Pharmacokinetics and Medication Administration: Nursing Process and Drug Interactions, Exams of Nursing

Download Pharmacokinetics and Medication Administration: Nursing Process and Drug Interactions and more Exams Nursing in PDF only on Docsity!

2024/2025 Pharm Nurs-360 Questions With 100%

Correct Answers A+

1. How a drug is absorbed or excreted is called: A. Pharmacodynamics B. Pharmacotherapeutics C. Pharmacokinetics D. Drug interactions
2. What type of drug interaction occurs when two drugs that produce the same effect are given together? A. Additive effect B. Potentiation C. Increased absorption D. Decreased effect
3. A client is prescribed phenobarbital sodium (Luminol) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed: A. Four times a day B. Three times a day C. Twice a day D. Once a day
4. A nurse is completing discharge teaching to a client who has a new prescription for a transdermal medication. Which of the following statements by the client indicates understanding of the teaching? A. I will place the new patch on the site of the old patch B. I will clean the site with an alcohol swab prior to applying the patch C. I will rotate the application sites weekly D. I will apply the patch to an area of skin with no hair.
5. Expected outcomes are defined as: A. Goals the patient and family ask you to accomplish B. Goals that are above the level the patient can realistically reach C. Goals that were met by the patient in the past D. Goals the patient should reach as a result of planned nursing interventions

Name Five Steps of the Nursing Process.

6. _Assessment
7. _Nursing Dx
8. Planning Implementation Evaluation
9. A patient is receiving morphine sulfate 4 mg intravenously every 3 hours for pain. The nurse understands that the half-life for morphine sulfate is approximately 3 hours. Which statement made by the nurse best demonstrates understanding of the meaning of half-life? A. “The half-life of a medication does not determine dosing intervals.” B. “The half-life for morphine sulfate would be 2 mg.” C. “The patient will require more morphine sulfate in 6 hours to keep the minimum effective concentration.” D. “The half-life of a medication refers to the time required for the amount of drug in the body to decrease by 50%.” Name the Six Rights of Medication Administration.
10. Right client
11. Right dose
12. Right Meds
13. Right time
14. Right route
15. Right documentation

16. A nurse is having a discussion with another nurse regarding the narrow therapeutic range of a particular drug. A patient has been taking this drug for 1 week. What is the most significant implication for the nurse who is caring for this patient? A. The drug will be ineffective, because it will have difficulty reaching the minimum effective concentration. B. The patient’s body will maintain therapeutic levels easily. C. The patient’s kidney function may be compromised. D. The patient should be monitored carefully for toxicity. Name two routes of medication administration that avoid first-pass metabolism.
17. sublingual
18. Intra venous
19. A patient with a history of cardiac problems is admitted to a telemetry unit. The prescriber orders digoxin (Lanoxin) at a high dose for 2 days, followed by a lower dose thereafter. What is the nurse’s best action? A. Delay administration of the drug in order to discuss the prescription with the pharmacist. B. Question the prescriber about the two doses, recognizing that a potentially hazardous situation exists. C. Administer the drug per the prescription, recognizing that a loading dose, followed by a maintenance dose, is being given. D. In the interest of patient advocacy, seek a second prescriber’s opinion before carrying out the prescription.

20. Two hours after taking a dose of penicillin, a patient arrives in the emergency department with complaints of shortness of breath, swelling of the throat, a rash, and itching. The patient appears very anxious. Select the most likely analysis of the situation. A. The patient is experiencing a moderate allergic reaction that will improve as the nurse applies oxygen. B. The patient is having a mild reaction that can be treated efficiently with administration of an antihistamine. C. These symptoms are most likely the result of another cause, because fewer than 10% of patients have true allergic responses. D. The patient is experiencing an anaphylactic response, and emergency interventions should be employed. 21. A nurse is providing patient education to the community regarding medication compliance. The nurse is correct to state that the most important factors affecting adherence to a drug regimen are: (Select all that apply.) A. Genetics B. Ability to pay C. Placebo effect D. Patient education E. Manual dexterity F. Visual acuity
21. The client is admitted to the hospital in chronic renal failure and is on several medications. What nursing assessment is vital to ensure this patient’s safe use of drugs? A. The client may have drug toxicity from all the drugs. B. The client may have decreased effectiveness of the drugs. C. The client’s liver may compensate for renal failure; the drugs may be effective. D. The client is more likely to develop an allergic reaction to a medication.
22. The client has been receiving quetiapine (Seroquel). The physician changes the order to aripiprazole (Abilify), a more potent drug. How will the nurse expect the physician’s new

order to read?

A. The order will state a higher dose of aripiprazole (Abilify), than quetiapine (Seroquel). B. The order will state to assess the client for increased side effects. C. The order will state to draw serum levels of aripiprazole (Abilify). D. The order will state a lower dose of aripiprazole (Abilify) than quetiapine (Seroquel). Match the type of drug name with the given example. A. Trade B. Chemical C. Generic

24. Aspirin C
25. Benadryl A
26. Thiazide B class name
27. Cephalosporin B class name
28. Fill in the following table: Route of Administration Nursing Implications Intravenous Use 16-gauge for trauma Use 18-gauge for surgical Use 22-24 gauge for all other patients Preferred sites are peripheral veins in the arm or hand. In neonates veins of the head, lower legs and feet May be used.

Z-track Z-track is use for what? Use this technique for all IM injections because it is less painful and it prevents medication from leaking back into subcutaneous tissue. ● Use for medications that cause visible or permanent skin stains, such as iron preparations.

Parenteral Use a tuberculin syringe for solution volume less than 0.5 mL. The vastus lateralis_ is the injection site usually recommended for infants and children less than 1 years of age. At age 2 the site may be used. Suppositories Position^ the^ patient^ in^ the^ Sims^ or^ Left lateral position.

29. A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. Phenobarbital has a long half-life of 4 days. Based on the half-life of phenobarbital, it will most likely be prescribed: A. Once a day B. Twice a day C. Three times a day D. Four times a day
30. An order has been written to draw peak and trough levels for a particular medication. When should blood be drawn for each level? Peak – refer to drug manual or ask pharmacist; Trough, immediately prior to next dose
31. Medication dosages may need to be decreased for which of the following reasons? Select all that apply: Increased renal excretion Increased medication-metabolizing enzymes Liver failure Peripheral vascular disease Concurrent use of medication metabolized by the same pathway
32. Proper administration of eye drops should include all except for which one of the following? A. Asking the client to look up at the ceiling B. Dropping medication into the center of the client’s conjunctival sac C. Instructing the client to close the eye gently after drops are instilled D. Using medical aseptic technique

Common medication errors include:

33. Wrong medication or IV Fluid
34. Incorrect dose or IV rate
35. Wrong client, route, or time
36. Administration of known allergic medication
37. Omission of dose
38. Incorrect discontinuation of medication or IV fluid
39. Are you allowed to leave medication at the patient’s bedside? Explain what you are allowed to do: No, topical only, unless specifically ordered by physician – must have order for any medication left at bedside for patient to self-administer
40. When preparing a medication, a nurse notes that the physician has doubled the previous dose of the medication. The nurse should: A. Administer the medication as prescribe B. Check the prescription with another nurse C. Check the progress notes for changes and check with the physician D. Record that a doubled dose was prescribed Match the terms with their definitions: A. How the medication produces the desired therapeutic effect B. Primary action for which the medication is prescribed C. Indications for why a medication should not be given D. A serious adverse effect usually caused by excessive dosing

41. C Contraindications
42. D Toxicity

43. A Mechanism of action
44. B Therapeutic effect
45. What is a fluid bolus? Large amount of IV fluid given in a short period of time, usually less than 1 hour. Give to rapidly replace fluid loss.
46. Potassium chloride should be infused how? Via infusion pump
47. Verify compatibility of medications before infusing a medication through tubing that is infusing another medication.
    1. Name a medication that will precipitate in Dextrose 5% and Water: Dilantin
48. IV sites should be changed every 72 hours.
49. Fluids should not hang more than _ 24 hours unless in a closed system.
50. Wipe all ports with Alcohol or antiseptic swab before connecting IV lines or inserting a syringe to the port.
    1. 51. Never Disconnect tubing for convenience or to position a patient or change the gown.
51. Correct catherter size is: 16 Trauma patient 18-20 Surgical client or rapid blood administration 22-_24 All other adult clients
52. Select vein for an IV by choosing distal veins first on the non-dominant hand.
53. Avoid starting IVs in veins in the inner wrist , in flexion areas, near valves , in lower extremities, and especially in the antecubital fossa.

55. List the findings of IV infiltration:

56. List the findings of Phlebitis/Thrombophlebitis: Warmth, tenderness, redness, and swelling along the course of the vein
57. List the findings of fluid overload:
    • Rapid weight gain.
    • Noticeable swelling (edema) in your arms, legs and face.
    • Swelling in your abdomen.
    • Cramping, headache, and stomach bloating.
    • Shortness of breath.
    • High blood pressure.
    • Heart problems, including congestive heart failure
58. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following is an appropriate nursing action? A. Administer an oral antihistamine at the same time B. Administer the prescribed dose C. Withhold the medication D. Ask the provider to change the prescription to an oral form
59. A nurse is providing discharge instructions to a client who has a new prescription for an antihypertensive medication. Which of the following is an appropriate statement by the nurse?

A. Change positions slowly when you move from sitting to standing

B. Avoid driving or working with heavy machinery while taking the medication C. Your medication dosage will be increased if you develop tachycardia D. You should check your blood pressure every 8 hours while taking this medication

60. A nurse in a provider’s office is reviewing the health care record of a client who is pregnant and is being seen for her first prenatal visit. Which of the following immunizations can be administered safely to this client? A. Measles B. Rubella C. Varicella vaccine D. Inactivated influenza vaccine
61. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors may be responsible for the client’s drowsiness? A. Reduced hepatic function B. Delayed toxic effect C. First-pass effect D. Reduced cardiac function
62. For pregnant women, which of the following categories means that adverse effects have been demonstrated on human fetuses based on data from investigational or marketing experience, but use of the medication during pregnancy may be warranted based on the potential benefits. A. Category A B. Category B C. Category C D. Category D
63. Give an example of a medication-food interaction. Warafin can be counter active by consuming foods containing vitamin K.
64. List seven physiologic changes associated with aging that impact pharmacokinetics: A. B. C.

D.

E.

F.

G.

65. What is polypharmacy? the simultaneous use of multiple drugs to treat a single ailment or condition. Match the following drugs and descriptions with the correct schedule category of DEA schedules of controlled substances: A. Schedule I B. Schedule II C. Schedule III D. Schedule IV E. Schedule V
66. E Limited abuse potential
67. A Heroin
68. A High abuse potential and no accepted medical use 69. A Marijuana
69. B Cocaine
70. D Antianxiety agents
71. B High abuse potential with severe dependence liability

73. Fill in the following table by looking up at least 5 drugs that will fit into each schedule category: Schedule Describe abuse potential: List^ of^ examples^ of^ these controlled substances: Schedule I Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse. marijuana, heroin, LSD, ecstasy, and magic mushrooms. Schedule II Substances in this schedule have a high potential for cocaine, meth, oxycodone, Adderall, Ritalin, and Vicodin.

abuse which may lead to

severe psychological or physical dependence. Schedule III Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence. Tylenol with codeine, ketamine, anabolic steroids, and testosterone. Schedule IV Substances in this schedule have a low potential for abuse relative to substances in Schedule III. Xanax, Soma, Darvocet, Valium, and Ambien. Schedule V Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. Robitussin AC, Lomotil, Motofen, Lyrica, and Parepectolin

74. You are preparing to send you patient to surgery and administer blood. You would plan to insert which of the following IV sizes? A. 22 gauge B. 18 gauge C. 14 gauge D. 10 gauge
75. Blood should be infused within: A. 1 to 2 hours B. 2 to 4 hours C. 3 to 6 hours

D. 4 to 6 hours

76. When you hang a unit of blood, you should always prime the tubing and hang the blood with: A. 5% Dextrose and Water B. Ringers Lactate solution C. Normal saline solution (0.9% NaCl) D. 5% Dextrose and 0.9% NaCl
77. If you think your patient has a hemolytic blood reaction, you should: A. Continue with the infusion and notify the physician B. Stop the infusion and obtain a urine specimen to send to the lab for RBC hemolysis C. Ask another RN to check the identification tag with you, remove, and discard the blood bag D. Remove the IV bags and IV line completely
78. Which of the following blood products is administered because it expands circulating blood volume by exerting oncotic pressure and is used for hypovolemia, burns, and severe nephrosis? A. Fresh frozen plasma B. Whole blood C. Packed red blood cells D. Albumin
79. A nurse is preparing to administer an infusion of 300 mL of platelet concentrate. The nurse should plan to administer the infusion over which of the following time frames? A. Within 4 hours per unit B. Within 2 hours per unit C. Within 1 hour per unit D. Within 30 minutes per unit
80. A nurse is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the nurse prepare to transfuse? A. Whole blood B. Platelets C. Fresh frozen plasma D. Packed red blood cells
81. A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications? A. Epinephrine (Adrenalin) B. Lorazepam (Ativan)

C. Furosemide (Lasix) D. Diphenhydramine (Benadryl)