Lehne’s Pharmacology for Nursing Care 12th Edition – Test Bank

Lehne’s Pharmacology for Nursing Care 12th Edition – Test Bank

Chapter 01: Orientation to Pharmacology

Lehne’s Pharmacology for Nursing Care, 12th Edition Test Bank

MULTIPLE CHOICE

1. The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of which topic?

Clinical pharmacology

b. Drug efficacy

c. Pharmacokinetics

4. Pharmacotherapeutics

ANS: D Pharmacotherapeutics is the study of the use of drugs to diagnose, meat, and prevent conditions. Clinical pharmacology is concerned with all aspects of drug-human interactions. Drug efficacy measures the extent to which a given drug causes an intended effect. Pharmacokinetics is the study of the impact of the body on a drug.

PTS: 1

DO: Cognitive Level: Compre

TOP: Nursing Proces: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parental Therapies

2. What is a desired outcome when a drug is described as easy to administer?

It can be stored indefinitely without need for refrigeration

b. It does not interact significantly with other medications.

c. It enhances patient adherence to the drug regimen

d. It is usually relatively inexpensive to produce.

ANS: C

A major benefit of drugs that are easy to administer is that patients taking them are more likely to comply with the drug regimen. Drugs that are easy to give may have the other attributes listed, but those properties are independent of ease of administration

PTS: 1

DIF: Cognitive Level: Compre

TOP: Nursing Process: Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

3. A patient tells the nurse that an analgesic he will begin taking may cause drowsiness and will decrease pain up to 4 hours at a time. Based on this understanding of the drug’s effects by the

patient, the surse will anticipate which outcome? Decreased chance of having a placebo effect

b. Decreased motivation to take the drug

c. Improved compliance with the drug regimen

d. Increased likelihood of drug overdose

ANS: C

A drug is effective if it produces the intended effects, even if it also produces side effects. Patients who understand both the risks and benefits of taking a medication are more likely to comply with the drug regimen

PTS: 1

DIF: Cognitive Level: Compreni

TOP: Norving Process: Evaluation

MSC: NCLEX Chiest Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

MULTIPLE RESPONSE

1. What are the properties of an ideal drug? (Select all that apply

Irreversible action

b. Predictability

c. Ease of administration

d. Chemical stability

e. A recognizable trade name

ANS: B. C. D

In addition to predictability, ease of administration, and chemical stability, other properties include a reversible action so that any harm the drug may cause can be undone and a simple generic name, because generic names are usually complex and difficult to remember and pronounce.

PTS: 1

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX Cheat Needs Category: Physiologic lategrity: Pharmacologic and Parenteral Therapies

2. Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient’s response to the medication? (Select all

that apply) Chemical stability of the medication

b. Ease of administration

e. Family medical history

4. Patient’s age

e. Patient’s diagnosis

ANS: C, D, E

The family medical history can indicate genetic factors that may affect a patient’s response to a medication. Patients of different ages can respond differently to medications. The patient’s illness can affect how drugs are metabolized. The chemical stability of the medication and the ease of administration are properties of drugs.

PTS: 1

DOF: Cognitive Level: Analysis

TOP: Norning Process Implementation

MSC: NCLEX Cient Needs Category: Physiologic Integrity: Reduction of Risk Potential

Chapter 02: Application of Pharmacology in Nursing Practice Lehne’s Pharmacology for Nursing Care, 12th Edition Test Bank

MULTIPLE CHOICE

1. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jinery sometimes when taking the medication, and she doesn’t feel that the medication is always effective. Which action is outside the nurse’s scope

of practice? a. Asking the patient to demonstrate use of the inhaler

b. Assessing the patient’s exposure to tobacco smoke

c. Auscultating hong sounds and obtaining vital signs

d. Suggesting that the patient use one puff to reduce side effects

ANS: D

It is not within the nurse’s scope of practice to change the dose of a medication without an order from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to evaluate the patient’s ability to administer the medication properly and is part of the nurse’s evaluation. Assessing tobacco smoke exposure helps the surse determine whether nondrug therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a physical assessment helps the nurse evaluate the patient’s response to the medication

PTS: 1

DIF: Cognitive Level: Application

TOP: Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity. Pharmacologic and Parenteral

Therapies

2. A postoperative patient is being discharged home with acetaminophen hydrocodone [Lortab] for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct?

a. “It is not safe to take over-the-counter drugs with prescription medications”

b. “Taking the two medications together poses a risk of drug toxicity.”

c. “There are no known drug interactions, so this will be safe.”

d. “Tylenol and Lortab are different drugs, so there is no risk of overdose.”

ANS: B

Tylenol is the trade name and acetaminophen is the generic name for the same medication. It is important to teach patients to be aware of the different names for the same drug to minimize the risk of overdose. Over-the-counter (OTC) medications and prescription medications may be taken together unless significant harmful drug interactions are possible. Even though no drug interactions are at play in this case, both drugs contain acetaminophen, which could lead to toxicity

PTS: 1

DIF: Cognitive Level: Application

TOP: Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity. Reduction of Risk Potential

3. The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process?

a. Asking the prescriber for an order to monitor serum drug levels

b. Monitoring the patient for drug interactions after giving the medication

c. Questioning the patient about over-the-counter medications

d. Taking the patient’s blood pressure throughout the course of treatment

ANS: C

The assessment part of the nursing process involves gathering information before beginning treatment, and this includes asking about other medications the patient may be taking Monitoring serum drug levels, watching for drug interactions, and checking vital signs after giving the medication are all part of the evaluation phase.

PTS: 1

DIF: Cognitive Level: Application

TOP: Nursing Process: Assessment

MSC: NCLEX Client Needs Category: Physiologic Integrity. Reduction of Risk Potential

4. A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10 (10) being the most extreme pain). The prescriber has ordered acetaminophen [Tylenol] 650 mg

PO every 6 hours PRN pain. What will these do?

a. Ask the patient what medications have helped with pain in the past.

b. Contact the provider to request a different analgesic medication.

c. Give the pain medication and reposition the patient to promote comfort.

d. Request an order to administer the medication every 4 hours.

ANS: B

The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication. Asking the patient to tell the worse what has helped in the past is part of an initial assessment and should be done preoperatively and not when the patient is having severe pain. Because the patient is having severe pain, acetaminophen combined with nondrug therapies will not be sufficient. Increasing the frequency of the dose of a medication for mild pain will not be effective

PTS: 1

DIF: Cognitive Level: Analysis

TOP: Nursing Process: Diagnosis

MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral

Therapies

5. A patient newly diagnosed with diabetes is to be discharged from the hospital. The surve teaching this patient about home management should begin by doing what?

a. Asking the patient to demonstrate how to measure and administer insulin

b. Discussing methods of storing insulin and discarding syringes

c. Giving information about how diet and exercise affect insulin requirements

d. Teaching the patient about the long-term consequences of poor diabetes control

ANS: A

Because insulin must be given correctly to control symptoms and because an overdose can be fatal, it is most important for the patient to know how to administer it. Asking for a demonstration of technique is the best way to determine whether the patient has understood the teaching. When a patient is seceiving a lot of new information, the information presented first is the most likely to be remembered. The other teaching points are important as well, but they are not as critical and can be taught later.

PTS: 1

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

6. The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is nor part of the six rights of drug administration?

a. Assessing the patient’s pain level 15 to 30 minutes after giving the medication

b. Checking the medication administration record to see when the last dose was administered

c. Consulting a drug manual to determine whether the amount the prescriber ordered is appropriate

4. Documenting the reason the medication was given in the patient’s electronic medical record

ANS: A

Assessing the patient’s pain after administering the medication is an important part of the nursing process when giving medications, but it is not part of the six rights of drug administration. Checking to see when the last dose was given helps ensure that the medication is given at the right time. Consulting a drug manual helps ensure that the medication is given in the right dose. Documenting the reason for a pain medication is an important part of the right documentation-the sixth right.

PTS: 1

DIF: Cognitive Level: Application

TOP: Nursing Process: Implementation

MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

7. A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not working. What will the nurse do?

a. Ask the patient about the number and frequency of tablets taken.

b. Assess the patient’s headache pain on a scale from 1 to 10.

c. Report the patient’s complaint to the prescriber.

4. Suggest biofeedback as an adjunct to drug therapy

ANS: A

When evaluating the effectiveness of a drug, it is important to determine whether the patient is using the drug as ordered. Asking the patient to tell the nurse how many tablets are taken and how often helps the surse 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 effectiveness as possible before contacting the prescriber. Biofeedback may be an effective adjunct to treatment, but it should not be recommended without complete information about drug effectiveness.