What is the difference between therapeutic and pharmacologic classifications? Identify the following classifications as therapeutic or pharmacologic:
... [Show More] betaadrenergic blocker, oral contraceptive, laxative, folic acid antagonist, and antianginal drug. - The therapeutic classification is a method of organizing drugs based on their therapeutic usefulness in treating particular diseases. The pharmacologic classification refers to how a drug works at the molecular, tissue, and body system levels. A beta-adrenergic blocker is a pharmacologic class; an oral contraceptive is a therapeutic class; laxative is a therapeutic class; folic acid antagonist is a pharmacologic class; antianginal is a therapeutic class.
Chapter 1
How does the FDA ensure the safety and effectiveness of drugs? What types of drugs does the FDA regulate or control? - The FDA, through its Center for Drug Evaluation and Research (CDER), exercises control over whether prescription drugs and OTC drugs may be used for therapy. The mission of the CDER is to facilitate the availability of safe, effective drugs; keep unsafe or ineffective drugs off the market; improve the health of Americans; and provide clear, easily understandable drug information for safe and effective use. The FDA's Center for Biologics Evaluation and Research (CBER) regulates the use of biologics including serums, vaccines, and blood products.
Chapter 2
Why are certain drugs placed in schedules? What does the nurse need to know when a scheduled drug is ordered? - Schedules refer to the potential for abuse. These schedules help the nurse identify the potential for abuse and require the nurse to maintain complete records for all quantities prescribed. The higher the abuse potential, the more restrictions are placed on the prescriber and the filling of refills. When educating the patient about a prescription, the nurse should also include this information on any prescription or refills as part of the education.
Chapter 2
A nurse is preparing to give a patient a medication and notes that a drug to be given is marked as a Schedule III drug. What does this information tell the nurse about this medication? - This Schedule III drug is a controlled substance restricted by the Controlled Substance Act of 1970 and regulated by the DEA. A Schedule III drug has a moderate abuse potential, moderate potential for physical dependency, and high potential for psychologic dependency.
Chapter 2
What is the role of the nurse in medication administration? (Select all that apply.)
1. Ensure that medications are administered and delivered in a safe manner.
2. Be certain that healthcare provider orders are accurate.
3. Inform the patient that prescribed medications need to be taken only if the patient agrees with the treatment plan.
4. Ensure that the patient understands the use and administration technique for all prescribed medications.
5. Prevent adverse drug reactions by properly administering all medications. - 1. Ensure that medications are administered and delivered in a safe manner.
4. Ensure that the patient understands the use and administration technique for all prescribed medications.
Chapter 3
Before administering drugs by the enteral route, the nurse should evaluate which of the following?
1. Ability of the patient to lie supine
2. Compatibility of the drug with intravenous fluid
3. Ability of the patient to swallow
4. Patency of the injection port - 3. Ability of the patient to swallow
Chapter 3
While the nurse takes the patient's admission history, the patient describes having a severe allergy to an antibiotic. What is the nurse's responsibility to prevent an allergic reaction? (Select all that apply.)
1. Instruct the patient to alert all providers about the allergy.
2. Document the allergy in the medical record.
3. Notify the provider and the pharmacy of the allergy and type of allergic reaction.
4. Place an allergy bracelet on the patient. 5. Instruct the patient not to allow anyone to give the antibiotic. - 2. Document the allergy in the medical record.
3. Notify the provider and the pharmacy of the allergy and type of allergic reaction.
4. Place an allergy bracelet on the patient.
Chapter 3
The order reads, "Lasix 40 mg IV STAT." Which action should the nurse take?
1. Administer the medication within 30 minutes of the order.
2. Administer the medication within 5 minutes of the order.
3. Administer the medication as required by the patient's condition.
4. Assess the patient's ability to tolerate the medication before giving. - 2. Administer the medication within 5 minutes of the order.
Chapter 3
Which medications would not be administered through a nasogastric tube? (Select all that apply.)
1. Liquids
2. Enteric-coated tablets
3. Sustained-release tablets
4. Finely crushed tablets
5. IV medications - 2. Enteric-coated tablets
3. Sustained-release tablets
5. IV medications
Chapter 3
A patient with diabetes has been NPO (nothing by mouth) since midnight for surgery in the morning. He usually takes an oral type 2 antidiabetic drug to control his diabetes. What would be the best action for the nurse to take concerning the administration of his medication?
1. Hold all medications as ordered.
2. Give him the medication with a sip of water.
3. Give him half the original dose.
4. Contact the provider for further orders. - 4. Contact the provider for further orders.
Chapter 3
A patient has a new medication prescription and the nurse is providing education about the drug. Which statement made by the patient would indicate the need for further medication education?
1. "I can consult my healthcare provider if I experience adverse effects."
2. "If I take more, I'll have a better response."
3. "Taking this drug with food will decrease how much drug gets into my system."
4. "The liquid form of the drug will absorb faster than the tablets." - 2. "If I take more, I'll have a better response"
Chapter 4
A patient with cirrhosis of the liver has hepatic impairment. This will require what possible changes? (Select all that apply.)
1. A reduction in the dosage of the drugs
2. A change in the timing of medication administration 3. An increased dose of prescribed drugs
4. Giving all prescribed drugs by intramuscular injection
5. More frequent monitoring for adverse drug effects - 1. A reduction in the dosage of the drugs
2. A change in the timing of medication administration
5. More frequent monitoring for adverse drug effects
Chapter 4
A combination of two different antihypertensive drugs in lower doses has been ordered for a patient whose hypertension has not been controlled by standard doses of either drug alone. The nursing student recognizes the interaction between these two drugs is known as what term?
1. Addition
2. Synergism
3. Antagonism
4. Displacement - 2. Synergism
Chapter 4
The patient requires a drug that is known to be completely metabolized by the first-pass effect. What change will be needed when this drug is administered?
1. The drug must be given more frequently.
2. The drug must be given in higher doses.
3. The drug must be given in a lipid-soluble form.
4. The drug must be given by a non-oral route, such as parenterally. - 4. The drug must be given by a non-oral route, such as parenterally
Chapter 4
A patient who has acute kidney injury (AKI) may have a diminished capacity to excrete medications. The nurse must assess the patient more frequently for what development?
1. Increased risk of allergy
2. Decreased therapeutic drug effects
3. Increased risk for drug toxicity
4. Increased absorption of the drug from the intestines - 3. Increased risk for drug toxicity
chapter 4
What is the rationale for the administration of a loading dose of a drug?
1. It decreases the number of doses that must be given.
2. It results in lower dosages being required to achieve therapeutic effects.
3. It decreases the risk of drug toxicity.
4. It more rapidly builds plasma drug levels to a plateau level. - 4. It more rapidly builds plasma drug levels to a plateau level
Chapter 4
Describe the types of barriers drugs encounter from the time they are administered until they reach their target cells. - For most medications, the greatest barrier is crossing the many membranes that separate the drug from its target cells. A drug taken by mouth must cross the plasma membranes of the mucosal cells of the GI tract and the capillary endothelial cells to enter the bloodstream. To leave the bloodstream, it must again cross capillary cells, travel through interstitial fluid, and enter target cells by passing through their plasma membranes. Depending on the mechanism of action, the drug may also need to enter cellular organelles, such as the nucleus, which are surrounded by additional membranes. While seeking their target cells and attempting to pass through the various membranes, drugs are subjected to numerous physiologic substances such as stomach acids and digestive enzymes.
Chapter 4
Why is a drug's plasma half-life important to nurses? - The plasma half-life is the time required for the concentration of the medication in the plasma to decrease to half its initial value after administration. This value is important to the nurse because the longer the halflife, the longer it takes the medication to be excreted. The medication will then produce a longer effect in the body. The half-life determines how often a medication will be administered. Kidney and liver diseases will prolong the half-life of drugs, increasing the potential for toxicity.
Chapter 4
Describe how the excretion process of pharmacokinetics may place patients at risk for adverse drug effects. - The process of eliminating drugs from the body most often occurs by excretion through the kidneys. Impairment of kidney function will alter this excretion, placing the patient at risk for adverse drug effects and drug toxicity. Gaseous forms of drugs are eliminated through respiration; patients with impaired respiratory effort or those with respiratory disease may also experience adverse drug effects. Because water-soluble forms of drugs may be eliminated through breast milk, infants of breastfeeding mothers may be at risk for adverse drug effects if the drug crosses through the milk in large enough quantities.
Chapter 4
Explain why drugs metabolized through the first-pass effect might need to be administered by the parenteral route. - Many oral drugs are rendered inactive by hepatic metabolism as the drug first passes through that system. Alternative routes of delivery that bypass the first pass effect (sublingual, rectal, or parenteral routes) may need to be considered for these drugs
Chapter 4
A patient experiences profound drowsiness when a stimulant drug is given. This is an unusual reaction for this drug, a reaction that has not been associated with this particular drug. What is the term for this type of drug reaction?
1. Allergic reaction
2. Idiosyncratic reaction
3. Enzyme-specific reaction
4. Unaltered reaction - 2. Idiosyncratic reaction
Chapter 5
The provider has ordered atropine, a drug that will prevent the patient's own chemical, acetylcholine, from causing parasympathetic effects. What type of drug would atropine be considered?
1. An antagonist
2. A partial agonist
3. An agonist
4. A protagonist - 1. An antagonist
Chapter 5
A nursing student reads in a pharmacology textbook that 10 mg of morphine is considered to provide the same pain relief as 200 mg of codeine. This indicates that the morphine would be considered more _____________ than codeine. - This indicates that the morphine would be considered more potent than codeine. Rationale: A drug that is more potent will produce a therapeutic effect at a lower dose.
Chapter 5
What is the term used to describe the magnitude of maximal response that can be produced from a particular drug?
1. Efficacy
2. Toxicity
3. Potency
4. Comparability - 1. Efficacy
Chapter 5
The nurse looks up butorphanol (Stadol) in a drug reference guide prior to administering the drug and notes that it is a partial agonist. What does this term tell the nurse about the drug?
1. It is a drug that produces the same type of response as the endogenous substance.
2. It is a drug that will occupy a receptor and prevent the endogenous chemical from acting.
3. It is a drug that causes unpredictable and unexplained drug reactions.
4. It is a drug that produces a weaker, or less efficacious, response than an agonist drug. - 4. It is a drug that produces a weaker, or less efficacious, response than an agonist drug
Chapter 5
The nurse reads that the drug to be given to the patient has a "narrow therapeutic index." The nurse knows that this means that the drug has what properties?
1. It has a narrow range of effectiveness and may not give this patient the desired therapeutic results.
2. It has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects.
3. It has a narrow range of conditions or diseases that the drug will be expected to treat successfully.
4. It has a narrow segment of the population for whom the drug will work as desired. - 2. It has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects.
Chapter 5
If the ED50 is the dose required to produce an effective response in 50% of a group of patients, what happens in the other 50% of the patients after a dose has been administered? - The other 50% of the patients did not experience the desired effect from the dose.
Chapter 5
Great strides are being made in pharmacogenomics and [Show Less]