Test Bank For Pharmacology: Connections to Nursing Practice 5th Edition All Chapters, Exams of Nursing

Download Test Bank For Pharmacology: Connections to Nursing Practice 5th Edition All Chapters and more Exams Nursing in PDF only on Docsity! Test Bank For Pharmacology: Connections to Nursing Practice 5th Edition All Chapters The nurse is teaching a pharmacology class to student nurses. What does the nurse include as key events in the history of pharmacology? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Initial drugs included morphine, cocaine, and penicillin. 2. Early researchers used themselves as test subjects. 3. The initial intention of pharmacology was to relieve human suffering. 4. Modern pharmacology began in the early 1600s. 5. Pharmacologists synthesized drugs in the laboratory in the twentieth century. - ANSWER>>2,3,5 The student nurse asks the nursing instructor why he needs to take anatomy and physiology, as well as microbiology, when he only wants to learn about pharmacology. What is the best response by the instructor? 1. Because pharmacology is an outgrowth of those subjects. 2. You must learn all, since those subjects, as well as pharmacology, are part of the curriculum. 3. Knowledge of all those subjects will prepare you to provide the best patient care, including the administration of medications. 4. Because an understanding of those subjects is essential to understanding pharmacology. - ANSWER>>4 The nursing instructor is teaching a pharmacology class to student nurses. The current focus is pharmacology and therapeutics. The nursing instructor determines that learning has occurred when the students make which comments? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Pharmacology is the use of drugs to relieve suffering. 2. Pharmacology is the study of medicines. 3. Therapeutics is the study of the therapeutic use of drugs. 4. Therapeutics is the study of drug interactions. 5. Pharmacology is the study of drugs to prevent disease. - ANSWER>>1,2 The nurse administers a vaccine to a child. What is the best understanding of the nurse as it relates to the manufacture of this vaccine? 1. The vaccine is produced by natural plant extracts in the laboratory. 2. The vaccine is naturally produced in animal cells or microorganisms. 3. The vaccine is produced by a combination of animal and plant products. 4. The vaccine is most commonly synthesized in a laboratory. - ANSWER>>2 The elderly client has gastrointestinal bleeding. The client says to the nurse I dont understand this. All I did was take ibuprofen (Advil) for my arthritis. Which plan would be best as it relates to the nurses education of this client? 1. A plan to teach the client to use drugs that bypass the gastrointestinal system, like topical drugs 2. A plan to teach the client to substitute safer drugs like acetaminophen (Tylenol) 3. A plan to teach the client to obtain physician approval prior to the use of over-the-counter (OTC) medications 4. A plan to teach the advantages and disadvantages of ibuprofen (Advil) - ANSWER>>4 The elderly client has gastrointestinal bleeding. The client says to the nurse I dont understand this. All I did was take ibuprofen (Advil) for my arthritis. Which plan would be best as it relates to the nurses education of this client? 1. A plan to teach the client to use drugs that bypass the gastrointestinal system, like topical drugs. 2. A plan to teach the client to substitute safer drugs like acetaminophen (Tylenol). 1. We should not take any over-the-counter (OTC) medicine without first calling and checking with the doctors office. 2. We should always ask the pharmacist about how to take the over-the-counter (OTC) medicine. 3. We must read all the directions on the label and call the doctors office if they are not clear. 4. Medicines that are available over-the-counter (OTC) are really safe, or they would be prescription medicines. - ANSWER>>3 The client has skin lesions that have not responded to prescription drugs. He tells the nurse he has heard about some research going on with a new drug and questions why he cant take it. What is the best response by the nurse? 1. I know it is frustrating, but the Food and Drug Administration (FDA) approval process is in place to ensure that drugs are safe. 2. The Food and Drug Administration (FDA) has very strict rules about new drugs; it is important to be patient regarding the review/approval process. 3. Your skin lesions really arent that bad, but maybe the new drug will be available soon. 4. Maybe you could contact the drug company about becoming involved in a clinical trial. - ANSWER>>1 What percentage of Americans takes at least one prescription drug per year? 1. 50% 2. 10% 3. 40% 4. 25% - ANSWER>>1 Modern pharmacology was introduced to the United States by the opening of the first department of pharmacology at the University of Michigan in the year 1. 1805. 2. 1890. 3. 1847. 4. 1908. - ANSWER>>2 The application of drugs for the purpose of disease prevention and treatment of suffering is known as 1. biologics. 2. pharmacotherapeutics. 3. alternative therapies. 4. therapeutics. - ANSWER>>2 A patient with chronic back pain informs the nurse he has been receiving therapeutic touch in addition to his medications. This type of therapy is best classified as 1. pharmacotherapy. 2. drug-absence therapy. 3. complementary therapy. 4. biologic therapy. - ANSWER>>3 How many years does it generally take to research and develop a drug before it is submitted to the FDA for review? 1. 6 years 2. 5 years 3. 11 years 4. 9 years - ANSWER>>3 A drug manufacturer that is performing the effects of a drug on laboratory animals would be in which phase of the new drug development timeline? 1. Clinical Investigation 2. Preclinical Investigation 3. New Drug Application Review 4. Postmarketing Studies - ANSWER>>2 The nurse is categorizing a clients list of medications completing a health history. Which agents would be categorized as complementary and alternative medicine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Garlic 2. Vitamin C 3. Zinc 4. Aspirin 5. Benadryl - ANSWER>>1,2,3 While reading a medication package inserts the nurse notes the information contained within the black box. What is the significance of this information to the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The drug can cause special problems. 2. It identifies extreme adverse drug reactions. 3. It differentiates a prescribed medication from an over-the-counter medication. 4. It highlights the cost of the medication. 5. It signifies the medication is generic. - ANSWER>>1,2 The nurse is participating in the New Drug Review step for a new therapeutic agent. Which activities will the nurse most likely perform during this phase of the drug approval process? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 3. The nurse taught the client about a prototype drug. 4. The nurse explained the consequences of not using the drug. - ANSWER>>2 During pharmacology class, the student nurse asks the nursing instructor how students will ever learn about the individual antibiotic drugs since there are so many. What is the best response by the nursing instructor? 1. You will learn a little trick called mnemonics. 2. You will learn how to do a flow chart to enhance memory. 3. You will learn how to categorize the individual drugs. 4. You will learn a representative drug from each class. - ANSWER>>4 The physician ordered a brand name drug for the client, paroxetine (Paxil). After taking this medication for a year, the client tells the nurse that it is no longer working. What is the best assessment of the nurse at this time? 1. This sounds like your medication needs changing. 2. Lets look for interactions with other medications you are taking. 3. Are you taking Paxil or paroxetine? 4. It is time for us to do the Beck Depression assessment again. - ANSWER>>3 The physician has prescribed a brand name drug for the client. The client tells the nurse that the medication is too expensive. What is the best plan by the nurse? 1. Help the client receive free medicine through a patient assistance program. 2. Ask the physician if a cheaper brand name drug may be substituted. 3. Ask the physician if a generic drug may be substituted. 4. Maintain the client on samples of the brand name drug from the physicians office. - ANSWER>>3 The nurse is teaching a medication class for parents of children with attention-deficit hyperactivity disorder who are receiving stimulant medications. The nurse has reviewed reasons why the medications are restricted. The nurse determines that learning has occurred when the parents make which response(s)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The use of these medications is restricted so that the pharmacies can track the rate of drug abuse in our city. 2. The use of these medications is restricted because the physician needs to evaluate our child more often. 3. The use of these medications is restricted because they have the potential for abuse. 4. The use of these medications is restricted so that the drug companies can make a bigger profit. 5. The use of these medications is restricted because this is the curren - ANSWER>>3,5 The client says to the nurse, My doctor said my drug is a controlled substance; am I considered an addict? What is the best response by the nurse? 1. Are you concerned about becoming an addict? We can discuss this in more detail it you would like to. 2. You are not an addict; the Drug Enforcement Administration (DEA) restricts the use of drugs with a high potential for abuse. 3. Why do you ask about becoming an addict? Not many of our clients have asked this question. 4. You are not an addict, but the Drug Enforcement Administration (DEA) will monitor you for this. - ANSWER>>2 The client is receiving methadone (Dolophine), a Schedule II drug. The client says to the nurse, A pharmacist told me his pharmacy must register with the Drug Enforcement Administration (DEA) to give me this drug; will DEA agents be snooping around my house? What is the best response by the nurse? 1. It is probably unlikely that Drug Enforcement Administration (DEA) agents will be bothering you. 2. No, the Drug Enforcement Administration (DEA) restricts drugs that have a high potential for abuse. 3. No. I think our system should be more like Europe; they have fewer controlled drugs. 4. Thats an interesting question. Are you worried about the Drug Enforcement Administration (DEA)? - ANSWER>>2 During the admission assessment, the client tells the nurse Sure I smoke a little weed (marijuana) to manage my stress. Doesnt everyone? What is the best assessment question for the nurse to ask? 1. What other ways do you think you might use to help you to manage your stress? 2. That is a Schedule I drug; arent you afraid of going to jail for a long time? 3. Do you really believe that everyone smokes marijuana to manage stress? 4. How often do you smoke marijuana, and how much each time? - ANSWER>>4 The mother of an adolescent receiving methylphenidate (Concerta) for attention-deficit hyperactivity disorder tells the nurse that her son is better and asks why she cant just get refills on the prescription. What is the best response by the nurse? 1. Just drop by and I will get a prescription for you without seeing your son. 2. We cant do that; maybe you can find another doctors office that will do it. 3. The law does not allow us to give you refills on this medication. 4. The medication can be addictive so your son needs a monthly medical evaluation. - ANSWER>>4 The client is receiving a very expensive medication. The client asks the nurse why the medicine is so expensive. What is the best response by the nurse? 1. It is expensive, but your insurance covers it and you have a low co-pay. 2. Drug companies are allowed to advertise medications and this adds to the cost. 3. Drug companies must recoup the cost of developing and producing the drug. 4. I think the drug companies should be more accountable for lowering costs. - ANSWER>>2 The nurse provides medication education to a client with terminal cancer. The physician has ordered morphine (MS Contin), a Schedule II drug, for the client. The nurse determines that learning has occurred when the client makes which statement? 4. Diazepam - ANSWER>>3 The presence of muscle tremors following drug cessation would most accurately be associated with which of the following? 1. Adverse effect 2. Psychological dependence 3. Therapeutic effect 4. Physical dependence - ANSWER>>4 A physician may telephone in an order for which of the following? 1. Morphine 2. Marijuana 3. Cocaine 4. Codeine - ANSWER>>4 A prototype drug is a single drug in a class and can be compared with all other medications in the class. The benefit of studying the prototype drug is that the nurse would be able to predict characteristics of other drugs in the same class, including Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. which drugs have the most favorable safety profile. 2. their therapeutic indications. 3. their actions and adverse effects. 4. their specific clinical use. 5. contraindications specific to any drug in that group. - ANSWER>>2,3,4 Chemical names are assigned for each drug. What are the major reasons that nursing usually does not use the chemical name of the drugs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. They are usually not brief or easy to remember. 2. They are often difficult to pronounce. 3. There is no standard for assigning names. 4. They do not explain the nature of the drug. 5. There is only one chemical name for each drug. - ANSWER>>1,2 A client is admitted to the emergency department with high blood pressure. The health care provider orders a diuretic and tells the client this medication will lower the blood pressure by decreasing intravascular fluid volume. What does this description address? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The drugs mechanism of action 2. The drugs pharmacologic classification 3. How the drug produces its effects in the body 4. The drugs therapeutic classification 5. What condition is being treated by the drug - ANSWER>>1,2,3 A client who is admitted to the intensive care unit for monitoring notices the arthritis medication does not look like the one used at home and asks the nurse why. What is the nurses best response? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. This is a different brand from the one you use at home, but it will give you the same pain relief. 2. Your health care provider feels we can safely substitute this drug for the drug you use at home. 3. This generic drug is the one we have on formulary in the pharmacy. It has the same ingredients as the one you use at home. 4. This is what we have in the pharmacy. Go ahead and take it for now and let me know if it doesnt relieve the pain. 5. The medications in the hospital often do not look like the ones you get from the pharmacy. - ANSWER>>1,2,3 A client who received a refill for a medication returns to the pharmacy and says, This medication is wrong! It doesnt look anything like my usual prescription. Which response by the pharmacist would be most appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Your usual prescription drug is too expensive, so I substituted it with a generic one. 2. There is no difference between this drug and the one you usually get. 3. Our state allows me to substitute a generic drug when the prescription calls for a brand- name drug. 4. Dont worry. Can you see that the generic ingredients are exactly the same? 5. This medication is a generic form of your other medication. That is why it looks different. But it has the same ingredients and should work the same way. - ANSWER>>3,5 A client tells the nurse that the health care provider has prescribed a new medication that has just come on the market. The nurse has not heard of this particular medication but is able to give the client important information based on its prototype drug because of which principles? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Knowing the prototype drug allows the nurse to predict the mechanism of action of the new medication. 2. The information regarding the prototype drug can be extended to any drug in the same class. 3. Is the noncompliance related to a lack of finances? 4. Did the patient understand why the medication had been prescribed? 5. Are side effects causing the patient to refuse the medication? - ANSWER>>1,3,4,5 The nurse is preparing for medication administration to a group of patients. What is the best overall outcome for the patients? 1. Patients will take the medications after receiving medication instruction. 2. Patients will receive the best therapeutic outcome from the medications. 3. Patients will state the reason they are receiving the medications. 4. Patients will experience minimal side effects after taking the medications. - ANSWER>>2 The nurse is managing care for several patients at a diabetic treatment center. What is the primary intervention for the nurse? 1. To administer the correct medicine to the correct patient at the correct dose and the correct time via the correct route 2. To return the patient to an optimum level of wellness while limiting adverse effects related to the patients medical diagnosis 3. To include any cultural or ethnic preferences in the administration of the medication 4. To ANSWER any questions the patient may have about the medicine, or any possible side effect of the medication - ANSWER>>2 What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission (TJC)? 1. Planning care 2. Teaching 3. Assessment 4. Evaluating care - ANSWER>>2 The Joint Commission (TJC) documented that patient education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem and focused on what likely nursing intervention? 1. Providing educational pamphlets about medications to the patients. 2. Asking the physicians to provide medication education to the patients. 3. Discussing medications each time they are administered to patients. 4. Requesting more frequent pharmacy consults for the patients. - ANSWER>>3 The nurse has several educational pamphlets for the patient about medications the patient is receiving. Prior to giving the patient these pamphlets, what is a primary assessment for the nurse? 1. Assess the patients readiness to learn new information. 2. Assess the patients religious attitudes toward medicine. 3. Assess the patients reading level. 4. Assess the patients cultural bias toward taking medicine. - ANSWER>>3 The nurse is caring for an adolescent with depression and suicidal thoughts. The nursing diagnosis is Risk for Suicide related to depression. What is the best outcome for this adolescent? 1. The patient will discuss his feelings in group therapy today. 2. The patient will list five reasons why he should not harm himself today. 3. The patient will not commit any acts of self-harm today. 4. The patient will take the antidepressant medication as prescribed today - ANSWER>>3 The nurse is assessing a newly admitted patients current medications. What does the best objective data include? 1. The patients wife tells the nurse what medications the patient has been receiving. 2. The nurse checks the prescription bottles the patient has brought to the hospital. 3. The nurse asks the physician what medications the patient was currently taking. 4. The patient lists the medications that have been prescribed. - ANSWER>>2 The nurse is administering medications to an elderly patient. Which laboratory tests are important for the nurse to assess prior to the administration of medication? 1. Complete blood count (CBC) and electrolytes 2. Kidney and liver function tests 3. Arterial blood gases (ABGs) and basic metabolic panel 4. Lipid panel and thyroid function tests - ANSWER>>2 Which of the following correctly identifies and orders the primary steps of the nursing process? 1. Establish nursing diagnosis, assessment, intervene, collaborate, evaluation 2. Establish goals, assessment, intervention, planning, communication 3. Assessment, establish nursing diagnosis, planning, interventions, evaluation 4. Assessment, planning, establish objectives, communication, evaluation - ANSWER>>3 About which of the following patient assessment data sets would the nurse be most concerned prior to medication administration? 1. White blood cell count, ability to speak, and temperature 2. Age, allergies, and level of consciousness 3. Hair color, gender, and body mass index 4. Weight, height, and blood type - ANSWER>>2 A trauma patient in the emergency department has a low hemoglobin and hematocrit, and has an order to receive normal saline IV solution. Which nursing diagnosis would be most appropriate regarding the need for administering the IV solution? 1. Activity intolerance 2. Fluid volume deficit 3. Decreased cardiac output 3. Vomiting 4. Changes in blood pressure 5. Loss of hearing - ANSWER>>1,2,3,4 A nurse is reinforcing discharge instructions concerning food?drug interactions. The nurse determines that the patient understands when the patient makes which statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I should take my medications with water to avoid any problems with my medications being absorbed. 2. I cannot take one of my medications with grapefruit juice because it will decrease the absorption of the medication. 3. I need to be sure to read the prescription label because the pharmacist will indicate if I need to take my medication with food or without food. 4. I should take my daily vitamin 2 hours after my medication so they do not affect each other. 5. If I take my medication with hot tea, it will not affect absorption. - ANSWER>>1,2,3,4 A patient returns to the clinic for follow up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the patient makes which statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Ive been taking my medication on an empty stomach like the prescription label said to. 2. I always take my medication with a full glass of water. 3. Im not drinking any alcohol close to the time that I take my medication. 4. I switched all my medications to one pharmacy like you suggested. 5. I was glad I could take my medications and supplements together. I dont really like to take a lot of pills during the day. - ANSWER>>1,2,3,4 A nurse is caring for a patient who is exhibiting signs of an adverse reaction to warfarin (Coumadin). Which statements made by the patient would lead the nurse to suspect that this is the case? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Im from the South, and we have buttermilk almost every meal. 2. I was suffering so much from hot flashes until my friend told me to try an herb called St. Johns wort. I dont seem to have as many symptoms as before. 3. My husband makes me put garlic in everything! He heard it helps keep our blood pressure normal. 4. I heard ginkgo was really good for improving memory so I started taking it a couple of months ago. 5. I was having difficulty sleeping a couple months ago, and my neighbor recommended I try kava. It seems to calm my nerves. - ANSWER>>1,2,3,4 The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse miscalculates the medication dose. 2. The nurse does not check the patients identification band. 3. The nurse does not validate an order with the physician. 4. The nurse misinterprets a physicians order. 5. The nurse administers the incorrect drug. - ANSWER>>1,2,4,5 The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration? 1. The nursing supervisor 2. The nursing unit manager 3. The pharmacist 4. The physician - ANSWER>>3 The nurse makes a medication error and a patient dies. In court, the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question? 1. Did you follow agency guidelines as in previous circumstances? 2. Did you follow the physicians orders and double-check them before administration? 3. Did you do the three checks and follow the five rights as taught in school? 4. Did you do what another nurse would have done under similar circumstances? - ANSWER>>4 The nurse manager plans to teach the graduate nurse the reason why the nursing unit has policies and procedures. What best describes the reason for policies and procedures? 1. The policies and procedures establish standards of care for the institution. 2. The policies and procedures indicate how nursing personnel are to perform skills. 3. The policies and procedures establish how the health care facility is to be run. 4. The policies and procedures indicate the steps that must be taken when a medication error occurs. - ANSWER>>1 The nurse in the emergency department administers an adult dose of an antibiotic to a 3- month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the health care facility? 1. The professional license of the nurse will be lost. 2. The morale of the staff involved will be depleted. 1. Report the adverse effect to the Food and Drug Administrations (FDA) MedWatch Website. 2. Report the adverse effect to the Food and Drug Administrations (FDA) Adverse Event Website. 3. Report the adverse effect to the Food and Drug Administrations (FDA) Safe Medicine Website. 4. Report the adverse effect to the Food and Drug Administrations (FDA) Med MARX Website. - ANSWER>>1 The nurse is on a committee to reduce medication errors in a large health care facility. What is a recommendation the nurse proposes that will most likely help to reduce medication errors? 1. Train medication technicians to administer medications. 2. Use robots to prepare all medications for administration by the nurse. 3. Use automated, computerized cabinets on all nursing units. 4. Designate nurses whose only function is to administer medication. - ANSWER>>3 Which of the following is an example of a medication error? 1. The wrong dose of a medication is drawn up, but is caught and corrected prior to administration. 2. A medication is administered to a patient with no allergies, yet an anaphylactic response occurs. 3. A medication is administered in liquid form instead of tablet form due to the patients difficulty swallowing. 4. A patient experiences unexpected hypotension as a result of medication administration. - ANSWER>>1 Which of the following statements correctly identifies factors that contribute to medication errors? 1. A nurse who observes the five rights will prevent all medication errors from occurring. 2. Nurses are always liable when a medication error occurs. 3. Handwritten orders are more frequently associated with medication errors than are typed orders. 4. An incorrect dose (based on weight) is ordered, dispensed, and administered to a patient. The administering nurse and ordering clinician would be the only parties held accountable. - ANSWER>>3 Which of the following best represents adherence to a standard of care? 1. Administering a medication within the time frame specified by hospital policy 2. Administering a medication intramuscularly when a patient refuses to take it orally 3. Using abbreviations while charting to save time 4. Discontinuing a medication at the request of a patient - ANSWER>>1 Which of the following statements regarding medication error rates is ethically accurate? 1. Error rates are acceptable when well below the national average. 2. Error rates are acceptable when associated costs exceed the costs necessary for preventative actions. 3. Error rates are never acceptable. 4. Error rates are only acceptable when associated costs are less than 5% of the facilitys yearly profit. - ANSWER>>3 Which of the following demonstrates ethical reporting of a medication error? 1. The nurse does not report the error, because the error was caught and corrected prior to drug administration. 2. The nurse does not report or document the error, since the error did not result in any harm to the patient. 3. The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action. 4. The nurse informs the patient, documents the error as per hospital policy, and notifies the physician. - ANSWER>>4 Nurses should implement strategies to prevent medication errors. Which strategies would be the most beneficial for reducing common errors? 1. Strategies to prevent wrong dosage errors 2. Strategies to prevent wrong route errors 3. Strategies to prevent wrong medication errors 4. Strategies to prevent wrong patient errors - ANSWER>>1 Patients who are discharged from the hospital on new medications should 1. be advised that their local pharmacy will provide them with the drug information and instructions they need. 2. be provided with oral and written drug information and instructions. 3. be provided oral drug information and instructions as opposed to written. 4. be provided with written drug information and instructions only. - ANSWER>>2 Which statement is accurate regarding the Institute for Safe Medication Practices (ISMP)? 1. It publishes a consumer newsletter regarding medication errors. 2. It is a governmental agency. 3. It accepts reports from anyone for a nominal fee. 4. It only accepts reports from health care professionals. - ANSWER>>1 The nurse makes a medication error, but the patient is not harmed. The patients family asks the nurse manager what is considered a medication error. Which of the following are potential responses by the nurse manager? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Failure to follow health care providers orders 2. Failure to give the right medication Standard Text: Select all that apply. 1. IU 2. SQ 3. Q.O.D. 4. U 5. mcg - ANSWER>>1,2,3,4 A patient looks up the drug he is taking in a drug guide. The patient asks the nurse why the physician prescribed a medication that has a lethal dose measure. What is the best response by the nurse? 1. It just refers to what is done in research; it is not used by doctors prescribing drugs. 2. It is a value determined during research, which helps to determine the safe dose to give. 3. All that means is that the drug could be lethal, but I will watch you for side effects. 4. Dont worry about that, Ill have your doctor explain it to you. - ANSWER>>2 Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the students understanding of therapeutic index? 1. The student is able to determine if the physician prescribed the best drug for the patient. 2. The student is able to determine if the patients are receiving safe doses of the medications. 3. The student is able to identify interactions among the drugs each patient is receiving. 4. The student is able to identify the patients who will need to have serum blood levels monitored. - ANSWER>>4 The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses? 1. About 50% of patients will experience severe side effects from the drug. 2. Some patients will respond differently depending on their ethnic background. 3. About 50% of patients will not experience any effect from the drug. 4. Some patients will require more or less than the average dose of the drug. - ANSWER>>4 The patient receives antibiotics for a serious infection. The patient asks the nurse, Why dont you just give me more of that drug to cure this infection faster? What is the best response by the nurse? 1. I will check with the doctor to see if it is time to increase the medication. 2. You are at a maximum dose; taking more will cause interactions with other medications. 3. You must stay on this drug for 2 more weeks before it can be increased. 4. You are at a maximum dose; taking more will not help. - ANSWER>>4 The nurse administers narcotics to surgical patients. Which statement represents the nurses best understanding as it relates to the potency of different narcotics? 1. Codeine is less potent than morphine; it will not produce an allergic reaction. 2. Morphine is more potent than codeine; a lesser dose will be required. 3. Morphine is more potent than codeine; it will produce more adverse effects. 4. Codeine is less potent than morphine; it will not relieve pain as well. - ANSWER>>2 The nurse is conducting medication education about the difference between potency and efficacy to a group of patients. The nurse correctly determines that learning has occurred when the patients makes which response? 1. The best drug for us is the one with the highest potency. 2. The best drug for us is the one with the greatest efficacy. 3. Drugs with the greatest efficacy will produce the least side effects. 4. Low potency drugs have efficacy and do not produce side effects. - ANSWER>>2 The patient has had hypertension for many years. The physician orders an antihypertensive drug that has just come on the market. The nurse teaches the patient that this drug works more effectively than his prior drug, and has fewer side effects. The patient asks how this can be. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Newer drugs are altered to affect your cells receptors in a different way. 2. Receptors tend to burn-out, so newer drugs are required. 3. Research into receptors helps fine-tune drugs to be more effective. 4. Changing the response of the drug to protein receptor-complexes produces fewer side effects. 5. It is a process of trial and error with receptors until the new drug proves effective. - ANSWER>>1,3 The nurse plans to teach a group of patients about how their medications work in their bodies. If education has been successful, what will be the best understanding of the patients? 1. Medications change the function of the cells in the body. 2. Medications help the body produce new enzymes. 3. Medications change how body tissues function. 4. Medications work by enhancing or blocking normal body functioning. - ANSWER>>4 The patient and his wife receive the same medication for hypertension. The patients wife asks the nurse why she is receiving a higher amount of the medication. What is the best response by the nurse? 1. Females have a higher metabolism, so you need more medication. 2. Everyone is unique and responds differently to medications. 3. Your hormones are different from your husbands, so you need more medication. 4. You have a greater percentage of body fat, so more medication is needed. - ANSWER>>2 The student nurse has been reading about the Human Genome Project and asks the nursing instructor how this will impact future pharmacological therapies. What is the best response by the instructor? 3. response intensity within a large group of people with similar characteristics. 4. response intensity within a small group of people with similar characteristics. - ANSWER>>1 At a dose of 10 mg, drug X lowers total cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 65mg/dL is achieved at 40 mg. At a dose of 5 mg, drug Y lowers cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 55 mg/dL is achieved at 10 mg. What can be concluded about the efficacy and potency of these two drugs? 1. Drug X is more potent, and drug Y has a higher efficacy. 2. Drug X is more potent, and has higher efficacy. 3. Drug Y is more potent, and has higher efficacy. 4. Drug Y is more potent, and drug X has a higher efficacy. - ANSWER>>4 If a clinician wanted to prevent the effects elicited from a previously administered medication, which type would be of the most use? 1. An agonist 2. A partial agonist 3. An antagonist 4. A partial antagonist - ANSWER>>3 Pharmacogenetics is a relatively new area within pharmacology. Which statement best describes the potential of this new area? 1. To customize drugs and prevent idiosyncratic responses 2. To reduce the overall number of drugs and their associated adverse effects 3. To reduce medication errors and provide optimal drug choices 4. To provide cost-effective pharmacotherapy and higher drug efficacy - ANSWER>>1 The nurse is participating in the clinical trial of a new medication for the treatment of hypertension. To assess the effectiveness of the medication, which interventions would the nurse perform to help determine whether the average dose is effective for the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Monitoring blood pressure 2. Monitoring heart rate 3. Interpreting laboratory values 4. Monitoring diet 5. Monitoring sleep habits - ANSWER>>1,2,3 The nurse explains to a student nurse that the median lethal dose of drugs is often determined in laboratory preclinical trials because Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. it would be unethical to determine these values in human subjects. 2. the safety of the medication must be determined prior to clinical trials. 3. it is difficult to obtain sufficient participants for clinical trials. 4. clinical trials determine only the effective dose of a drug. 5. it is too costly to conduct the studies during clinical trials. - ANSWER>>1,2 A patient with hypertension is taking a potent antihypertensive without results. The patient is concerned when the health care provider orders a new drug. The nurse explains, Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The drug you took is very potent, and a higher dose is needed. 2. The new drug has greater efficacy, so it will help reduce your blood pressure. 3. The prescriber must have made an error in the orders. 4. Efficacy in treating your hypertension is more important than potency. 5. You are correct. I think the prescriber meant to order both drugs. - ANSWER>>2,4 The nurse is reviewing the medication administration record for a group of patients and recognizes that which agents have nonspecific cellular responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Ethyl alcohol 2. General anesthetics 3. Osmotic diuretics 4. Calcium channel blockers 5. Alpha-adrenergic antihypertensives - ANSWER>>1,2,3 The nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement? 1. We can safely take the drug for at least 6 months beyond the expiration date. 2. We dont need to worry about storage of the drug, it wont lose potency. 3. We should not take our medications with milk or dairy products. 4. We need to be careful about taking the medication with certain foods. - ANSWER>>4 The physician ordered a loading dose of medication for the patient; it is to be followed by a lower dose. When the patient receives the lower dose, she says to the nurse, I think my doctor made a mistake; my medication dose is too low. What is the best response by the nurse? 1. The initial dose shortened the half-life, so the medication would work more quickly. 2. We always give medications this way; the doctor did not make a mistake. 3. You had a larger dose initially so that the medication would work more quickly. 4. Giving a larger dose initially will reduce the chance of side effects. - ANSWER>>3 1. How drugs move from the site of administration to circulating fluids 2. How drugs are converted to a form that is easily removed from the body 3. How drugs change body illnesses and pathogens 4. How drugs are transported throughout the body 5. How drugs are removed from the body - ANSWER>>1,2,4,5 The patient is scheduled to receive a medication that is an enzyme inducer of the P450 system. What best describes the effect of this medication on the patient? 1. In time, the patient will experience no effect from other medications. 2. In time, the patient will experience increased effects from other medications. 3. In time, the patient will experience a reduced effect from this medication. 4. In time, the patient will experience an increased effect from this medication. - ANSWER>>3 The patient tells the nurse that he is on many medications, and questions how they all get to the right places. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. It depends on how much protein you have in your body. 2. It depends on the health of your kidneys. 3. It depends on whether they are fat based or water based. 4. It depends on the amount of blood flow to your body tissues. 5. It depends on the health of your liver. - ANSWER>>1,3,4 The patient receives a drug that is excreted in the bile. What will the best nursing assessment of the effect of this drug on the patient include? 1. The effect of the drug will be a prolonged action. 2. The effect of the drug will be increased side effects. 3. The effect of the drug will be decreased side effects. 4. The effect of the drug will be decreased. - ANSWER>>1 The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect? 1. Intravenous route 2. Oral route 3. Rectal route 4. Sublingual route - ANSWER>>2 Enzymatic activity that changes a medication into a less active form is an example of 1. pharmacodynamics. 2. active transport. 3. pharmacokinetics. 4. diffusion. - ANSWER>>3 Which of the following are the four categories of pharmacokinetics? 1. Diffusion, active transport, interspersing, and storage 2. Ingestion, metabolism, interspersing, and excretion 3. Absorption, distribution, metabolism, and excretion 4. Ingestion, settling, movement, and storage - ANSWER>>3 Following ingestion, a drug crosses a membrane from an area of higher concentration to an area of lower concentration. This is an example of 1. active transport. 2. osmosis. 3. diffusion. 4. metabolism. - ANSWER>>3 Aspirin is ionized as it enters the small intestine. Which statement is accurate regarding the absorption of aspirin in the small intestine? 1. Absorption is decreased. 2. Absorption is increased. 3. Ionization has nothing to do with the absorption rate. 4. Aspirin must travel past the small intestine for absorption to occur. - ANSWER>>1 Which statement regarding medication distribution within the body is accurate? 1. The bloodbrain barrier inhibits rapid crossing of all medications. 2. Body organs with high levels of blood flow are more difficult organs to which to deliver drugs. 3. Medications that are lipid-soluble are more completely distributed. 4. Drugprotein complexes must form prior to crossing capillary membranes. - ANSWER>>3 Which organ is the most responsible for the first-pass effect? 1. Bladder 2. Kidneys 3. Liver 4. Stomach - ANSWER>>3 Which of the following substances would have the lowest rate of crossing renal tubular membranes, and would therefore be excreted in the urine? 1. Lipid-soluble drugs 2. Water 3. Ionized drugs 4. Non-ionized drugs - ANSWER>>3 1. Morphine 10 mg IV every 2 to 4 hours as needed for pain 2. Morphine 10 mg IM every 2 to 4 hours as needed for pain. 3. Morphine 10 mg transdermal patch every 2 to 4 hours as needed for pain. 4. Morphine 10 mg sublingual every 2 to 4 hours as needed for pain. 5. Morphine 10 mg subcutaneous every 2 to 4 hours as need for pain. - ANSWER>>1,4 The nurse recognizes that medications can be excreted by which routes? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Fecal 2. Gastric 3. Glandular 4. Pulmonary 5. Renal - ANSWER>>1,3,4,5 A patient asks the nurse why he experiences a metallic taste after taking certain medications. The nurse explains that a medication may cause glandular secretions that occur by which routes? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Saliva 2. Sweat 3. Breast milk 4. Urine 5. Feces - ANSWER>>1,2,3 The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a patient makes which response? 1. The baby can only be harmed by medications during the first trimester. 2. It is important to not take over-the-counter (OTC) drugs during my pregnancy. 3. Exposure to teratogens can result in my babys death or in malformations. 4. If I breastfeed my baby, drugs can come through my breast milk. - ANSWER>>1 The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse? 1. Be sure to check the label to see if the herbal product could be used during breastfeeding. 2. Most drugs can be transferred to the infant during breastfeeding, so this is not recommended. 3. Herbal products are considered natural, so it should be fine to use them during breastfeeding . 4. This should be fine, as long as there is at least 12 hours between the time you use the product and when you breastfeed. - ANSWER>>2 The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What will the best plan of the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Keep the toddler awake and observe for side effects of the medication. 2. Keep all medications locked up and stored out of reach of the toddler. 3. Use syrup of ipecac immediately if the toddler has ingested medication. 4. Call the Poison Control Center for guidance with any medication ingested. 5. Teach the toddler that medications are for adult use only. - ANSWER>>2,4 The nursing instructor teaches student nurses about the Food and Drug Administration (FDA) Pregnancy Categories. What is the best information to include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Food and Drug Administration (FDA) Pregnancy Category C is safe to use during pregnancy. 2. Food and Drug Administration (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women. 3. Food and Drug Administration (FDA) Pregnancy categories for individual drugs seldom change once they are established. 4. Food and Drug Administration (FDA) Pregnancy categories are based on studies using clinical human research trials. 5. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. - ANSWER>>2,5 The nurse plans to administer medication to the preschool child. Which approach indicates the nurse has an understanding of growth and development? 1. The child is often more cooperative if the parent is not in the room. 2. The child does better with verbal instruction than with play instruction. 3. There should be no need to restrain a child of this age. 4. Use a brief rationale, followed by quick administration of the medication. - ANSWER>>4 The nurse will administer medication to a school-age child. What is the preferred action by the nurse? 1. Teach the child the action and expected side effects of the medication. 2. Tell the child he will not be allowed to go to recess if the medication is not taken. 3. Offer the child a choice of beverage with which to take the medication. 4. Offer to play with the child prior to medication administration. - ANSWER>>3 An adolescent patient comes to the school nurse with complaints of vague abdominal pain. What assessment data would help to confirm the nurses suspicion that the adolescent has body image concerns? Which stage of fetal development poses the greatest risk to the fetus related to medication administration? 1. Each stage is equal in risk. 2. Pre-implantation period 3. Third trimester 4. Embryonic - ANSWER>>4 A drug for which research has shown an adverse effects in animals but not in pregnant women would be categorized as Category 1. A. 2. B. 3. D. 4. C. - ANSWER>>2 Which of the following kinds of drugs would be most likely to enter breast milk? 1. Ionized 2. Lipid-soluble 3. Water-soluble 4. Bound to plasma protein - ANSWER>>2 Which method is the most appropriate for administering medications to school-age children? 1. Allowing the child to make decisions regarding the time the medications are taken 2. Providing a brief explanation 3. Administering drugs while holding the child down 4. Providing a lengthy explanation followed by quick drug administration - ANSWER>>2 Which statement is accurate regarding pharmacotherapy in the older adult? 1. Increased body water can lead to a higher risk of drug toxicity. 2. Plasma levels are increased, leading to a heightened drug response. 3. Generally, drug doses should be increased due to prolonged drug metabolism. 4. Drug absorption is slower due to increased gastric pH. - ANSWER>>4 A patient presents with hypotension and bradycardia. The patient indicates that one of her physicians recently prescribed three new medications to her current list of 10 medications per day. Based on this information, which statement would be the most accurate? 1. The patient is having an allergic reaction to one of the new medications. 2. The patient is experiencing adverse reactions as a result of polypharmacy. 3. The patient is not in compliance with her prescribed medications. 4. The patient is experiencing an adverse effect that will go away in time. - ANSWER>>2 When possible, drug therapy is postponed until after pregnancy and lactation. However, certain acute and chronic conditions must be managed during pregnancy, including Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. epilepsy. 2. serious cystic acne. 3. sexually transmitted infections. 4. gestational diabetes. 5. hypertension. - ANSWER>>1,3,4,5 The nurse preparing a teaching plan for an adolescent postpartum mother includes which topics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Most medications are secreted into breast milk. 2. The new mothers insulin will not be secreted into her breast milk. 3. Over-the-counter (OTC) drugs and herbal products are secreted into breast milk and have the potential to cause harm to the infant. 4. Topical medications must be avoided as these also are secreted into breast milk. 5. Most drugs are safe to take right after breastfeeding because they have not reached the blood stream yet. - ANSWER>>1,2,3 The nurse is planning care for a pregnant patient prone to substance abuse. When the patient states, My baby isnt getting my drugs, I am, how does the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Most illicit drugs will cross the placenta and hurt the baby. 2. Even drugs that do not cross the placenta can hurt your baby by preventing nutrients from getting across the placenta. 3. Research shows taking drugs can cause your baby to be born too early. 4. You are correct. You are far enough along in your pregnancy that drugs will not harm your baby. 5. If you continue to take drugs, it will make you have a very irritable infant. - ANSWER>>1,2,3 A pregnant patient suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the patient about which complications associated with drug use during pregnancy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Preterm birth 2. Low birth weight 3. Birth defects A patient is diagnosed with cancer. The physician has recommended chemotherapy, which would likely save the patients life. The patient tells the nurse, This is punishment from God for sins I have committed; some women at my church say so. What will the best plan of the nurse include? 1. With the patients permission, plan to involve a hospital minister to discuss the patients perspective about cancer. 2. With the patients permission, plan to bring the case before the hospitals board of ethics. 3. With the patients permission, plan to contact the patients minister to discuss the patients perspective about cancer. 4. With the patients permission, plan to meet with family members to discuss the patients perspective about cancer. - ANSWER>>3 The African American patient has panic attacks, is suicidal, and is on an inpatient psychiatric unit. The psychiatrist orders sertraline (Zoloft) and clonazepam (Klonopin). The patient refuses the drugs; he requests to have herbs and African objects in his room to remove the curse. What is the priority action by the nurse? 1. Allow the request without seeking further information from the patient. 2. Allow the request as long as the herbs and objects do not pose a safety risk for the patient or other patients. 3. Allow the request after the patient signs a release of responsibility to avoid litigation. 4. Allow the request after all members of the treatment team agree to it. - ANSWER>>2 The public health nurse notices that several patients in the hypertension clinic have poorly controlled hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these patients? 1. Does your religion allow the use of high blood pressure medication? 2. Do you think your high blood pressure is a problem? 3. Can you afford the high blood pressure medication? 4. Does your culture use herbs to treat high blood pressure? - ANSWER>>3 The nurse is providing group education about warfarin (Coumadin) to minority patients who have experienced strokes (brain attacks). The nurse determines that learning has occurred when the patients make which statement? 1. We may need to have more frequent blood tests. 2. We may need to have less frequent blood tests. 3. We may need more medication than other ethnic groups. 4. We may need less medication than other ethnic groups. - ANSWER>>4 The nurse is conducting a holistic assessment of a patient with alcoholism. What are the important questions to ask? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. How is drinking alcohol viewed by your culture? 2. Have you ever attended Alcoholic Anonymous meetings? 3. Did you see your parents drinking alcohol when you were growing up? 4. Have you been in alcohol rehabilitation before now? 5. What blood relatives of yours are addicted to alcohol? - ANSWER>>1,3,5 The patient is an American Indian admitted to the hospital for chemotherapy. At any given time, five family members are in the patients room, which is private. The nurse tells the patient that according to hospital policy; only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the nurses action? 1. The nurse should have assessed the patients preferences about how many family members she wanted to be present. 2. The nurse should have called the physician and obtained an order for additional family members to be present. 3. This was the correct action; the nurse was following protocol by informing the patient about hospital policy. 4. The nurse should have allowed the patient to have as many family members as she wanted to be present. - ANSWER>>1 The physician has prescribed a chemotherapeutic drug for the patient with cancer. This drug commonly causes loss of hair. The patient asks the nurse, Will all of my hair fall out? What is the most therapeutic response by the nurse? 1. We are not really sure; applying an ice bag to your head may help. 2. Dont worry, we can recommend an excellent wig company if need be. 3. Yes, that is one of the expected side effects of this medication. 4. It might. Have you discussed this with your physician? - ANSWER>>3 The patient is admitted to the hospital following an abortion, and she is septic. The physician orders antibiotics that the patient refuses stating, I dont deserve them. The nurse providing care has anti-abortion beliefs. What is the best response by the nurse? 1. I think you need to do what is best for you. 2. You have a serious infection and really need the drug. 3. Do you think you should be punished because you had an abortion? 4. Ill call your physician and let him know about your decision. - ANSWER>>2 The African American patient had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse caring for the patient is Caucasian. The nurse assesses the patients diet to be very high in fat. What is the best plan by the nurse to improve the patients diet and reduce the risk for additional medications? 1. With the patients permission, plan to ask an African American nurse to speak to him about a low-fat diet. 2. With the patients permission, plan to discuss his diet with whomever prepares meals for his family. 3. Plan to give the patient information specific to African Americans about low-fat diets. 4. Plan to ask the physician for a consult by dietary services so a dietician can teach the patient about low-fat diets. - ANSWER>>2 2. Middle-aged patient with Down syndrome living in a group home 3. Recently divorced mother of three children with breast cancer 4. Sixteen-year-old requesting birth control without parental consent 5. Seven-year-old with asthma in a foster care home - ANSWER>>1,2,3 The nurse in charge of a clinical study welcomes the participants in an open forum. One patient is surprised that there are men and women from several ethnic groups. The nurse tells the group that in the past, ethnic variables were largely unknown or ignored for what reasons? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Clinical trials failed to include ethnically diverse subjects. 2. Clinical trials comprised mostly Caucasian males. 3. Little attention was focused on identifying the different effects drugs had on various ethnic groups. 4. Research proved there were no differences among ethnic groups. 5. The large majority of clinical trials included Caucasian females. - ANSWER>>1,2,3 The nurse in the emergency department is caring for several patients from diverse cultures. Which statement shows the nurses ability to provide culturally competent care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I understand your religion prohibits blood transfusions. Would you consider nonblood alternatives? 2. I just want to make sure you and your spouse understand the risks as you consider the options. 3. I dont really understand why you are afraid to take the medication. Do you have any questions I can ANSWER to alleviate your fear? 4. I really dont understand why you wont consider an abortion. Your admission papers say you are an atheist. 5. Im not quite sure why the health care provider is giving you these prescriptions. You didnt get them filled the last time you were here. - ANSWER>>1,2,3 A home health nurses patient caseload is ethnically diverse. Which interventions show understanding of cultural variables? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible 2. Assessing the patients response to acupuncture for pain 3. Discussing the patients beliefs regarding treatment 4. Notifying the health care provider of the patients intentions to consult with a medicine man for spiritual guidance 5. Removing the patients collection of herbs to decrease the risk of an adverse effect when taken with Western medicine - ANSWER>>1,2,3 A patient asks the nurse why a medication prescribed by the provider didnt do anything at all. Which statement by the nurse accurately describes how genetics influence drug action? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Genetic differences can result in significant differences in how each patients body handles the same medication. 2. Genetic differences can cause mutations in enzymes, changing the way they function. This can alter how the body metabolizes and excretes drugs. 3. Because of genetic differences, medication may accumulate to toxic levels in one patient while in another patient may be inactivated before it can have a therapeutic effect. 4. Genetic differences can be expressed as an alteration in the structure of an enzyme, which can cause a defective receptor and an allergic response to drugs. 5. Genetic - ANSWER>>1,2,3 A nurse administering medications to a variety of patients on a medical-surgical floor recognizes that which patients may need additional education about medication adherence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Fifty-year-old recently remarried male taking antihypertensive medication 2. Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive 3. Sixty-eight-year-old male recently started on antidepressants known to cause gynecomastia 4. Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth 5. Seventy-eight-year-old male taking estrogen as therapy for prostate cancer - ANSWER>>1,2,4 The patient confides in the nurse that she is drawn to complementary and alternative medicine because it promotes the whole person. The patient would like spirituality and prayer included in her plan of care. What is the best response by the nurse? 1. We will include spirituality in your plan. Would you like to say a prayer? 2. I think your spiritual concerns are best left up to you and your minister. 3. What exactly do you mean by spirituality and prayer? 4. We usually do not pray with patients; is there something you are worried about? - ANSWER>>1 The nurse plans to teach patients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse? 1. Herbs, like prescription drugs, usually only contain one active ingredient. 2. The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts. 4. Herbal preparations can be dangerous if you are allergic to them. - ANSWER>>3 The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse? 1. Fish oil will help to enhance your brain function. 2. Chromium will help you achieve and maintain optimum weight. 3. Dietary supplements will help support and maintain hydration. 4. Soy isoflavone will help prevent Alzheimer disease. - ANSWER>>1 The patient takes St. Johns wort for depression, but does not tell anyone about this. The psychiatrist prescribes an MAO inhibitor. What will the best assessment of the nurse reveal? 1. Blood pressure of 210/100 mmHg 2. Serum glucose level of 340 3. Blood pressure of 78/40 mmHg 4. Serum potassium of 6.0 - ANSWER>>1 The patient is being treated for a cardiac dysrhythmia with amiodarone (Cordarone). The patient has elevated liver function tests (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated liver function tests LFTs? 1. The patient was taking Kava-Kava for anxiety. 2. The patient was taking Echinacea to treat cold symptoms. 3. The patient was taking St. Johns wort for depression. 4. The patient was taking gingko biloba for memory problems. - ANSWER>>2 The nurse has been teaching a patient about herbal preparations and determines that additional teaching is required when the patient makes which statement? 1. I should check with you before using an herbal product. 2. Herbal products usually contain only one active ingredient. 3. I need to be careful about where I store my herbal product. 4. Herbal preparations are available in solid and liquid forms. - ANSWER>>2 The nurse prepares to teach patients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the nurse? 1. Herbal preparations must be tested for safety and efficacy prior to marketing. 2. The label on the herbal preparation is required by the Dietary Supplement Health and Education Act (DSHEA) to be accurate. 3. Herbal preparations have to meet the same safety and efficacy standards as prescription and over-the-counter (OTC) drugs. 4. The manufacturer does not have to prove the safety or efficacy of the herbal preparation. - ANSWER>>4 The patient takes several prescription medications and asks the nurse about using complementary and alternative medicine. What is the best reply by the nurse? 1. Complementary and alternative medicine (CAM) is a good idea that you should discuss with your doctor. 2. Complementary and alternative medicine (CAM) is an approach that might reduce your need for medications. 3. Complementary and alternative medicine (CAM) might help, but you will still need your medications. 4. Complementary and alternative medicine (CAM) has not been demonstrated to help with your kind of symptoms. - ANSWER>>2 The patient is pregnant and asks the nurse about changing from her prescription antidepressant medication to St. Johns wort because it is natural. What is the best response by the nurse? 1. It should be okay because your baby has been exposed to an antidepressant. 2. St. Johns wort is a drug, and this should be discussed with your doctor. 3. No, herbal preparations are just not safe to take during pregnancy. 4. Yes, you can change, but let your doctor know at your next appointment. - ANSWER>>2 Which statement best describes the relationship of complementary and alternative therapies to pharmacology? 1. They are more effective than medication use. 2. They can reduce patient medication needs. 3. They serve as competitors, and should not be promoted. 4. They have little-to-no value in disease prevention and treatment. - ANSWER>>2 Which of the following is a reason for the increase in popularity of herbal remedies? 1. They are being marketed very aggressively. 2. Most insurance policies cover them. 3. They are more effective for treating bacterial infections. 4. Their popularity is decreasing, not increasing. - ANSWER>>1 The active ingredients of herbs 1. can be found in all parts of the herb. 2. are found only in the root system. 3. are found only in the rhizome. 4. are found only in the stems and leaves. - ANSWER>>1 Which statement is accurate regarding the Dietary Supplement Health and Education Act (DSHEA) of 1994? 1. It ensures that herbal products provide proof of their intended effects. 2. It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease. 3. It mandates that herbal product labels contain accurate information. 4. It requires that herbal products undergo the same rigorous testing as drugs do under the FDA. - ANSWER>>2 A patient with inflammatory arthritis asks about adding an anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the patient discuss the efficacy of which herbs with the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Tumeric 2. St. Johns wort 3. Ginger 4. Ginseng 5. Bilberry - ANSWER>>1,2,3 A patient who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. include their contact information on the label so consumers can report adverse effects. 2. notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect. 3. keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA). 4. demonstrate product effectiveness prior to release of the product to the public. 5. state which conditions the product is intended to cure or - ANSWER>>1,2,3 The nurse is teaching patients in a senior center about complementary and alternative therapies. Which statement by a patient indicates understanding of the information the nurse has presented? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I see now that ?natural doesnt really mean ?safe, and I should ask my health care provider about any supplements I want to take. 2. I didnt realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor. 3. I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery. 4. Its good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy. 5. Im allergic to many foods. - ANSWER>>1,2,3