D116 Comprehensive assessment with explanations
Study online at https://quizlet.com/_cg5p9y
1. Which factors could be attributed to lim- Inaccessibility of patient care
ited prescriptive authority for APRNs?Se- Feedback: Limiting prescriptive authority for
lect all that apply. APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to
poor collaboration among providers and higher
health care costs. It would not directly impact
patient's health literacy.
Higher health care costs
Feedback: Limiting prescriptive authority for
APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to
poor collaboration among providers and higher
health care costs. It would not directly impact
patient's health literacy.
2. A patient reports that a medica- Ask the patient about the number and frequency
tion prescribed for recurrent migraine of tablets taken
headaches is not working. Which action Feedback: using the drug as ordered. Asking the
should be taken first? patient to tell the nurse how many tablets are
taken and how often helps the nurse determine
compliance. Assessing current pain does not
yield information about how well the medication
is working unless the patient is currently taking
it. The nurse should gather as much information
about compliance, symptoms, and drug effec-
tiveness as possible before contacting the pre-
scriber. Biofeedback may be an effective adjunct
to treatment, but it should not be recommended
without complete information about drug effec-
tiveness
3.
, D116 Comprehensive assessment with explanations
Study online at https://quizlet.com/_cg5p9y
A patient is receiving intravenous gen- The patient is taking another medication that
tamicin. A serum drug test reveals tox- binds to serum albumin
ic levels. The dosing is correct, and this Feedback: Gentamicin binds to albumin, but
medication has been tolerated bythis pa- only weakly, and in the presence of another
tient inthe past. Which could be a prob- drug that binds to albumin, it can rise to toxic
able cause of the test result? levels in blood serum. A loading dose increases
the initial amount ofa drug and is used to bring
drug levels to the desired plateau more quickly.
A drug that is not completely dissolved carries
a risk of causing embolism. A drug given at
a frequency longer than the drug half-life will
likely be at subtherapeutic levels and not at toxic
levels
4. The nurse is administering morning Binding of one or both agents will be reduced
medications. The nurse gives a patient Plasma levels of free drug will rise
multiple medications, two of which com- The increase in free drug will intensify effects
pete for plasma albumin receptor sites. Feedback: When two drugs bind to the same
As a result of this concurrent administra- site on plasma albumin, coadministration of
tion, the nurse can anticipate that what those drugs produces competition for binding.
might occur? Select all that apply As a result, binding of one or both agents is
reduced, causing plasma levels of free drug to
rise. The increase in free drug can intensify the
effect, but it usually undergoes rapid elimina-
tion. The increase in plasma levels of free drug
is rarely sustained.
5. Which patients are at increased risk for A 2-month-old infant taking a medication for
adverse drug events? Select all that ap- gastroesophageal reflux disease
ply A 40-year-old male who is intubated in the in-
tensive care unit and taking antibiotics and car-
diac medications
, D116 Comprehensive assessment with explanations
Study online at https://quizlet.com/_cg5p9y
A 7-year-old female receiving insulin for dia-
betes
An 80-year-old male taking medications for
COPD
Feedback: Patients at increased risk for adverse
drug events include the very young, the very old,
and those who have serious illnesses. Females,
children, and young adults taking single med-
ications do not have increased risk for adverse
events.
6. A patient asks a nurse why a friend who metabolism of drugs
is taking the same drug responds differ- Feedback: The most common source of genetic
ently to that drug. The nurse knows that variation in drug response is related to alter-
the most common variation in drug re- ations in drug metabolism and is determined
sponse is due to differences in each pa- by genetic codes for various drug-metaboliz-
tient's: ing isoenzymes. There are known genetic dif-
ferences in codes for drug target sites, but
these are not as numerous asthose for metabol-
ic isoenzymes. Hypersensitivity potential is also
genetically determined, but variations produce
differences in adverse reactions to drugs and
not in drug effectiveness. Psychosocial respons-
es vary for many less measurable reasons, such
as individual personalities and variations in cul-
tures
7. A patient with migraines is started on "I need to take it every day to reduce the fre-
a beta blocker. The nurse explains the quency of migraines."
benefits of taking the medication for mi- Feedback: When taken prophylactically, med-
graines. Which statement by the patient ications such as beta blockers can reduce the
frequency of migraine attacks. They do not pro-
Study online at https://quizlet.com/_cg5p9y
1. Which factors could be attributed to lim- Inaccessibility of patient care
ited prescriptive authority for APRNs?Se- Feedback: Limiting prescriptive authority for
lect all that apply. APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to
poor collaboration among providers and higher
health care costs. It would not directly impact
patient's health literacy.
Higher health care costs
Feedback: Limiting prescriptive authority for
APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to
poor collaboration among providers and higher
health care costs. It would not directly impact
patient's health literacy.
2. A patient reports that a medica- Ask the patient about the number and frequency
tion prescribed for recurrent migraine of tablets taken
headaches is not working. Which action Feedback: using the drug as ordered. Asking the
should be taken first? patient to tell the nurse how many tablets are
taken and how often helps the nurse determine
compliance. Assessing current pain does not
yield information about how well the medication
is working unless the patient is currently taking
it. The nurse should gather as much information
about compliance, symptoms, and drug effec-
tiveness as possible before contacting the pre-
scriber. Biofeedback may be an effective adjunct
to treatment, but it should not be recommended
without complete information about drug effec-
tiveness
3.
, D116 Comprehensive assessment with explanations
Study online at https://quizlet.com/_cg5p9y
A patient is receiving intravenous gen- The patient is taking another medication that
tamicin. A serum drug test reveals tox- binds to serum albumin
ic levels. The dosing is correct, and this Feedback: Gentamicin binds to albumin, but
medication has been tolerated bythis pa- only weakly, and in the presence of another
tient inthe past. Which could be a prob- drug that binds to albumin, it can rise to toxic
able cause of the test result? levels in blood serum. A loading dose increases
the initial amount ofa drug and is used to bring
drug levels to the desired plateau more quickly.
A drug that is not completely dissolved carries
a risk of causing embolism. A drug given at
a frequency longer than the drug half-life will
likely be at subtherapeutic levels and not at toxic
levels
4. The nurse is administering morning Binding of one or both agents will be reduced
medications. The nurse gives a patient Plasma levels of free drug will rise
multiple medications, two of which com- The increase in free drug will intensify effects
pete for plasma albumin receptor sites. Feedback: When two drugs bind to the same
As a result of this concurrent administra- site on plasma albumin, coadministration of
tion, the nurse can anticipate that what those drugs produces competition for binding.
might occur? Select all that apply As a result, binding of one or both agents is
reduced, causing plasma levels of free drug to
rise. The increase in free drug can intensify the
effect, but it usually undergoes rapid elimina-
tion. The increase in plasma levels of free drug
is rarely sustained.
5. Which patients are at increased risk for A 2-month-old infant taking a medication for
adverse drug events? Select all that ap- gastroesophageal reflux disease
ply A 40-year-old male who is intubated in the in-
tensive care unit and taking antibiotics and car-
diac medications
, D116 Comprehensive assessment with explanations
Study online at https://quizlet.com/_cg5p9y
A 7-year-old female receiving insulin for dia-
betes
An 80-year-old male taking medications for
COPD
Feedback: Patients at increased risk for adverse
drug events include the very young, the very old,
and those who have serious illnesses. Females,
children, and young adults taking single med-
ications do not have increased risk for adverse
events.
6. A patient asks a nurse why a friend who metabolism of drugs
is taking the same drug responds differ- Feedback: The most common source of genetic
ently to that drug. The nurse knows that variation in drug response is related to alter-
the most common variation in drug re- ations in drug metabolism and is determined
sponse is due to differences in each pa- by genetic codes for various drug-metaboliz-
tient's: ing isoenzymes. There are known genetic dif-
ferences in codes for drug target sites, but
these are not as numerous asthose for metabol-
ic isoenzymes. Hypersensitivity potential is also
genetically determined, but variations produce
differences in adverse reactions to drugs and
not in drug effectiveness. Psychosocial respons-
es vary for many less measurable reasons, such
as individual personalities and variations in cul-
tures
7. A patient with migraines is started on "I need to take it every day to reduce the fre-
a beta blocker. The nurse explains the quency of migraines."
benefits of taking the medication for mi- Feedback: When taken prophylactically, med-
graines. Which statement by the patient ications such as beta blockers can reduce the
frequency of migraine attacks. They do not pro-
