Nclex review Exam 1 Flashcards
A nurse is preparing to give an oral dose of drug X to treat a patient’s high blood pressure. After giving the drug, the nurse finds that it not only reduces the blood pressure without serious harmful effects, but it also causes the patient to have nausea and headache. Based on this information, which property of an ideal drug is this drug lacking?
Effectiveness
Safety
Selectivity
Ease of administration
Selectivity
The nurse is preparing to give a drug with certain properties. Which property of the drug is the most compelling indication that it should not be given?
The drug produces an unwanted side effect.
The drug is difficult to administer.
The drug’s effects are reversible.
The drug is not effective for its intended purpose.
The drug is not effective for its intended purpose
Why is it important for drugs to have ease of administration? Fewer administration errors Less risk of side effects Greater chemical stability Greater likelihood of reversibility
Fewer administration errors
The nurse teaches a patient not to consume alcohol with nitroglycerine, because the blood pressure often drops significantly when nitroglycerine is taken with alcohol. Which drug property does this illustrate? Chemical instability Drug interaction Reversible action Drug selectivity
Drug interaction
When studying the impact a drug has on the body, the nurse is reviewing what? The drug’s pharmacokinetics The drug’s selectivity The drug’s pharmacodynamics The drug’s predictability
The drugs pharmacodynamics
When studying the effects of drugs in humans, the nurse is learning about what? Pharmacology Clinical pharmacology Therapeutics Effectiveness
clinical pharmacology
Which statement by a new nurse indicates that further study is indicated?
Effectiveness is the most important property a drug can have.
There is no such thing as a safe drug.
Drugs are defined as illegal substances.
There is no such thing as a selective drug; all medications cause side effects.
drugs are defined as illegal substances
What is the ultimate concern for the nurse when administering a drug? Intensity of the response Dosage Route of administration Timing of administration
intensity of response
What is the objective of drug therapy?
To provide maximum benefit with minimal harm
To provide minimum benefit with maximum harm
To provide total relief of symptoms regardless of harm
To provide as much benefit as possible
to provide maximum benefit with minimal harm
Characteristics unique to each patient can influence pharmacokinetic and pharmacodynamic processes. What characteristics may determine the patient’s response to a drug? (Select all that apply.) Age Gender Weight Mood Genetics
age, gender, weight, genetics
The nurse is preparing to administer a dose of penicillin. Before administering the medication, the nurse assesses the patient’s allergy history. Which aspect of drug therapy does this represent? Making PRN (as needed) decisions Evaluating therapeutic effects Ensuring proper dosage Identifying high-risk patients
identifying high risk patients
The nurse is preparing to administer a medication with the following order: “Aldomet 250 mg daily.” What should the nurse do?
Administer the medication as it was given last time.
Administer the medication by mouth.
Verify the order with the prescriber.
Ask the patient how this medication is usually given.
Verifying the order with the prescriber
Which aspect of drug therapy indicates to the nurse whether a drug is having a beneficial effect?
Performing a preadministration assessment
Evaluating therapeutic responses
Minimizing adverse effects
Managing toxicity
Evaluating therapeutic responses
he nurse is managing the care of a group of patients with cancer who will be receiving chemotherapy. The nurse defines goals, sets priorities, identifies interventions, and establishes criteria for evaluating success. Which phase of the nursing process does this represent? Assessment Planning Implementation Evaluation
Planning
The nurse identifies which as the goal of drug therapy in the treatment of patients?
Cure of the disease
Follow-up with the prescriber
Correct administration technique
Production of maximum benefit with minimum harm
Production of maximum benefit with minimum harm
A diabetic patient is taught the signs and symptoms of hypoglycemia with insulin use. The patient knows to eat fast-acting carbohydrates. This is an example of which goal? Minimizing adverse effects Promoting therapeutic effects Minimizing adverse interactions Managing toxicity
Minimizing adverse effects
When questioning a patient about his or her allergic reaction to a drug, the nurse should ask for which additional information? The dose taken The type of reaction Who gave the drug What was eaten with the drug
The type of reaction
The nurse is obtaining a drug history for a patient admitted to the unit. The nurse obtains information about past and present health histories, currently used prescription drugs, behavioral factors, and use of over-the-counter (OTC) drugs. What other information does the nurse need to obtain? (Select all that apply.)
Use of recreational drugs and substances
Usual sleep patterns and disturbances
Highest level of education completed
Use of herbal remedies
Self-treatment with complementary and alternative drugs
use of recreational drug and substances
use of herbal remedies
self-treatment with complementary and alternative drugs
Which statements about medication administration would the nurse identify as true? (Select all that apply.)
All drugs have the potential to produce undesired effects.
Drug therapy often can be enhanced by nonpharmacologic measures.
Patients taking two drugs are not likely to have a drug interaction.
Nurses’ knowledge of pharmacology is more important for standing orders than for PRN medications.
Patient adherence is essential in achieving the therapeutic objective of medications.
All drugs have the potential to produce undesired effects
drug therapy often can be enhanced by nonpharmacologic measures
patient adherence is essential…
hen educating patients about their medications, the nurse includes information about which topics? (Select all that apply.) What to do if a dose is missed The duration of treatment Prescription of drug coverage The method of drug storage Symptoms of adverse effects
what to do if a dose is missed
the duration of treatment
the method of drug storage
symptoms of adverse effects
Which legislation sets rules for the manufacture and distribution of drugs considered to have the potential for abuse?
Food, Drug, and Cosmetic Act of 1938
Harris-Kefauver Amendments of 1962
Controlled Substances Act of 1970
Food and Drug Administration Modernization Act of 1997
Controlled Substances Act of 1970
What is a result of the Prescription Drug User Fee Act (PDUFA) of 1992?
New drugs reach the market sooner than ever before.
Controlled substances are categorized into schedules.
Drugs for acquired immunodeficiency syndrome (AIDS) receive accelerated approval.
More research is conducted on drug safety in children.
New drugs reach the market sooner than ever before.
Which is a true statement about new drug development in the United States?
Development and testing of new drugs take about 3 to 5 years.
About 50% of drugs undergoing clinical trials gain approval.
Randomized controlled trials are the best way to assess drug therapy.
The cost of developing a new drug is usually around $1 million.
Randomized controlled trials are the best way to assess drug therapy.
N-acetyl-para-aminophenol is an example of which type of drug name? Proprietary Chemical Generic Trade
Chemical
A new medication becomes available for treatment of a debilitating neurologic disease. What would the nurse expect about the safety of the drug?
The drug is safe for administration to children.
The drug has been tested in pregnant women.
All possible adverse effects have been identified by animal testing.
The drug has passed the FDA approval process.
The drug has passed the FDA approval process.
Why are trade names much easier to say and remember than generic names?
The FDA assigns every drug’s generic name.
Trade names must be the same regardless of which drug company manufactures the drug.
Companies have a marketing advantage when the trade name is easier to recognize.
Trade names improve oral and written communication in the healthcare system.
Companies have a marketing advantage when the trade name is easier to recognize
Which term is commonly used for nonprescription drugs? Legend Generic Over-the-counter Pharmaceutical
OTC
Which is a true statement about new drug development? (Select all that apply.)
Preclinical testing of drugs is always performed in healthy, nonpregnant adults.
Drug trials require that those involved don’t know which subjects are receiving the drug or control.
During preclinical testing, drugs are evaluated for toxicities, kinetic properties, and useful effects.
When a new drug is released, all adverse effects are known.
Drug trials require that those involved don’t know which subjects are receiving the drug or control.
During preclinical testing, drugs are evaluated for toxicities, kinetic properties, and useful effects.
Which statements about over-the-counter (OTC) drugs would the nurse identify as true? (Select all that apply.)
Most illnesses initially are treated with an OTC agent.
More prescription drugs than OTC agents are administered each year in the United States.
The average home medicine cabinet contains eight OTC preparations.
Forty percent of Americans take at least one OTC drug every 2 days.
Some drugs that originally were sold by prescription are now OTC.
Most illnesses initially are treated with an OTC agent
Forty percent of Americans take at least one OTC drug every 2 days.
Some drugs that originally were sold by prescription are now OTC.
Which statements about the Family Smoking Prevention and Tobacco Control Act (2009) would the nurse identify as true? (Select all that apply.)
All ingredients in tobacco products must be listed on the warning label.
A gradual reduction of nicotine to nonaddictive levels is required.
Marketing to youth is prohibited.
Harmful additives are restricted.
Purchasers of tobacco products must be age 21 years or older.
All ingredients in tobacco products must be listed on the warning label.
A gradual reduction of nicotine to nonaddictive levels is required.
Marketing to youth is prohibited.
Harmful additives are restricted
A new graduate nurse preparing to administer medications knows that which of the following is required for a drug to move through the body? Selectivity and effectiveness The ability to cross membranes Development of an electric charge A transporter protein
The ability to cross membranes
The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug? Slowly Rapidly Unpredictably Variably
Rapidly
The nurse is administering warfarin, an anticoagulant, to a patient with a low albumin level. Which effect of this medication should the nurse expect to observe? Increased PT/INR levels Deep vein thromboses Reduced risk of bruising Increased platelet aggregation
Increased PT/INR levels
A nurse prepares to administer acetaminophen [Tylenol] to a patient with an oral temperature of 101.7°F. Which preparation would the nurse expect to have the most rapid onset of action? Tylenol elixir Tylenol tablets Tylenol capsules Tylenol gel caps
Tylenol elixir
The nurse should provide which teaching point when administering an enteric-coated oral tablet to a patient?
“Chew the tablet before swallowing.”
“Break the tablet in half before swallowing.”
“Allow the tablet to be absorbed under the tongue.”
“Swallow the tablet whole after double-checking the dose.”
“Swallow the tablet whole after double-checking the dose.”
When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient? A 3-week-old neonate A 12-year-old boy A 25-year-old woman A 15-month-old infant
3-week-old neonate
For which reason should the nurse follow safe medication administration for intravenous (IV) medications?
The IV route can result in delayed absorption of the medication.
The IV route results in a delayed onset of action.
Control over the levels of drug in the body is unpredictable.
IV administration is irreversible.
IV administration is irreversible.
The nurse is preparing to administer an intravenous (IV) medication. What is the minimum injection time to reduce the risk of harm to the patient? 10 seconds 30 seconds 60 seconds 30 minutes
60 seconds
The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system, very little active drug is left in the general circulation as a result of what? Therapeutic range First-pass effect Drug half-life Plasma protein binding
First-pass effect
The nurse should instruct a patient complaining of pain to do what to reduce fluctuations in drug levels?
“Take pain medication around the clock at specified intervals and doses.”
“Take pain medication when the pain level reaches an 8 or 9 on a 1 to 10 scale.”
“Take pain medication at night before bed and avoid daytime dosing because of drowsiness.”
“Take pain medication after breakfast and dinner to reduce stomach upset.”
Take pain medication around the clock at specified intervals and doses.
The nurse understands that the dose-response relationship is graded and should expect to observe which response?
Once a drug is given, the response is predictably all-or-nothing.
The response is maintained at a specific level when the therapeutic objective is achieved.
As the dosage increases, the response becomes progressively greater.
A graded response is based on relative potency and maximal efficacy.
As the dosage increases, the response becomes progressively greater.
The nurse demonstrates the concept of maximal efficacy by administering which drug for a headache that the patient describes as a “mild dullness” and as a 2 on a 1 to 10 scale? Meperidine [Demerol] Pentazocine [Talwin] Aspirin Morphine sulfate
Aspirin
Which statement by the nursing student indicates a need for further instruction about drug selectivity?
“Botulinum toxin is very selective and therefore very safe for administration.”
“Selective drug action is made possible by many types of receptors in the body.”
“The more selective a drug is, the fewer side effects it will produce.”
“Even though a drug is selective, it can produce nonselective results.”
Botulinum toxin is very selective and therefore very safe for administration.
hich drug property is most enhanced by the presence of many different types of receptors throughout the body? Potency Safety Selectivity Convenience
Selectivity
he drug dobutamine acts as an agonist of norepinephrine (NE) receptors. Which effect is the nurse most likely to observe in a patient receiving this medication? Increased heart rate Atrioventricular heart block Sinus bradycardia Reduced cardiac output
Increased heart rate
he nurse prepares to give a drug that will prevent receptor activation. Which term would describe this drug? Antagonist Selective Agonist Potent
Antagonist
Why does the nurse administer naloxone to a patient receiving morphine sulfate who has a respiratory rate of 8 breaths per minute?
Naloxone causes hypersensitivity of the opioid receptors.
Naloxone prevents the activation of opioid receptors.
Naloxone is a partial agonist, requiring a lesser dose to achieve pain relief.
Naloxone is an agonist, leading to desensitization of the opioid receptors.
Naloxone prevents the activation of opioid receptors
Why does the nurse monitor the patient closely when administering a drug with a low therapeutic index?
The average lethal dose of the drug is much higher than the therapeutic dose.
The dose required to produce a therapeutic response in 50% of patients is low.
The highest dose needed to produce a therapeutic effect is close to the lethal dose.
There is a low variability of responses to this drug.
The highest dose needed to produce a therapeutic effect is close to the lethal dose
The nursing student learns that not all drugs produce effects binding to a receptor. Which drugs do not act through receptors? Antacids Analgesics Antihistamines Steroid hormones
Antacids
The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug? It is very potent. It has a low efficacy. It is probably lethal. It is relatively safe.
It is relatively safe.
