Chapter 01: Nursing Practice in Canada and Drug Therapy
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
MULTIPLE CHOICE
1. Which is a judgement about a particular patient‘s potential need or
problem?
a. A goal
b. An assessment
c. Subjective data
d. A nursing diagnosis
ANS: D
Nursing diagnosis is the phase of the nursing process during which
a clinical judgement is made about how a patient responds to heath conditions and life
processes or vulnerability forthat response.
DIF: Cognitive Level: Knowledge REF: p. 11
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is
unable to swallow, he cannot take medication orally, as ordered. The nurse needs to contact
the physician. What type of problem is this?
a. A ―right time‖ problem
b. A ―right dose‖ problem
c. A ―right route‖ problem
d. A ―right medication‖ problem
ANS: C
This is a ―right route‖ problem: the nurse cannot assume the route and must clarify the route
with the prescriber. This is not a ―right time‖ problem because the ordered frequency has not
changed. This is not a ―right dose‖ problem because the dose is not related to an inability to
swallow. This is not a ―right medication‖ problem because the medication ordered will not
change, just the route.
DIF: Cognitive Level: Application REF: p. 14
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first
dose and has been documenting signs of possible adverse effects. What nursing process phase
is the nurse practising?
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis
ANS: B
Monitoring the patient‘s progress is part of the evaluation phase. Planning, implementation,
and nursing diagnosis are not illustrated by this example.
DIF: Cognitive Level: Application REF: p. 19
,4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient adheres to the new insulin treatment regimen.
d. The patient demonstrates safe insulin self-administration technique.
ANS: D
Having the patient demonstrate safe insulin self-administration technique is a specific and
measurable outcome criterion. Following instructions and avoiding complications are not
specific criteria. Adherence to the new insulin treatment regimen is not objective and would
be difficult to measure.
DIF: Cognitive Level: Application REF: p. 13
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with type 1 diabetes mellitus?
a. Providing education regarding self-injection technique
b. Setting goals and outcome criteria with the patient‘s input
c. Recording a history of over-the-counter medications used at home
d. Formulating nursing diagnoses regarding knowledge deficits related to the new
treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcome criteria reflects the planning phase. Recording a drug history reflects the assessment
phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analysis of data
as part of the planning phase.N
DIF: Cognitive Level: Analysis REF: p. 8 | p. 13
6. The nurse is working during a very busy night shift, and the health care provider has just
given the nurse a medication order over the telephone, but the nurse does not recall the route.
What is the best way for the nurse to avoid medication errors?
a. Recopy the order neatly on the order sheet, with the most common route indicated
b. Consult with the pharmacist for clarification about the most common route
c. Call the health care provider to clarify the route of administration
d. Withhold the drug until the health care provider visits the patient
ANS: C
If a medication order does not include the route, the nurse must ask the health care provider to
clarify it. Never assume the route of administration.
DIF: Cognitive Level: Application | Cognitive Level: Analysis REF: p. 17
7. Which constitutes the traditional Five Rights of medication administration?
a. Right drug, right route, right dose, right time, and right patient
b. Right drug, the right effect, the right route, the right time, and the right patient
c. Right patient, right strength, right diagnosis, right drug, and right route
d. Right patient, right diagnosis, right drug, right route, and right time
ANS: A
, The traditional Five Rights of medication administration were considered to be Right drug,
Right route, Right dose, Right time, and Right patient. Right effect, right strength, and right
diagnosis are not part of the traditional Five Rights.
DIF: Cognitive Level: Comprehension REF: p. 13
8. What correctly describes the nursing process?
a. Diagnosing, planning, assessing, implementing, and finally evaluating
b. Assessing, then diagnosing, implementing, and ending with evaluating
c. A linear direction that begins with assessing and continues through diagnosing,
planning, and finally implementing
d. An ongoing process that begins with assessing and continues with diagnosing,
planning, implementing, and evaluating
ANS: D
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that
begins with assessing and continues through diagnosing, planning, implementing, and finally
evaluating, which may then lead back to any of the other phases.
DIF: Cognitive Level: Application REF: p. 8
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
a. The patient‘s identification
b. The patient‘s weight
c. The patient‘s last meal
d. Any drug or food allergies
ANS: C
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with
regard to any drug–food interactions or compatibility issues. The patient‘s identification,
weight, and drug or food allergies are not affected by the drug‘s timing.
DIF: Cognitive Level: Application REF: p. 17
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for
her nursing diagnosis?
a. Anxiety
b. Anxiety related to new drug therapy
c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements
such as ―I‘m upset about having to give myself shots‖
d. Anxiety related to new drug therapy, as evidenced by statements such as ―I‘m
upset about having to give myself shots‖
ANS: D
, Formulation of nursing diagnoses is usually a three-step process. The only complete answer is
―Anxiety related to new drug therapy, as evidenced by statements such as ‗I‘m upset about
having to give myself shots.‘‖ The answer ―Anxiety‖ is missing the ―related to‖ and ―as
evidenced by‖ portions. The answer ―Anxiety related to new drug therapy‖ is missing the ―as
evidenced by‖ portion of defining characteristics. The ―related to‖ section in ―Anxiety related
to anxious feelings about drug therapy, as evidenced by statements such as ‗I‘m upset about
having to give myself shots‘‖ is simply a restatement of the problem ―anxiety,‖ not a separate
factor related to the response.
DIF: Cognitive Level: Analysis REF: p. 9
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
DIF: Cognitive Level: Analysis REF: p. 9
,Chapter 02: Pharmacological Principles
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
MULTIPLE CHOICE
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are
both absorbed into the circulation in identical amounts. Which term best denotes that the
drugs have the same absorption rates?
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. ―Equivalent‖ is incorrect because the
term ―bioavailability‖ is used to express the extent of drug absorption. ―Synergistic‖ is
incorrect because this term refers to two drugs given together whose resulting effect is greater
than the sum of the effects of each drug given alone. ―Compatible‖ is incorrect because this
term is a general term used to indicate that two substances do not have a chemical reaction
when mixed (or given, in the case of drugs) together.
DIF: Cognitive Level: Comprehension REF: p. 26
2. A patient is receiving medication via intravenous injection. Which information should the
nurse provide for patient education?
fN
a. The medication will cause U eR
ewS dIv e rTs e effecOts when given intravenously.
r aN
b. The medication will be absorbed slowly into the tissues over time.
c. The medication‘s action will begin faster when given intravenously.
d. Most of the drug is inactivated by the liver before it reaches the target area.
ANS: C
Intravenous injections are the fastest route of absorption. The intravenous route does not
affect the number of adverse effects, the intravenous route is not a slow route of absorption,
and the intravenous route does not cause inactivation of the drug by the liver before it reaches
the target area.
DIF: Cognitive Level: Comprehension REF: p. 32
3. Which is true regarding parenteral drugs?
a. They bypass the first-pass effect.
b. They decrease blood flow to the stomach.
c. They are altered by the presence of food in the stomach.
d. They exert their effects while circulating in the bloodstream.
ANS: A
, Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed
into cells and tissues before they can exert their effects. Enteral drugs (drugs taken orally), not
parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food
in the stomach. 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.
DIF: Cognitive Level: Analysis REF: p. 32
4. A drug‘s half-life is best defined as
a. The time it takes for the drug to elicit half its therapeutic response.
b. The time it takes one-half of the original amount of a drug to reach the target cells.
c. The time it takes one-half of the original amount of a drug to be removed from the
body.
d. The time it takes one-half of the original amount of a drug to be absorbed into the
circulation.
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.
Answers A, B, and D are not correct definitions of a drug‘s half-life.
DIF: Cognitive Level: Comprehension REF: p. 36
5. The term ―duration of action‖ is best defined as
a. The time it takes for the drug to elicit a therapeutic response.
b. The time it takes a drug to reach its maximum therapeutic response.
c. The length of time it tak eN
sUtoRreSmIoN
veGaTdBru.gCfrO
oM
m circulation.
d. The time during which drug concentration is sufficient to elicit a therapeutic
response.
ANS: D
Duration of action is the time during which drug concentration is sufficient to elicit a
therapeutic response. The time it takes for a drug to elicit a therapeutic response is the drug‘s
―onset of action.‖ The time it takes a drug to reach its maximum therapeutic response is a
drug‘s ―peak effect.‖ ―The length of time it takes to remove a drug from circulation‖ defines a
drug‘s elimination and does not correctly define a drug‘s duration of action.
DIF: Cognitive Level: Comprehension REF: p. 37
6. A drug interacts with enzymes by
a. altering cell membrane permeability.
b. ―fooling‖ a receptor on the cell wall.
c. enhancing the drug‘s effectiveness within the cells.
d. ―fooling‖ the enzyme into binding with it instead of its normal target cell.
ANS: D
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
MULTIPLE CHOICE
1. Which is a judgement about a particular patient‘s potential need or
problem?
a. A goal
b. An assessment
c. Subjective data
d. A nursing diagnosis
ANS: D
Nursing diagnosis is the phase of the nursing process during which
a clinical judgement is made about how a patient responds to heath conditions and life
processes or vulnerability forthat response.
DIF: Cognitive Level: Knowledge REF: p. 11
2. The patient is to receive oral furosemide (Lasix) every day; however, because the patient is
unable to swallow, he cannot take medication orally, as ordered. The nurse needs to contact
the physician. What type of problem is this?
a. A ―right time‖ problem
b. A ―right dose‖ problem
c. A ―right route‖ problem
d. A ―right medication‖ problem
ANS: C
This is a ―right route‖ problem: the nurse cannot assume the route and must clarify the route
with the prescriber. This is not a ―right time‖ problem because the ordered frequency has not
changed. This is not a ―right dose‖ problem because the dose is not related to an inability to
swallow. This is not a ―right medication‖ problem because the medication ordered will not
change, just the route.
DIF: Cognitive Level: Application REF: p. 14
3. The nurse has been monitoring the patient‘s progress on his new drug regimen since the first
dose and has been documenting signs of possible adverse effects. What nursing process phase
is the nurse practising?
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis
ANS: B
Monitoring the patient‘s progress is part of the evaluation phase. Planning, implementation,
and nursing diagnosis are not illustrated by this example.
DIF: Cognitive Level: Application REF: p. 19
,4. The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient adheres to the new insulin treatment regimen.
d. The patient demonstrates safe insulin self-administration technique.
ANS: D
Having the patient demonstrate safe insulin self-administration technique is a specific and
measurable outcome criterion. Following instructions and avoiding complications are not
specific criteria. Adherence to the new insulin treatment regimen is not objective and would
be difficult to measure.
DIF: Cognitive Level: Application REF: p. 13
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with type 1 diabetes mellitus?
a. Providing education regarding self-injection technique
b. Setting goals and outcome criteria with the patient‘s input
c. Recording a history of over-the-counter medications used at home
d. Formulating nursing diagnoses regarding knowledge deficits related to the new
treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcome criteria reflects the planning phase. Recording a drug history reflects the assessment
phase. Formulating nursing diagnoses regarding a knowledge deficit reflects analysis of data
as part of the planning phase.N
DIF: Cognitive Level: Analysis REF: p. 8 | p. 13
6. The nurse is working during a very busy night shift, and the health care provider has just
given the nurse a medication order over the telephone, but the nurse does not recall the route.
What is the best way for the nurse to avoid medication errors?
a. Recopy the order neatly on the order sheet, with the most common route indicated
b. Consult with the pharmacist for clarification about the most common route
c. Call the health care provider to clarify the route of administration
d. Withhold the drug until the health care provider visits the patient
ANS: C
If a medication order does not include the route, the nurse must ask the health care provider to
clarify it. Never assume the route of administration.
DIF: Cognitive Level: Application | Cognitive Level: Analysis REF: p. 17
7. Which constitutes the traditional Five Rights of medication administration?
a. Right drug, right route, right dose, right time, and right patient
b. Right drug, the right effect, the right route, the right time, and the right patient
c. Right patient, right strength, right diagnosis, right drug, and right route
d. Right patient, right diagnosis, right drug, right route, and right time
ANS: A
, The traditional Five Rights of medication administration were considered to be Right drug,
Right route, Right dose, Right time, and Right patient. Right effect, right strength, and right
diagnosis are not part of the traditional Five Rights.
DIF: Cognitive Level: Comprehension REF: p. 13
8. What correctly describes the nursing process?
a. Diagnosing, planning, assessing, implementing, and finally evaluating
b. Assessing, then diagnosing, implementing, and ending with evaluating
c. A linear direction that begins with assessing and continues through diagnosing,
planning, and finally implementing
d. An ongoing process that begins with assessing and continues with diagnosing,
planning, implementing, and evaluating
ANS: D
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step process that
begins with assessing and continues through diagnosing, planning, implementing, and finally
evaluating, which may then lead back to any of the other phases.
DIF: Cognitive Level: Application REF: p. 8
9. When the nurse is considering the timing of a drug dose, which is most important to assess?
a. The patient‘s identification
b. The patient‘s weight
c. The patient‘s last meal
d. Any drug or food allergies
ANS: C
The pharmacokinetic and pharmacodynamic properties of the drug need to be assessed with
regard to any drug–food interactions or compatibility issues. The patient‘s identification,
weight, and drug or food allergies are not affected by the drug‘s timing.
DIF: Cognitive Level: Application REF: p. 17
10. The nurse is writing nursing diagnoses for a plan of care. Which reflects the correct format for
her nursing diagnosis?
a. Anxiety
b. Anxiety related to new drug therapy
c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements
such as ―I‘m upset about having to give myself shots‖
d. Anxiety related to new drug therapy, as evidenced by statements such as ―I‘m
upset about having to give myself shots‖
ANS: D
, Formulation of nursing diagnoses is usually a three-step process. The only complete answer is
―Anxiety related to new drug therapy, as evidenced by statements such as ‗I‘m upset about
having to give myself shots.‘‖ The answer ―Anxiety‖ is missing the ―related to‖ and ―as
evidenced by‖ portions. The answer ―Anxiety related to new drug therapy‖ is missing the ―as
evidenced by‖ portion of defining characteristics. The ―related to‖ section in ―Anxiety related
to anxious feelings about drug therapy, as evidenced by statements such as ‗I‘m upset about
having to give myself shots‘‖ is simply a restatement of the problem ―anxiety,‖ not a separate
factor related to the response.
DIF: Cognitive Level: Analysis REF: p. 9
OTHER
1. Place the phases of the nursing process in the correct order, starting with the first phase.
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
DIF: Cognitive Level: Analysis REF: p. 9
,Chapter 02: Pharmacological Principles
Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
MULTIPLE CHOICE
1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are
both absorbed into the circulation in identical amounts. Which term best denotes that the
drugs have the same absorption rates?
a. Equivalent
b. Synergistic
c. Compatible
d. Bioequivalent
ANS: D
Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. ―Equivalent‖ is incorrect because the
term ―bioavailability‖ is used to express the extent of drug absorption. ―Synergistic‖ is
incorrect because this term refers to two drugs given together whose resulting effect is greater
than the sum of the effects of each drug given alone. ―Compatible‖ is incorrect because this
term is a general term used to indicate that two substances do not have a chemical reaction
when mixed (or given, in the case of drugs) together.
DIF: Cognitive Level: Comprehension REF: p. 26
2. A patient is receiving medication via intravenous injection. Which information should the
nurse provide for patient education?
fN
a. The medication will cause U eR
ewS dIv e rTs e effecOts when given intravenously.
r aN
b. The medication will be absorbed slowly into the tissues over time.
c. The medication‘s action will begin faster when given intravenously.
d. Most of the drug is inactivated by the liver before it reaches the target area.
ANS: C
Intravenous injections are the fastest route of absorption. The intravenous route does not
affect the number of adverse effects, the intravenous route is not a slow route of absorption,
and the intravenous route does not cause inactivation of the drug by the liver before it reaches
the target area.
DIF: Cognitive Level: Comprehension REF: p. 32
3. Which is true regarding parenteral drugs?
a. They bypass the first-pass effect.
b. They decrease blood flow to the stomach.
c. They are altered by the presence of food in the stomach.
d. They exert their effects while circulating in the bloodstream.
ANS: A
, Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed
into cells and tissues before they can exert their effects. Enteral drugs (drugs taken orally), not
parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food
in the stomach. 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.
DIF: Cognitive Level: Analysis REF: p. 32
4. A drug‘s half-life is best defined as
a. The time it takes for the drug to elicit half its therapeutic response.
b. The time it takes one-half of the original amount of a drug to reach the target cells.
c. The time it takes one-half of the original amount of a drug to be removed from the
body.
d. The time it takes one-half of the original amount of a drug to be absorbed into the
circulation.
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.
Answers A, B, and D are not correct definitions of a drug‘s half-life.
DIF: Cognitive Level: Comprehension REF: p. 36
5. The term ―duration of action‖ is best defined as
a. The time it takes for the drug to elicit a therapeutic response.
b. The time it takes a drug to reach its maximum therapeutic response.
c. The length of time it tak eN
sUtoRreSmIoN
veGaTdBru.gCfrO
oM
m circulation.
d. The time during which drug concentration is sufficient to elicit a therapeutic
response.
ANS: D
Duration of action is the time during which drug concentration is sufficient to elicit a
therapeutic response. The time it takes for a drug to elicit a therapeutic response is the drug‘s
―onset of action.‖ The time it takes a drug to reach its maximum therapeutic response is a
drug‘s ―peak effect.‖ ―The length of time it takes to remove a drug from circulation‖ defines a
drug‘s elimination and does not correctly define a drug‘s duration of action.
DIF: Cognitive Level: Comprehension REF: p. 37
6. A drug interacts with enzymes by
a. altering cell membrane permeability.
b. ―fooling‖ a receptor on the cell wall.
c. enhancing the drug‘s effectiveness within the cells.
d. ―fooling‖ the enzyme into binding with it instead of its normal target cell.
ANS: D
