Pharmacology and the Nursing process 10th Edition (PHARMACOLOGY) garrunteed success, Exams of Pharmacology

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For Pharmacology And The Nursing Process 10th Edition By Linda

Lilley, Shelly Collins, Julie Snyder All Chapters 1-58 LATEST

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Contents

• Chapter 01: The Nursing Process and Drug Therapy....................................................................................
• Chapter 02: Pharmacologic Principles
• Chapter 03: Lifespan Considerations...........................................................................................................
• Chapter 04: Cultural, Legal, and Ethical Considerations............................................................................
• Chapter 05: Medication Errors: Preventing and Responding.....................................................................
• Chapter 06: Patient Education and Drug Therapy
• Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements
• Chapter 08: Gene Therapy and Pharmacogenomics
• Chapter 09: Photo Atlas of Drug Administration .........................................................................................
• Chapter 10: Analgesic Drugs
• Chapter 11: General and Local Anesthetics
• Chapter 12: Central Nervous System Depressants and Muscle Relaxants
• Chapter 13: Central Nervous System Stimulants and Related Drugs
• Chapter 14: Antiepileptic Drugs
• Chapter 15: Antiparkinson Drugs
• Chapter 16: Psychotherapeutic Drugs
• Chapter 17: Substance Use Disorder
• Chapter 18: Adrenergic Drugs.....................................................................................................................
• Chapter 19: Adrenergic-Blocking Drugs
• Chapter 20: Cholinergic Drugs
• Chapter 21: Cholinergic-Blocking Drugs ....................................................................................................
• Chapter 22: Antihypertensive Drugs
• Chapter 23: Antianginal Drugs
• Chapter 24: Heart Failure Drugs
• Chapter 25: Antidysrhythmic Drugs
• Chapter 26: Coagulation Modifier Drugs
• Chapter 27: Antilipemic Drugs...................................................................................................................
• Chapter 28: Diuretic Drugs ........................................................................................................................
• Chapter 29: Fluids and Electrolytes
• Chapter 30: Pituitary Drugs

3. The nurse has been monitoring the patient ’ s progress on a new drug regimen since the first dose and documenting the patient ’ s therapeutic response to the medication. Which phase of the nursing process do these actions illustrate? a. Nursing diagnosis

b. (^) Planning c. Implementation d. Evaluation

ANSWERS: D

Monitoring the patient ’ s progress, including the patient ’ s response to the medication, is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by this example.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? a. The patient will follow instructions. b. (^) The patient will not experience complications. c. The patient will adhere to the new insulin treatment regimen. d. The patient will demonstrate correct blood glucose testing technique.

ANSWERS: D

“ Demonstrating correct blood glucose testing technique ” is a specific and measurable outcome criterion. “ Following instructions ” and “ not experiencing complications ” are not specific criteria. “ Adhering to new regimen ” would be difficult to measure. NURSINGTB.COM DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care

5. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension? a. Providing education on keeping a journal of blood pressure readings b. Setting goals and outcome criteria with the patient ’ s input c. Recording a drug history regarding over-the-counter medications used at home d. Formulating nursing diagnoses regarding deficient knowledge related to the new treatment regimen

ANSWERS: A

Education is an intervention that occurs during the implementation phase. Setting goals and outcomes reflects the planning phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses reflects analysis of data as part of planning.

DIF: COGNITIVE LEVEL: Applying (Application)

a. (^) Give the medication intravenously because the patient might vomit. b. Give the medication orally because the tablets are available in 4-mg doses. c. Contact the prescriber to clarify the route of the medication ordered. d. Hold the medication until the prescriber returns to make rounds.

ANSWERS: C

A complete medication order includes the route of administration. If a medication order does not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral routes are not interchangeable. Holding the medication until the prescriber returns would mean that the patient would not receive a needed medication.

DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? a. (^) The patient ’ s ability to swallow b. The patient ’ s height c. The patient ’ s last meal d. The patient ’ s allergies

ANSWERS: C

The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may be affected by the timing of the last meal. TNhUe (^) RpSaItNi eGnTt ’ Bs. Ca (^) Ob iMl i t y to swallow, height, and allergies are not factors to consider regarding the timing of the drug ’ s administration.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care

8. The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data? a. Blood pressure 158/96 mm Hg b. Weight 255 pounds c. The patient reports that he uses the herbal product ginkgo. d. The patient ’ s laboratory work includes a complete blood count and urinalysis.

ANSWERS: C

Subjective data include information shared through the spoken word by any reliable source, such as the patient. Objective data may be defined as any information gathered through the senses or that which is seen, heard, felt, or smelled. A patient ’ s blood pressure, weight, and laboratory

tests are all examples of objective data.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care

MULTIPLE RESPONSE

Chapter 02: Pharmacologic Principles

MULTIPLE CHOICE

1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Which term is used to identify this principle? a. Bioequivalent b. Synergistic c. Prodrugs d. Steady state

ANSWERS: A

Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug ’ s steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies NURSINGTB.COM

2. When given an intravenous medication, the patient says to the nurse, “ I usually take pills. Why does this medication have to be given in the arm? ” What is the nurse ’ s best answer? a. “ The medication will cause fewer adverse effects when given intravenously. ” b. “ The intravenous medication will have delayed absorption into the body ’ s tissues. ” c. “ The action of the medication will begin sooner when given intravenously. ” d. “ There is a lower chance of allergic reactions when drugs are given intravenously. ”

ANSWERS: C

An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? a. Parenteral drugs bypass the first-pass effect.

b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. c. Absorption of parenteral drugs is faster when the stomach is empty. d. Parenteral drugs exert their effects while circulating in the bloodstream.

ANSWERS: A

TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these? a. The time it takes for a drug to elicit a therapeutic response b. (^) The amount of time needed to remove a drug from circulation c. (^) The time it takes for a drug to achieve its maximum therapeutic response d. (^) The time period at which a drug ’ s concentration is sufficient to cause a therapeutic response

ANSWERS: D Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug ’ s onset of action is the time it takes for the drug to elicit a therapeutic response. A drug ’ s peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction? a. The drug alters cell membrane permeability. b. (^) The drug ’ s effectiveness within the cNeUllRwSaINllGs ToBf.tChOe Mt arge t tissue is enhanced. c. (^) The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme ’ s action with the normal target cell.

ANSWERS: D With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells. As a result, the target cells are protected from the action of the enzymes. This results in a drug effect. The actions described in the other options do not occur with selective enzyme interactions.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient ’ s albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound? a. Renal excretion will be faster. b. (^) The drug will be metabolized quickly. c. The duration of action of the medication will be shorter.

Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter.

DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? a. Under the tongue b. (^) On top of the tongue c. At the back of the throat d. In the space between the cheek and the gum

ANSWERS: A Drugs administered via the sublingual route are placed under the tongue. Drugs administered via the buccal route are placed in the space between the cheek and the gum; oral drugs are swallowed. The other options are incorrect.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The nurse is administering medications tNoUthReSIpNaGtiTeBn.tCwOhMo is in renal failure resulting from end- stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase? a. Absorption b. Distribution c. Metabolism d. Excretion

ANSWERS: D The kidneys are the organs that are most responsible for drug excretion. Renal function does not affect the absorption and distribution of a drug. Renal function may affect metabolism of drugs to a small extent.

DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? a. Palliative therapy b. Maintenance therapy c. Empiric therapy d. Supplemental therapy

ANSWERS: A

MULTIPLE RESPONSE

1. Which drugs would be affected by the first-pass effect? (Select all that apply.) a. Morphine given by IV push injection b. (^) Sublingual nitroglycerin tablets c. (^) Diphenhydramine (Benadryl) elixir d. Levothyroxine (Synthroid) tablets e. Transdermal nicotine patches f. (^) Esomeprazole (Nexium) capsules g. Penicillin given by IV piggyback infusion

ANSWERS: C, D, F Orally administered drugs (elixirs, tablets, capsules) undergo the first-pass effect because they are metabolized in the liver after being absorbed into the portal circulation from the small intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal patches also enter the bloodstream without going directly to the liver, thus avoiding the first-pass effect.

DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

COMPLETION

1. A drug dose that delivers 250 mg has a hNaUlfR-lSi fI Ne (^) GoTf (^) B (^5). Ch (^) Oo uMr s. Identify how much drug will remain in the body after one half-life.

ANS: 125 mg

A drug ’ s half-life is the time required for one half of an administered dose of a drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%. Therefore, one half of 250 mg equals 125 mg.

DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies