Pharmacology star wars – Flashcards

question
How much does a child who weighs 34 lb weigh in kg?
answer
a)15 b)34 c)68 d)74.8
question
Which organ is most heavily involved in drug metabolism?
answer
Liver
question
Which function is primarily the role of the pharmacist in drug therapy?
answer
Dispensing a drug according to the instructions written in the prescription
question
What action or condition is a major disadvantage of the oral drug delivery route?
answer
First-pass loss of drug is extensive
question
What major consideration allows a drug to be available OTC rather than by prescription?
answer
The drug is safe when the direction for the dosage and scheduling are followed
question
What is the minimal effective concentration?
answer
The smallest amount od drug necessary in the blood or target tissue to result in a measurable intended response
question
What is the meaning of the word contraindication?
answer
A personal or health-related reason why a drug should not be given to a patient
question
What route of a drug administration Is the most commonly used for drug therapy?
answer
Enteral
question
A recently hospitalized patient plans to purchase an OTC drug. What is the most important thing patients should know about using OTC drugs?
answer
OTC drugs still can interact with other medications, so patients should always tell their health care provider before using them with other drugs they may be taking
question
Which term is defined as "the way in which drugs work to change body function?"
answer
Pharmacodynamics
question
A patient has been taking an antihistamine drug for 10 days and reports having drowsiness. What do you suspect the patient is experiencing?
answer
Side effect
question
A drug has a half-life of 6 hours. In how many hours will the drug be considered eliminated from the body (less than 10% of the drug remains)?
answer
24
question
Which category of drugs is available only from a pharmacy?
answer
Prescription
question
The route in which to give a drug is determined by which pharmacokinetic action?
answer
Absorption
question
What are the distribution compartments of a drug?
answer
Intracellular space, bloodstream, and Interstitial space
question
Through which body systems are drugs eliminated?
answer
Digestive, Integumentary, Respiratory, and Urinary
question
Which conditions increase the amount of drug in the blood?
answer
Loading dose, liver impairment and long drug half-life
question
What are the nurse's roles in a patient's drug therapy?
answer
-To teach patients about the drugs prescribed -To administer prescribed drugs directly to the patient
question
Which patient response indicates a drug's intended action or therapeutic response?
answer
a) ankle swelling b) bone strengthening c) constipation d) dizziness b
question
What type of reaction is a child having when he/she becomes more alert and excited when taking an antihistamine that usually makes people sleepy?
answer
a) adverse reaction b) allergic reaction c) intended reaction d) paradoxical reaction d
question
A small molecule that changes a body function by working at the chemical or molecular level
answer
drug
question
Drug therapies include which factors?
answer
a) identifying the specific health problem b)determine what drug or drugs would best help the problem c)deciding the best delivery method and schedule d) ensuring that the proper amount of the drug is given e) helping the patient become an active participant in his or her drug therapy all of the above
question
Pharmacology
answer
the study of drugs
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Extrinsic drugs
answer
medication made outside the body
question
medication made inside the body is?
answer
Intrinsic drugs
question
Drugs that are weaker and have a less potential for harmful side effects without a prescription is?
answer
OTC
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Prescription drugs
answer
drugs that have a greater potential for harm, strong sedating effects, or a potential for addiction are considered too dangerous for self-medication
question
High alert drugs have increase risk for causing a patient harm if it used in error. High alert drugs are:
answer
PINCH (Potassium, Insulin, Narcotics, Chemotherapy,Heparin)
question
Hypokalemia
answer
low blood K+ levels
question
_____________ are places on or in a cell where a drug can attach itself and control cell activity. When extrinsic drug binds to the receptors of a cell and causes the same response that intrinsic drug does, the extrinsic drug is called _____________? An extrinsic drug that works by blocking the receptors site is called ______________?
answer
receptors; agonist; antagonist
question
Physiological effect
answer
the outcome of the mechanism of action of a drug
question
Personal response is also known
answer
idiosyncratic response
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Pharmacokinetics
answer
a drug that enters a living human body, the body exerts its effect on a drug
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____________ is the movement of a drug from the outside of the body into the bloodstream. _____________ is the amount of a drug dose that actually reaches the blood.
answer
absorption; bioavailabilty
question
Percutaneous route (transdermal)
answer
drug enters through the skin or membrane (examples: mouth, nose, lungs, rectum or vagina) (inhaled by the mouth or nose, placed under tongue to dissolve)
question
Enteral route
answer
drug that goes through the GI (examples: swallow, liquid, tube directly inserted in the stomach or rectum)
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Parenteral route
answer
drugs that are injected into the body (examples : IM, IV)
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Distribution of a drug can spread to three specific compartments
answer
bloodstream, watery space between body cells, space inside the cell
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Metabolism
answer
is the chemical reaction in the body that changes the chemical shape and content of the drug (the organs and cells most involved in drug metabolism are the liver, kidney, lungs and WBC)
question
Elimination is the removal of drugs from the body. Drugs can leave the body in the __________, _____________, ______________, _______________, ________________ and _______________.
answer
feces, urine, exhaled air, sweat, tears, saliva and breast milk
question
Liver damage is called? Kidney damage is called?
answer
hepatotoxicity;nephrotoxicity
question
Drugs can interact with
answer
drugs, food, vitamins and herbal compounds
question
Microdrip tubing set delivers very small drops. This would be ideal for _________ and __________.
answer
children and elderly
question
Macrodrip delivers larger drops and its used when fast infusion rates or larger quantities of fluids or drugs are needed. This is ideal for ________.
answer
adults.
question
For an order to start IV therapy to be valid it must be valid, it, it must contain:
answer
-the specific drug to IV solution to be infused -the dosage or volume -the duration -the rate of infusion
question
Infiltration
answer
a condition that occurs when an IV needle or catheter
question
When the fluid or drug that infiltrates is irritating and leads to tissue damage or loss
answer
Extravasation
question
True or False: If you notice that the IV therapy is 2 hours behind schedule, it is a good idea to speed up the IV to make up for lost time.
answer
False
question
True or False: You can use the 15- Second Rule can be used on pump IV bags.
answer
False
question
True or False: For micro drip tubing, the drop factor is 60 drops/mL.
answer
True
question
True or False: Always calculate both the start and stop times and then time-tape the IV bag, even when it is on a controller or pump
answer
True
question
In starting a shift, the nurse notices that a patient's intravenous (IV) therapy is 4 hours behind schedule. What is the first course of action taken by the nurse?
answer
a) Assess the IV site. b) Count the drips in 15 seconds. c) Speed up the IV rate. d) Remove the IV line. a
question
Which of the eight rights should you apply immediately after you give a drug?
answer
Right documentation
question
For which order do you administer a drug as the patient needs it?
answer
PRN order
question
Which process was developed to ensure that a patient receives the correct medications when transferred from the ICU to a medical patient care unit?
answer
medication reconciliation
question
Which are parenteral routes?
answer
Intradermal, subcutaneous, and intravenous
question
What must you do to protect yourself when giving a topical drug like nitroglycerin ointment?
answer
Put clean gloves
question
What is the best way to check that you are giving the drug to the right patient?
answer
Check two unique patient identifiers
question
A patient receiving a daily dose of furosemide needs a daily dose of oral K+. Which type of order does the prescriber use?
answer
Standing/routine order
question
Which intervention is the best way to prevent drug errors such as omissions, duplication, dosing errors, and drug interaction?
answer
Follow the procedure of the eight "rights"
question
You are giving ear drops to a 10 year-old child, which technique will you use?
answer
Pull the ear lobe up and out
question
What are the 8 rights
answer
-documentation -dosage -time -patient -route -response -diagnose -drug
question
Standing (routine) order
answer
written when a patient is receiving a drug on a regular basis
question
Single-dose order
answer
an order for a drug that is given only once
question
PRN order
answer
given to patients as needed
question
STAT order
answer
given to patients one time and immediately
question
drug error
answer
is defined as a preventable event that leads to inappropriate drug use or patient harm
question
Leading cause of death and injury
answer
drug error
question
Important guidelines to follow before giving any drug
answer
-never give drugs prepared by someone else -use sterile technique with syringes and needles -be alert to drug names that sound or look alike -always document the administration of a drug
question
After giving a certain medication, what should you do?
answer
-document the drug's administration -check the patient for effects
question
Upon assessing a patient's intravenous (IV) site, the nurse notices that the skin is cool to the touch and the patient reports that it hurts. The IV pump alarm has not gone off. What should the nurse do next?
answer
a)Provide a warming pad. b)Restart the IV line at another site. c)Slow the IV rate. d)Speed up the IV rate to complete the infusion. b
question
A patient's IV order reads "infuse1000 mL in 6 hours." How many milliliters will the nurse infuse in 1 hour?
answer
a)60 b)125 c)167 d)6000 c
question
The nurse is using a macrodrip shortcut. What is the drip rate (drops/minute) the nurse calculates for 1000 mL lactated Ringer's in 8 hours with a drop factor of 15?
answer
a)13 b)31 c)42 d)60 b
question
The nurse is using the 15-second rule on a manual drip. How many drips should the nurse count for a drip rate of 13 gtt/min?
answer
a)3 b)13 c)15 d)125 a
question
The nurse is about to administer total parenteral nutrition (TPN) to a patient. What infusion control technique should the nurse use?
answer
a)Manual b)Controller c)Pump Correct d)Syringe pump c
question
The nurse is assessing a patient's intravenous site. It is red and warm to the touch, with hard streaks following the vein path. What should the nurse suspect?
answer
a)Extravasation b)Phlebitis c)Infection d)Infiltration b
question
The nurse is assessing a patient who is receiving intravenous (IV) fluid therapy. What is the most common systemic imbalance for the nurse to assess?
answer
a)Electrolyte imbalance b)Overload c)Extravasation d)Infiltration b
question
The nurse is checking a patient's intravenous (IV) insertion site for signs of infection. How often should the nurse assess the site for infection?
answer
a)Hourly b)Every 2 hours c)Every 4 hours d)Every 8 hours c
question
The nurse is assessing a patient's intravenous (IV) site. What are the most common complications resulting from (IV) therapy that the nurse must watch for? (select all that apply)
answer
a)Adverse drug reactions b)Acquired immune deficiency syndrome (AIDS) c)Fluid overload d)Infection e)Infiltration a,c,d,e
question
The nurse is assessing a patient who is receiving intravenous therapy. What patients are at highest risk for fluid overload during (IV) therapy? (select all that apply)
answer
a)Older adult b)Infant c)Patient with kidney problems d)Patient with heart problems e)Patient with digestive problems a,b,c,d
question
Which is a common health problem resulting from IV therapy?
answer
A. The patient is more likely to gain weight when receiving IV therapy B. Adverse drug reactions happen more quickly with IV drugs C. Patients are required to stay in bed during IV therapy D. IV drugs cost more than oral drugs B
question
Why does a drop factor of 10 result in a faster infusion at the same number of drops per minute than a drop factor diameter of the 15?
answer
A. A drop factor of 10 is a bigger individual drop than a drop factor of 15 B. An infusion set with a drop factor of 10 has more drops per milliliter than an infusion set with a drop factor of 15 C. An infusion set with a drop factor of 10 has macrotubing, and an infusion set with a drop factor of 15 has microtubing. D. An infusion set with a drop factor of 15 has macrotubing, and an infusion set with a drop factor of 10 has microtubing A
question
Which parts of an order are needed to correctly calculate the flow rate?
answer
A. Drop factor, drop rate B. Specific fluid, number of hours C. Specific fluid, total volume to be infused D. Total volume to be infused, number of hours D
question
Calculate the flow rate for 1000 mL of dextrose 5% in NS to be infused over 6 hours. The tubing that is available has a drop factor of 20 gtts/mL.
answer
44 gtts/min
question
A patient's IV infusion is supposed to have a drip rate of 31 gtts/min. You count 6 gtts/15 seconds. What is your best action?
answer
A. Nothing; the IV flow rate is correct. B. increase the drip rate to 8 gtts/15 seconds. C. Increase the drip rate to 10 gtts/15 seconds. D. Decrease the drip rate to 4 gtts/15 seconds. B
question
Which parts of a written order for IV therapy are needed for it to be a valid order?
answer
A. Drop factor, flow rate, IV site B. Specific fluid, number of hours, drop rate C. Specific fluid, total volume to be infused, number of hours D. Total volume to be infused, number of hours, specific drop factor C
question
Cancer cell features:
answer
-have continuous cell division -divide more quickly than other cells -do not respond to signals for normal cell death (unlimited life span/immortal) -overgrow and spread(metastasize) into other boys areas
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Carcinogenesis
answer
changing a normal cell to a cancer cell.
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True or False: The first step in cancer development is damaged to the genes controlling cell division.
answer
True.
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Metastasis
answer
Tumors that spread and form new tumors elsewhere.
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True or False: When the tumor is now in another organ, the cancer alters tissues.
answer
False.
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Cancer causes:
answer
question
True or False: Advancing age is the most important risk factor for cancer. Exposure to carcinogens adds up over a lifetime, and immune protection decreases with age.
answer
True.
question
Cancer Treatment:
answer
-Surgery -Radiation -Chemotherapy -Hormone manipulation -Targeted therapy
question
Chemotherapy
answer
The treatment of cancer with chemical agents, which can increase survival time and may cure the disease. It is used for when cancer has spread and is not contained/ systemic.
question
Cytotoxic effects
answer
cell-damaging and cell-killing effects
question
The 6 major chemotherapy drug categories are:
answer
-Antimetabolites -Antitumor antibiotics -Antimitotics -Alkylating agents -Topoisomerase inhibitors -Miscellaneous drugs
question
The nurse is caring for a patient with cancer. The nurse knows that what is the main reason healthy cells change into cancer cells?
answer
A)Loss of balance between cell division and death B)Exposure to carcinogens C)Age of the cell D)Ability of a cancer cell to move from a primary location to a secondary locations A
question
A patient asks the nurse about the difference between cancerous tumors and benign tumors. What statement by the nurse is true?
answer
A)Cancerous tumors do not migrate. B)Benign tumors can become cancers. C)Benign tumors grow by expansion. D)Cancerous tumors can become benign tumors. C
question
A patient with lung cancer asks the nurse why a brain scan has been scheduled. The nurse's response should be based on what knowledge?
answer
A)Brain cancer often metastasizes to the lung. B)To rule out any metastasis to the brain C)Brain cancer and lung cancer frequently originate simultaneously. D)Lung cancer often results from brain cancer. B
question
The nurse is caring for a patient receiving intravenous therapy (IV). The nurse knows that what is the most important intervention to prevent (IV) extravasation?
answer
A)Changing the IV tubing according to hospital policy B)Using an IV pump C)Checking IV flow rate and the infusion site D)Documentation C
question
The oncology nurse is caring for a cancer patient receiving treatment. The nurse knows that what less-than-normal patient assessment can delay the administration of chemotherapy the morning of a scheduled treatment?
answer
A)Height and weight B)Vital signs C)Low white blood cell (WBC) count (neutropenia) D)Platelet count of 2000,000/mm3 C
question
A specialized oncology nurse is assessing the learning needs of an oncology patient and family and coordinating the highly complex patient/family education. What cancer therapy side effect can be life threatening and is the most common reason for changing the therapy's dose or schedule?
answer
A)Changes in cognitive function B)Bone marrow blood cell formation suppression C)Dehydration related to nausea/vomiting D)Open sores on mucous membranes (mucositis) B
question
The nurse is caring for a patient receiving high-dose biologic response mediators (BRMs) therapy. Where should the patient receive this type of cancer treatment?
answer
A)Cancer care floor unit B)Outpatient clinic C)Intensive care unit D)Emergency department C
question
A patient with multiple myeloma asks the nurse, "How does thalidomide (Thalomid) work?" What is the nurse's best response?
answer
A)"Thalidomide increases the formation of blood vessels in tumors." B)"With thalidomide, tumor blood vessels are reduced." C)"Thalidomide blocks hormones from enhancing tumor cells." D)"Thalidomide stimulates the immune system cells to attack and destroy cancer cells." B
question
A patient with breast cancer asks the oncology nurse why she can't have the same targeted therapy her friend, who is having great results, is receiving. What is the nurse's best response?
answer
A)"Targeted therapy isn't compatible with your therapy." B)"Your friend's cancer must be different." C)"Your friend's cell targets must be stronger." D)"Not all cells have enough of a target for the therapy to work." D
question
The oncology nurse knows that colony-stimulating factors are a type of biological response modifiers (BRMs). For what type of cancer is this therapy contraindicated?
answer
A)Bone B)Brain C)Prostate D)Leukemia D
question
A patient admitted to rule out cancer asks the nurse what are some of the risk factors for cancer. The nurse knows that what is the most important risk factor for cancer?
answer
A)Pollution B)Genetics C)Worksite chemicals D)A person's age D
question
The oncology nurse knows that what cancer treatments actually kill cancer cells?
answer
A)Chemotherapy B)Hormonal therapy C)Immunotherapy D)Targeted therapy A
question
A patient receiving hormone manipulation with estrogen for cancer therapy has all of the following side effects. For which one should the prescriber be notified immediately?
answer
A)Acne and darkening of the skin B)Breast swelling and tenderness C)Fluid retention with weight gain D)Redness, pain, and swelling of the calf D
question
How is therapy with biological response modifiers (BRMs) different from targeted therapy?
answer
A)BRMs are always administered as oral agents, whereas targeted therapies must be administered intravenously to prevent deactivation by the intestinal tract enzymes. B)Targeted therapy is effective only for those cancers that are inherited or familial, and BRMs are most effective against cancers that do not run in families. C)BRMs can affect the general immune response of anyone who takes the drug, and targeted therapies affect only the cancer cell that has a specific target. D)There is no difference between these two therapies. BRMs are just another name for targeted therapy. C
question
The oncology nurse is caring for a group of cancer patients. What factors does the nurse know determine the types of cancer therapies that will most likely benefit a patient? (select all that apply)
answer
A)Type of cancer B)Metastasis C)Health of the patient D)Patient's insurance E)Treatment availability A,B,C
question
The cancer center knows that what groups of people who have completed an approved chemotherapy course can safely and legally administer chemotherapy drugs intravenously? (select all that apply)
answer
A)Registered nurses (RNs) B)Pharmacists C)Licensed practical/vocational nurses (LPNs/LVNs) D)Advanced practice nurses E)Nurse's aides (NAs) A,D
question
The nurse is caring for a patient receiving hormonal therapy. The nurse knows that this type of therapy is recommended for which types of cancers? (select all that apply)
answer
A)Bone B)Brain C)Breast D)Stomach E)Prostate C,E
question
Which personal factor is the most common cause of cancer development?
answer
A. Living in a geographic area with poor sanitation B. Having parents who died of cancer C. Eating a high-fat diet D. Advancing age D
question
How do most cytotoxic chemotherapy drugs rid the body of cancer cells?
answer
A. Interfering with cancer cell division B. Preventing cancer cells from receiving needed vitamins C. Enhancing the immune system's ability to recognize and kill cancer cells D. Forcing cancer cells to undergo reverse transformation to become normal cells A
question
Which chemotherapy drug has the highest potential to induce nausea and vomiting?
answer
A. azacitidine (Vidaza) B. fludarabine (Fludara) C. cyclophosphamide (Cytoxan) D. irinotecan (Camptosar) C
question
Which agents for targeted therapy belong to the epidermal growth factor receptor inhibitor (EGRFI) class of drug? (Select all that apply.)
answer
A. bevacizumab (Avastin) B. cetuximab (Erbitux) C. gefitinib (Iressa) D. imatinib (Gleevec) E. lapatinib (Tykerb) F. rituximab (Rituxan) G. trastuzumab (Herceptin) B,C,G
question
Which class of chemotherapy drugs exert their effect the actions needed for proper DNA maintenance so that DNA breakage occurs leading to cancer cell death?
answer
A. Antitumor antibiotics B. Hormone antagonists C. Multikinase inhibitors D. Topoisomerase inhibitors D
question
Which of the following chemotherapy agents listed belong to the alkylating agent class? Select all that apply.
answer
A. azacitidine (Vidaza) B. bleomycin (Blenoxane) C. busulfan (Busulfex) D. cyclophosphamide (Cytoxan) E docetaxel (Taxotere) F. irinotecan (Camptosar) G. methotrexate (Mexate) H. procarbazine (Matulane) I. oxaliplatin (Eloxatin) J. temozolomine (Temodar) C,D,I,J
question
Which action is most important to prevent nausea and vomiting in the patient prescribed intravenous cytotoxic chemotherapy?
answer
A. Keeping the patient NPO (nothing by mouth) during the time the chemotherapy drugs are infusing B. Administering antiemetic medications before administering chemotherapy C. Ensuring that the chemotherapy is infused over a 4- to 6-hour period D. Assessing the patient's responses hourly during the infusion period B
question
A patient asks why cancer cell growth is considered "uncontrolled." What is your best response?
answer
A. "Cancer cells always divide more rapidly than normal cells." B. "When each cancer cell divides, it usually produces more than two cells." C. "As you age, your immune system is less active, which allows cancer cells to grow faster." D. "Cancer cells divide almost continuously, and normal cells divide only when they are needed." D
question
A patient with breast cancer asks why so many drugs are used together to treat her cancer. What is your best response?
answer
A. "Each drug works against cancer cells in different ways, and using several increases the likelihood that the cancer will be cured." B. "By using several drugs together, we can avoid using radiation therapy, which would cause many more permanent side effects." C. "Each drug goes to a separate body area. That way, because your cancer has spread to so many areas, all areas with cancer will receive the right drug." D. "The doctors are not sure which drug will work best against the cancer type that you have. Using several at the same time improves the chances that one will work" A
question
You are monitoring a patient receiving IV chemotherapy that was started by a chemotherapy- certified nurse. After 2 hours the patient reports burning and pain at the IV site. Lowering the IV results in an observable brisk blood return. What is your best first action?
answer
A. Stop the drug infusion and run at least 100 mL of normal saline into IV access B. Notify the chemotherapy-certified nurse who started C. Slow the rate of infusion but continue it because there is a good blood return D. Discontinue the infusion, remove the IV and document the site condition D
question
A patient receiving tamoxifen (Nolvadex) asks how this therapy helps fight breast cancer. In addition to telling her that the breast cancer cells need estrogen to continue growing, what is your best response?
answer
A. "This agent reduces the availability of estrogen to your cancer cells." B. "This agent causes you to secrete testosterone instead of estrogen." C. "This agent kills off both the normal estrogen- secreting cells and the cancer cells." D. "This agent destroys circulating estrogen and all other female hormones." A
question
A patient who has just been diagnosed with lymphoma asks why the treatment plan does not include the drug rituximab (Rituxan) about which he has read. What is your best response?
answer
A. "Your immune system is too weak to tolerate Rituxan." B. "This drug is experimental and too dangerous for you to take before trying other therapies C. "Your lymphoma cells do not have the protein on which this drug works, so you would not benefit from this therapy." D. "You are young and can better tolerate the standard therapies for lymphoma that have been proven effective but have strong side effects."
question
A patient is prescribed tamoxifen (Nolvadex) 20 mg orally twice daily for a total daily dosage of 40 mg. The drug comes in 10-mg tablets. How many tablets does the patient take twice daily?_________ tablet (s)
answer
2
question
A child with cancer is to receive methotrexate 2.5 mg/kg intravenously. The child weighs 39.6 lb a. What is the child's weight in kilograms?______ kg b. What is the appropriate dose?_______ mg c. The drug is prepared at a concentration of 25 mg/mL How many milliliters are the correct dose?_______ mL The same drug is to be administered to an adult who weighs 165 lb. d. What is the adult's weight in kilograms?_______ kg. e. What is the appropriate dose?_______ mg f. The drug is prepared at a concentration of 25 mg/mL. How many milliliters are the correct dose?________mL.
answer
a. 18kg b. 45mg c. 1.8mL d. 75kg e. 187.5mg f. 7.5mL
question
An adult with lung cancer is prescribed to receive cisplatin (Platino) intravenously at a dosage of 79 mg per m^2. He is 6'4" tall and weighs 210 lb. a. What is his height in cm?________ b. What is his weight in kg?______ kg c. What is his body surface area in m2?______ d. What is the correct dose of cisplatin for this patient?____mg
answer
a. 193.4cm b. 95.5kg c. 1.84 d. 145
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question
How much does a child who weighs 34 lb weigh in kg?
answer
a)15 b)34 c)68 d)74.8
question
Which organ is most heavily involved in drug metabolism?
answer
Liver
question
Which function is primarily the role of the pharmacist in drug therapy?
answer
Dispensing a drug according to the instructions written in the prescription
question
What action or condition is a major disadvantage of the oral drug delivery route?
answer
First-pass loss of drug is extensive
question
What major consideration allows a drug to be available OTC rather than by prescription?
answer
The drug is safe when the direction for the dosage and scheduling are followed
question
What is the minimal effective concentration?
answer
The smallest amount od drug necessary in the blood or target tissue to result in a measurable intended response
question
What is the meaning of the word contraindication?
answer
A personal or health-related reason why a drug should not be given to a patient
question
What route of a drug administration Is the most commonly used for drug therapy?
answer
Enteral
question
A recently hospitalized patient plans to purchase an OTC drug. What is the most important thing patients should know about using OTC drugs?
answer
OTC drugs still can interact with other medications, so patients should always tell their health care provider before using them with other drugs they may be taking
question
Which term is defined as "the way in which drugs work to change body function?"
answer
Pharmacodynamics
question
A patient has been taking an antihistamine drug for 10 days and reports having drowsiness. What do you suspect the patient is experiencing?
answer
Side effect
question
A drug has a half-life of 6 hours. In how many hours will the drug be considered eliminated from the body (less than 10% of the drug remains)?
answer
24
question
Which category of drugs is available only from a pharmacy?
answer
Prescription
question
The route in which to give a drug is determined by which pharmacokinetic action?
answer
Absorption
question
What are the distribution compartments of a drug?
answer
Intracellular space, bloodstream, and Interstitial space
question
Through which body systems are drugs eliminated?
answer
Digestive, Integumentary, Respiratory, and Urinary
question
Which conditions increase the amount of drug in the blood?
answer
Loading dose, liver impairment and long drug half-life
question
What are the nurse's roles in a patient's drug therapy?
answer
-To teach patients about the drugs prescribed -To administer prescribed drugs directly to the patient
question
Which patient response indicates a drug's intended action or therapeutic response?
answer
a) ankle swelling b) bone strengthening c) constipation d) dizziness b
question
What type of reaction is a child having when he/she becomes more alert and excited when taking an antihistamine that usually makes people sleepy?
answer
a) adverse reaction b) allergic reaction c) intended reaction d) paradoxical reaction d
question
A small molecule that changes a body function by working at the chemical or molecular level
answer
drug
question
Drug therapies include which factors?
answer
a) identifying the specific health problem b)determine what drug or drugs would best help the problem c)deciding the best delivery method and schedule d) ensuring that the proper amount of the drug is given e) helping the patient become an active participant in his or her drug therapy all of the above
question
Pharmacology
answer
the study of drugs
question
Extrinsic drugs
answer
medication made outside the body
question
medication made inside the body is?
answer
Intrinsic drugs
question
Drugs that are weaker and have a less potential for harmful side effects without a prescription is?
answer
OTC
question
Prescription drugs
answer
drugs that have a greater potential for harm, strong sedating effects, or a potential for addiction are considered too dangerous for self-medication
question
High alert drugs have increase risk for causing a patient harm if it used in error. High alert drugs are:
answer
PINCH (Potassium, Insulin, Narcotics, Chemotherapy,Heparin)
question
Hypokalemia
answer
low blood K+ levels
question
_____________ are places on or in a cell where a drug can attach itself and control cell activity. When extrinsic drug binds to the receptors of a cell and causes the same response that intrinsic drug does, the extrinsic drug is called _____________? An extrinsic drug that works by blocking the receptors site is called ______________?
answer
receptors; agonist; antagonist
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Physiological effect
answer
the outcome of the mechanism of action of a drug
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Personal response is also known
answer
idiosyncratic response
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Pharmacokinetics
answer
a drug that enters a living human body, the body exerts its effect on a drug
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____________ is the movement of a drug from the outside of the body into the bloodstream. _____________ is the amount of a drug dose that actually reaches the blood.
answer
absorption; bioavailabilty
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Percutaneous route (transdermal)
answer
drug enters through the skin or membrane (examples: mouth, nose, lungs, rectum or vagina) (inhaled by the mouth or nose, placed under tongue to dissolve)
question
Enteral route
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drug that goes through the GI (examples: swallow, liquid, tube directly inserted in the stomach or rectum)
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Parenteral route
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drugs that are injected into the body (examples : IM, IV)
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Distribution of a drug can spread to three specific compartments
answer
bloodstream, watery space between body cells, space inside the cell
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Metabolism
answer
is the chemical reaction in the body that changes the chemical shape and content of the drug (the organs and cells most involved in drug metabolism are the liver, kidney, lungs and WBC)
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Elimination is the removal of drugs from the body. Drugs can leave the body in the __________, _____________, ______________, _______________, ________________ and _______________.
answer
feces, urine, exhaled air, sweat, tears, saliva and breast milk
question
Liver damage is called? Kidney damage is called?
answer
hepatotoxicity;nephrotoxicity
question
Drugs can interact with
answer
drugs, food, vitamins and herbal compounds
question
Microdrip tubing set delivers very small drops. This would be ideal for _________ and __________.
answer
children and elderly
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Macrodrip delivers larger drops and its used when fast infusion rates or larger quantities of fluids or drugs are needed. This is ideal for ________.
answer
adults.
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For an order to start IV therapy to be valid it must be valid, it, it must contain:
answer
-the specific drug to IV solution to be infused -the dosage or volume -the duration -the rate of infusion
question
Infiltration
answer
a condition that occurs when an IV needle or catheter
question
When the fluid or drug that infiltrates is irritating and leads to tissue damage or loss
answer
Extravasation
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True or False: If you notice that the IV therapy is 2 hours behind schedule, it is a good idea to speed up the IV to make up for lost time.
answer
False
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True or False: You can use the 15- Second Rule can be used on pump IV bags.
answer
False
question
True or False: For micro drip tubing, the drop factor is 60 drops/mL.
answer
True
question
True or False: Always calculate both the start and stop times and then time-tape the IV bag, even when it is on a controller or pump
answer
True
question
In starting a shift, the nurse notices that a patient's intravenous (IV) therapy is 4 hours behind schedule. What is the first course of action taken by the nurse?
answer
a) Assess the IV site. b) Count the drips in 15 seconds. c) Speed up the IV rate. d) Remove the IV line. a
question
Which of the eight rights should you apply immediately after you give a drug?
answer
Right documentation
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For which order do you administer a drug as the patient needs it?
answer
PRN order
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Which process was developed to ensure that a patient receives the correct medications when transferred from the ICU to a medical patient care unit?
answer
medication reconciliation
question
Which are parenteral routes?
answer
Intradermal, subcutaneous, and intravenous
question
What must you do to protect yourself when giving a topical drug like nitroglycerin ointment?
answer
Put clean gloves
question
What is the best way to check that you are giving the drug to the right patient?
answer
Check two unique patient identifiers
question
A patient receiving a daily dose of furosemide needs a daily dose of oral K+. Which type of order does the prescriber use?
answer
Standing/routine order
question
Which intervention is the best way to prevent drug errors such as omissions, duplication, dosing errors, and drug interaction?
answer
Follow the procedure of the eight "rights"
question
You are giving ear drops to a 10 year-old child, which technique will you use?
answer
Pull the ear lobe up and out
question
What are the 8 rights
answer
-documentation -dosage -time -patient -route -response -diagnose -drug
question
Standing (routine) order
answer
written when a patient is receiving a drug on a regular basis
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Single-dose order
answer
an order for a drug that is given only once
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PRN order
answer
given to patients as needed
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STAT order
answer
given to patients one time and immediately
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drug error
answer
is defined as a preventable event that leads to inappropriate drug use or patient harm
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Leading cause of death and injury
answer
drug error
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Important guidelines to follow before giving any drug
answer
-never give drugs prepared by someone else -use sterile technique with syringes and needles -be alert to drug names that sound or look alike -always document the administration of a drug
question
After giving a certain medication, what should you do?
answer
-document the drug's administration -check the patient for effects
question
Upon assessing a patient's intravenous (IV) site, the nurse notices that the skin is cool to the touch and the patient reports that it hurts. The IV pump alarm has not gone off. What should the nurse do next?
answer
a)Provide a warming pad. b)Restart the IV line at another site. c)Slow the IV rate. d)Speed up the IV rate to complete the infusion. b
question
A patient's IV order reads "infuse1000 mL in 6 hours." How many milliliters will the nurse infuse in 1 hour?
answer
a)60 b)125 c)167 d)6000 c
question
The nurse is using a macrodrip shortcut. What is the drip rate (drops/minute) the nurse calculates for 1000 mL lactated Ringer's in 8 hours with a drop factor of 15?
answer
a)13 b)31 c)42 d)60 b
question
The nurse is using the 15-second rule on a manual drip. How many drips should the nurse count for a drip rate of 13 gtt/min?
answer
a)3 b)13 c)15 d)125 a
question
The nurse is about to administer total parenteral nutrition (TPN) to a patient. What infusion control technique should the nurse use?
answer
a)Manual b)Controller c)Pump Correct d)Syringe pump c
question
The nurse is assessing a patient's intravenous site. It is red and warm to the touch, with hard streaks following the vein path. What should the nurse suspect?
answer
a)Extravasation b)Phlebitis c)Infection d)Infiltration b
question
The nurse is assessing a patient who is receiving intravenous (IV) fluid therapy. What is the most common systemic imbalance for the nurse to assess?
answer
a)Electrolyte imbalance b)Overload c)Extravasation d)Infiltration b
question
The nurse is checking a patient's intravenous (IV) insertion site for signs of infection. How often should the nurse assess the site for infection?
answer
a)Hourly b)Every 2 hours c)Every 4 hours d)Every 8 hours c
question
The nurse is assessing a patient's intravenous (IV) site. What are the most common complications resulting from (IV) therapy that the nurse must watch for? (select all that apply)
answer
a)Adverse drug reactions b)Acquired immune deficiency syndrome (AIDS) c)Fluid overload d)Infection e)Infiltration a,c,d,e
question
The nurse is assessing a patient who is receiving intravenous therapy. What patients are at highest risk for fluid overload during (IV) therapy? (select all that apply)
answer
a)Older adult b)Infant c)Patient with kidney problems d)Patient with heart problems e)Patient with digestive problems a,b,c,d
question
Which is a common health problem resulting from IV therapy?
answer
A. The patient is more likely to gain weight when receiving IV therapy B. Adverse drug reactions happen more quickly with IV drugs C. Patients are required to stay in bed during IV therapy D. IV drugs cost more than oral drugs B
question
Why does a drop factor of 10 result in a faster infusion at the same number of drops per minute than a drop factor diameter of the 15?
answer
A. A drop factor of 10 is a bigger individual drop than a drop factor of 15 B. An infusion set with a drop factor of 10 has more drops per milliliter than an infusion set with a drop factor of 15 C. An infusion set with a drop factor of 10 has macrotubing, and an infusion set with a drop factor of 15 has microtubing. D. An infusion set with a drop factor of 15 has macrotubing, and an infusion set with a drop factor of 10 has microtubing A
question
Which parts of an order are needed to correctly calculate the flow rate?
answer
A. Drop factor, drop rate B. Specific fluid, number of hours C. Specific fluid, total volume to be infused D. Total volume to be infused, number of hours D
question
Calculate the flow rate for 1000 mL of dextrose 5% in NS to be infused over 6 hours. The tubing that is available has a drop factor of 20 gtts/mL.
answer
44 gtts/min
question
A patient's IV infusion is supposed to have a drip rate of 31 gtts/min. You count 6 gtts/15 seconds. What is your best action?
answer
A. Nothing; the IV flow rate is correct. B. increase the drip rate to 8 gtts/15 seconds. C. Increase the drip rate to 10 gtts/15 seconds. D. Decrease the drip rate to 4 gtts/15 seconds. B
question
Which parts of a written order for IV therapy are needed for it to be a valid order?
answer
A. Drop factor, flow rate, IV site B. Specific fluid, number of hours, drop rate C. Specific fluid, total volume to be infused, number of hours D. Total volume to be infused, number of hours, specific drop factor C
question
Cancer cell features:
answer
-have continuous cell division -divide more quickly than other cells -do not respond to signals for normal cell death (unlimited life span/immortal) -overgrow and spread(metastasize) into other boys areas
question
Carcinogenesis
answer
changing a normal cell to a cancer cell.
question
True or False: The first step in cancer development is damaged to the genes controlling cell division.
answer
True.
question
Metastasis
answer
Tumors that spread and form new tumors elsewhere.
question
True or False: When the tumor is now in another organ, the cancer alters tissues.
answer
False.
question
Cancer causes:
answer
question
True or False: Advancing age is the most important risk factor for cancer. Exposure to carcinogens adds up over a lifetime, and immune protection decreases with age.
answer
True.
question
Cancer Treatment:
answer
-Surgery -Radiation -Chemotherapy -Hormone manipulation -Targeted therapy
question
Chemotherapy
answer
The treatment of cancer with chemical agents, which can increase survival time and may cure the disease. It is used for when cancer has spread and is not contained/ systemic.
question
Cytotoxic effects
answer
cell-damaging and cell-killing effects
question
The 6 major chemotherapy drug categories are:
answer
-Antimetabolites -Antitumor antibiotics -Antimitotics -Alkylating agents -Topoisomerase inhibitors -Miscellaneous drugs
question
The nurse is caring for a patient with cancer. The nurse knows that what is the main reason healthy cells change into cancer cells?
answer
A)Loss of balance between cell division and death B)Exposure to carcinogens C)Age of the cell D)Ability of a cancer cell to move from a primary location to a secondary locations A
question
A patient asks the nurse about the difference between cancerous tumors and benign tumors. What statement by the nurse is true?
answer
A)Cancerous tumors do not migrate. B)Benign tumors can become cancers. C)Benign tumors grow by expansion. D)Cancerous tumors can become benign tumors. C
question
A patient with lung cancer asks the nurse why a brain scan has been scheduled. The nurse's response should be based on what knowledge?
answer
A)Brain cancer often metastasizes to the lung. B)To rule out any metastasis to the brain C)Brain cancer and lung cancer frequently originate simultaneously. D)Lung cancer often results from brain cancer. B
question
The nurse is caring for a patient receiving intravenous therapy (IV). The nurse knows that what is the most important intervention to prevent (IV) extravasation?
answer
A)Changing the IV tubing according to hospital policy B)Using an IV pump C)Checking IV flow rate and the infusion site D)Documentation C
question
The oncology nurse is caring for a cancer patient receiving treatment. The nurse knows that what less-than-normal patient assessment can delay the administration of chemotherapy the morning of a scheduled treatment?
answer
A)Height and weight B)Vital signs C)Low white blood cell (WBC) count (neutropenia) D)Platelet count of 2000,000/mm3 C
question
A specialized oncology nurse is assessing the learning needs of an oncology patient and family and coordinating the highly complex patient/family education. What cancer therapy side effect can be life threatening and is the most common reason for changing the therapy's dose or schedule?
answer
A)Changes in cognitive function B)Bone marrow blood cell formation suppression C)Dehydration related to nausea/vomiting D)Open sores on mucous membranes (mucositis) B
question
The nurse is caring for a patient receiving high-dose biologic response mediators (BRMs) therapy. Where should the patient receive this type of cancer treatment?
answer
A)Cancer care floor unit B)Outpatient clinic C)Intensive care unit D)Emergency department C
question
A patient with multiple myeloma asks the nurse, "How does thalidomide (Thalomid) work?" What is the nurse's best response?
answer
A)"Thalidomide increases the formation of blood vessels in tumors." B)"With thalidomide, tumor blood vessels are reduced." C)"Thalidomide blocks hormones from enhancing tumor cells." D)"Thalidomide stimulates the immune system cells to attack and destroy cancer cells." B
question
A patient with breast cancer asks the oncology nurse why she can't have the same targeted therapy her friend, who is having great results, is receiving. What is the nurse's best response?
answer
A)"Targeted therapy isn't compatible with your therapy." B)"Your friend's cancer must be different." C)"Your friend's cell targets must be stronger." D)"Not all cells have enough of a target for the therapy to work." D
question
The oncology nurse knows that colony-stimulating factors are a type of biological response modifiers (BRMs). For what type of cancer is this therapy contraindicated?
answer
A)Bone B)Brain C)Prostate D)Leukemia D
question
A patient admitted to rule out cancer asks the nurse what are some of the risk factors for cancer. The nurse knows that what is the most important risk factor for cancer?
answer
A)Pollution B)Genetics C)Worksite chemicals D)A person's age D
question
The oncology nurse knows that what cancer treatments actually kill cancer cells?
answer
A)Chemotherapy B)Hormonal therapy C)Immunotherapy D)Targeted therapy A
question
A patient receiving hormone manipulation with estrogen for cancer therapy has all of the following side effects. For which one should the prescriber be notified immediately?
answer
A)Acne and darkening of the skin B)Breast swelling and tenderness C)Fluid retention with weight gain D)Redness, pain, and swelling of the calf D
question
How is therapy with biological response modifiers (BRMs) different from targeted therapy?
answer
A)BRMs are always administered as oral agents, whereas targeted therapies must be administered intravenously to prevent deactivation by the intestinal tract enzymes. B)Targeted therapy is effective only for those cancers that are inherited or familial, and BRMs are most effective against cancers that do not run in families. C)BRMs can affect the general immune response of anyone who takes the drug, and targeted therapies affect only the cancer cell that has a specific target. D)There is no difference between these two therapies. BRMs are just another name for targeted therapy. C
question
The oncology nurse is caring for a group of cancer patients. What factors does the nurse know determine the types of cancer therapies that will most likely benefit a patient? (select all that apply)
answer
A)Type of cancer B)Metastasis C)Health of the patient D)Patient's insurance E)Treatment availability A,B,C
question
The cancer center knows that what groups of people who have completed an approved chemotherapy course can safely and legally administer chemotherapy drugs intravenously? (select all that apply)
answer
A)Registered nurses (RNs) B)Pharmacists C)Licensed practical/vocational nurses (LPNs/LVNs) D)Advanced practice nurses E)Nurse's aides (NAs) A,D
question
The nurse is caring for a patient receiving hormonal therapy. The nurse knows that this type of therapy is recommended for which types of cancers? (select all that apply)
answer
A)Bone B)Brain C)Breast D)Stomach E)Prostate C,E
question
Which personal factor is the most common cause of cancer development?
answer
A. Living in a geographic area with poor sanitation B. Having parents who died of cancer C. Eating a high-fat diet D. Advancing age D
question
How do most cytotoxic chemotherapy drugs rid the body of cancer cells?
answer
A. Interfering with cancer cell division B. Preventing cancer cells from receiving needed vitamins C. Enhancing the immune system's ability to recognize and kill cancer cells D. Forcing cancer cells to undergo reverse transformation to become normal cells A
question
Which chemotherapy drug has the highest potential to induce nausea and vomiting?
answer
A. azacitidine (Vidaza) B. fludarabine (Fludara) C. cyclophosphamide (Cytoxan) D. irinotecan (Camptosar) C
question
Which agents for targeted therapy belong to the epidermal growth factor receptor inhibitor (EGRFI) class of drug? (Select all that apply.)
answer
A. bevacizumab (Avastin) B. cetuximab (Erbitux) C. gefitinib (Iressa) D. imatinib (Gleevec) E. lapatinib (Tykerb) F. rituximab (Rituxan) G. trastuzumab (Herceptin) B,C,G
question
Which class of chemotherapy drugs exert their effect the actions needed for proper DNA maintenance so that DNA breakage occurs leading to cancer cell death?
answer
A. Antitumor antibiotics B. Hormone antagonists C. Multikinase inhibitors D. Topoisomerase inhibitors D
question
Which of the following chemotherapy agents listed belong to the alkylating agent class? Select all that apply.
answer
A. azacitidine (Vidaza) B. bleomycin (Blenoxane) C. busulfan (Busulfex) D. cyclophosphamide (Cytoxan) E docetaxel (Taxotere) F. irinotecan (Camptosar) G. methotrexate (Mexate) H. procarbazine (Matulane) I. oxaliplatin (Eloxatin) J. temozolomine (Temodar) C,D,I,J
question
Which action is most important to prevent nausea and vomiting in the patient prescribed intravenous cytotoxic chemotherapy?
answer
A. Keeping the patient NPO (nothing by mouth) during the time the chemotherapy drugs are infusing B. Administering antiemetic medications before administering chemotherapy C. Ensuring that the chemotherapy is infused over a 4- to 6-hour period D. Assessing the patient's responses hourly during the infusion period B
question
A patient asks why cancer cell growth is considered "uncontrolled." What is your best response?
answer
A. "Cancer cells always divide more rapidly than normal cells." B. "When each cancer cell divides, it usually produces more than two cells." C. "As you age, your immune system is less active, which allows cancer cells to grow faster." D. "Cancer cells divide almost continuously, and normal cells divide only when they are needed." D
question
A patient with breast cancer asks why so many drugs are used together to treat her cancer. What is your best response?
answer
A. "Each drug works against cancer cells in different ways, and using several increases the likelihood that the cancer will be cured." B. "By using several drugs together, we can avoid using radiation therapy, which would cause many more permanent side effects." C. "Each drug goes to a separate body area. That way, because your cancer has spread to so many areas, all areas with cancer will receive the right drug." D. "The doctors are not sure which drug will work best against the cancer type that you have. Using several at the same time improves the chances that one will work" A
question
You are monitoring a patient receiving IV chemotherapy that was started by a chemotherapy- certified nurse. After 2 hours the patient reports burning and pain at the IV site. Lowering the IV results in an observable brisk blood return. What is your best first action?
answer
A. Stop the drug infusion and run at least 100 mL of normal saline into IV access B. Notify the chemotherapy-certified nurse who started C. Slow the rate of infusion but continue it because there is a good blood return D. Discontinue the infusion, remove the IV and document the site condition D
question
A patient receiving tamoxifen (Nolvadex) asks how this therapy helps fight breast cancer. In addition to telling her that the breast cancer cells need estrogen to continue growing, what is your best response?
answer
A. "This agent reduces the availability of estrogen to your cancer cells." B. "This agent causes you to secrete testosterone instead of estrogen." C. "This agent kills off both the normal estrogen- secreting cells and the cancer cells." D. "This agent destroys circulating estrogen and all other female hormones." A
question
A patient who has just been diagnosed with lymphoma asks why the treatment plan does not include the drug rituximab (Rituxan) about which he has read. What is your best response?
answer
A. "Your immune system is too weak to tolerate Rituxan." B. "This drug is experimental and too dangerous for you to take before trying other therapies C. "Your lymphoma cells do not have the protein on which this drug works, so you would not benefit from this therapy." D. "You are young and can better tolerate the standard therapies for lymphoma that have been proven effective but have strong side effects."
question
A patient is prescribed tamoxifen (Nolvadex) 20 mg orally twice daily for a total daily dosage of 40 mg. The drug comes in 10-mg tablets. How many tablets does the patient take twice daily?_________ tablet (s)
answer
2
question
A child with cancer is to receive methotrexate 2.5 mg/kg intravenously. The child weighs 39.6 lb a. What is the child's weight in kilograms?______ kg b. What is the appropriate dose?_______ mg c. The drug is prepared at a concentration of 25 mg/mL How many milliliters are the correct dose?_______ mL The same drug is to be administered to an adult who weighs 165 lb. d. What is the adult's weight in kilograms?_______ kg. e. What is the appropriate dose?_______ mg f. The drug is prepared at a concentration of 25 mg/mL. How many milliliters are the correct dose?________mL.
answer
a. 18kg b. 45mg c. 1.8mL d. 75kg e. 187.5mg f. 7.5mL
question
An adult with lung cancer is prescribed to receive cisplatin (Platino) intravenously at a dosage of 79 mg per m^2. He is 6'4" tall and weighs 210 lb. a. What is his height in cm?________ b. What is his weight in kg?______ kg c. What is his body surface area in m2?______ d. What is the correct dose of cisplatin for this patient?____mg
answer
a. 193.4cm b. 95.5kg c. 1.84 d. 145