Pharm 1 Flashcards
The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of
a. clinical pharmacology.
b. drug efficacy.
c. pharmacokinetics.
d. pharmacotherapeutics.
ANS: D
Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent
conditions. Clinical pharmacology is concerned with all aspects of drug–human interactions.
Drug efficacy measures the extent to which a given drug causes an intended effect.
Pharmacokinetics is the study of the impact of the body on a drug.
What does it mean when a drug is described as easy to administer?
a. It can be stored indefinitely without need for refrigeration.
b. It does not interact significantly with other medications.
c. It enhances patient adherence to the drug regimen.
d. It is usually relatively inexpensive to produce.
ANS: C
A major benefit of drugs that are easy to administer is that patients taking them are more
likely to comply with the drug regimen. Drugs that are easy to give may have the other
attributes listed, but those properties are independent of ease of administration.
Before administering a medication, what does the nurse need to know to evaluate how individual
patient variability might affect the patient’s response to the medication? (Select all that apply.)
a. Chemical stability of the medication
b. Ease of administration
c. Family medical history
d. Patient’s age
e. Patient’s diagnosis
ANS: C, D, E
The family medical history can indicate genetic factors that may affect a patient’s response to
a medication. Patients of different ages can respond differently to medications. The patient’s
illness can affect how drugs are metabolized. The chemical stability of the medication and the
ease of administration are properties of drugs.
A postoperative patient is being discharged home with acetaminophen/hydrocodone
(Lortab) for pain. The patient asks the nurse about using Tylenol for fever. Which statement
by the nurse is correct?
a. “It is not safe to take over-the-counter drugs with prescription medications.”
b. “Taking the two medications together poses a risk of drug toxicity.”
c. “There are no known drug interactions, so this will be safe.”
d. “Tylenol and Lortab are different drugs, so there is no risk of overdose.”
ANS: B
Tylenol is the trade name and acetaminophen is the generic name for the same medication. It
is important to teach patients to be aware of the different names for the same drug to minimize
the risk of overdose. Over-the-counter (OTC) medications and prescription medications may
be taken together unless significant harmful drug interactions are possible. Even though no
drug interactions are at play in this case, both drugs contain acetaminophen, which could lead
to toxicity
The nurse is preparing to care for a patient who will be taking an antihypertensive medication.
Which action by the nurse is part of the assessment step of the nursing process?
a.
Asking the prescriber for an order to monitor serum drug levels
b. Monitoring the patient for drug interactions after giving the medication
c. Questioning the patient about over-the-counter medications
d. Taking the patient’s blood pressure throughout the course of treatment
ANS: C
The assessment part of the nursing process involves gathering information before beginning
treatment, and this includes asking about other medications the patient may be taking.
Monitoring serum drug levels, watching for drug interactions, and checking vital signs after
giving the medication are all part of the evaluation phase.
A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10 (10
being the most extreme pain). The prescriber has ordered acetaminophen (Tylenol) 650 mg PO
every 6 hours PRN pain. What will the nurse do?
a. Ask the patient what medications have helped with pain in the past.
b. Contact the provider to request a different analgesic medication.
c. Give the pain medication and reposition the patient to promote comfort.
d. Request an order to administer the medication every 4 hours.
ANS: B
The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to
moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication.
Asking the patient to tell the nurse what has helped in the past is a part of an initial assessment
and should be done preoperatively and not when the patient is having severe pain. Because the
patient is having severe pain, acetaminophen combined with nondrug therapies will not be
sufficient. Increasing the frequency of the dose of a medication for mild pain will not be
effective.
A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse
teaching this patient about home management should begin by doing what?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
ANS: A
Because insulin must be given correctly to control symptoms and because an overdose can be
fatal, it is most important for the patient to know how to administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood
the teaching. When a patient is receiving a lot of new information, the information presented
first is the most likely to be remembered. The other teaching points are important as well, but
they are not as critical and can be taught later.
A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not
working. What will the nurse do?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Report the patient’s complaint to the prescriber.
d. Suggest biofeedback as an adjunct to drug therapy.
When evaluating the effectiveness of a drug, it is important to determine whether the patient is
using the drug as ordered. Asking the patient to tell the nurse how many tablets are taken and
how often helps the nurse determine compliance. Assessing current pain does not yield
information about how well the medication is working unless the patient is currently taking it.
The nurse should gather as much information about compliance, symptoms, and drug
effectiveness as possible before contacting the prescriber. Biofeedback may be an effective
adjunct to treatment, but it should not be recommended without complete information about
drug effectiveness.
A nurse is preparing to administer medications. Which patient would the nurse consider
to have the greatest predisposition to an adverse reaction?
a. A 30-year-old man with
kidney disease
b. A 75-year-old woman with cystitis
c. A 50-year-old man with an upper respiratory tract infection
d. A 9-year-old boy with an ear infection
The individual with impaired kidney function would be at risk of having the drug accumulate
to a toxic level because of potential excretion difficulties. Cystitis is an infection of the
bladder and not usually the cause of excretion problems that might lead to an adverse reaction
from a medication. A respiratory tract infection would not predispose a patient to an adverse
reaction, because drugs are not metabolized or excreted by the lungs. A 9-year-old boy would
not have the greatest predisposition to an adverse reaction simply because he is a child; nor
does an ear infection put him at greater risk.
A nurse consults a drug manual before giving a medication to an 80-year-old patient. The
manual states that elderly patients are at increased risk for hepatic side effects. Which action by
the nurse is correct?
a. Contact the provider to discuss an order for pretreatment laboratory work.
b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of
adverse effects.
c. Notify the provider that this drug is contraindicated for this patient.
d. Request an order to give the medication intravenously so that the drug does not pass
through the liver.
ANS: A
The drug manual indicates that this drug should be given with caution to elderly patients.
Getting information about liver function before giving the drug establishes baseline data that
can be compared with post-treatment data to determine whether the drug is affecting the liver.
Giving the correct dose at the correct interval helps to minimize risk, but without baseline
information, the effects cannot be determined. The drug is not contraindicated.
Someone asks a nurse about a new drug that is in preclinical testing and wants to know why
it cannot be used to treat a friend’s illness. Which statement by the nurse is correct?
a. “A drug at this stage of development can be used only in patients with serious disease.”
b. “At this stage of drug development, the safety and usefulness of the medication is
unknown.”
c. “Clinical trials must be completed to make sure the drug is safe to use in humans.”
d. “Until postmarketing surveillance data are available, the drug cannot be used.”
ANS: B
Preclinical testing must be completed before drugs can be tested in humans. In this stage,
drugs are evaluated for toxicities, pharmacokinetic properties, and potentially useful effects.
Some drugs can be used in patients before completion of Phase III studies, but this is after
preclinical testing is complete. Clinical trials proceed in stages, and each stage has guidelines
defining how a new drug may be used and which patients may receive it. Postmarketing
surveillance takes place after a drug is in general use.
A patient asks a nurse why drugs that have been approved by the FDA still have unknown side
effects. The nurse tell the patient that:
a. testing for all side effects of a medication would be prohibitively expensive.
b. patients in drug trials often are biased by their preconceptions of a drug’s benefits.
c. researchers tend to conduct studies that will prove the benefits of their new drugs.
d. subjects in drug trials do not always represent the full spectrum of possible patients.
ANS: D
All drug trials are limited by a relatively small group of subjects who may not have all the
characteristics of people who will be using the drug; therefore, some side effects go
undetected until the drug is in use. Although drug trials are very expensive, this is only an
indirect reason they do not detect all side effects before approval. In theory, well-designed
drug trials, using blinded studies, minimize or eliminate subject bias. Designing studies to
prove desired results is unethical.