Pharm Test 1 - Flashcards | StudyHippo.com

Q: Which warning label on a medication bottle does the nurse recognize that reflects chemical stability?

\"Keep refrigerated.\" Some chemicals are more or less stable under certain conditions, such as temperature or type of solution. A warning to keep a drug refrigerated identifies this property.

Q: Which statement indicates understanding regarding the objective of drug therapy?

\"The goal is to provide maximum benefit with minimum harm.\" Because all drugs have side effects, and because desired effects are often unpredictable, the goal is to balance these concerns by providing maximum benefit with minimal harm.

question

Which warning label on a medication bottle does the nurse recognize that reflects chemical stability?

answer

"Keep refrigerated." Some chemicals are more or less stable under certain conditions, such as temperature or type of solution. A warning to keep a drug refrigerated identifies this property.

question

Which property of a drug affects the health care provider's ability to manage adverse effects?

answer

Reversibility Reversibility is the characteristic that causes the effects of a drug to subside over time. Health care providers who know when drug effects subside can better manage adverse effects.

question

A patient asks the nurse what it means when a prescribed drug is described as being "selective." What will the nurse tell this patient?

answer

The drug only elicits the response for which it is given. Drugs can elicit many different responses; selectivity refers to the drug only eliciting the response for which it is given.

question

A patient will need to take a hypertension medication daily for an indefinite period. When an antihypertensive drug is selected for this patient, which property should be considered to help improve compliance?

answer

Drug cost Expense can be a significant factor when a patient has to take a drug for a long time, and can cause a financial burden. Patients are more likely to adhere to a drug regimen if the drug is affordable.

question

Which statement indicates understanding regarding the objective of drug therapy?

answer

"The goal is to provide maximum benefit with minimum harm." Because all drugs have side effects, and because desired effects are often unpredictable, the goal is to balance these concerns by providing maximum benefit with minimal harm.

question

What will the nurse assess when evaluating the effectiveness of a patient's drug therapy?

answer

Evidence of therapeutic benefit Effectiveness determines whether a drug produces the desired effect.

question

How would a drug that is prescribed in high doses for a long time with few harmful effects be classified?

answer

Safe A safe drug is defined as one that cannot produce harmful effects—even if administered in very high doses and for a very long time.

question

A nurse is caring for an older patient with decreased kidney functioning, and is aware the patient may have difficulty excreting drugs. The nurse is demonstrating which aspect of pharmacology?

answer

Pharmacokinetics Pharmacokinetics describes what the body does to a drug in order for a drug action to occur. It includes the absorption, distribution, metabolism, and excretion of drugs from the body.

question

Which organ is primarily responsible for the metabolism of a drug?

answer

The liver Metabolism of drugs primarily occurs in the liver.

question

When performing an admission assessment, the nurse learns that a patient has a history of gastric bypass surgery, limiting the size of the stomach. What pharmacokinetic process would this affect when medications are given?

answer

Absorption Absorption of oral medications occurs primarily in the stomach and small intestine, so a history of gastric bypass surgery would affect this pharmacokinetic process.

question

Which medical history might alert the nurse to improper excretion in a patient?

answer

Kidney disease When healthy, the kidneys serve to limit the duration of action of many drugs because they account for the majority of drug excretion. In the presence of renal disease, the duration and intensity of drug responses may increase.

question

The nursing instructor asks what the difference is between pharmacodynamics and pharmacokinetics. Which student response indicates correct understanding?

answer

"Pharmacodynamics is the study of what a drug does to the body. Pharmacokinetics is what the body does to the drug." Pharmacodynamics studies what a drug does to the body once it has reached the target site or sites. The actions of a drug involve receptor binding, enzymes, and nonselective interactions. Pharmacokinetics describes what the body does to a drug in order for a drug action to occur.

question

With respect to pharmacokinetics, which laboratory values are especially important to review in older adult patients prior to initiating drug therapy?

answer

Renal and hepatic function tests Kidney and liver function decline with age, so it is important to monitor their function to help prevent drug toxicity caused by poor excretion and decreased drug metabolism.

question

Which statement by a student nurse regarding drug distribution indicates that further teaching is needed?

answer

"The presence of food in the stomach may impair absorption of certain drugs." This is a true statement regarding absorption, not distribution of a drug.

question

What is it called when groups of drugs have similar effects and actions on the body?

answer

Drug classification

question

What are the most important characteristics of a drug?

answer

-safety -selectivity -effectiveness

question

What is the nurse learning about when studying the effects of drugs in humans?

answer

Clinical pharmacology

question

Which processes does pharmacokinetics include?

answer

-absorption -distribution -metabolism -excretion

question

What is the process of drug movement throughout the body that is necessary to achieve drug action?

answer

-Pharmacokinetics

question

Pharmacokinetics

answer

Drugs must be absorbed, distributed, metabolized, and eventually excreted to achieve optimal drug action. Pharmacokinetics is the study of these processes, or the action of the body on the drugs.

question

Once a drug has reached its sites of action, what processes determine the nature and intensity of the response?

answer

Pharmacodynamics

question

Pharmacodynamics

answer

Pharmacodynamics describes the actions of the drugs, or how drugs affect the body. This can include drug-receptor interactions, the patient's functional state, or placebo effects.

question

How does the nursing process apply to pharmacology?

answer

It guides individualized medication therapy and related care for a patient.

question

What is pre-administration assessment data?

answer

Data that establishes a patient's baseline before administration of a medication.

question

What is the purpose of the nursing process in terms of pharmacology?

answer

-to ID human responses to medication -to treat human responses with medication -to evaluate human response to medication -to diagnose human responses to medication

question

The nurse is reviewing discharge medications with Mr. Jackson and his mother. Which statements made by the mother would be important for the nurse to consider during the assessment stage of the nursing process?

answer

-ricky occasionally takes a laxative for intermittent constipation -ricky takes extra strength acetaminophen 1-2 times a day for shoulder pain after a baseball injury

question

The next medication the nurse reviews with Mr. Jackson is his prescribed antibiotic, which will need to be taken twice a day (bid) for 7 days. Which question should the nurse ask during the pre-administration assessment?

answer

"How will you remember to take the medication at each dosing time?"

question

What actions take place during the planning stage of the pharmacologic process?

answer

-defining goals -setting priorities -ID interventions -Establishing evaluation criteria

question

How is a nursing diagnosis defined?

answer

A diagnosis based on information found in the nursing assessment regarding patient responses to actual or potential health processes.

question

How does a medical diagnosis differ from a nursing diagnosis?

answer

-A medical diagnosis identifies a disease condition. -A medical diagnosis identifies results of procedures. -A medical diagnosis identifies results of diagnostic tests.

question

Which are components of the original five rights of medication administration?

answer

-right time -right dose -right patient -right medication

question

The Joint Commission requires two forms of identification verification before administering medications. Which right of medication administration does this support?

answer

-Right patient

question

What are the additional five rights to medication administration?

answer

-right evaluation -right assessment -right documentation -patient's right to refuse

question

Using the nursing process, what is the nurse discerning during the evaluation phase?

answer

Degree of goal attainment

question

What must the nurse know to evaluate the patient for a therapeutic response?

answer

The anticipated patient outcome

question

Which methods can be used to evaluate the patient's adherence to a drug regimen?

answer

-Counting pills -Interviewing patient -Measuring plasma drug levels

question

Which type of data collection is obtaining the patient's vital signs?

answer

Objective Obtaining vital signs is objective data collection.

question

An older adult patient is confused. How does the nurse assess self-care capacity?

answer

Asking how the patient takes medications at home This assesses self-care capacity by learning how a patient manages their medications at home.

question

The patient describes to the nurse how a new medication made him feel. What kind of data collection is this?

answer

Subjective A patient's report of how a medication made them feel is subjective data.

question

Which people may provide subjective data about the patient's health?

answer

-family -friends -patients

question

Which nursing diagnoses are most appropriate for a patient on a post-operative medication regimen?

answer

-Acute Pain related to surgery -Risk for Injury related to side effects of medication -Readiness for Enhanced Knowledge related to medication schedule and medication side/adverse effects

question

Which nursing diagnosis has the highest priority for the nurse?

answer

Ineffective Breathing Pattern related to adverse reaction to a medication

question

Compromised airway has the _________________, as it is life threatening to the patient.

answer

highest priority

question

How does the nurse evaluate the treatment of a patient who recently started insulin?

answer

Review glucose and insulin dose log.

question

A patient has been admitted for intractable nausea, and her morning medications are due. Which of the original rights of medication administration will require special attention by the health care provider?

answer

Right route

question

What is missing from this drug administration documentation: Metoprolol 25 mg given at 0900 on 6/12/16 By A.B, RN

answer

The route

question

Pediatric medications are often given based on weight. This could affect which of the 5 rights of medication administration?

answer

Right dose

question

The patient is refusing her prescribed beta-blocker. The patient is of sound mind. What is the nurse's next action?

answer

Document the refusal in the patient's medical record.

question

A patient reports losing his job. How would the nurse evaluate for medication compliance?

answer

Resources to obtain medications

question

A patient states dissatisfaction with her current medication regimen. Which factors may be the cause of the patient's dissatisfaction?

answer

-high cost -difficulty of administration -unacceptable side effects -inconvenient dosing schedule

question

A patient is not compliant with the drug regimen. Which steps should be included in the nurse's evaluation of this patient?

answer

-Ask the patient if he understands what dose to take. -Determine if the patient is administering the medication correctly. -Determine if the patient understands when to take the medication.

question

A patient taking a diuretic has not adhered to medication therapy because it induces nocturia. How will the nurse educate the patient?

answer

Remind the patient to take it in early morning.

question

Which drug name is based on the compounds that make up the drug?

answer

Chemical name

question

Once a drug is approved by FDA, what types of names are given?

answer

-generic name -brand name

question

When reading an order on the medication administration record, how does the nurse know what name is the brand name?

answer

It is in upper case.

question

Which regulatory agency is responsible for the safety of medications in the United States?

answer

The Food and Drug Administration (FDA)

question

Ms. Davis asks the nurse about the risk of ondansetron to her unborn baby. How will the nurse respond? CASE STUDY DETAILS

answer

"Research on animals has shown no risks to the fetus."

question

How did the Federal Food, Drug, and Cosmetic Act of 1938 ensure medication safety?

answer

-Ensures that all drugs are tested for harmful effects. -Requires that drugs be labeled with accurate information. -Requires that drugs be labeled with detailed information, including adverse effects.

question

What does it mean if a drug is included in the United States Pharmacopeia National Formulary (USP-NF)?

answer

The drugs have met high standards for therapeutic use, patient safety, quality, purity, strength, packaging safety, and dosage form.

question

High potential for drug abuse. No accepted medical use.

answer

Schedule I

question

High potential for drug abuse. Accepted medical use.

answer

Schedule II

question

Medically accepted drugs. Lower potential for abuse.

answer

Schedule III

question

Medically accepted drugs. May cause dependence.

answer

Schedule IV

question

Medically accepted drugs. Very limited potential for dependence.

answer

Schedule V

question

While completing the health history, the nurse asks the patient, "What medications do you take regularly?" Which drug name would the nurse expect the patient to use in providing the answer?

answer

Trade name

question

Trade name

answer

The trade name is the brand name and is used by pharmaceutical companies in marketing, so is more likely to be used by the consumer.

question

What do the final syllables of the drug's generic name usually indicate?

answer

Pharmacologic class

question

Why are generic medications usually less expensive than the brand name medications?

answer

Generic drug manufacturers do not have to do extensive testing.

question

What are examples of medications in which brand names would be preferred?

answer

-Anticonvulsant -Anticoagulant -Heart failure -Aspirin

question

What is the most dangerous outcome if only trade names are used when prescribing?

answer

The same medication can be prescribed by multiple health care providers.

question

What does an "A" rating for a generic drug mean?

answer

The generic drug is bioequivalent to the brand name drug.

question

What happens once a drug company's patent expires for a trade name medication?

answer

Other drug companies can manufacture the drug under the generic name.

question

When a patient will be traveling internationally, the nurse should explain what regarding trade name medications and prescriptions?

answer

-Trade names for the same drug can differ between countries. -Medications with the same trade name may have different active ingredients in different countries. -Language barriers may prevent obtaining the correct medication.

question

What was the result of the Dietary Supplemental Health and Education Act?

answer

Established labeling requirements for dietary supplements.

question

The nurse receives a medication order for a Schedule 1 drug. What is the priority nursing action?

answer

Question the order as these drugs are not approved for medical use.

question

A nurse reviews a medication order for a schedule V drug. What is the most important fact they should know regarding this category of medication?

answer

They have very limited abuse potential.

question

What is the primary purpose of federal legislation regarding drugs?

answer

Ensure safe use in patients.

question

FDA has categories according to probable risk to fetus. Which drugs in which category cause the most harm?

answer

Category X

question

Which pregnancy category causes the least potential risk to fetus?

answer

Category A

question

What is considered the strongest safety warning a drug can carry and still remain on the market?

answer

Black box

question

Which type of drug interaction occurs when two drugs are administered in combination and the response is equal to the sum of the effect of the two drugs taken separately?

answer

Additive effect

question

What occurs during a synergistic effect when two or more drugs are given together?

answer

Response is substantially increased beyond what any drug given could produce alone.

question

During a routine physical examination, the patient reports muscle soreness to the nurse. Laboratory liver function tests are normal. The patient is taking simvastatin, and likes to eat grapefruit for breakfast. What does the nurse anticipate?

answer

Drug-food interaction

question

The student nurse asks what an adverse drug reaction (ADR) is. What is the appropriate nursing instructor response?

answer

An unintentional, unexpected reaction, which occurs at normal drug dosages

question

Which symptom would indicate to the nurse that a patient is experiencing an anaphylactic drug reaction?

answer

Angioedema

question

Who is responsible for reducing adverse drug reactions (ADRs)?

answer

-Patient -Patient's family -ealth care provider -Pharmaceutical industry

question

For which reasons does the nurse educate a patient about adverse drug reactions?

answer

-To allow the patient to be more involved in their care -To allow for early identification of adverse drug reaction and to seek timely treatment -To partially fulfill the nurse's accountability

question

Which causes of medication errors are human factors?

answer

-Performance deficits -Knowledge deficits -Dosage miscalculation -Transcription errors

question

The nurse erroneously gives a patient 1 tablet of medication instead of the prescribed ½ tablet. The patient had no adverse reaction. What does this reflect?

answer

Medication error

question

Which method of documentation has been shown to reduce medication errors?

answer

Computerized order entry

question

The electronic health record indicates that a patient's continuous infusion of heparin intravenously was to be stopped at 1000. At 1900, the nurse notices that the heparin is still running. Which type of medication error is this?

answer

Wrong duration of treatment

question

A patient with a history of gastrointestinal esophageal reflux disease (GERD) reports taking an over-the-counter (OTC) medication to treat "heartburn discomfort." The nurse notices that the patient also takes two prescribed medications for hypertension. For which type of possible reaction does the nurse assess?

answer

Drug-drug interaction

question

A nurse is providing a patient with education regarding grapefruit consumption while taking a medication. Which type of interaction is the nurse teaching the patient to avoid?

answer

Drug-food interaction

question

How do drugs interfere with clinical laboratory testing?

answer

-Cross-reaction with antibodies -Altering chemical reactions -Interference with enzyme reactions

question

A patient reports insomnia and excitement after taking alprazolam. Which type of effect does the nurse recognize?

answer

Paradoxical

question

The nurse is caring for a patient with G6PD deficiency, an X-linked inherited condition that commonly occurs in people of African and Mediterranean ancestry. For which effect will the nurse monitor?

answer

Idiosyncratic

question

A patient is given lorazepam, a benzodiazepine, to decrease symptoms of anxiety and restlessness on the evening prior to a planned surgery. The nurse knows that the patient is experiencing a paradoxical drug reaction when which of the following is assessed?

answer

Increased agitation and insomnia

question

The nurse is preparing to administer morphine sulfate to a patient who just had an appendectomy. The electronic health record indicates that the patient has no drug allergies or history of adverse drug reactions. The patient reports, "The last time I received morphine, I got itchy and my eyes swelled shut." What is the appropriate nursing action?

answer

-Notify the health care provider and pharmacy of the patient's previous adverse reaction. -Contact the surgeon for an alternate pain control medication.

question

A patient taking a new medication experiences a torso rash. The nurse does not see "rash" listed as a reported side effect of the new medication. What is the appropriate nursing action?

answer

Report the side effect to MedWatch.

question

Which method does the Food and Drug Administration (FDA) use for special alerts or medication guidelines?

answer

-Risk Evaluation and Mitigation Strategy (REMS) -Medication guides (MedGuide) -Boxed warnings

question

The nurse is preparing to administer the first dose of an oral antibiotic. What is the priority nursing action?

answer

Verify patient allergies before administering the drug.

question

The nurse is reviewing a prescription for oxycodone that states, "take 5 to 10 mg by mouth every 4 to 6 hours." What is the appropriate nursing action?

answer

Contact the health care provider and clarify the prescription.

question

How are drug errors addressed in a system that operates according to principles associated with a just culture?

answer

Individuals are encouraged to report drug errors so that the system may be repaired.

question

To prevent drug errors, nurse managers should implement which concept?

answer

-Give ongoing recognition -Provide education for all employees -Embrace a nonpunitive culture

question

What is defined as the largest effect that a drug can produce?

answer

Potency

question

Selective action at specific receptor sites results in a change to which characteristic of a drug?

answer

Side effects

question

Safety of a drug is determined by the ratio between which components?

answer

Intrinsic activity and maximal efficacy

question

After administration of a medication, the nurse should evaluate for which outcome?

answer

First-pass effect

question

The nurse is explaining the need for monitoring warfarin to Mr. Walters. Which statement made by the nurse is correct? CASE STUDY DETAILS

answer

"Warfarin has a long half-life and must be monitored more frequently."

question

The nurse is performing the physical exam on Mr. Walters and notes bruising to his arms and legs. Which intervention by the nurse is correct?

answer

Instruct the patient to take half the dose of warfarin.

question

A patient has been admitted to the hospital for new onset of seizures and was started on valproic acid and notes that it is highly protein-bound. What does this mean to the nurse?

answer

The nurse knows highly protein-bound medications are non-toxic.

question

When a nurse is performing an assessment about medication, the drug history should include which components?

answer

-Potency of the medication -Herbal medications taken by family members

question

If a patient receives an average effective dose (ED₅₀) at initial treatment and shows signs of toxicity, which action by the health care provider should the nurse anticipate?

answer

Reduce the dosage.

question

The patient read that a new medication has a high therapeutic index, and asks the nurse what that means. How should the nurse respond?

answer

"A high therapeutic index indicates that a drug is relatively safe."

question

Why is it difficult to predict how each individual patient will respond to a medication?

answer

Therapeutic response can vary between patients due to interpatient variability.

question

How is duration of action defined?

answer

The length of time the drug exerts a therapeutic effect.

question

Which statement by the nurse indicates understanding regarding medication with high potency?

answer

"This medication will produce a significant therapeutic response at a low dose."

question

A drug's affinity to its receptor is most closely associated with which characteristic of the drug?

answer

Potency

question

The nurse is monitoring the therapeutic drug level for a patient on vancomycin and notes that the level is within the accepted range. What does this indicate to the nurse?

answer

The drug level is appropriate to exert therapeutic effects.

question

The nurse is teaching the patient about a newly prescribed medication. Which statement made by the patient indicates the need for further medication education?

answer

"The liquid form of the drug will be absorbed faster than the tablets."

question

A patient's primary language is Vietnamese. How should the nurse provide education regarding a newly prescribed medication to this patient?

answer

Provide health information written in the patient's primary language.

question

What should the nursing assessment include when determining which medications can be prescribed?

answer

Allergies

question

The patient has a history of dysphagia. How may this hinder the patient?

answer

Taking oral medications

question

How does Mr. McCallister's chronic kidney disease affect his response to morphine?

answer

Decreased kidney function reduces the amount of morphine excreted out of the body.

question

What are the advantages of intravenous medication administration?

answer

-Rapid onset -Strict control of drug levels -Bypass barriers to absorption

question

What are the four processes of pharmacokinetics?

answer

Absorption, distribution, metabolism, and excretion

question

What are the parenteral routes of drug administration?

answer

-Intravenous -Subcutaneous -Intramuscular

question

Which organ is most important for drug excretion?

answer

Kidney

question

When assessing a patient prior to administering a new prescription, which information should the nurse collect?

answer

Patient medication history

question

What should the nurse monitor when evaluating a patient on a medication regimen?

answer

Patient adherence to the medication therapies

question

A patient is on a fixed income. What should the nurse assess prior to initiating a new medication?

answer

The patient's ability to pay for the medication

question

Drugs must be given with the most appropriate route, dosage, and timing. Why is this important?

answer

To achieve a balance between high enough drug concentrations to be effective and to minimize the risk to the patient.

question

How can the first-pass effect typically be avoided?

answer

Administer medication parenterally

question

Why do older adult patients sometimes require reduced doses of medications?

answer

Some older adult patients have a decreased ability to metabolize drugs, which can lead to drug toxicity.

question

How can a prodrug be effective as a medication?

answer

A prodrug is inactive when administered and, through metabolism, undergoes conversion to an active form.

question

How does drug metabolism take place in the liver?

answer

The hepatic microsomal enzymes break down drugs into metabolites.

question

Why are medications with a narrow therapeutic range difficult to administer safely?

answer

They have little margin between therapeutic and toxic plasma concentrations.

question

When is a steady drug level achieved in the body?

answer

When the amount of drug eliminated between doses equals the dose administered.

question

Why is it important for the nurse to know about a patient's history of bariatric surgery when the patient is prescribed a new medication?

answer

Previous gastric surgery can change the absorption of medications.

question

A patient on prescription medication states, "I plan to start taking vitamins." What education would the nurse provide?

answer

The patient should contact the health care provider prior to taking any new over-the-counter medications or supplements.

question

A nurse is administering two medications that are highly protein bound. The nurse should monitor the patient for what?

answer

Signs and symptoms of drug toxicity

question

Why is it important for the nurse to determine if a patient uses complementary or alternative therapies prior to initiating a new medication?

answer

Complementary and alternative therapies may interact with the new medication.

question

What can the nurse anticipate when a patient is discontinuing the use of a drug enzyme inducer?

answer

That a dose adjustment will be required for the drug that was taken in conjunction with the inducing agent.

question

Why is it important for a nurse to review information provided by drug companies and pharmacies?

answer

To check protein-binding percentage of drugs and the need for therapeutic monitoring.

question

The patient is being discharged from the health care facility with new medications. What is the responsibility of the nurse at discharge?

answer

To ensure that the patient has medication teaching so that they are aware of potential drug interactions, and will know what effects to report immediately to the health care provider.

question

A patient reports that they take a medication with a long half-life at breakfast and dinner. What would the nurse do first in this situation?

answer

Report this finding to the health care provider.

question

What are the two types of cholinergic receptors?

answer

-Nicotinic receptors -Muscarinic receptors

question

Which drugs affect the parasympathetic nervous system?

answer

-Parasympatholytics -Cholinergic agonists

question

Bethanechol binds with which receptors to cause activation?

answer

Cholinergic

question

What are some of the contraindications for atropine?

answer

-Tachycardia -Paralytic ileus -Narrow-angle glaucoma -Benign prostatic hypertrophy

question

Which medication is used as an antidote for cholinergic overdose?

answer

Atropine sulfate

question

Which intervention should be added to Mr. Graves' plan of care?

answer

Assess for rhonchi and wheezes.

question

Which instruction should be added to Mr. Graves' patient education plan?

answer

Sit up slowly from a lying position to avoid dizziness.

question

The nurse is administering bethanechol and teaches the patient about manifestations of muscarinic excess. Which symptoms are the manifestations that the patient should report?

answer

-Salivation -Bradycardia -Hypotension -Urinary urgency

question

After administering atropine, what should the nurse teach the patient?

answer

-Maintain good oral hygiene. -Chew gum or suck on hard candy. -Drink adequate amounts of fluids.

question

Adrenergic drugs mimic the effects of which sympathetic nervous system neurotransmitters?

answer

Norepinephrine and epinephrine

question

Which is true about the effect epinephrine has on cardiac output?

answer

Epinephrine increases cardiac output.

question

Which is the time of onset for albuterol administered by inhalation?

answer

5-15 minutes

question

Which condition is contraindicated for administration of albuterol?

answer

Monoamine oxidase inhibitor (MAOI) therapy

question

What therapy does the nurse anticipate will be ordered to treat Alyssa's anaphylaxis?

answer

Subcutaneous epinephrine

question

What teaching information should the nurse offer to Alyssa and her parents about the use of the EpiPen?

answer

-"Take the medication as it is prescribed." -"Keep an EpiPen available at all times, and store extra medication in a cool, dark place." -"The EpiPen must be administered instantly upon the first occurrence of difficulty breathing, wheezing, hives, itching, hoarseness, or swelling of the lips and tongue."

question

Which lab values should be documented with the administration of epinephrine?

answer

-Liver function -Renal function

question

Which action should a patient take immediately after self-injection of epinephrine?

answer

Massage the site.

question

The nurse should teach the patient to administer an EpiPen using which route(s)?

answer

-Intramuscular -Subcutaneous

question

A patient has recently received epinephrine. The nurse anticipates which effects on the cardiovascular system?

answer

-Increase in heart rate -Peripheral vasoconstriction -Increase in systolic blood pressure

question

By which mechanism does albuterol reduce airway resistance?

answer

Activation of beta 2-mediated bronchodilators

question

When epinephrine is administered for cardiac arrest, what is its expected onset of action?

answer

3-5 minutes

question

A patient with emphysema is prescribed albuterol. Which does the nurse recognize as the primary use of albuterol?

answer

To prevent and treat bronchospasm

question

A patient has an allergic reaction to peanuts. The nurse knows which drug is the treatment of choice for anaphylactic shock?

answer

Epinephrine

question

A nurse is preparing to administer albuterol. Which are the priority assessment data?

answer

-Vital signs -Breath sounds

question

A patient with emphysema receives albuterol breathing treatments every 6 hours. Which assessment findings indicate the effectiveness of albuterol?

answer

-Clear breath sounds -Decreased respiratory rate

question

The nurse observes redness and irritation at the intravenous infusion site of a patient who received epinephrine IV. The nurse is especially concerned due to which factor?

answer

Epinephrine can cause tissue necrosis.

question

The nurse should assess for which anticipated side effect after a patient receives a breathing treatment of albuterol?

answer

Increased heart rate

question

Which is the priority nursing action for the patient receiving albuterol?

answer

Auscultate lung sounds

question

The nurse is providing instructions for a patient with a new EpiPen. Which item should be included in the instructions?

answer

Hold the device in place for 5-10 seconds.

question

A patient reports to the nurse that he uses his EpiPen an average of four times weekly. Which is the most appropriate action by the nurse?

answer

Notify the primary care provider.

question

The nurse is teaching a patient to use an albuterol inhaler. Which instruction should be included in the teaching plan?

answer

Rinse the mouth after each use.

question

Which statement by a patient taking albuterol indicates the need for further education by the nurse?

answer

"I can take up to 6 puffs of my inhaler if I feel short of breath."

question

The nurse should caution the patient about which common side effect associated with albuterol?

answer

Nervousness

question

The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first?

answer

Assess the patient's pain and pain level.

question

The patient's medication administration record lists two antiepileptic medications that are due at 0900, but the patient is NPO for a barium study. The nurse's coworker suggests giving the medications via IV because the patient is NPO. What will the nurse do?

answer

Call the health care provider to clarify the instructions.

question

The day shift charge nurse is making rounds. A patient tells the nurse that the night shift nurse never gave him his medication, which was due at 2100. What will the nurse do first to determine whether the medication was given?

answer

Check the medication administration record.

question

A nurse makes an error when administering medications to a patient. Which action by the nurse requires the supervising nurse to intervene? The nurse

answer

records completion of an incident report in the medical chart.

question

A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow pills. What will the nurse do?

answer

Call the pharmacy and ask for the liquid form of the medication.

question

The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do?

answer

Remove the old patch and apply the new patch to a different, clean area

question

The nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from IV to PO. The nurse expects the oral dose to be

answer

higher because of the first-pass effect.

question

A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route?

answer

PO

question

When teaching a pregnant woman about the use of drugs during pregnancy, which statement will the nurse include?

answer

Drug transfer to a fetus is most likely to occur during the last trimester of pregnancy.

question

When administering medications to pediatric patients, the nurse understands that the dosage calculations for pediatric patients are different than for adults because pediatric patients

answer

have immature liver and kidney function, resulting in impaired drug metabolism and excretion.

question

What does the nurse identify as a pharmacokinetic change that occurs in older adults?

answer

The number of intact nephrons is decreased.

question

Which racial group is predicted to be nearly one in three U.S. residents in 2050?

answer

Hispanic

question

Which of the following statements regarding African Americans' responses to antihypertensive medication therapy is true?

answer

African Americans respond better to diuretics than to beta blockers.

question

A research group is conducting an investigational drug study on a promising new drug for osteoporosis. It has been difficult to find research participants who meet the criteria. Just before the conclusion of the study, four participants approach the researchers and express their desire to withdraw from the study. The researcher should first

answer

acknowledge that they can withdraw at any time from the study.

question

A nurse does not notice that a patient's IV site is swollen, red, painful, and warm to touch nor that the IV has quit infusing properly. This is an example of

answer

breach of duty.

question

A nurse has been asked to participate in an elective procedure that violates the nurse's personal ethical principles. The nurse should

answer

speak to the manager or supervisor.

question

In a 2006 IOM study, it was estimated that some form of medication error resulted in harm to how many patients?

answer

1.5 million

question

The nurse is administering a drug that has been ordered as follows: "Give 10 mg on odd-numbered days and 5 mg on even-numbered days." When the date changes from May 31 to June 1, what should the nurse do?

answer

Consult the prescriber to verify that the dose should alternate each day, no matter whether the day is odd or even numbered

question

The nursing student realizes that she has given a patient a double dose of an antihypertensive medication. The tablet was supposed to be cut in half, but the student forgot and administered the entire tablet. The patient's blood pressure just before the dose was 146/98 mm Hg. What should the student nurse do first?

answer

Notify the clinical faculty.

question

The nurse is caring for an 85-year-old patient in the hospital and teaching him how to use an inhaler. His 84-year-old wife attends the teaching sessions, and their daughter comes in to visit in the evenings. The patient is having trouble remembering the steps. The nurse should

answer

provide small amounts of information at a time, repeating information frequently.

question

A patient with newly diagnosed type 1 diabetes mellitus has completed a diabetes education program. One month later, the patient confesses at a follow-up appointment that he "just didn't feel like" giving himself the insulin injections. Which nursing diagnosis will the nurse assign the patient?

answer

Noncompliance

question

A nurse is providing patient teaching for a community health center that serves a primarily Portuguese population. The nurse would best serve this patient population by

answer

learning Portuguese.

question

After providing education regarding medications to a patient who has been newly diagnosed with type 2 diabetes mellitus, the nurse would use which part of the nursing process to assess whether the patient understands these new instructions?

answer

Evaluation

question

OTC medications now account for about what percent of all medications used in the United States?

answer

60%

question

A 56-year-old man is taking OTC antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for more than 1 month because "it works for me." The nurse's main concern is that

answer

this self-treatment may be delaying treatment of a more serious problem.

question

The nurse associates use of which OTC medication with the development of hepatotoxicity?

answer

Acetaminophen (Tylenol)

question

A patient tells the nurse that he wants to stop taking his antilipemic drugs and start taking garlic to lower his cholesterol. The nurse's best reply would be:

answer

"Let's explore the evidence that supports the use of garlic to lower your cholesterol."

question

Which statement regarding gene therapy is accurate?

answer

The majority of the world's insulin supply has been produced by recombinant gene technology.

question

A patient's daughter asks the nurse, "What did the test results show? I know they were doing genetic testing on my mother." How should the nurse respond?

answer

Remind the daughter that private information cannot be discussed without the patient's permission.

question

A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first?

answer

The bronchodilator

question

A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time?

answer

albuterol

question

A patient on a dobutamine drip starts to complain that her intravenous line "hurts." The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first?

answer

Stop the intravenous infusion.

question

A patient on a dobutamine drip starts to complain that he feels a "tightness" in his chest that he had not felt before. What will the nurse do first?

answer

Check the patient's vital signs.

question

A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. The nurse's immediate assessment priority would be to

answer

monitor Spo2 with a pulse oximeter.

question

When phentolamine is used to diagnose the presence of pheochromocytoma, the nurse will assess for what indicative finding?

answer

Rapid decrease in blood pressure

question

When administering an alpha blocker for the first time, it is most important for the nurse to assess the patient for the development of

answer

hypotension.

question

A 58-year-old patient is recovering in the intensive care unit after a myocardial infarction (MI). The nurse notes an order for the beta blocker metoprolol (Lopressor). The purpose of this drug is to

answer

inhibit stimulation of the myocardium by circulating catecholamines.

question

The nurse knows that the adverse effects of a nonselective beta blocker are likely to be the most immediately life threatening in which patient?

answer

Patient with asthma

question

A patient with type 2 diabetes is taking a beta blocker as part of treatment for hypertension. Which complication is most likely to develop?

answer

Hypoglycemia

question

The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing

answer

early signs of a cholinergic crisis.

question

A 60-year-old woman asks the nurse about taking ginkgo to help with her memory. The patient has a history of arthritis, type 2 diabetes, thyroid disease, and hypertension. She is currently taking NSAIDs for arthritis, oral antidiabetic medications, thyroid replacement hormone, and a beta blocker for blood pressure. What potential adverse effect from the gingko would be of most concern for this patient?

answer

Bleeding

question

A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect?

answer

1130

question

A patient with Alzheimer's disease accidentally took 2 weeks' worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment?

answer

Administration of atropine

question

Which finding would the nurse anticipate when assessing a patient with an atropine overdose?

answer

Urinary retention

question

Glycopyrrolate (Robinul) and an opioid are administered to a patient before surgery in the preoperative area. The anticholinergic is used to

answer

control secretions during surgery.

question

Before administering tolterodine (Detrol), it is most important for the nurse to assess the patient for a history of which condition?

answer

Angle-closure glaucoma

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