Pharmacology Exam I

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Which of the following is of highest priority when obtaining a pharmacology history from a patient?

allergies

When administering medications to a patient, which action will the nurse perform?

Check the patients armband before administering the medication

List one activity the nurse is responsible for during the evaluation phase of drug administration.

Monitor the patient continuously for therapeutic as well as adverse effects.

The nurse is caring for Mrs. Smith, a 72 year old woman. Assuming all of the following statements are true, which documented note is appropriate?

Mrs. Smith received 4 units of regular insulin to treat morning capillary blood glucose level of 210 milligrams/dL

The nurse should include which information when evaluating the outcome after a patient's medication has been administered?

Medication effect on the patient

The nurse has an order for administering a medication to her patient. Which providers have legal authority to prescribe medications for patients?

physician, dentist, physician assistant, nurse practitioner

The nurse should check a medication how many times prior to administration of a medication under the "right drug" part of Six Rights?

three times

The nurse notes that a medication was scheduled to be administered at 0900. A medication error has occurred if the medication was administered at which time?

0800

What is the study of the physiochemical properties of drugs and how they influence the body called?

Pharmacodynamics

Pharmacokinetics involves the study of __________.

distribution rates among various body compartments

How can drugs exert their action on the body?

interact with receptors, inhibit the action of a specific enzyne, alter the metabolic process

Which is an alternate name for biotransformation of a drug?

metabolism

A drug given by which route is altered by first pass effect?

oral

Drug half-life is defined as the amount of time required for 50% of a drug to _________________.

be eliminated by the body

Which action will increase the absorption of a medication administered intramuscularly?

massage the site after injection

Highly protein bound drugs ___________________.

increase the risk of drug-drug interaction

To achieve the most rapid onset of action, by which route will the health care provider administer medication?

intravenously

Patients with renal failure would most likely have problems with drug ____________________.

excretion

What is the ratio between a drug's therapeutic effects and toxic effects called?

therapeutic index

Which factors will affect the absorption of orally administered medication?

presence of food in the stomach, pH of stomach, form of drug preparation, time of day

When a patient asks the nurse why a lower dose of intravenous pain medication is being given than the previous oral dose, what knowledge will the nurse draw on for her response?

medications given intravenously are not affected by the first pass effect

When calculating pediatric dosages, what will the nurse take into consideration?

dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

When teaching a pregnant mother about the effects of medication on the fetus, the nurse recognizes that the greatest harm from maternally ingested medications occurs during which time period?

first trimester

Knowing that albumin in neonates and infants has a lower binding capacity for medications, a health care provider would do which of the following to minimze the risk of toxicity?

decrease the amount of drug given

The physiologic changes that normally occur in the older adult have which of the following implications for the nurse who is assessing drug response in this patient?

drug half-life is lengthened

The nurse is admitting an 82 year old patient for treatment of heart failure. During the assessment of the patient's history, the nurse notes a subjective complaint of chronic constipation. Of the prescribed medications the patient was taking prior to admission, which would the nurse suspect might contribute to the gastrointestinal complaint?

verapamil, a calcium channel blocking drug

The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor?

drug properties

A mother of a one month old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breast feeding. What is the best repsonse for this patient?

Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking.

A nurse working with elderly patients is concerned with the number of medications each patient is taking. Which will the nurse assess as the highest priority for her patients related to polypharmacy?

drug interactions

What is the nurse's role in the development of new and investigational drugs?

Monitoring for and reporting any adverse effects noted during phase four studies.

Ethically, a nurse has the responsibility to _______________________.

transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles.

Which of the following statements best reflects the nurse's understanding of cultural influences on drug therapy and other health related practices?

Administration of some drugs may elicit varied responses in specific-ethnic groups.

The nurse is assessing her patient's culture and race on admission to the hospital. Which is important for the nurse to understand regardinig drug therapy as it relates to different races of individuals?

polymorphism

The nurse is documenting the history of a patient of Asian culture in the emergency room. The patient states that she has not taken any medications, but the nurse notes a bottle of capsules in the patient's purse. What information should the nurse collect next?

use of herbs or over the counter medications

New drugs must go through much research and testing prior to approval for humans. The nurse is providing education to a patient on a new medication and will inform the patient that the average length of time a medication is researched before being used in humans is ______________.

14 to 16 years

A pharmaceutical company is voluntarily conducting a post marketing study to obtain further proof of the therapeutic effects of a new drug. What phase of drug study is this considered?

phase five

When planning interventions aimed at reducing medication errors, the nurse recognizes that _______________________.

The majority of medication errors result from weaknesses within the system rather than an individual's shortcomings.

When receiving a patient transferred from another unit, which action is most useful to p revent medication errors.

completing a medication reconciliation between units

When admitting an elderly patient to an acute care setting, which nursing strategy is most appropriate to prevent medication errors?

ask the patient and/or family to bring all medications the patient was taking at home

Why are specific medications classified as "high alert" medications?

potential for patient harm is higher with these medications

The nurse administers a medication to the wrong client. Which is the appropriate nursing action following the error?

notify the provider and document the error on an incident report

Which action assists the nurse in prevention of a potential medication error?

encourage the patient to question medications if the medications are different than he or she expects

The nurse knows that the medication reconciliation process involves what three steps?

reconciliation, verification, clarification

Which assessment findings best support the nursing diagnosis of "Deficient knowledge related to medication therapy?"

Patient is unable to verbalize reason for taking the medication.

When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self administer enoxaparin (Lovenox) subcutaneously upon discharge." Which of the following methods best evaluates the patient's achievement of this outcome?

Have the patient perform a return demonstration procedure.

The nurse is providing discharge teaching to an elderly patient with short-term memory problems. Which strategies will the nurse use in educating the patient?

Repeat information frequently.
Provide written instructions for home use.
Encourage use of daily medication containers with alarms.
Perform several short teaching-learning sessions.

The nurse is educating a patient diagnosed with Type 1 Diabetes. When the nurse has the patient demonstrate how to perform self-injections of insulin, which domain of learning is the nurse assessing?

Psychomotor domain

Prior to providing education on a new medication to a patient and family, what is the priority step of the nursing process?

Outcome planning

When the nurse completes patient teaching on a new medication, which method will the nurse use to evaluate the patient's understanding of the information.

Ask specific questions to evaluate understanding.

Which of the following statements is accurate when discussing self-treatment options with a patient?

"Over-the-counter medications can, at times, be used in place of prescription drugs. It is important to discuss the use of these with your health care provider."

The nurse would question the use of kava in a patient with a history of which condition?

Hepatitis

The nurse obtains a medication history from a patient diagnosed with primary hypertension. A nursing diagnosis of "Deficient knowledge related to medication therapy" would be identified when the patient states that he or she takes which over-the counter medication and/or supplement?

Ginseng

A patient provides a list of her medications to the nurse. The patient tells the nurse that she takes medications prescribed by her physicians as well as herbs from the local health food store. Based on this information, the patient uses which type of medicine?

Complementary medicine

The nurse is providing education to a group of patients interested in complementary medicine. The nurse will include which teaching point as priority education for the group?

Confirm with your health care provider that any herbs you take will not interact with prescribed medication.

When administering a medication subcutaneously, the nurse will ______________________________________.

Insert the needle at a 45 to 90 degree angle, depending on patient size, to penetrate subcutaneous tissue.

Z-Track intramuscular injections are indicated in which situation.

With medications that are known to be irritating, painful, and/or staining to tissues.

Which are appropriate landmarks for an intramuscular injection into the dorsogluteal region?

Anterior to the diagonal line from the greater trochanter to the posterior superior iliac spine.

When administering a sublingual medication, which action will the nurse perform/

Wear gloves to place the tablet under the patient's tongue.

Which nursing intervention is most appropriate when crushing oral medications to administer to a patient with dysphagia?

Crush and administer each medication seperately.

In which of the following positions is it most appropriate to place a patient when administering medications via nasogastric tube?

High Fowler's position

When planning to administer an intradermal medication, the nurse recognizes that the preferred site of injection on the forearm is ___________________________________.

3 to 4 finger widths below the antecubital space

When administering opthalmic eyerops, the nurse will perform which action?

Drop the prescribed number of drops into the conjunctival sac.

The nurse is preparing to administer an intramuscular medication using an airlock to prevent leakage of the medication into the subcutaneous space. Which amount of air should the nurse withdraw for the air lock?

0.2mL

The nurse will check how many patient identifiers, required by The Joint Commissions's standards, prior to administering a medication to a patient?

Two

While obtaining a medication history on a newly admitted patient, the nurse notes that the patient is currently prescribed naltrexone (ReVia). The nurse would further question the patient regarding a history _______________________.

Opioid abuse

A patient comes to the emergency department complaining of severe back pain and asking for "something to take the pain away." Nursing assessment findings include mydriasis, rhinorrhea, diaphoresis, lacrimation, BP 160/84, heart rate 116, and respiratory rate 24. Which conditions should the nurse suspect?

Opioid withdrawal

A 17 year old man is carried into the ER by his friends. The patient is unresponsive, and his friends tell you they were too scared to call 911 as they were at a party "popping roofies". Which of the following medications would the nurse expect to administer to this patient?

Flumazenil (Romazicon)

The nurse is providing care to a patient in the ER. The patient reports headache and weakness and is noted to have dysrhythmias on an EKG. The patient is talkative, restless, anxious, and asking to leave the ED. The nurse suspects that the patient might be taking which substance of ?abuse?

Stimulants

The nurse is assessing a patient's history of substance abuse on admission to inpatient rehabilitation. The patient informs the nurse that he has been increasing his drug dosage to get the same effect. What is the patient experiencing?

Tolerance

A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. The best nursing diagnosis for this situation is _____________________________.

risk for injury

A patient's chart includes an order that reads as follows: "Lanoxin 250mcg once daily at 0900. Which action taken by the nurse is correct?

The nurse should contact the prescriber to verify the dosage route.

An 86 year old patient is being discharged to home on digitalis therapy and has very little information regardin the medication. Which statement best reflects a realistic goal or outcome of patient teaching activities.

The patient and patient's daughter will state the correct dosing and administration of the drug.

The nurse is compiling a drug history for a patient. The most helpful question the nurse can ask is __________________________________.

When you take pain medicine, does it relieve the pain?

A 77 year old man who has been diagnosed with an upper respiratory infection tells the nurse that he is allergic to penicillin. What is a good question for the nurse to ask?

What type of reaction did you have when you took penicillin?

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