenhealthncarenproviderntonclarifynit.n
dministration.
DIF: CognitivenLevel:nApplicationn|nCognitivenLevel:nAnalysis
7. WhichnconstitutesnthentraditionalnFivenRightsnofnmedicationnadministration?
a. Rightndrug,nrightnroute,nrightndose,nrightntime,nandnrightnpatient
b. Rightndrug,nthenrightneffect,nthenrightnroute,nthenrightntime,nandnthenrightnpatient
c. Rightnpatient,nrightnstrength,nrightndiagnosis,nrightndrug,nandnrightnroute
d. Rightnpatient,nrightndiagnosis,nrightndrug,nrightnroute,nandnrightntime
ANS:nA
ThentraditionalnFivenRightsnofnmedicationnadministrationnwerenconsideredntonbenRightndrug,nRightnroute,n
ightnpatient.nRightneffect,nrightnstrength,nandnrightndiagnosisnarennotnpartnofnthentraditionalnFivenRights.
DIF: CognitivenLevel:nComprehension
8. Whatncorrectlyndescribesnthennursingnprocess?
a. Diagnosing,nplanning,nassessing,nimplementing,nandnfinallynevaluating
b. Assessing,nthenndiagnosing,nimplementing,nandnendingnwithnevaluating
c. Anlinearndirectionnthatnbeginsnwithnassessingnandncontinuesnthroughndiagnosing,n
planning,nandnfinallynimplementing
d. Annongoingnprocessnthatnbeginsnwithnassessingnandncontinuesnwithndiagnosing,n
planning,nimplementing,nandnevaluating
ANS:nD
Thennursingnprocessnisnannongoing,nflexible,nadaptable,nandnadjustablenfive-
stepnprocessnthatnbeginsnwithnassessingnandncontinuesnthroughndiagnosing,nplanning,nimplementing,nandnf
ennleadnbackntonanynofnthenothernphases.
DIF: CognitivenLevel:nApplication
9. Whennthennursenisnconsideringnthentimingnofnandrugndose,nwhichnisnmostnimportantntonassess?
a. Thenpatient’snidentification
b. Thenpatient’snweight
c. Thenpatient’snlastnmeal
d. Anyndrugnornfoodnallergies
ANS:nC
Thenpharmacokineticnandnpharmacodynamicnpropertiesnofnthendrugnneedntonbenassessednwithnregardntonan
foodninteractionsnorncompatibilitynissues.nThenpatient’snidentification,nweight,nandndrugnornfoodnallergiesn
ntiming.
DIF: CognitivenLevel:nApplication
10. Thennursenisnwritingnnursingndiagnosesnfornanplannofncare.nWhichnreflectsnthencorrectnformatnfornhernnursin
a. Anxiety
b. Anxietynrelatedntonnewndrugntherapy
c. Anxietynrelatedntonanxiousnfeelingsnaboutndrugntherapy,nasnevidencednbyn
statementsnsuchnasn“I’mnupsetnaboutnhavingntongivenmyselfnshots”
d. Anxietynrelatedntonnewndrugntherapy,nasnevidencednbynstatementsnsuchnasn“I’mn
upsetnaboutnhavingntongivenmyselfnshots”
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Chapter 02: Pharmacological Principles
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Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition
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MULTIPLEnCHOICE
1. Anpatientnisnreceivingntwondifferentndrugs,nwhich,natntheirncurrentndosenformsnandndosages,narenbothnabsor
enticalnamounts.nWhichntermnbestndenotesnthatnthendrugsnhaventhensamenabsorptionnrates?
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS:nnD
Twondrugsnabsorbednintonthencirculationnatnthensamenamountn(innspecificndosagenforms)nhaventhensamenbio
ioequivalent.n“Equivalent”nisnincorrectnbecausenthentermn“bioavailability”nisnusedntonexpressnthenextentnof
ic”nisnincorrectnbecausenthisntermnrefersntontwondrugsngivenntogethernwhosenresultingneffectnisngreaternthan
hndrugngivennalone.n“Compatible”nisnincorrectnbecausenthisntermnisnangeneralntermnusedntonindicatenthatntw
hemicalnreactionnwhennmixedn(orngiven,ninnthencasenofndrugs)ntogether.
DIF: CognitivenLevel:nComprehension
2. Anpatientnisnreceivingnmedicationnvianintravenousninjection.nWhichninformationnshouldnthennursenprovide
a. Thenmedicationnwillncausenfewernadverseneffectsnwhenngivennintravenously.
b. Thenmedicationnwillnbenabsorbednslowlynintonthentissuesnoverntime.
c. Thenmedication’snactionnwillnbeginnfasternwhenngivennintravenously.
d. Mostnofnthendrugnisninactivatednbynthenlivernbeforenitnreachesnthentargetnarea.
ANS:nnC
Intravenousninjectionsnarenthenfastestnroutenofnabsorption.nThenintravenousnroutendoesnnotnaffectnthennumb
ntravenousnroutenisnnotnanslownroutenofnabsorption,nandnthenintravenousnroutendoesnnotncauseninactivationn
orenitnreachesnthentargetnarea.
DIF: CognitivenLevel:nComprehension
3. Whichnisntruenregardingnparenteralndrugs?
a. Theynbypassnthenfirst-passneffect.
b. Theyndecreasenbloodnflowntonthenstomach.
c. Theynarenalterednbynthenpresencenofnfoodninnthenstomach.
d. Theynexertntheirneffectsnwhilencirculatingninnthenbloodstream.
ANS:nnA
Drugsngivennbynthenparenteralnroutenbypassnthenfirst-
passneffect,nbutntheynstillnmustnbenabsorbednintoncellsnandntissuesnbeforentheyncannexertntheirneffects.nEnter
notnparenteralndrugs,ndecreasenbloodnflowntonthenstomachnandnaren alterednbynthenpresencenofnfoodninnthenst
tnbenabsorbednintoncellsnandntissuesnfromnthencirculationnbeforentheyncannexertntheirneffects;ntheyndonnotnex
ingninnthenbloodstream.
DIF: CognitivenLevel:nAnalysis
4. Andrug’snhalf-lifenisnbestndefinednas
a. Thentimenitntakesnfornthendrugntonelicitnhalfnitsntherapeuticnresponse.
b. Thentimenitntakesnone-
halfnofnthenoriginalnamountnofnandrugntonreachnthentargetncells.
c. Thentimenitntakesnone-
halfnofnthenoriginalnamountnofnandrugntonbenremovednfromnthenbody.
d. Thentimenitntakesnone-
halfnofnthenoriginalnamountnofnandrugntonbenabsorbednintonthencirculation.
ANS:nnC
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6. Andrugninteractsnwithnenzymesnby
a. alteringncellnmembranenpermeability.
b. “fooling”nanreceptornonnthencellnwall.
c. enhancingnthendrug’sneffectivenessnwithinnthencells.
d. “fooling”nthenenzymenintonbindingnwithnitninsteadnofnitsnnormalntargetncell.
ANS:nD
Whenndrugsninteractnwithnenzymes,ntheyninhibitnthenactionnofnanspecificnenzymenbyn“fooling”nthenenzyme
fntonitsnnormalntargetncell.nThus,nthentargetncellsnarenprotectednfromnthenactionnofnthenenzymesntonresultninna
ofncellnmembranenpermeability,nthen“fooling”nofnanreceptornonnthencellnwall,nandnthenenhancementnofnthene
nncellsndonnotnoccurnwithnselectivenenzymeninteractions.
DIF: CognitivenLevel:nComprehension
7. Whennadministeringnannewnmedicationntonanpatient,nthennursenreadsnthatnitnisnhighlynproteinnbound.nWhich
omnthisnproteinnbinding?
a. Renalnexcretionnwillntakenlonger.
b. Thendrugnwillnbenmetabolizednquickly.
c. Thendurationnofnactionnofnthenmedicationnwillnbenlonger.
d. Thendurationnofnactionnofnthenmedicationnwillnbenshorter.
ANS:nC
Drugsnthatnarenboundntonplasmanproteinsnarencharacterizednbynanlongerndurationnofnaction.nProteinnbinding
xcretionnlongernandndoesnnotnincreasenmetabolismnofnthendrug.nProteinnbindingnofnandrugnmeansnthatnthend
ger,nnotnshorter.
DIF: CognitivenLevel:nApplication
8. Whennmonitoringnanpatientnonnanninsulinndripntonreducenbloodnglucosenlevels,nthennursennotesnthatnthenpati
xtremelynlow,nandnthenpatientnisnlethargicnandndifficultntonawaken.nWhichnadversendrugnreactionnisnthennur
a. Annadverseneffect
b. Annallergicnreaction
c. Annidiosyncraticnreaction
d. Anpharmacologicalnreaction
ANS:nD
Anpharmacologicalnreactionnisnannextensionnofnthendrug’snnormalneffectsninnthenbody.nInnthisncase,ntheninsu
odnglucosenlevelsntoonmuch.nAnnadverseneffectnisnanpredictable,nwell-
knownnadversendrugnreactionnthatnresultsninnminornornnonchangesninnpatientnmanagement.nAnnallergicnreac
ensitivitynreaction)ninvolvesnthenpatient’snimmunensystem.nAnnidiosyncraticnreactionnisnunexpectednandnis
erminednabnormalnresponsentonnormalndosagesnofnandrug.
DIF: CognitivenLevel:nComprehension
9. Anpatientnisnexperiencingnchestnpainnandnneedsntontakenansublingualnformnofnnitroglycerin.nWherenshouldnt
acenthentablet?
a. Undernthentongue
b. Innthenspacenbetweennthencheeknandngum
c. Atnthenbacknofnthenthroat,nforneasynswallowing
d. Onnannon-hairynareanonnthenchest
ANS:nA
Drugsntakennbynthensublingualnroutenarenplacednundernthentongue.nPlacingnthentabletninnthenspacenbetweenn
rnthenbuccalnroute;nplacingnthentabletnatnthenbacknofnthenthroatn(forneasynswallowing)nisndoneninnthenoralnrou
nnon-hairynareanonnthenchestnisndoneninnthentopicalnorntransdermalnroute.
DIF: CognitivenLevel:nComprehension
10. Thennursenisnadministeringnmedicationsntonanpatientnwhonisninnlivernfailurenduentonend-
stagencirrhosis.nThennursenisnawarenthatnpatientsnwithnlivernfailurenarenmostnlikelyntonhavenproblemsnwithnw