practice questions Flashcards
if phenobarbital has a four day half-life, and a client accidentally took 200mg of the drug on Tuesday morning, and no intervention occurred, how much medication will remain in the bloodstream of that client on Thursday morning?
150mg
you receive a patient with a new diagnosis of epilepsy. the doctor has order a larger than normal dose to reach the minimum effective serum concentration level. you realize this is known as what?
Loading dose
Revision of a clients care plan goals included in which phase of the nursing process?
evaluation
a nurse is explaining evidence-based practice (EBP) to a new student nurse. which statement are part of EBP?
Integrate clients preferences into the clients care.
guided by research, use the most currently approved approach to providing care.
the nurse recognizes that which of the following are examples of objective data? (select all that apply)
Heart rate from radial pulse
lab values
observed conditions of the patients wound
observed productive cough
the nurse acknowledges that the correct sequence of the 4 process of pharmacokinetic are:
Absorption
distribution
metabolism
excretion
which of these assessments is not considered essential prior to giving medications to an acute ill client?
mood
the nurse is explaining the disintegration of enteric coated tablets to a client. where would the nurse teach that this occurs at in the body?
small intestines
a laboring mother wants to know why pain medication is not advisable. what rationales could the nurse offer for this? (select all that apply)
the liver of an infant is not well developed, so the effects of sedation can linger in the infant.
epidural analgesia offers an alternative that will not harm the infant.
the blood brain barrier of an infant is not fully developed, so infants are at risk for sedation.
when entering the clients room for assessment purposes, which of these things would b inappropriate by the nurse? (select all that apply)
the nurse shares his/her own date of birth
taking a picture of the clients wound and sharing it outside of work
agreeing to be friends on social media
the nurse has just given a dose of antibiotic . which measurement checks for the highest plasma/serum concentration of the drugh?
peak level
which of this factors might impair the absorption of an oral medication?
the presence of food in the stomach
the nurse receives a client with a risk for injury due to taking sedatives. this includes in what phase of the nursing process?
Nursing diagnosis
the nurse is explaining to a new student nurse the nursing process. which of the following is the correct order of this process?
Assessment Nursing Diagnosis Planning Implementation Evaluation
a malnourished elderly client has a low albumin level. what is the implication of this finding?
Protein insufficiency can lead to loss of metabolizing enzymes and consequential drug accumulation.
less protein binding will occur, medication will be more free to bind with target receptors. this may cause excessive effects.
a client reports that he has been swallowing his nitroglycerin instead of leaving it under his tongue. teaching is needed. what can happen if sublingual medications are swallowed?
first pass may inactivate the medication
a client who takes theophylline for asthma is experiencing theophylline toxicity. which of these may be a contributing factor?
chewing the capsule
cirrhosis with gallstones
forgetfulness leading to double dosing
the nurse knows that for a drug to pass rapidly through the GI membrane it needs to be what?
lipid soluble and nonionized
the nurse is wanting to measure the margin of safety of a medication. which description below is correct for this measurement?
therapeutic index
a client is going home on a medication that cannot be stopped suddenly, which is included in the discharge teaching. what part of the nursing process is this included in?
implementation
what are three core ethical principles?
Respect for persons: patient should be treated as independent persons capable of making decisions in their own best interest.
beneficence: is the duty to protect research subjects from harm.
justice: requires that the selection of research subjects to fair.
what is autonomy?
is the right to self-determination. autonomy is relevant to the conduct of research as it is in health care decision making; patients have the right to refuse to participate in a research study and may withdraw from studies at any time without penalty.
what is risk benefit ratio?
is one of the most complex problems faced by the researcher.
good clinical practice (GCP)
An international ethical and scientific quality standard for Designing , Conducting, Monitoring, Auditing, Recording, Analyzing, and Reporting clinical research.
Preclinical trials
before the implementation research, the FDA requires pre clinical trials to determine a drugs toxic and pharmacologic effects through and in vivo animal testing in the laboratory.
genotoxicity
the ability of a compound to damage genetic information in a cell, in addition to drug absorption, distribution, metabolism, and excretion.
National institute of health (NIH)
In 1993 congress passed the NIH revitalization act, which helped establish guidelines to include women and minorities in clinical research.
Best pharmaceuticals for children act (BPCA) 2002, and Pediatric research Equity Act (PREA) 2003:
Encourage pharmaceutical companies to study their drug in children
drug research phases:
Phase One: researches test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range and identify side effects.
Phase two: the drug or treatment is given to a large group of people to see if it is effective and to further evaluate its safety.
Phase three: the drug or treatment is given to a large groups of people to confirm its effectiveness, monitoring side effects, compare it with commonly used treatments and collect information that will allow the drug or treatment to be used safely.
Phase four: effects associated with long term use.
The United States Pharmacopeia and the National Formulary (USP-NF)
The authoritative source for drug standards (dosage, forms, drug substances, excipients, biologics, compounded preparations, and dietary supplements), it is published annually.
Federal Legislation
Federal legislation attempts to protect the public from drugs that are impure, toxic, ineffective or not tested before public sale.
1912: the Sherley amendment
prohibited false therapeutic claims on drug labels.
1914: the Harrison narcotics Tax Act
required prescriptions for drugs that exceed set narcotic limits.
