Week 1

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1

The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?

The patient will demonstrate correct blood glucose testing technique.

2

Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?

Providing education on keeping a journal of blood pressure readings

3

When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?

The patient’s last meal

4

When giving medications, the nurse will follow the rights of medication administration, which include what rights? (Select all that apply.)

Right drug

Right route

Right dose

Right time

Right patient

Right documentation

5

The patient is to receive ounce of liquid cough medicine. Calculate the number of milliliters the patient will receive.

15 mL

1 ounce : 30 mL :: ounce : x mL

(1 ´ x) = (30 ´ ); 1x = 15; x = 15; therefore 15 mL = ounce

6

The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Thus, because they have the same absorption rates, they are

bioequivalent.

7

When given an intravenous medication, the patient says to the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best answer?

“The action of the medication will begin sooner when given intravenously.”

8

The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?

Parenteral drugs bypass the first-pass effect.

9

When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?

A pharmacologic reaction

10

When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that 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.

11

When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time

period when a drug’s concentration is sufficient to cause a therapeutic response.

12

When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. This process occurs when the drug

binds to an enzyme molecule and inhibits or enhances the enzyme’s action with the normal target cell.

13

When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient’s albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?

The duration of action of the medication will be longer.

14

The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?

Under the tongue

15

The nurse is administering medications to the patient who is in liver failure resulting from end-stage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase?

Metabolism

16

A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?

Palliative therapy

17

The nurse administered a sleeping pill to an elderly patient at bedtime. Two hours later, the patient was irritable, restless, and unable to sleep. The nurse describes the patient’s response as which type of reaction?

Idiosyncratic reaction

18

The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?

A powder

19

The nurse will be injecting a drug into the fatty tissue of the patient’s abdomen. Which route does this describe?

Sub Q

20

Which drugs would be affected by the first-pass effect? (Select all that apply.)

elixir

tablets

capsules

21

A drug dose that delivers 750 mg has a half-life of 4 hours. How much drug will remain in the body after one half-life?

375mg

22

Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

Increased amount of protein-bound drug in maternal circulation

23

The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration (FDA) pregnancy safety category?

Category D

24

When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?

Mg/kg formula

25

The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?

The patient uses multiple medications simultaneously

26

The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?

Sedatives

27

For accurate medication administration to pediatric patients, the nurse must take into account which criteria?

Organ maturity

28

The nurse recognizes that it is not uncommon for an elderly patient to experience a reduction in the stomach’s ability to produce hydrochloric acid. This change may result in which effect?

Altered absorption of weakly acidic drugs

29

The nurse is administering drugs to neonates and will consider which factor that may contribute the most to drug toxicity?

The liver is not fully developed.

30

An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems?

Fatigue, leg cramps, and dehydration

31

An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?

The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.

32

The nurse is trying to give a liquid medication to a 2-year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child?

Give the medication with spoonfuls of ice cream

33

The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age-appropriate for this child?

Offer a brief, concrete explanation of the procedure at the patient’s level and with the parent or caregiver present.

34

Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.)

The levels of microsomal enzymes are decreased.

Perfusion to the kidneys may be decreased and may result in reduced renal function.

First-pass elimination is reduced because of the immaturity of the liver.

Gastric emptying is slowed because of slow or irregular peristalsis.

35

Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)

The levels of microsomal enzymes are decreased.

Fat content is increased because of decreased lean body mass.

The number of intact nephrons is decreased.

Gastric pH is less acidic.

36

A 7-year-old child will be receiving amoxicillin (Amoxil) 80 mg/kg/day in 2 divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 50 mg/mL. How many milliliters will the child receive per dose?

20 mL

Convert pounds to kilograms: 55 pounds = 25 kg

25 kg ´ 80 mg/kg/day = 2000 mg/day.

To get the amount per dose, divide 2000 by 2, which equals 1000 mg/dose.

To calculate the milliliters:

50 mg : 1 mL :: 1000 mg : x mL

(50 ´ x) = (1 ´ 1000); 50x = 1000; x = 20; give 20 mL per dose

37

During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug’s usefulness

A placebo

38

A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study?

Phase I

39

During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III?

The patient may have no more than 5 refills in a 6-month period.

40

A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates that the patient

has had the study’s purpose, procedures, and the risks involved explained to him.

41

For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits?

Native Americans

42

The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects?

The nurse’s assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.

43

When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs?

Drugs with high potential for abuse that have accepted medical use

44

The nurse is reviewing facts about pharmacology for a review course. The term legend drug refers to which item?

Prescription drugs

45

Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as?

Veracity

46

A patient is undergoing major surgery and asks the nurse about a living will. He states, “I don’t want anybody else making decisions for me. And I don’t want to prolong my life.” The patient is demonstrating which ethical term?

Autonomy

47

The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on the list. Which is a characteristic of Schedule C-I drugs?

Are used only with approved protocols

48

During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for

nursing negligence

49

The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drug polymorphism? (Select all that apply.)

Inherited factors

The patient’s diet and nutritional status

The patient’s health beliefs and practices

50

The nurse is performing an admission assessment. Which findings reflect components of a cultural assessment? (Select all that apply.)

The patient uses aspirin as needed for pain.

The patient uses herbal tea to relax in the evenings.

The patient does not eat pork products for religious reasons.

The patient does not speak English.

51

The nurse is reviewing medication errors. Which situation is an example of a medication error?

A patient receives a double dose of a medication because the nurse did not cut the pill in half.

52

The nurse is transcribing a verbal medication order. Which is the proper notation of the dose of the drug ordered?

Digoxin 0.125 mg

53

When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?

“Let me check on the order first before you take it.”

54

The prescriber has written admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber’s handwriting. Which is the best action for the nurse to take at this time?

Contact the prescriber to clarify the order.

55

When taking a telephone order for a medication, which action by the nurse is most appropriate?

Repeat the order to the prescriber before hanging up the telephone.

56

The nurse can prevent medication errors by following which principles? (Select all that apply.)

Use two patient identifiers before giving medications.

Do not give a medication that another nurse has drawn up in a syringe.

Minimize the use of verbal and telephone orders.

57

Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication?

Deficient knowledge related to newly prescribed drug therapy

58

The nurse is developing a care plan for a patient who will be self-administering insulin injections. Which statement reflects a measurable goal?

The patient will demonstrate the proper technique of self-administering insulin injections.

59

During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?

“What medications do you take?”

60

The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?

Develop large-print handouts that reflect the verbal information presented.

61

When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?

After demonstrating the procedure, allow the patient to do several return demonstrations.

62

A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?

Cognitive

63

During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?

A translator who does not know the patient

64

The nurse is teaching a 16-year-old patient who has a new diagnosis of type 1 diabetes about blood glucose monitoring and the importance of regulating glucose intake. When developing a teaching plan for this teenager, which of Erikson’s stages of development should the nurse consider?

Identity versus role confusion

65

A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation?

Assisting the patient with obtaining and learning to use a calendar or pill container

66

Which are appropriate considerations when the nurse is assessing the learning needs of a patient? (Select all that apply.)

Cultural background

Level of education

Readiness to learn

Health beliefs

67

A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mg strength. How many tablets will the patient receive?

3 tablets

1 tablet : 2.5 mg :: x tablet : 7.5 mg

(1 ´ 7.5) = (2.5 ´ x); 7.5 = 2.5x; x = 3; therefore 7.5 mg = 3 tablets

68

A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go “natural” with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can “avoid taking any drugs.” Which statement by the nurse is correct?

“It’s important to remember that herbal remedies do not have proven safety ratings for pregnant women.”

69

The patient is asking the nurse about current U.S. laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act (DSHEA) of 1994, which statement is true?

Medicinal herbs are viewed as dietary supplements.

70

The patient wants to take the herb valerian to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs?

Sedatives

71

The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had “stomach problems” for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?

“Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider.”

72

During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic?

Insulin

73

A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements?

It may reduce elimination of drugs that are excreted by the kidneys.

74

A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs?

Anticoagulants

75

The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.)

Use of OTC drugs may delay treatment of serious ailments.

OTC drugs may relieve symptoms without addressing the cause of the problem.

Patients may misunderstand product labels and use the drugs improperly.

76

The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the-counter status in the United States are accurate? (Select all that apply.)

The drug must be easy to use.

The consumer must be able to monitor the drug’s effectiveness.

The drug must have a low potential for abuse.