Deck 9: Individual Variations in Drug Response Preview As Pdf Pdf

Question 1

Which of the following best indicates an ethnic characteristic that can affect pharmacotherapy?

A) Genetic differences
B) Diet
C) Health beliefs
D) Alternative therapies

Answer 1

Genetic differences

Question 2

Which statement regarding human DNA sequences is accurate?

A) Only 2% of human DNA is different among the different ethnicities.
B) Due to enzyme polymorphism, Hispanics are less likely to metabolize codeine to morphine.
C) Even though human genetic differences are small, significant differences can be seen with drug metabolism.
D) Asian Americans are the ethnic group known to be slow acetylators.

Answer 2

Even though human genetic differences are small, significant differences can be seen with drug metabolism.

Question 3

Which statement is accurate regarding gender and pharmacology?

A) Women tend to seek medical care earlier than men do.
B) Heart disease has traditionally been thought of as a woman's disease.
C) Since the 1980s, the FDA has mandated that research studies include both male and female subjects.
D) Studies indicate that men and women suffer from Alzheimer's disease in equal numbers.

Answer 3

Women tend to seek medical care earlier than men do.

Question 4

The nurse manager would determine that a nurse understands culturally sensitive care if which statements are made?

A) "Since all of our patients have the same illnesses, I sometimes get bored."
B) "I have been helping my patient understand how to choose foods from our diet menu."
C) "I am concerned because my patient needs sterile dressing changes but has no running water at home."
D) "My patient and I worked out a way to get her medications delivered to her at home."
E) "I invited a group from my church to come and sing hymns for our patients."

Question 5

The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and will not allow her to receive any analgesia during the experience. What is the best action by the nurse?

A) Inform the husband that it is his wife's choice whether or not to receive analgesia.
B) Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital.
C) Allow the request but inform the husband that the physician will make the final decision about analgesia.
D) Allow this request and be available in the event the request changes.

Question 6

The African American patient has panic attacks, is suicidal, and is on an inpatient psychiatric unit. The psychiatrist orders sertraline (Zoloft) and clonazepam (Klonopin). The patient refuses the drugs; he requests to have herbs and African objects in his room to "remove the curse." What is the priority action by the nurse?

A) Allow the request without seeking further information from the patient.
B) Allow the request as long as the herbs and objects do not pose a safety risk for the patient or other patients.
C) Allow the request after the patient signs a release of responsibility to avoid litigation.
D) Allow the request after all members of the treatment team agree to it.

Question 7

The public health nurse notices that several patients in the hypertension clinic have poorly controlled hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these patients?

A) "Does your religion allow the use of high blood pressure medication?"
B) "Do you think your high blood pressure is a problem?"
C) "Can you afford the high blood pressure medication?"
D) "Does your culture use herbs to treat high blood pressure?"

Question 8

A nurse is teaching a community group about holistic medicine. Which information should the nurse include about Western medicine?

A) Western medicine focuses on the cause of disease.
B) Western medicine is not compatible with holistic medicine.
C) The patient is at the center of concern in Western medicine.
D) Disease is often viewed as a malfunction in a specific body system.
E) Western medicine may focus on disease treatment.

Question 9

The patient is receiving a beta-blocker medication. The nurse has done medication education and provided the patient with printed information to take home. During the next appointment, the nurse notes that the patient is not taking the medication properly. What is a therapeutic assessment question to ask this patient?

A) "Do I have to inform your physician about your noncompliance?"
B) "Why didn't you take your medicine as we talked about?"
C) "Are you able to read and comprehend the printed information?"
D) "Don't you understand how important it is to take the medicine?"

Question 10

The African American patient had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse caring for the patient is Caucasian. The nurse assesses the patient's diet to be very high in fat. What is the best plan by the nurse to improve the patient's diet and reduce the risk for additional medications?

A) With the patient's permission, plan to ask an African American nurse to speak to him about a low-fat diet.
B) With the patient's permission, plan to discuss his diet with whomever prepares meals for his family.
C) Plan to give the patient information specific to African Americans about low-fat diets.
D) Plan to ask the physician for a consult by dietary services so a dietician can teach the patient about low-fat diets.

Question 11

The nurse is conducting a holistic assessment of a patient with alcoholism. What are the important questions to ask?

A) "How is drinking alcohol viewed by your culture?"
B) "Have you ever attended Alcoholics Anonymous meetings?"
C) "Did you see your parents drinking alcohol when you were growing up?"
D) "Have you been in alcohol rehabilitation before now?"
E) "What blood relatives of yours are addicted to alcohol?"

Question 12

The patient, who is an American Indian, has been admitted to the hospital for chemotherapy. At any given time, five family members are in the patient's room, which is private. The nurse tells the patient that according to hospital policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the nurse's action?

A) The nurse should have assessed the patient's preferences about how many family members she wanted to be present.
B) The nurse should have called the physician and obtained an order for additional family members to be present.
C) This was the correct action; the nurse was following protocol by informing the patient about hospital policy.
D) The nurse should have allowed the patient to have as many family members as she wanted to be present.

Question 13

The nurse is providing education about warfarin (Coumadin) to a patient of Asian ancestry. The nurse determines that learning has occurred when the patient makes which statement?

A) "I may need to have more frequent blood tests."
B) "I may need to have less frequent blood tests."
C) "I may need more medication than someone from a different ethnic group."
D) "I may need less medication than someone from a different ethnic group."

Question 14

The nurse is doing a holistic assessment on a patient prior to the initiation of antihypertensive medication. What will the best assessment include?

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

Question 15

A patient is diagnosed with cancer. The physician has recommended chemotherapy, which would likely save the patient's life. The patient tells the nurse, "This is punishment from God for sins I have committed; some women at my church say so." What will the best plan of the nurse include?

A) With the patient's permission, plan to involve a hospital minister to discuss the patient's perspective about cancer.
B) With the patient's permission, plan to bring the case before the hospital's board of ethics.
C) With the patient's permission, plan to contact the patient's minister to discuss the patient's perspective about cancer.
D) With the patient's permission, plan to meet with family members to discuss the patient's perspective about cancer.

Question 16

The nurse is assessing several patients. For which patient does assessment reveal a psychosocial history that may affect the patient's outcome?

A) Older adult who recently suffered a stroke, has an unsteady gait, and lives in a two-story home
B) Middle-aged patient 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

Question 17

The physician has prescribed a chemotherapeutic drug for the patient with cancer. This drug commonly causes loss of hair. The patient asks the nurse, "Will all of my hair fall out?" What is the most therapeutic response by the nurse?

A) "We are not really sure; applying an ice bag to your head may help."
B) "Don't worry, we can recommend an excellent wig company if need be."
C) "Yes, that is one of the expected side effects of this medication."
D) "It might. Have you discussed this with your physician?"

Question 18

The patient is admitted to the hospital following an abortion, and she is septic. The physician orders antibiotics that the patient refuses stating, "I don't deserve them." The nurse providing care has anti-abortion beliefs. What is the best response by the nurse?

A) "I think you need to do what is best for you."
B) "You have a serious infection and really need the drug."
C) "It seems you think you should be punished because you had an abortion"
D) "I'll call your physician and let him know about your decision."

Question 19

All of the patients listed have cancer and are receiving chemotherapy. Which patient does the nurse evaluate as having the highest probability for a remission?

A) The patient with a support group of cancer survivors
B) The patient who is also seeing a psychiatrist for treatment of depression
C) The wealthy patient who can afford the best medical care available
D) The patient who is a former physician

Question 20

The adolescent Hispanic male has been diagnosed with attention-deficit hyperactivity disorder (ADHD), and is taking methylphenidate (Ritalin). Even though the drug helps with focus and grades, the adolescent will not go to the school office at noon for his medication. Which statement best describes the result of the nurse's evaluation?

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

Question 21

A nurse has been asked to present health promotion information at a community clinic whose clients are primary non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include information about which disorders?

A) Stroke
B) Coronary artery disease
C) Diabetes
D) Illicit drug use
E) Prenatal care

Question 22

The nurse in charge of a clinical study welcomes the participants in an open forum. One patient 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 what reasons?

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.

Question 23

A patient's genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this discovery?

A) Teaching the patient to avoid caffeine-containing drugs.
B) Planning additional time and interventions to help the patient stop smoking.
C) Use of an alternative to the drug warfarin.
D) Increased surveillance for the development of lung cancer.
E) Frequent monitoring of blood pressure.

Question 24

A patient who is strictly vegetarian due to religious beliefs has been prescribed a medication contained in a gelatin capsule. Which nursing actions are indicated?

A) Do not tell the patient the capsule contains gelatin.
B) Collaborate with the prescriber to find an alternative medication.
C) Check to see if the capsule can be opened for administration.
D) Work to convince the patient that this application does not violate vegetarian beliefs.
E) Tell the patient that the gelatin is an inactive ingredient in the medication.

Question 25

The nurse in the emergency department is caring for several patients from diverse cultures. Which statement shows the nurse's ability to provide culturally competent care?

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 26

A patient 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?

A) "Genetic differences can result in significant differences in how each patient'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 patient while in another patient 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 patients who are biracial result in an allergic response to medications."

Question 27

Which patient statements would the nurse evaluate as negatively affecting access to health care?

A) An older adult says, "If I tell my doctor that I fall frequently, I might have to go to a nursing home."
B) A young adult says, "A benefit of my new job is that it pays for my health, dental, and vision insurance."
C) A patient being discharged says, "Can you call my prescriptions in to the pharmacy?"
D) The patient's new insurance plan requires a $10 copay for office visits.
E) A patient asks to be discharged before noon as he has a 3-hour drive home.

Question 28

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

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) Thirty-eight-year-old male recently started on an antidepressant
D) Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth
E) Seventy-eight-year-old female being treated for shingles

Question 29

A home health nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural variables?

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

Question 30

A patient's genetic testing indicates presence of a genetic polymorphism of the CYP 450 enzyme. The nurse expects this difference to be one of which classifications?

A) Extensive
B) Poor
C) Normal
D) Ultrarapid
E) Inefficient