Pharm Quiz #1

Pharm Quiz #1 Multiple Choice Identify the choice that best completes the statement or answers the question. 1. 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 patientÕs ability to swallow b. The patientÕs height c. The patientÕs last meal d. The patientÕs allergies ____ 2. When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patientÕs 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. ____ 3. The nurse is administering medications to the patient who is in liver failure resulting from end-stage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase? a. Absorption b. Distribution c. Metabolism d. Excretion ____ 4. An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems? a. Constipation and anorexia b. Fatigue, leg cramps, and dehydration c. Daytime sedation and lethargy d. Edema, nausea, and blurred vision ____ 5. When given a scheduled morning medication, the patient states, ÒI havenÕt seen that pill before. Are you sure itÕs correct?Ó The nurse checks the medication administration record and verifies that it is listed. Which is the nurseÕs best response? a. ÒItÕs listed here on the medication sheet, so you should take it.Ó b. ÒGo ahead and take it, and then IÕll check with your doctor about it.Ó ____ c. d. ÒIt wouldnÕt be listed here if it were not ordered for you!Ó ÒLet me check on the order first before you take it.Ó 6. When taking a telephone order for a medication, which action by the nurse is most appropriate? a. Verify the order with the charge nurse. b. Call back the prescriber to review the order. c. Repeat the order to the prescriber before hanging up the telephone. d. Ask the pharmacist to double-check the order. ____ 7. When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session? a. Provide written pamphlets for instruction. b. Show a video, and allow the patient to practice as needed on his own. c. Verbally explain the procedure, and provide written handouts for reinforcement. d. After demonstrating the procedure, allow the patient to do several return demonstrations. ____ 8. The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had Òstomach problemsÓ for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient? a. ÒThe over-the-counter drug has helped you, so you should continue to take it.Ó b. ÒThe over-the-counter dosage may not be strong enough. You should be taking prescription-strength for best effects.Ó c. ÒFor best results, you need to watch what you eat in addition to taking this drug.Ó d. ÒUsing this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider.Ó ____ 9. The nurse is administering an intravenous (IV) push medication through an IV lock. After injecting the medication, which action will be taken next? a. Flushing the lock ____ b. c. d. Regulating the IV flow Clamping the tubing for 10 minutes Holding the patientÕs arm up to improve blood flow 10. While the nurse is assisting a patient in taking his medications, the medication cup falls to the floor, spilling the tablets. What is the nurseÕs best action at this time? a. Discarding the medications and repeating preparation b. Asking the patient if he will take the medications c. Waiting until the next dose time, and then giving the medications d. Retrieving the medications and administering them to avoid waste ____ Pharm Quiz #1 Answer Section MULTIPLE CHOICE 1. ANS: C The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may be affected by the timing of the last meal. The patientÕs ability to swallow, height, and allergies are not factors to consider regarding the timing of the drugÕs administration. PTS: 1 DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 13 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. 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. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 26 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 3. ANS: C The liver is the organ that is most responsible for drug metabolism. Decreased liver function most strongly affects the metabolism of a drug. Liver function does not affect the absorption and distribution of a drug. Excretion is affected only because decreased liver function may not transform drugs into water-soluble substances for elimination via the kidneys, but that is not the best answer for this question. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 27 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 4. ANS: B Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe complications that occur when these drugs are given to the elderly. PTS: 1 DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 45 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 5. ANS: D When giving medications, the nurse should always listen to and honor any concerns or doubts expressed by the patient. If the patient doubts an order, the nurse should check the written order and/or check with the prescriber. The other options illustrate that the nurse is not listening to the patientÕs concerns. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 69 TOP: NURSING PROCESS: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 6. ANS: C For telephone or verbal orders, repeat the order back to the prescriber before hanging up the telephone. The other options are incorrect. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 69 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 7. ANS: D Return demonstration allows the nurse to evaluate the patientÕs newly learned skills. The techniques in the other options are incorrect because those suggestions do not allow for evaluation of the patientÕs technique. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 75 TOP: NURSING PROCESS: Implementation | NURSING PROCESS: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. ANS: D The use of OTC drugs may postpone effective management of chronic disease states and may delay treatment of serious or life-threatening disorders because these drugs may relieve symptoms without necessarily addressing the cause of the disorder. The other options do not address the need to investigate the cause of the symptoms and are incorrect. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: pp. 85-86 TOP: NURSING PROCESS: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. ANS: A IV locks are to be flushed before and after each use; either heparin or saline flush is used, depending on the individual institutionÕs policy. The other actions are not appropriate. PTS: 1 REF: p. 126 DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 10. ANS: A Medications that fall to the floor must be discarded, and the procedure must be repeated with new medications. The other actions are not appropriate. PTS: 1 DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: p. 103 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control