TEST BANK - FOCUS ON NURSING PHARMACOLOGY 8TH EDITION | ALL CHAPTERS1 -59 COVERED.
Chapter 01 - Introduction to Drugs
A nurse working in radiology admi... [Show More] nisters iodine to a patient who is having a computed tomography(CT)
scan. The nurse working on the oncology unit administers chemotherapy to patients who have
cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR)
vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best
describes the actions of all three nurses?
Pharmacoeconomics
Pharmacotherapeutics
Pharmacodynamics
Pharmacokinetics
Ans: B
Feedback:
Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical
pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of
drugs to treat, prevent, and diagnose disease. The radiology nurse is administering a drug to help
diagnose a disease. The oncology nurse is administering a drug to help treat a disease.
Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a
drug affects the body and pharmacokinetics is how the body acts on the body.
A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as neededfor
pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential.
Under what category would morphine be classified?
Schedule I
Schedule II
Schedule III
Schedule IV
Ans: B
Feedback:
Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence
liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs
have a lesser abuse potential than II and an accepted medical use. Schedule IV drugs have low
abuse potential and limited dependence liability.
When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
Working with animals who are given experimental drugs
Choosing appropriate patients to be involved in the drug study
Monitoring and observing patients closely for adverse effects
Conducting research to determine effectiveness of the drugAns: C
Feedback:
Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record
any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect
and analyze the information to be shared with the Food and Drug Administration (FDA) but would not
conduct research independently because nurses do not prescribe medications. Use of animals in drug
testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate
in studies where the participants have the disease the drug is intended to treat. These patients are
monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers
who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
What concept is considered when generic drugs are substituted for brand name drugs?
Bioavailability
Critical concentration
Distribution
Half-life
Ans: A
Feedback:
Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to
act on body cells. Binders used in a generic drug may not be the same as those used in the brand
name drug. Therefore, the way the body breaks down and uses the drug may differ, which may
eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to
cause a therapeutic effect and should not differ between generic and brand name medications.
Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body’s
tissues and is the
same in generic and brand name drugs. A drug’s half-life is the time it takes for the amount of drug to
decrease to half the peak level, which should not change when substituting a generic medication.
A nurse is assessing the patient’s home medication use. After listening to the patient list current
medications, the nurse asks what priority question?
Do you take any generic medications?
Are any of these medications orphan drugs?
Are these medications safe to take during pregnancy?
Do you take any over-the-counter medications?
Ans: D
Feedback:
It is important for the nurse to specifically question use of over-the-counter medications because
patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs
unless they too are health care providers. Safety during pregnancy, use of a generic medication, or
classification of orphan drugs are things the patient would be unable to answer but could be found in
reference books if the nurse wishes to research them.
After completing a course on pharmacology for nurses, what will the nurse know?
Everything necessary for safe and effective medication administration
Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
General drug information; the nurse can consult a drug guide for specific drug information.
The drug actions that are associated with each classification of medicationAns:
C
Feedback:
After completing a pharmacology course nurses will have general drug information needed for safe and
effective medication administration but will need to consult a drug guide for specific drug information
before administering any medication. Pharmacology is constantly changing, with new drugs entering
the market and new uses for existing drugs identified. Continuing education in pharmacology is
essential to safe practice. Nurses tend to become familiar with the medications they administer most
often, but there will always be a need to research new drugs and also those the nurse is not familiar with
because no nurse knows all medications.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy
Category B drug. What would the nurse inform the patient?
Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studiesin pregnant
women.
Animal studies have shown an adverse effect on the fetus, but there are no adequate studies inpregnant
women.
There is evidence of human fetal risk, but the potential benefits from use of the drug may beacceptable
despite potential risks.
Ans: B
Feedback:
Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have
not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of
pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in
pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters.
Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate
studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the
use of the drugs in pregnant women may outweigh potential risks.
Discharge planning for patients leaving the hospital should include instructions on the use of over-thecounter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC
drugs?
OTC drugs are safe and do not cause adverse effects if taken properly.
OTC drugs have been around for years and have not been tested by the Food and Drug
Administration (FDA).
OTC drugs are different from any drugs available by prescription and cost less.
OTC drugs could cause serious harm if not taken according to directions.
Ans: D
Feedback:
It is important to follow package directions because OTCs are medications that can cause serious harm
if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed;
however, all drugs can produce adverse effects even when taken properly. They may have originally
been prescription drugs that were tested by the FDA or they may have been grandfathered in when the
FDA laws changed. OTC education should always be included as a part of the hospital discharge
instructions.
What would be the best source of drug information for a nurse?
Drug Facts and Comparisons
A nurse’s drug guide
A drug package insert
The Physicians’ Drug Reference (PDR)Ans:
B
Feedback:
A nurse’s drug guide provides nursing implications and patient teaching points that are most useful to
nurses in addition to need-to-know drug information in a very user friendly organizational
style.Lippincott’s Nursing Drug Guide (LNDG) has drug monographs organized alphabetically and
includes nursing implications and patient teaching points. Numerous other drug handbooks are also on
the market and readily available for nurses to use. Although other drug reference books such as Drug
Facts and Comparisons, PDR, and drug package inserts can all provide essential drug information, they
will not contain nursing implications and teaching points and can be more difficult to use than nurse’s
drug guides.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiledbut the
name of the medication is still readable. What is the nurse’s priority action?
Discard the entire bottle and contents and obtain a new bottle.
Find the drug information and create a new label for the bottle.
Ask another nurse to verify the contents of the bottle.
Administer the medication if the name of the drug can be clearly read.
Ans: A
Feedback:
When the drug label is soiled obscuring some information the safest action by the nurse is to discard the
bottle and contents because drug labels contain a great deal of important information, far more than just
the name of the drug. Concentration of the drug, expiration date, administration directions, and
precautions may be missing from the label and so put the patient at risk. Looking up drug information
in a drug handbook or consulting with another nurse will not supply the expiration date or
concentration of medication. Be safe and discard the bottle and its contents.
What aspect of pharmacology does a nurse study? (Select all that apply.)
Chemical pharmacology
Molecular pharmacology
Impact of drugs on the body
The body’s response to a drug
Adverse and anticipated drug effects Ans: C,
D, E
Feedback:
Nurses study pharmacology from a pharmacotherapeutic level, which includes the effect of drugs on
the body, the body’s response to drugs, and both expected and unexpected drug effects. Chemical and
molecular pharmacology (Options A and B) are not included in nursing pharmacology courses. [Show Less]
