Deck 5: The Nursing Process and Pharmacology

Question 1

A client who is being discharged has been prescribed digoxin.The client has minimal information about the drug.Which of the following best reflects an expected goal or outcome of client teaching activities?

A) The client is provided written instructions about the medication
B) Significant others are included in teaching about the drug
C) The client will be able to identify three untoward reactions of the drug
D) The client is instructed about the monitoring activities associated with a cardiac drug

Answer 1

The client will be able to identify three untoward reactions of the drug

Question 2

A drug interaction occurs in the syringe during preparation.The nurse recognizes this as indicating

A) drug hypersensitivity.
B) drug incompatibility.
C) the drug's primary effect.
D) drug contraindication.

Answer 2

drug incompatibility.

Question 3

During a home health visit,the nurse surveys the homebound older adult's home for storage places for medication.The purpose of this survey is to

A) observe only prescribed medications.
B) ascertain that medications are in a locked cabinet.
C) ascertain that all medications are kept in the refrigerator.
D) evaluate the client's knowledge of how to store medication.

Answer 3

evaluate the client's knowledge of how to store medication.

Question 4

About which of the following drugs would the nurse be least concerned as being incompatible with other drugs?

A) Diazepam (Valium)
B) Phenytoin (Dilantin)
C) Sodium bicarbonate
D) Digoxin (Lanoxin)

Question 5

The nurse explains that ingestion of certain tyramine-containing foods is contraindicated with monoamine oxidase inhibitors.Which of the following food items should the nurse caution the client to avoid?

A) Almonds
B) Milk
C) Bread
D) Chocolate

Question 6

The nurses teaches the client that the net effect of eating tyramine-containing foods while taking monoamine oxidase inhibitors includes distressing conditions such as

A) diarrhea.
B) diaphoresis.
C) hypertension.
D) hyperemesis.

Question 7

Which type of drug order should be administered immediately?

A) Routine order
B) PRN order
C) Stat order
D) Single order

Question 8

The nurse would use which of the following as the most accurate statement when teaching a client about the deleterious effects of smoking when taking pharmacokinetic drugs?

A) Blood flow is increased by nicotine,so maximal drug absorption is problematic
B) Liver metabolism of drugs is stopped,and toxicity may result
C) Drug plasma levels are generally decreased because of the induction of enzymatic activity
D) Excretion of drugs is hindered by the decreased absorption of most drugs

Question 9

The nurse is concerned that a client will have decreased intestinal absorption of drugs when the client is noted to be taking which of the following substances?

A) Tyramine-containing foods
B) Electrolytes
C) Histamine blockers
D) Antacids

Question 10

The nurse has an order to administer a dose of a medication by the subcutaneous route.The nurse would avoid using a site where the skin is

A) shiny.
B) hairy.
C) bruised.
D) pale.

Question 11

The nurse would be especially careful to avoid placing which of the following medications in a syringe with another medication because of the great risk for chemical incompatibility?

A) Morphine sulfate (Morphine)
B) Hydromorphone (Dilaudid)
C) Furosemide (Lasix)
D) Phenytoin (Dilantin)

Question 12

Which of the following questions would be most effective when compiling a drug history from a client?

A) "Do you frequently take analgesics?"
B) "Do you have the same pharmacist fill all your prescriptions?"
C) "Have you ever had an anaphylactic or iatrogenic reaction?"
D) "Do you have any drug allergies? If so,what types of symptoms are associated with them?"

Question 13

The nurse would place highest priority on assessing which of the following body systems that demonstrates enhanced problems in the woman who smokes cigarettes and takes oral contraceptives?

A) Endocrine
B) Musculoskeletal
C) Cardiovascular
D) Gastrointestinal

Question 14

For a client who is taking warfarin (Coumadin),the nurse should provide instructions about a diet low in

A) vitamin B₁₂.
B) vitamin C.
C) vitamin K.
D) vitamin A.

Question 15

Of the following fluids,the best one for the nurse to administer with iron to a client is

A) orange juice.
B) carbonated cola.
C) pineapple juice.
D) milk.

Question 16

The nurse would allow a client taking which of the following medications to have grapefruit juice on the breakfast tray?

A) Iron
B) Calcium channel blockers
C) Lovastatin (Mevacor)
D) Triazolam (Halcion)

Question 17

Of the more than 100 most frequently prescribed drugs,more than 50 contain chemicals that adversely interact with

A) alcohol.
B) caffeine.
C) vitamins.
D) nicotine.

Question 18

Which of the following is not a required element of a valid prescription?

A) Route of administration
B) Physician's signature
C) Medication strength
D) Manufacturer's identification

Question 19

A client's alcohol consumption would be of most concern if she was discharged home with which of the following medications?

A) Acetaminophen
B) A sedative
C) Vitamins
D) A diuretic

Question 20

The nurse would withhold the dose of which of the following and telephone the physician,knowing that it interacts adversely with an ordered tetracycline preparation?

A) Digoxin
B) Vitamin C
C) Iron
D) Aspirin

Question 21

The nurse is administering IV nitroprusside (Nipride),a nitrate.The nurse uses a special procedure because this form of the drug is sensitive to

A) heat.
B) temperature.
C) moisture.
D) light.

Question 22

The dose of a prochlorperazine (Compazine)suppository is twice what has actually been ordered.The most appropriate nursing intervention would be to

A) cut the suppository in half.
B) call the physician for clarification.
C) administer another type of suppository.
D) have the client hold the suppository in for only half of the time.

Question 23

The best dosage form for the nurse to administer to an unconscious client is

A) an elixir.
B) a powder.
C) a capsule.
D) a suppository.

Question 24

During an emergency,the nurse administers drugs through which of the following preferred methods?

A) Sublingual
B) IM
C) IV bolus
D) IV infusion

Question 25

Amber-colored containers or packages are designed to prevent deterioration of a drug when it is exposed to

A) extreme temperatures.
B) light.
C) moisture.
D) cotton filler.

Question 26

Which of the following client statements is most accurate regarding the proper storage of insulin?

A) "It is best to keep the insulin in my bathroom medicine cabinet."
B) "I can store the medication in a warm and dark environment such as a cabinet in the kitchen."
C) "I need to make sure that I put the medication vial in a clear plastic bag in the dresser drawer."
D) "I should store my insulin in a special place set aside in the refrigerator."

Question 27

You are about to administer an astringent to a client.You explain to the client that this type of medication is given to

A) inhibit the growth of bacteria.
B) remove dirt and debris.
C) soothe and soften the skin.
D) vasoconstrict and contract tissue.

Question 28

You would withhold a dose of a rectal suppository and contact the prescriber if which of the following is newly noted?

A) Vomiting
B) Fever
C) Constipation
D) Hemorrhoids

Question 29

The nurse conducting client teaching about sublingual medications would include that an advantage of this route is that the medication is

A) absorbed rapidly.
B) excreted rapidly.
C) metabolized minimally.
D) distributed equally.

Question 30

Which of the following accepted abbreviations is paired with the correct meaning?

A) PRN: as ordered at bedtime
B) pc: after meals
C) bid: as needed twice daily
D) qod: every day

Question 31

The source of discomfort associated with injections is usually which of the following?

A) The needle puncture of the skin
B) The length of the needle used in the injection
C) The stretching of tissue as it accommodates the volume of the drug
D) The sharpness of the needle used in the injection

Question 32

The nurse should instruct a client to place nitroglycerin tablets

A) on the roof of the mouth.
B) on any nonhairy skin area.
C) under the tongue.
D) in the buccal sac.

Question 33

Which of the following actions would be the most appropriate when administering subcutaneous insulin?

A) Limit the volume to 1 mL ideally
B) Avoid massaging the area after administering
C) Do not aspirate with subcutaneous injections
D) Inject into the ventrogluteal site

Question 34

The implementation phase in drug therapy is composed of which of the following activities?

A) Evaluation of activities through qualitative data collection
B) Techniques and procedures with modifications for individual client situations
C) The compilation of a thorough drug and allergy history
D) The establishment of long-term and short-term outcomes for drug therapy

Question 35

Topical drug administration is enhanced when the skin is

A) intact.
B) macerated.
C) atrophied.
D) clean.

Question 36

One advantage of the oral versus parenteral route is that medications given orally

A) have a more prolonged action.
B) have nonirritating effects.
C) have a wider safety margin.
D) have a steady state of pharmacokinetics.

Question 37

Which of the following are the appropriate landmarks for an IM injection into the dorsal gluteal region?

A) A "V" formation between the anterior iliac spine and the greater trochanter
B) A hand's breadth below the greater trochanter and the sacroiliac joint
C) Anterior to the diagonal line from the greater trochanter to the posterior iliac spine
D) Below the iliac spine and between the greater trochanter and the iliac crest

Question 38

The nurse would use an intramuscular injection route in which of the following situations?

A) When insufficient muscle mass is present in the landmarked area
B) When massaging the area after medication administration is contraindicated
C) With a medication known to be irritating,painful,or staining to subcutaneous tissues
D) With any injection given for allergy testing

Question 39

To facilitate the swallowing of an oral medication by an older adult client,the nurse should

A) crush the enteric tablet with a paper-lined mortar and pestle and then administer it with juice.
B) open the capsule and have the client chew the time-release granules;then have the client drink a glass of water.
C) sprinkle the capsule's powder on a small portion of applesauce.
D) let the client take what he or she can and dispose of the remaining amount.

Question 40

Which of the following individuals are not legally permitted to write prescriptions for medications?

A) Nurses with advanced practice credentials
B) Dentists
C) Osteopaths
D) Chiropractors

Question 41

What is one disadvantage of using the unit dose system?

A) Decreased medication safety
B) Decreased costs to set up the system
C) The need for additional pharmacy personnel to fill out new orders
D) Individual drug labeling

Question 42

Which of the following client statements reflects effective management of the therapeutic medication regimen?

A) "I am concerned about my sexual dysfunction."
B) "This drug really makes me sleepy and hungry."
C) "Don't worry,I take this pill all the time at home."
D) "I can give my own injections this time."

Question 43

Which of the following should the nurse consider before conducting a medication teaching session with a client?

A) Information should be detailed and as explicit as possible
B) Printed information and checklist forms should be included if the client can read
C) Start with the client's family members to get their help
D) Teach quickly and decisively to prevent confusion

Question 44

Your client has had difficulty swallowing food and pills.Which of the following actions would be most helpful to her when swallowing medications?

A) Have her tilt her head backward and take several sips of water
B) Crush any of her pills and administer them with an ounce of water
C) Offer her small amounts of water just before taking the pill and follow it with at least 240 mL water
D) Place her in a lateral position and put the pill on the back of her tongue

Question 45

An example of a potentially dangerous combination that results from competition for binding sites would be

A) warfarin (Coumadin)and acetylsalicylic acid.
B) magnesium aluminum hydroxide (Maalox)and tetracycline.
C) phenytoin (Dilantin)and total parenteral nutrition.
D) naloxone (Narcan)and heroin.