RNSG 1301 - EXAM 2 EXAM WITH
COMPLETE SOLUTIONS
An 18-month-old patient has been started on chemotherapy. Which means are used to
adjust the drug dosages?
Therapeutic response
Drug dosage calculator
Plasma drug concentrations
Body surface area calculation
Extrapolated from adult dosage - ANSTherapeutic response - Drug therapy must be
adjusted based on therapeutic response to chemotherapy.
Plasma drug concentrations - Drug therapy must be adjusted based on plasma drug
concentrations.
Which family-centered education techniques would the nurse use when teaching the
parents of a 12-month-old infant how to administer oral antibiotics?
Administer the drug all at once
Have parent soothe the 12-month-old patient
Disguise the drug taste with grape juice
Use an oral syringe to administer the drug
Allow the 12-month-old patient to suck on a pacifier - ANSHave parent soothe the 12-
month-old patient - The parent should maintain safe and secure positioning of the infant
(e.g., holding, rocking, cuddling, soothing).
Use an oral syringe to administer the drug - The parents should use a calibrated
dropper or an oral syringe.
Allow the 12-month-old patient to suck on a pacifier - The parents should allow self-
comforting measures as age-appropriate (e.g., use of pacifier or sucking on fingers).
Which factors increase the incidence of older adults experiencing adverse drug effects
(ADEs) from drug therapy?
Polypharmacy
Cognitive impairment
Use of drugs with wide therapeutic index
,Kidney dysfunction
Intact hepatic function - ANSPolypharmacy - Polypharmacy contributes to the increased
incidence of ADEs experienced by older adults.
Cognitive impairment - Cognitive impairment contributes to the increased incidence of
ADEs experienced by older adults.
Kidney dysfunction - Altered pharmacokinetics (e.g., decreased kidney function)
contributes to the increased incidence of ADEs experienced by older adults.
Match the drug or drug class requiring special monitoring to the condition. - ANSBladder
flow obstruction - Anticholinergics
Clotting disorders - Nonsteroidal antiinflammatory drugs (NSAIDs)
Hypertension - Over-the-counter cold products
Falls - Opioids
To reduce the incidence of polypharmacy, on which factors would the nurse educate an
older adult?
Side effects of their drugs
Interactions of each drug
The name and appearance of their drugs
Therapeutic effects of their drugs
Altering drug therapy based on symptoms - ANSSide effects of their drugs - Older
adults should be educated on the name, appearance, therapeutic effects, and side
effects of each drug.
Interactions of each drug - Older adults should be educated on potential adverse effects
and interactions of each drug.
The name and appearance of their drugs - Older adults should be educated about the
name and appearance of their drugs.
Therapeutic effects of their drugs - Older adults should be educated on the name,
appearance, therapeutic effects, and side effects of each drug.
Which considerations would the nurse use to promote drug adherence in older adults?
Recommend simple drug regimens
Speak in a sharp tone of voice
Use a font with sanserif, or "no feet and tails
Recommend keeping a drug list in purse or wallet
,Ask the pharmacy to provide containers that are easy to open - ANSRecommend
simple drug regimens - The nurse would recommend the health care provider simplify
the drug regimen for the older adult (i.e., use combination drugs to reduce the number
of pills the patient takes or use long-acting formulations to reduce the number of doses
per day).
Recommend keeping a drug list in purse or wallet - The nurse would instruct the patient
to keep a list of all drugs and bring it to all health appointments; the nurse would also
advise the older adult to keep a copy of the list in their wallet or purse.
Ask the pharmacy to provide containers that are easy to open - The nurse would ask
the pharmacist to label drug containers using a large print size and provide containers
that are easy to open by patients with impaired strength and dexterity (e.g., those with
arthritis).
Which statement accurately describes the glucocorticoid that is secreted from the
adrenal cortex along with its effect in the body?
Cortisol, which impacts carbohydrate metabolism
Aldosterone, which impacts carbohydrate metabolism
Cortisol, which maintains sodium levels and blood pressure
Aldosterone, which maintains sodium levels and blood pressure - ANSCortisol, which
impacts carbohydrate metabolism - Cortisol is a glucocorticoid that is secreted from the
adrenal cortex. It affects carbohydrate, fat, and protein metabolism.
Which statements accurately describe the actions glucocorticoids exert in the
inflammatory process?
Stimulation of erythroid cells
Maintenance of sodium levels in the blood
Reduction of interleukin-1 release from white blood cells
Promotion of protein metabolism, glycogen production, and fat redistribution
Stabilization of lysosomal cell membranes to reduce capillary permeability and
leukocyte migration - ANSStimulation of erythroid cells - Glucocorticoids are able to
stimulate the erythroid cells that eventually become red blood cells.
Reduction of interleukin-1 release from white blood cells - Glucocorticoids modulate the
inflammatory response by reducing interleukin-1 release from white cells to decrease
fever.
Promotion of protein metabolism, glycogen production, and fat redistribution - They
promote protein metabolism, glycogen production, and fat redistribution from peripheral
to central areas of the body.
, Stabilization of lysosomal cell membranes to reduce capillary permeability and
leukocyte migration - Glucocorticoids stabilize the cell membranes of lysosomes to
reduce capillary permeability and cell migration.
Which statement about fludrocortisone is accurate?
Fludrocortisone is a glucocorticoid that is used in the management of inflammatory
conditions such as rheumatoid arthritis.
Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity.
The anticipated onset of action of fludrocortisone is 1 to 2 hours.
When given orally, it is minimally protein bound. - ANSFludrocortisone possesses both
mineralocorticoid and glucocorticoid activity. - Fludrocortisone possesses potent
mineralocorticoid activity but also has significant glucocorticoid activity.
Which patients does a nurse determine cannot safely receive prednisone?
A 33-year-old patient with active tuberculosis
A 48-year-old patient with hypothyroidism
A 55-year-old patient with type 2 diabetes
A 59-year-old patient with dyslipidemia
A 61-year-old patient with benign prostatic hyperplasia
A 78-year-old patient with cataracts - ANSA 33-year-old patient with active tuberculosis
- Patients with an active infection like tuberculosis should not receive glucocorticoids.
Given prednisone's effect on the immune system, the body may not be able to clear the
infection.
A 78-year-old patient with cataracts - Patients with cataracts should not receive
glucocorticoids because they can worsen the cataracts.
A patient has been prescribed prednisone 10 mg PO daily for worsening systemic lupus
erythematous (SLE). The patient is also on hydroxychloroquine (for SLE) and warfarin
(for venous thromboembolism). Which effect does the nurse anticipate will occur if
prednisone is administered to this patient?
The prednisone will interact with warfarin, increasing the effects of warfarin.
The prednisone will interact with warfarin, decreasing the effects of warfarin.
The prednisone will interact with hydroxychloroquine, increasing the effects of
hydroxychloroquine.
The prednisone will interact with hydroxychloroquine, decreasing the effects of
hydroxychloroquine. - ANSThe prednisone will interact with warfarin, increasing the
effects of warfarin. - When prednisone is given with warfarin, it will likely increase the
effects of warfarin, increasing the risk for bleeding in this patient. The patient's warfarin
will need to be monitored more closely.
COMPLETE SOLUTIONS
An 18-month-old patient has been started on chemotherapy. Which means are used to
adjust the drug dosages?
Therapeutic response
Drug dosage calculator
Plasma drug concentrations
Body surface area calculation
Extrapolated from adult dosage - ANSTherapeutic response - Drug therapy must be
adjusted based on therapeutic response to chemotherapy.
Plasma drug concentrations - Drug therapy must be adjusted based on plasma drug
concentrations.
Which family-centered education techniques would the nurse use when teaching the
parents of a 12-month-old infant how to administer oral antibiotics?
Administer the drug all at once
Have parent soothe the 12-month-old patient
Disguise the drug taste with grape juice
Use an oral syringe to administer the drug
Allow the 12-month-old patient to suck on a pacifier - ANSHave parent soothe the 12-
month-old patient - The parent should maintain safe and secure positioning of the infant
(e.g., holding, rocking, cuddling, soothing).
Use an oral syringe to administer the drug - The parents should use a calibrated
dropper or an oral syringe.
Allow the 12-month-old patient to suck on a pacifier - The parents should allow self-
comforting measures as age-appropriate (e.g., use of pacifier or sucking on fingers).
Which factors increase the incidence of older adults experiencing adverse drug effects
(ADEs) from drug therapy?
Polypharmacy
Cognitive impairment
Use of drugs with wide therapeutic index
,Kidney dysfunction
Intact hepatic function - ANSPolypharmacy - Polypharmacy contributes to the increased
incidence of ADEs experienced by older adults.
Cognitive impairment - Cognitive impairment contributes to the increased incidence of
ADEs experienced by older adults.
Kidney dysfunction - Altered pharmacokinetics (e.g., decreased kidney function)
contributes to the increased incidence of ADEs experienced by older adults.
Match the drug or drug class requiring special monitoring to the condition. - ANSBladder
flow obstruction - Anticholinergics
Clotting disorders - Nonsteroidal antiinflammatory drugs (NSAIDs)
Hypertension - Over-the-counter cold products
Falls - Opioids
To reduce the incidence of polypharmacy, on which factors would the nurse educate an
older adult?
Side effects of their drugs
Interactions of each drug
The name and appearance of their drugs
Therapeutic effects of their drugs
Altering drug therapy based on symptoms - ANSSide effects of their drugs - Older
adults should be educated on the name, appearance, therapeutic effects, and side
effects of each drug.
Interactions of each drug - Older adults should be educated on potential adverse effects
and interactions of each drug.
The name and appearance of their drugs - Older adults should be educated about the
name and appearance of their drugs.
Therapeutic effects of their drugs - Older adults should be educated on the name,
appearance, therapeutic effects, and side effects of each drug.
Which considerations would the nurse use to promote drug adherence in older adults?
Recommend simple drug regimens
Speak in a sharp tone of voice
Use a font with sanserif, or "no feet and tails
Recommend keeping a drug list in purse or wallet
,Ask the pharmacy to provide containers that are easy to open - ANSRecommend
simple drug regimens - The nurse would recommend the health care provider simplify
the drug regimen for the older adult (i.e., use combination drugs to reduce the number
of pills the patient takes or use long-acting formulations to reduce the number of doses
per day).
Recommend keeping a drug list in purse or wallet - The nurse would instruct the patient
to keep a list of all drugs and bring it to all health appointments; the nurse would also
advise the older adult to keep a copy of the list in their wallet or purse.
Ask the pharmacy to provide containers that are easy to open - The nurse would ask
the pharmacist to label drug containers using a large print size and provide containers
that are easy to open by patients with impaired strength and dexterity (e.g., those with
arthritis).
Which statement accurately describes the glucocorticoid that is secreted from the
adrenal cortex along with its effect in the body?
Cortisol, which impacts carbohydrate metabolism
Aldosterone, which impacts carbohydrate metabolism
Cortisol, which maintains sodium levels and blood pressure
Aldosterone, which maintains sodium levels and blood pressure - ANSCortisol, which
impacts carbohydrate metabolism - Cortisol is a glucocorticoid that is secreted from the
adrenal cortex. It affects carbohydrate, fat, and protein metabolism.
Which statements accurately describe the actions glucocorticoids exert in the
inflammatory process?
Stimulation of erythroid cells
Maintenance of sodium levels in the blood
Reduction of interleukin-1 release from white blood cells
Promotion of protein metabolism, glycogen production, and fat redistribution
Stabilization of lysosomal cell membranes to reduce capillary permeability and
leukocyte migration - ANSStimulation of erythroid cells - Glucocorticoids are able to
stimulate the erythroid cells that eventually become red blood cells.
Reduction of interleukin-1 release from white blood cells - Glucocorticoids modulate the
inflammatory response by reducing interleukin-1 release from white cells to decrease
fever.
Promotion of protein metabolism, glycogen production, and fat redistribution - They
promote protein metabolism, glycogen production, and fat redistribution from peripheral
to central areas of the body.
, Stabilization of lysosomal cell membranes to reduce capillary permeability and
leukocyte migration - Glucocorticoids stabilize the cell membranes of lysosomes to
reduce capillary permeability and cell migration.
Which statement about fludrocortisone is accurate?
Fludrocortisone is a glucocorticoid that is used in the management of inflammatory
conditions such as rheumatoid arthritis.
Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity.
The anticipated onset of action of fludrocortisone is 1 to 2 hours.
When given orally, it is minimally protein bound. - ANSFludrocortisone possesses both
mineralocorticoid and glucocorticoid activity. - Fludrocortisone possesses potent
mineralocorticoid activity but also has significant glucocorticoid activity.
Which patients does a nurse determine cannot safely receive prednisone?
A 33-year-old patient with active tuberculosis
A 48-year-old patient with hypothyroidism
A 55-year-old patient with type 2 diabetes
A 59-year-old patient with dyslipidemia
A 61-year-old patient with benign prostatic hyperplasia
A 78-year-old patient with cataracts - ANSA 33-year-old patient with active tuberculosis
- Patients with an active infection like tuberculosis should not receive glucocorticoids.
Given prednisone's effect on the immune system, the body may not be able to clear the
infection.
A 78-year-old patient with cataracts - Patients with cataracts should not receive
glucocorticoids because they can worsen the cataracts.
A patient has been prescribed prednisone 10 mg PO daily for worsening systemic lupus
erythematous (SLE). The patient is also on hydroxychloroquine (for SLE) and warfarin
(for venous thromboembolism). Which effect does the nurse anticipate will occur if
prednisone is administered to this patient?
The prednisone will interact with warfarin, increasing the effects of warfarin.
The prednisone will interact with warfarin, decreasing the effects of warfarin.
The prednisone will interact with hydroxychloroquine, increasing the effects of
hydroxychloroquine.
The prednisone will interact with hydroxychloroquine, decreasing the effects of
hydroxychloroquine. - ANSThe prednisone will interact with warfarin, increasing the
effects of warfarin. - When prednisone is given with warfarin, it will likely increase the
effects of warfarin, increasing the risk for bleeding in this patient. The patient's warfarin
will need to be monitored more closely.
