Deck 11: Individual Variations in Drug Responses

Question 1

The nurse is caring for an Asian American client diagnosed with terminal cancer.Which factor should the nurse consider to achieve adequate pain control for the client?

A)All ethnic groups respond to medications in the same manner.
B)The only variation in drug metabolism occurs among African Americans.
C)Asians respond differently to antidepressants only.
D)Opioids are metabolized differently in individuals of Asian and Native American descent.

Answer 1

Opioids are metabolized differently in individuals of Asian and Native American descent.

Question 2

The nurse in charge of a clinical study welcomes the participants in an open forum.One client 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 which reasons?
Select all that apply.

A)Clinical trials failed to include ethnically diverse subjects.
B)Clinical trials comprised mostly Caucasian males.
C)Little attention was focused on identifying the different effects drugs had on various ethnic groups.
D)Research proved there were no differences among ethnic groups.
E)The large majority of clinical trials included Caucasian females.

Answer 2

Clinical trials failed to include ethnically diverse subjects.
Clinical trials comprised mostly Caucasian males.
Little attention was focused on identifying the different effects drugs had on various ethnic groups.

Question 3

The nurse is teaching a mixed-gender class how to prevent heart attacks.What important factor related to gender will the nurse include in the teaching plan?

A)Heart disease affects men and women equally.
B)All medications used to prevent heart attacks affect men and women the same.
C)Certain medications,such as aspirin,are more effective in preventing heart attacks in women than in men.
D)Certain medications,such as aspirin,are more effective in preventing heart attacks in men than in women.

Answer 3

Certain medications,such as aspirin,are more effective in preventing heart attacks in men than in women.

Question 4

A Caucasian nurse is caring for an African American client who has a history of myocardial infarction and is receiving atorvastatin (Lipitor).The nurse assesses the client's diet to be very high in fat.Which teaching plan would be most effective at improving the client's diet and possibly reducing the need for additional medications?

A)Plan to ask an African American nurse to speak to the client about low-fat diets.
B)Discuss the client's diet with whoever prepares meals for the family.
C)Give the client a printout about low-fat diets specific to African Americans.
D)Ask the health care provider for a consult by dietary services so a dietician can teach the client about low-fat diets.

Question 5

The nurse is providing education about warfarin (Coumadin)to a group of Asian American and African American clients who have experienced strokes.The nurse determines that learning has occurred when the clients make which statement?

A)We might need to have more frequent blood tests."
B)We might need less medication than other ethnic groups."
C)We might need to have less frequent blood tests."
D)We might need more medication than other ethnic groups."

Question 6

A health care provider recommends chemotherapy for a client diagnosed with cancer.The client tells the nurse,This is a punishment from God for the sins I have committed.Some of the women at my church say so." Which intervention will best meet the client's spiritual needs?

A)Plan to involve a hospital minister to discuss the client's perspective about cancer.
B)Plan to meet with family members to discuss their feeling about the cancer and prognosis.
C)Plan to contact the client's minister to make a visit.
D)Plan to bring the case before the hospital's board of ethics.

Question 7

The nurse is conducting a holistic assessment of a client diagnosed with alcoholism.Which priority questions should the nurse include in the assessment?
Select all that apply.

A)Did you see your parents drink alcohol when you were growing up?"
B)How old were you when you started drinking?"
C)Have you ever attended Alcoholic Anonymous meetings?"
D)Have you been treated with any medications that are designed to discourage consumption of alcohol?"
E)Have any of your blood relatives been addicted to alcohol?"

Question 8

A woman from an Arab culture is in labor and delivery.Her husband insists he must stay with her and will not allow her to receive any analgesia.Which action by the nurse is the most appropriate?

A)Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital.
B)Allow this request,and be available in the event the request changes.
C)Inform the husband that it is his wife's choice whether to receive analgesia.
D)Allow the request,but inform the husband that the primary health care provider will make the final decision regarding analgesia.

Question 9

The nurse in the emergency department is caring for several clients from diverse cultures.Which statements show the nurse's ability to provide culturally competent care?
Select all that apply.

A)I understand your religion prohibits blood transfusions.Would you consider nonblood alternatives?"
B)I just want to make sure you and your spouse understand the risks as you consider the options."
C)I don't really understand why you are afraid to take the medication.Do you have any questions I can answer to alleviate your fear?"
D)I really don't understand why you won't consider an abortion.Your admission papers say you are an atheist."
E)I'm not quite sure why the health care provider is giving you these prescriptions.You didn't get them filled the last time you were here."

Question 10

An adolescent Hispanic male with attention deficit hyperactivity disorder (ADHD)is taking methylphenidate (Ritalin).The adolescent will not go to the school nurse at noon for his medication.Which statement best describes the likely result of the nurse's assessment?

A)The adolescent really does not need an additional dose of methylphenidate (Ritalin)at school.
B)The adolescent is embarrassed about having to take medicine at school; it is a social stigma.
C)The adolescent is fearful that this drug might be a gateway drug" and he will abuse other substances.
D)The adolescent has developed alternative coping mechanisms to increase his focus during classes.

Question 11

A client asks the nurse why a medication prescribed by the provider didn't do anything at all." Which statement by the nurse accurately describes how genetics influence drug action?
Select all that apply.

A)Genetic differences can result in significant differences in how each client's body handles the same medication."
B)Genetic differences can cause mutations in enzymes,changing the way they function.This can alter how the body metabolizes and excretes drugs."
C)Because of genetic differences,medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic effect."
D)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."
E)Genetic differences in clients who are biracial result in an allergic response to medications."

Question 12

A Native American client is admitted to receive chemotherapy.At any given time,five family members are in the client's private room.The nurse tells the client that according to hospital policy,only two visitors at a time are allowed.What is the nurse manager's analysis of the situation?

A)The nurse should allow the client to have as many family members visiting as desired.
B)The nurse followed protocol by informing the client about hospital policy.
C)The nurse should have called the health care provider and obtained an order allowing additional family members to be present.
D)The nurse should have assessed the client's preference about the number of family members present.

Question 13

A nurse administering medications to a variety of clients on a medical-surgical floor recognizes that which clients may need additional education about medication adherence?
Select all that apply.

A)Fifty-year-old recently remarried male taking antihypertensive medication
B)Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive
C)Sixty-eight-year-old male recently started on antidepressants known to cause gynecomastia
D)Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth
E)Seventy-eight-year-old male taking estrogen as therapy for prostate cancer

Question 14

The primary health care provider has prescribed isoniazid (INH)for a client of Japanese descent diagnosed with tuberculosis.What factor must be considered in regard to the therapeutic effectiveness of this drug?

A)People of Japanese descent are known as rapid acetylators.
B)People of Japanese descent are usually allergic to isoniazid.
C)People of Japanese descent do not need medication to treat their tuberculosis.
D)People of Japanese descent are known as slow acetylators.

Question 15

The nurse is performing a holistic assessment on a client prior to administering antihypertensive medication.Which factors would be included in the holistic assessment?
Select all that apply.

A)Blood pressure
B)Belief in a higher power
C)Level of education
D)The symptoms of the hypertension only
E)Mood

Question 16

A home health nurse's client caseload is ethnically diverse.Which interventions show understanding of cultural variables?
Select all that apply.

A)Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible
B)Assessing the client's response to acupuncture for pain
C)Discussing the client's beliefs regarding treatment
D)Notifying the health care provider of the client's intentions to consult with a medicine man for spiritual guidance
E)Removing the client's collection of herbs to decrease the risk of an adverse effect when taken with Western medicine

Question 17

A male client comes to the emergency department with chest pain.Upon assessment the nurse notes that his blood pressure is 210/100 mmHg.The client's wife says to the nurse,He has not been taking his blood pressure medication,and we can afford it." What should the nurse's plan of action include?

A)Plan to assess the client for any cultural concerns about the medication.
B)Plan to teach the client the importance of taking his medication.
C)Plan to assess the client for sexual side effects such as erection difficulty.
D)Plan to design a teaching plan about medication that includes the client's wife.

Question 18

The nurse is assessing several clients.For which client does assessment reveal a psychosocial history that may affect the client's outcome?
Select all that apply.

A)Older adult who recently suffered a stroke,has an unsteady gait,and lives in a two-story home
B)Middle-aged client with Down syndrome living in a group home
C)Recently divorced mother of three children with breast cancer
D)Sixteen-year-old requesting birth control without parental consent
E)Seven-year-old with asthma in a foster care home