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Nurs 6015 Exam 1 Practice chapters 1-11 Questions With Complete Solutions A diabetic patient is taught the signs and symptoms of hypoglycemia with insulin use. The patient knows to eat fast- acting carbohydrates. This is an example of which goal? a. Minimizing adverse effects b. Promoting therapeutic effects c. Minimizing adverse interactions d. Managing toxicity Correct Answers a. Minimizing adverse effects A drug has a half-life of ten hours. How long will it take that drug to reach a plateau level in the blood? a. 20 hours b. 30 hours c. 40 hours d. 50 hours Correct Answers c. 40 hours A new graduate nurse preparing to administer medications knows that which of the following is required for a drug to move through the body? a. Selectivity and effectiveness b. The ability to cross membranes c. Development of an electric charge d. A transporter protein Correct Answers b. The ability to cross membranes A new medication becomes available for treatment of a debilitating neurologic disease. What would the nurse expect about the safety of the drug?
a. The drug is safe for administration to children. b. The drug has been tested in pregnant women. c. All possible adverse effects have been identified by animal testing. d. The drug has passed the FDA approval process. Correct Answers d. The drug has passed the FDA approval process. A nurse is educating a breast-feeding patient about her medications. Which statements by the nurse are true? (Select all that apply.) a. "Drugs taken by lactating women can be excreted in breast milk." b. "If drug concentrations in milk are high enough, a pharmacologic effect can occur in the infant." c. "There is a lot of research regarding drugs taken by lactating women." d. "Most drugs can be detected in milk, but concentrations are usually too low to cause harm." e. "Nearly all drugs can enter breast milk, and the extent of entry is the same for all drugs." Correct Answers a, b, and d A nurse is preparing to give an oral dose of drug X to treat a patient's high blood pressure. After giving the drug, the nurse finds that it not only reduces the blood pressure without serious harmful effects, but it also causes the patient to have nausea and headache. Based on this information, which property of an ideal drug is this drug lacking? a. Effectiveness b. Safety c. Selectivity d. Ease of administration Correct Answers c. Selectivity
d. "It is a condition in which the patient requires increased doses of morphine sulfate to achieve pain relief." Correct Answers d. "It is a condition in which the patient requires increased doses of morphine sulfate to achieve pain relief." A patient is told not to take his antibiotic with grapefruit juice. What is the most common drug interaction with grapefruit juice? a. Decreased excretion b. Decreased absorption c. Decreased metabolism d. Decreased distribution Correct Answers c. Decreased metabolism A patient who is admitted to the nursing unit from the postanesthesia care unit is moaning in pain. The patient is due for another dose of pain medication. What is the nursing priority at this time? a. Administer prescribed pain-relieving drugs b. Assess the patient's vital signs, tubes, and surgical site c. Obtain the patient's pain rating on a scale of 1- d. Review the patient's allergy history Correct Answers b. Assess the patient's vital signs, tubes, and surgical site A teratogenic drug, such as methotrexate, is most likely to cause learning deficits during which phase of fetal development? a. Conception through week 2 b. Weeks 3 to 8 c. First trimester d. Second and third trimesters Correct Answers d. Second and third trimesters
According to the FDA Pregnancy Risk categories, which category represents the greatest risk for fetal harm? a. A b. B c. C d. D e. X Correct Answers e. X Before administrating the dosage of a prescribed medication, the nurse observes precipitation formation of the intravenous (IV) solution. What is the priority nursing action? a. Verify the prescription. b. Discard the IV solution. c. Prepare another dose to administer. d. Check the expiration date of the drug. Correct Answers b. Discard the IV solution. Characteristics unique to each patient can influence pharmacokinetic and pharmacodynamic processes. What characteristics may determine the patient's response to a drug? (Select all that apply.) a. Age b. Gender c. Weight d. Mood e. Genetics Correct Answers a, b, c, and e Drug A increases the metabolism of Drug B. This means that there may be: a. Increased therapeutic response to drug A b. Increased therapeutic response to drug B
N-acetyl-para-aminophenol is an example of which type of drug name? a. Proprietary b. Chemical c. Generic d. Trade Correct Answers b. Chemical Older adult patients are at high risk for adverse drug reactions (ADRs). Which measures can reduce the incidence of ADRs? (Select all that apply.) a. Taking a thorough drug history, including over-the-counter (OTC) medications b. Monitoring clinical response and laboratory results to help determine proper dosage c. Using as many drugs as possible to reduce symptoms and improve outcome d. Regularly monitoring patients for drug-drug and drug-nutrient interactions e. Helping patients to avoid prescriptions for drugs on the Beers list Correct Answers a, b, d, and e Phase 1 drug studies involve: a. Testing the drug on animals b. Testing the dose needed in patients with the disease the drug is designed to treat c. Healthy human volunteers d. Testing the drug against the standard therapy in a large-scale clinical trial Correct Answers c. Healthy human volunteers
T OR F: A drug with a narrow therapeutic range is safer than a drug with a wide therapeutic index Correct Answers false T OR F: A drug with high maximal efficacy is always more desirable than one with a lower maximal efficacy Correct Answers false T OR F: If drug A is more potent than drug B, then drug A is more effective than drug B Correct Answers false T OR F: It is more important to look at the efficacy of a drug than the potency of a drug Correct Answers true T OR F: We have limited information on how women and children will respond to drug therapy because, until recently, they have been excluded from drug trials Correct Answers true T OR F: Your responsibility concerning pharmacotherapeutics ends after you administer the medication to the client Correct Answers false The client needs to receive immediate effects of a drug. Which of the following routes of administration would provide the client with the most rapid effects? a. Oral b. Subcutaneous c. Intramuscular d. Intravenous Correct Answers d. Intravenous
he general circulation as a result of what? a. Therapeutic range b. First-pass effect c. Drug half-life d. Plasma protein binding Correct Answers b. First-pass effect The nurse cares for an adult patient who is started at the average effective dose of a medication. Which statement best indicates to the nurse that the medication dose for the patient is effective? a. The patient has taken the average adult dose for 10 days b. The patient has not experienced any adverse effects c. The patient takes the medication every day as prescribed d. The patient does not exhibit the disease signs and symptoms Correct Answers d. The patient does not exhibit the disease signs and symptoms The nurse demonstrates the concept of maximal efficacy by administering which drug for a headache that the patient describes as a "mild dullness" and as a 2 on a 1 to 10 scale? a. Meperidine [Demerol] b. Pentazocine [Talwin] c. Aspirin d. Morphine sulfate Correct Answers c. Aspirin The nurse identifies which as the goal of drug therapy in the treatment of patients? a. Cure of the disease b. Follow-up with the prescriber c. Correct administration technique
d. Production of maximum benefit with minimum harm Correct Answers d. Production of maximum benefit with minimum harm The nurse is administering warfarin, an anticoagulant, to a patient with a low albumin level. Which effect of this medication should the nurse expect to observe? a. Increased PT/INR levels b. Deep vein thromboses c. Reduced risk of bruising d. Increased platelet aggregation Correct Answers a. Increased PT/INR levels The nurse is caring for a 12-year-old boy who weighs 72 pounds. The healthcare provider should make the most precise dosage adjustments for this patient's medications based on what? a. Body surface area b. Body mass index c. Body weight d. Body fat percentage Correct Answers a. Body surface area The nurse is caring for a group of female patients receiving medication therapy. Which factor is of greatest concern with regard to drug therapy in these patients? a. Most drug research has been carried out exclusively in male subjects. b. Hormonal differences make managing drug therapy more difficult in most women. c. Overall, women tend to be less compliant with medication therapy.
The nurse is caring for a patient prescribed abacavir [Ziagen] to treat human immunodeficiency virus (HIV) infection. To reduce the potential fatal hypersensitivity reaction, which recommendation is suggested prior to initiating abacavir drug therapy? a. Administer a test dose b. Obtain liver function studies c. Drug skin testing d. Genetic screening Correct Answers d. Genetic screening The nurse is caring for a patient prescribed Isoniazid for the treatment of tuberculosis. The nurse should assess for which signs and symptoms of drug-induced liver toxicity? (Select all that apply.) a. Nausea b. Malaise c. Jaundice d. Vomiting e. Clear urine Correct Answers a, b, c, and d The nurse is caring for a patient who has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing? a. An idiosyncratic drug effect on the bone marrow b. Iatrogenic disease of the kidneys c. Drug toxicity of the liver d. An allergic reaction Correct Answers c. Drug toxicity of the liver The nurse is caring for a patient who is experiencing a respiratory rate of 6 breaths per minute as a result of a large dose
of pain medication. Which term most accurately describes this reaction? a. Side effect b. Toxicity c. Allergic reaction d. Idiosyncratic effect Correct Answers b. Toxicity The nurse is caring for a patient with epilepsy who is on anticonvulsant therapy and is also breast-feeding. Which patient teaching instruction should minimize the risk to the baby? a. "Give the dose just before breast-feeding." b. "Avoid drugs that have a long half-life." c. "Discontinue the drug until you have stopped breast-feeding." d. "Increase your fluid intake." Correct Answers b. "Avoid drugs that have a long half-life." The nurse is caring for a pregnant patient who has chronic asthma. When administering medications to this patient, which of the options should the nurse do? a. Give the medications as ordered, because most drugs do not cross the placenta. b. First assess the creatinine level, because renal blood flow decreases during pregnancy. c. Hold the medications and notify the ordering physician, because drugs that are not known teratogens may not be safe during pregnancy. d. Advise the patient that taking asthma medications during pregnancy improve fetal outcomes. Correct Answers d. Advise the patient that taking asthma medications during pregnancy improve fetal outcomes.
The nurse is monitoring for adverse drug reactions (ADRs) of assigned patients. Which patient is most at risk for the development of drug toxicity? a. A 30-year-old man admitted for altered mental status b. A 55-year-old woman with abnormal arterial blood gas values c. A 70-year-old woman with an elevated creatinine level d. A laboring 25-year-old woman with a positive Homans' sign Correct Answers c. A 70-year-old woman with an elevated creatinine level The nurse is obtaining a drug history for a patient admitted to the unit. The nurse obtains information about past and present health histories, currently used prescription drugs, behavioral factors, and use of over-the-counter (OTC) drugs. What other information does the nurse need to obtain? (Select all that apply.) a. Use of recreational drugs and substances b. Usual sleep patterns and disturbances c. Highest level of education completed d. Use of herbal remedies e. Self-treatment with complementary and alternative drugs Correct Answers a, d, and e The nurse is preparing a discharge teaching plan to a patient prescribed phenobarbital and oral contraceptives which are known to induce CYP isoenzymes. What patient teaching should the nurse include in the discharge plan? a. "Continue taking your medications as prescribed." b. "Condoms are not necessary while taking phenobarbital. It is not an antibiotic."
c. "Plan to use another form of birth control while taking phenobarbital." d. "Your dose of birth control pills will be reduced while you are taking phenobarbital." Correct Answers c. "Plan to use another form of birth control while taking phenobarbital." The nurse is preparing a staff education inservice about specific safety measures that reduce patient medication errors. Which measure improves safety for patients during care transition? a. Medication reconciliation b. MEDWATCH program c. Risk Evaluation and Mitigation Strategy d. Regional Medication Safety Program Correct Answers a. Medication reconciliation The nurse is preparing to administer a dose of penicillin. Before administering the medication, the nurse assesses the patient's allergy history. Which aspect of drug therapy does this represent? a. Making PRN (as needed) decisions b. Evaluating therapeutic effects c. Ensuring proper dosage d. Identifying high-risk patients Correct Answers d. Identifying high-risk patients The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug? a. It is very potent. b. It has a low efficacy. c. It is probably lethal. d. It is relatively safe. Correct Answers d. It is relatively safe.
The nurse is preparing to give a drug with certain properties. Which property of the drug is the most compelling indication that it should not be given? a. The drug produces an unwanted side effect. b. The drug is difficult to administer. c. The drug's effects are reversible. d. The drug is not effective for its intended purpose. Correct Answers d. The drug is not effective for its intended purpose. The nurse is preparing to give a medication for pain. The label states that the drug is "lipid soluble." How soon should the nurse expect to observe the effects of the drug? a. Slowly b. Rapidly c. Unpredictably d. Variably Correct Answers b. Rapidly The nurse is reading a genetic research study. The study discusses how genetic variants can directly affect the metabolism of clopidogrel [Plavix], reducing the antiplatelet response. The nurse understands reduced efficacy of clopidogrel can increase the risk of which cardiovascular event? (Select all that apply.) a. Stroke b. Cancer c. Myocardial infarction d. Pulmonary embolism e, Palpitations Correct Answers a and c
The nurse is reviewing the laboratory value for a patient prescribed atorvastatin [Lipitor]. Which laboratory value is most useful for monitoring this drug? a. Aspartate aminotransferase (AST) b. Blood urea nitrogen (BUN) c. International normalized ratio (INR) d. C-reactive protein (CRP) Correct Answers a. Aspartate aminotransferase (AST) The nurse is teaching a patient prescribed felodipine [Plendil] for the treatment of hypertension. Which statement is the most appropriate for the nurse to include in the teaching session? a. "Avoid grapefruit juice while you are taking this medication." b. "Do not eat foods high in tyramine such as aged cheese." c. "Herbal agents can help this drug work more effectively." d. "This drug is free of dangerous drug interactions." Correct Answers a. "Avoid grapefruit juice while you are taking this medication." The nurse is teaching young parents about medication administration in their child. Which statements are appropriate to include in the teaching plan? (Select all that apply.) a. "Guard against spills and spitting to ensure that your child gets an accurate dose." b. "Do not mix your child's medication with food or drink." c. "This calibrated spoon will help your child get an accurate dose." d. "Keep a medication record to make sure you do not give more than one dose at a time." e. "If your child spits some medication out, give another full dose at that time." Correct Answers a, c, and d
