Pharmacology and the Nursing Process 9th Edition 9780323529495DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
Evaluation
MSC:
... [Show More] NCLEX: Safe and Effective Care Environment: Management of Care
4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient will adhere to the new insulin treatment regimen.
d. The patient will demonstrate correct blood glucose testing technique.
ANS: D
“Demonstrating correct blood glucose testing technique” is a specific and measurable
outcome criterion. “Following instructions” and “not experiencing complications” are not
specific criteria. “Adhering to new regimen” would be difficult to measure.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?
a. Providing education on keeping a journal of blood pressure readings
b. Setting goals and outcome criteria with the patient’s input
c. Recording a drug history regarding over-the-counter medications used at home
d. Formulating human needs statements regarding insufficient knowledge related to
the new treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals
and outcomes reflects the planning phase. Recording a drug history reflects the assessment
phase. Formulating human needs statements reflects analysis of data as part of planning.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
6. The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before
beginning chemotherapy to prevent nausea.” The nurse notes that the route is missing from
the order. What is the nurse’s best action?
a. Give the medication intravenously because the patient might vomit.
b. Give the medication orally because the tablets are available in 4-mg doses.
c. Contact the prescriber to clarify the route of the medication ordered.
d. Hold the medication until the prescriber returns to make rounds.
ANS: C
A complete medication order includes the route of administration. If a medication order
does not include the route, the nurse must ask the prescriber to clarify it. The intravenous
and oral routes are not interchangeable. Holding the medication until the prescriber returns
would mean that the patient would not receive a needed medication.
DIF: Cognitive Level: Applying (Application)
Chapter 1 - The Nursing Process and Drug Therapy 4
Pharmacology and the Nursing Process 9th Edition 9780323529495TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. When the nurse considers the timing of a drug dose, which factor is appropriate to
consider when deciding when to give a drug?
a. The patient’s ability to swallow
b. The patient’s height
c. The patient’s last meal
d. The patient’s allergies
ANS: C
The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that
may be affected by the timing of the last meal. The patient’s ability to swallow, height,
and allergies are not factors to consider regarding the timing of the drug’s administration.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
8. The nurse is performing an assessment of a newly admitted patient. Which is an example
of subjective data?
a. Blood pressure 158/96 mm Hg
b. Weight 255 pounds
c. The patient reports that he uses the herbal product ginkgo.
d. The patient’s complete blood count results.
ANS: C
Subjective data include information shared through the spoken word by any reliable
source, such as the patient. Objective data may be defined as any information gathered
through the senses or that which is seen, heard, felt, or smelled. A patient’s blood pressure,
weight, and laboratory tests are all examples of objective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. When giving medications, the nurse will follow the rights of medication administration.
The rights include the right documentation, the right reason, the right response, and the
patient’s right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
d. Right diagnosis
e. Right time
f. Right patient
ANS: A, B, C, E, F
Additional rights of medication administration must always include the right drug, right
dose, right time, right route, and right patient. The right diagnosis is incorrect.
Chapter 1 - The Nursing Process and Drug Therapy 5
Pharmacology and the Nursing Process 9th Edition 9780323529495DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
2. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5
as the last phase. (Select all that apply.)
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Human needs statement
ANS: A, B, C, D, E
The nursing process is an ongoing process that begins with assessing and continues with
human needs statement, planning, implementing, and evaluating.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
General
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Chapter 1 - The Nursing Process and Drug Therapy 6
Pharmacology and the Nursing Process 9th Edition 9780323529495Chapter 02: Pharmacologic Principles
Lilley: Pharmacology and the Nursing Process, 9th Edition
MULTIPLE CHOICE
1. The patient is receiving two different drugs. At current dosages and dosage forms, both
drugs have the same concentration of the active ingredient. Which term is used to identify
this principle?
a. Bioequivalent
b. Synergistic
c. Prodrugs
d. Steady state
ANS: A
Two drugs absorbed into the circulation in the same amount (in specific dosage forms)
have the same bioavailability; thus, they are bioequivalent. A drug’s steady state is the
physiologic state in which the amount of drug removed via elimination is equal to the
amount of drug absorbed from each dose. The term synergistic refers to two drugs, given
together, with a resulting effect that is greater than the sum of the effects of each drug
given alone. A prodrug is an inactive drug dosage form that is converted to an active
metabolite by various biochemical reactions once it is inside the body.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. When given an intravenous medication, the patient says to the nurse, “I usually take pills.
Why does this medication have to be given in the arm?” What is the nurse’s best answer?
a. “The medication will cause fewer adverse effects when given intravenously.”
b. “The intravenous medication will have delayed absorption into the body’s tissues.”
c. “The action of the medication will begin sooner when given intravenously.”
d. “There is a lower chance of allergic reactions when drugs are given intravenously.”
ANS: C
An intravenous (IV) injection provides the fastest route of absorption. The IV route does
not affect the number of adverse effects, nor does it cause delayed tissue absorption (it
results in faster absorption). The IV route does not affect the number of allergic reactions.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral
drugs?
a. Parenteral drugs bypass the first-pass effect.
b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
c. Absorption of parenteral drugs is faster when the stomach is empty.
d. Parenteral drugs exert their effects while circulating in the bloodstream.
ANS: A
Chapter 2 - Pharmacologic Principles 7
Pharmacology and the Nursing Process 9th Edition 9780323529495Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the
stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not
to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the
circulation before they can exert their effects; they do not exert their effects while
circulating in the bloodstream.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure,
the nurse notes that the patient’s blood pressure is extremely low, and the patient is
lethargic and difficult to awaken. This would be classified as which type of adverse drug
reaction?
a. Adverse effect
b. Allergic reaction
c. Idiosyncratic reaction
d. Pharmacologic reaction
ANS: D
A pharmacologic reaction is an extension of a drug’s normal effects in the body. In this
case, the antihypertensive drug lowered the patient’s blood pressure levels too much. The
other options do not describe a pharmacologic reaction. An adverse effect is a predictable,
well-known adverse drug reaction that results in minor or no changes in patient
management. An allergic reaction (also known as a hypersensitivity reaction) involves the
patient’s immune system. An idiosyncratic reaction is unexpected and is defined as a
genetically determined abnormal response to normal dosages of a drug.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which
sentence defines a drug’s half-life?
a. The time it takes for the drug to cause half of its therapeutic response
b. The time it takes for one half of the original amount of a drug to reach the target
cells
c. The time it takes for one half of the original amount of a drug to be removed from
the body
d. The time it takes for one half of the original amount of a drug to be absorbed into
the circulation
ANS: C
A drug’s half-life is the time it takes for one half of the original amount of a drug to be
removed from the body. It is a measure of the rate at which drugs are removed from the
body. The other options are incorrect definitions of half-life.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 2 - Pharmacologic Principles 8
Pharmacology and the Nursing Process 9th Edition 97803235294956. When administering drugs, the nurse remembers that the duration of action of a drug is
defined as which of these?
a. The time it takes for a drug to elicit a therapeutic response
b. The amount of time needed to remove a drug from circulation
c. The time it takes for a drug to achieve its maximum therapeutic response
d. The time period at which a drug’s concentration is sufficient to cause a therapeutic
response
ANS: D
Duration of action is the time during which drug’s concentration is sufficient to elicit a
therapeutic response. The other options do not define duration of action. A drug’s onset of
action is the time it takes for the drug to elicit a therapeutic response. A drug’s peak effect
is the time it takes for the drug to reach its maximum therapeutic response. Elimination is
the length of time it takes to remove a drug from circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug
works by selective enzyme interaction. Which of these processes describes selective
enzyme interaction?
a. The drug alters cell membrane permeability.
b. The drug’s effectiveness within the cell walls of the target tissue is enhanced.
c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from
binding to that receptor.
d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme’s
action with the normal target cell.
ANS: D
With selective enzyme interaction, the drug attracts the enzymes to bind with the drug
instead of allowing the enzymes to bind with their normal target cells. As a result, the
target cells are protected from the action of the enzymes. This results in a drug effect. The
actions described in the other options do not occur with selective enzyme interactions.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. When administering a new medication to a patient, the nurse reads that it is highly protein
bound. Assuming that the patient’s albumin levels are normal, the nurse would expect
which result, as compared to a medication, that is not highly protein bound?
a. Renal excretion will be faster.
b. The drug will be metabolized quickly.
c. The duration of action of the medication will be shorter.
d. The duration of action of the medication will be longer.
ANS: D
Drugs that are bound to plasma proteins are characterized by longer duration of action.
Protein binding does not make renal excretion faster, does not speed up drug metabolism,
and does not cause the duration of action to be shorter.
Chapter 2 - Pharmacologic Principles 9
Pharmacology and the Nursing Process 9th Edition 9780323529495DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin.
Where does the nurse instruct the patient to place the tablet?
a. Under the tongue
b. On top of the tongue
c. At the back of the throat
d. In the space between the cheek and the gum
ANS: A
Drugs administered via the sublingual route are placed under the tongue. Drugs
administered via the buccal route are placed in the space between the cheek and the gum;
oral drugs are swallowed. The other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
10. The nurse is administering medications to the patient who is in renal failure resulting from
end-stage renal disease. The nurse is aware that patients with kidney failure would most
likely have problems with which pharmacokinetic phase?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
ANS: D
The kidneys are the organs that are most responsible for drug excretion. Renal function
does not affect the absorption and distribution of a drug. Renal function may affect
metabolism of drugs to a small extent.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. A patient who has advanced cancer is receiving opioid medications around the clock to
keep him comfortable as he nears the end of his life. Which term best describes this type
of therapy?
a. Palliative therapy
b. Maintenance therapy
c. Empiric therapy
d. Supplemental therapy
ANS: A
Chapter 2 - Pharmacologic Principles 10
Pharmacology and the Nursing Process 9th Edition 9780323529495The goal of palliative therapy is to make the patient as comfortable as possible. It is
typically used in the end stages of illnesses when all attempts at curative therapy have
failed. Maintenance therapy is used for the treatment of chronic illnesses such as
hypertension. Empiric therapy is based on clinical probabilities and involves drug
administration when a certain pathologic condition has an uncertain but high likelihood of
occurrence based on the patient’s initial presenting symptoms. Supplemental therapy (or
replacement therapy) supplies the body with a substance needed to maintain normal
function.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. The patient is stating that he has a headache and asks the nurse which over-the-counter
medication form would work the fastest to help reduce the pain. Which medication form
will the nurse suggest?
a. A capsule
b. A tablet
c. An enteric-coated tablet
d. A powder
ANS: D
Of the types of oral medications listed, the powder form would be absorbed the fastest,
thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet
would be absorbed next, in that order.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
13. The nurse will be injecting a drug into the superficial skin layers immediately underneath
the epidermal layer of skin. Which route does this describe?
a. Intradermal
b. Subcutaneous
c. Intramuscular
d. Transdermal
ANS: A
Injections under the more superficial skin layers immediately underneath the epidermal
layer of skin and into the dermal layer are known as intradermal injections. Injections into
the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous
injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to
as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive
patch.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
Chapter 2 - Pharmacologic Principles 11
Pharmacology and the Nursing Process 9th Edition 97803235294951. Which drugs would be affected by the first-pass effect when administered? (Select all that
apply.)
a. Morphine given by IV push injection
b. Sublingual nitroglycerin tablets
c. Diphenhydramine (Benadryl) elixirs
d. Levothyroxine (Synthroid) tablets
e. Transdermal nicotine patches
f. Esomeprazole (Nexium) capsules
g. Penicillin given by IV piggyback infusion
ANS: C, D, F
Orally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect,
because they are metabolized in the liver after being absorbed into the portal circulation
from the small intestine. IV medications (IV push and IV piggyback) enter the
bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal
patches also enter the bloodstream without going directly to the liver, thus avoiding the
first-pass effect.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
COMPLETION
1. A drug dose that delivers 800 mg has a half-life of 5 hours. Identify how much drug will
remain in the body after one half-life. _______
ANS:
400 mg
A drug’s half-life is the time required for one half of an administered dose of a drug to be
eliminated by the body, or the time it takes for the blood level of a drug to be reduced by
50%. Therefore, one half of 800 mg equals 400 mg.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 2 - Pharmacologic Principles 12
Pharmacology and the Nursing Process 9th Edition 9780323529495Chapter 03: Lifespan Considerations
Lilley: Pharmacology and the Nursing Process, 9th Edition
MULTIPLE CHOICE
1. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which
reason?
a. Decreased fetal surface area
b. Increased placental surface area
c. Enhanced blood flow to the fetus
d. Increased amount of protein-bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of
enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface
area, not decreased, is a factor that affects drug transfer to the fetus. The placenta’s surface
area does not increase during this time. Drug transfer is increased because of an increased
amount of free drug, not protein-bound drug, in the mother’s circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
General
MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed
gestational diabetes and pneumonia. She is given medications that pose a possible fetal
risk, but the potential benefits may warrant the use of the medications in her situation. The
nurse recognizes that these medications are in which U.S. Food and Drug Administration
pregnancy safety category?
a. Category X
b. Category B
c. Category C
d. Category D
ANS: D
Pregnancy category D fits the description given. Category B indicates no risk to animal
fetus; information for humans is not available. Category C indicates adverse effects
reported in animal fetus; information for humans is not available. Category X consists of
drugs that should not be used in pregnant women because of reports of fetal abnormalities
and positive evidence of fetal risk in humans.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. When discussing dosage calculation for pediatric patients with a clinical pharmacist, the
nurse notes that which type of dosage calculation is used most commonly in pediatric
calculations?
a. West nomogram
b. Clark rule
c. Height-to-weight ratio
Chapter 3 - Lifespan Considerations 13
Pharmacology and the Nursing Process 9th Edition 9780323529495d. Milligram per kilogram of body weight formula
ANS: D
The milligram per kilogram formula, based on body weight, is the most common method
of calculating doses for pediatric patients. The other options are available methods but are
not the most commonly used. Height-to-weight ratio is not used.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
4. The nurse is assessing a newly admitted 83-year-old patient and determines that the patient
is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
a. The patient is experiencing multiple illnesses.
b. The patient uses one medication for an illness several times per day.
c. The patient uses over-the-counter drugs for an illness.
d. The patient uses multiple medications simultaneously.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications
for each of them, possibly prescribed by different specialists who may be unaware of other
treatments the patient is undergoing. The other options are incorrect. Polypharmacy
addresses the medications taken, not just the illnesses. Polypharmacy means the patient is
taking several different medications, not just one, and can include prescription drugs,
over-the-counter medications, and herbal products.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common
responses in an elderly patient who is taking which type of drug?
a. Laxatives
b. Anticoagulants
c. Sedatives
d. Antidepressants
ANS: C
Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy,
forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and
antidepressants may cause adverse effects in the elderly, but not the ones specified in the
question.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
6. For accurate medication administration to pediatric patients, the nurse must take into
account which criteria?
a. Organ maturity
b. Renal output
c. Body temperature
d. Height [Show Less]