lilley.
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,Chapter01:The Nursing Processand Drug Therapy
Lilley: Pharmacologyand theNursing Process,10thEdition
MULTIPLE CHOICE
1. The nurse is developing a human needs statement for a patient who has a new diagnosis of heart
failure.Identificationof humanneedsstatementsoccur with which of theseactivities?
a. Collectionof patientdata
b. Administeringinterventions
c. Deciding on patientoutcomes
d. Documentingthepatient‘sbehavior
ANS: A
Identificationof humanneedsoccurswith thecollectionof patientdata.
DIF: CognitiveLevel:Understanding(Comprehension)
TOP: Nursing Process: Human Needs Statement
MSC: NCLEX: Safeand EffectiveCare Environment:Managementof Care
2. The patientis to receiveoral guaifenesintwicea day. Today, thenursewasbusyand gavethe
medication 2 hours after the scheduled dose was due. What type of problem does
represent?
this
a. ―Right time‖
b. ―Right dose‖
c. ―Right route‖
d. ―Right medication‖
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
administrationis
scheduled.―Route‖ is incorrectbecausetherouteis not affected.
―Medication‖ is incorrectbecausethemedicationorderedwill notchange.
DIF: CognitiveLevel:Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safeand EffectiveCare Environment:Safetyand InfectionControl
3. The nurse has been monitoring the patient‘s progress on a new drug regimen since the first dose
and documentingthepatient‘stherapeuticresponseto themedication.Which phaseof the
nursing process do these actions illustrate?
a. Human needsstatement
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,b. Planning
c. Implementation
d. Evaluation
ANS: D
Monitoring the patient‘sprogress,including the patient‘sresponseto the medication,is part of the
evaluationphase.Planning, implementation,and human needsstatementare not illustrated by this
example.
DIF: CognitiveLevel:Understanding(Comprehension) TOP: Nursing Process:Evaluation
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, MSC: NCLEX: Safeand EffectiveCare Environment:Managementof Care
4. The nurseis assignedto apatientwho is newlydiagnosedwith type1 diabetesmellitus. Which
statement best illustrates an outcome criterion for this patient?
a. The patient will followinstructions.
b. The patientwill not experiencecomplications.
c. The patientwill adhereto thenewinsulin treatmentregimen.
d. The patientwill demonstratecorrectbloodglucosetestingtechnique.
ANS: D
―Demonstrating correct blood glucose ‖ is a specific and measurable
testing technique outcome
criterion.―Followinginstructions‖ and ―notexperiencingcomplications‖ arenot specific criteria.
―Adhering to new regimen ‖ would be difficult to measure.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. Which activitybestreflectstheimplementationphaseof thenursing processfor thepatient who is
newly diagnosed with hypertension?
a. Providing education onkeepinga journal ofblood pressurereadings
b. Settinggoalsand outcomecriteriawith thepatient‘sinput
c. Recordinga drug historyregardingover-the-countermedicationsusedat home
d. Formulatinghumanneedsstatementsregardingdeficientknowledgerelatedto the new
treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and outcome
reflectstheplanningphase.Recordinga drug historyreflectstheassessmentphase. Formulating human
needs statements reflects analysis of data as part of planning.
DIF: CognitiveLevel:Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safeand EffectiveCare Environment:Managementof Care
―Give ondansetron 4 mg, 30 minutes before beginning
6. The medication order reads,
chemotherapyto prevent nausea.‖ The nursenotes thattherouteis missing fromtheorder. What
is the nurse‘s best action?
a. Give themedicationintravenouslybecausethe patientmight vomit.
b. Give themedicationorally becausethetabletsare availablein 4-mg doses.
c. Contacttheprescriber to clarify
therouteof themedicationordered.
d. Hold themedication untiltheprescriberreturnsto makerounds.
ANS: C
A completemedicationorderincludestherouteof administration.If a medicationorderdoes not
includetheroute,thenursemustask theprescriberto clarify it. The intravenousand oral routes are
not interchangeable. Holding the medication until the prescriber returns would mean that the
patient would not receive a needed medication.
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