Week 1 Sherpath Questions Flashcards
Which statements are classified as objective data?
(choose all that apply)
“Temperature 97.4°F.”
“Facial expression does not match body language.”
“Patient is a widow and lives with her oldest son.”
“Coughing up yellow phlegm.”
“Patient reports cough for 1 week.”
“Temperature 97.4°F.”
“Facial expression does not match body language.”
“Coughing up yellow phlegm.”
Information from which sources would be classified as subjective data?
(choose all that apply)
Friends
Health care provider notes
Family members
Patient
Laboratory test results
Friends
Family members
Patient
Which description of pre-administration assessment data is accurate?
Data that establish a patient’s baseline before administration of a drug
Data that reflect how a drug affected the patient after administration
Financial and demographic data obtained before a patient is admitted to the hospital
Data from the pharmaceutical company that contain recommendations for drug administration
Data that establish a patient’s baseline before administration of a drug
Which description correctly defines a nursing diagnosis?
A diagnosis based on information found in the nursing assessment regarding patient responses to actual or potential problems
A diagnosis that identifies a disease condition that explains a patients signs and symptoms
A diagnosis made by the nurse based on information regarding the patient’s psychological responses to health processes
A diagnosis made by the nurse based on information regarding the patient’s physiologic responses to health processes
A diagnosis based on information found in the nursing assessment regarding patient responses to actual or potential problems
Which actions occur during the planning stage of the nursing process?
(choose all that apply)
Defining goals
Collecting data
Setting priorities
Identifying interventions
Identifying high-risk patients
Establishing evaluation criteria
Defining goals
Setting priorities
Identifying interventions
Establishing evaluation criteria
How does a medical diagnosis differ from a nursing diagnosis?
(choose ll that apply)
A medical diagnosis identifies a disease process.
A medical diagnosis identifies results of procedures.
A medical diagnosis promotes safe and effective care.
A medical diagnosis identifies results of diagnostic tests.
A medical diagnosis guides the development of a patient-centered plan of care.
A medical diagnosis identifies a disease process.
A medical diagnosis identifies results of procedures.
A medical diagnosis identifies results of diagnostic tests.
Which “rights” are components of the original five rights of drug administration?
(choose all that apply)
Right patient
Right drug
Right dose
Right time
Right administrator
Right pharmacy
Right patient
Right drug
Right dose
Right time
The Joint Commission requires two forms of identification verification before administering drugs. Which right of drug administration does this support?
Right drug
Right time
Right dose
Right patient
Right patient
Incorporating religious considerations into the implementation of drug therapy relates to which component?
Patient education
Drug administration
Interventions to promote therapeutic effects
Interventions to minimize side and adverse effects
Patient education
Which rights are additional rights of the five-plus-five rights of drug administration?
(choose all that apply)
Right evaluation
Right location
Right assessment
Right documentation
Right administrator
Patient’s right to refuse
Right evaluation
Right assessment
Right documentation
Patient’s right to refuse
Using the nursing process, which component is the nurse discerning during the evaluation phase?
Degree of goal attainment
Problem identification
Implementation
Diagnosis
Degree of goal attainment
To determine patient response to drug therapy, which factors would the nurse evaluate?
(choose all that apply)
Adherence
Adverse effects
Patient education
Patient satisfaction
Therapeutic response
Adherence
Adverse effects
Patient satisfaction
Therapeutic response
Which methods can be used to evaluate the patient’s adherence to a drug regimen?
(choose all that apply)
Interviewing the patient
Counting pills
Measuring plasma drug levels
Return demonstration of drug administration
Evaluating common side effects of drug therapy
Interviewing the patient
Counting pills
Measuring plasma drug levels
Which statement describes how the nursing process applies to pharmacology?
It predicts nonadherence to the drug regimen.
It directs the prescriptive process of pharmacology.
It promotes adherence to a prescribed drug regimen.
It creates a nursing-centered approach to pharmacology
It promotes adherence to a prescribed drug regimen.
A nurse notes in the electronic health records that the patient was constantly twisting his or her wedding band during the admission assessment. Which type of data collection does this fall under?
Biased
Objective
Subjective
Emotional
Objective
A patient describes to the nurse that a newly prescribed drug made them feel shaky. Which type of data is this?
Subjective
Objective
Perceptive
Quantitative
Subjective
Which nursing diagnoses are appropriate for a patient with a hip fracture?
Select all that apply.
Fall risk
Acute pain
Osteoporosis
Hypophosphatemia
Fracture of the greater trochanter
Fall risk
Acute pain
Which interventions related to drug therapy are part of the planning phase of the nursing process?
Select all that apply.
Setting priorities
Providing patient education
Enhancing therapeutic effects
Minimizing drug interactions
Establishing evaluation criteria
Providing patient education
Enhancing therapeutic effects
Minimizing drug interactions
Match the aspect of planning to its example.
Resolution of confusion within 48 hours
Patient safety during period of resolution
Move the patient to a room closer to the nurses’ station
Patient has remained free of injury; patient is alert and oriented
Answer choices
Priority, Evaluation ,Intervention , goal
Resolution of confusion within 48 hours
Goal
Patient safety during period of resolution
Priority
Move the patient to a room closer to the nurses’ station
Intervention
Patient has remained free of injury; patient is alert and oriented
Evaluation
Which components need to be addressed to facilitate patient adherence to pharmacologic therapy?
Select all that apply.
Diet
Side effects
Self-administration
Cultural considerations
Need for health teaching
Diet
Side effects
Self-administration
Cultural considerations
A patient has been admitted for intractable nausea, and his or her morning drugs are due. Which of the original rights of drug administration will require special attention by the nurse?
Right route
Right drug
Right dose
Right time
Right route
Match the “right” to its example.
Collection of appropriate data after drug administration
Provision of drug information
Appraisal of a drug’s therapeutic, side, and adverse effects
Patient has remained free of injury; patient is alert and oriented
Answer Choices
Right education, Right evaluation, Right documentation, Right assessment
Collection of appropriate data after drug administration
Right assessment
Provision of drug information
Right education
Appraisal of a drug’s therapeutic, side, and adverse effects
Right evaluation
Patient has remained free of injury; patient is alert and oriented
Right documentation
Interventions were implemented to reduce a patient’s pain level to less than 3 on a pain scale and prevent side effects from hydrocodone/acetaminophen. Which assessment data indicates the goal was not met?
The patient is eating breakfast without complaints of nausea.
The patient is restless and unable to sleep at 0100 hours.
The patient obtained 7.5 hours of uninterrupted sleep.
The patient is performing their self-care with standby assist for the first time during the hospital stay.
The patient is restless and unable to sleep at 0100 hours.
Which factors may cause a patient’s dissatisfaction with their current drug regimen?
Select all that apply.
High cost
Unacceptable side effects
Difficulty of administration
Presence of terminal illness
Inconvenient dosing schedule
Bedside manner of health care provider
High cost
Unacceptable side effects
Difficulty of administration
Inconvenient dosing schedule
Match the factor affecting absorption with its characteristics.
Explains why oral drugs are formulated to be absorbed from small intestine
Drug that easily crosses membranes that separate it from the blood
Process where drug accumulates on side of membrane favoring its ionization
Solutions have a faster onset than capsules due to this factor
Answers choices
Rate of dissolution, Lipid soluble , Surface area, pH partitioning
Explains why oral drugs are formulated to be absorbed from small intestine
Surface area
Drug that easily crosses membranes that separate it from the blood
Lipid soluble
Process where drug accumulates on side of membrane favoring its ionization
pH partitioning
Solutions have a faster onset than capsules due to this factor
Rate of dissolution
Which route of administration provides rapid onset of delivery to enhance safety and efficacy?
Oral
Sublingual
Intravenous
Intramuscular
Intravenous
Which statements regarding the rectal administration of drugs are accurate?
Rectal drugs are rapidly absorbed.
Absorption of rectal drugs is unpredictable.
Defecation can interrupt absorption of rectal drugs.
Rectal administration is preferred for poorly soluble drugs.
Rectal administration decreases systemic drug effects.
Rectal drugs are rapidly absorbed.
Absorption of rectal drugs is unpredictable.
Defecation can interrupt absorption of rectal drugs.
Which factors affect drug distribution?
(choose all that apply)
Blood flow to tissues
Ability of drug to enter cells
Route of drug administration
Regional blood flow
Ability of drug to exit blood vessels
Blood flow to tissues
Ability of drug to enter cells
Ability of drug to exit blood vessels
Which statements about protein binding are accurate?
(choose all that apply)
The portion of the drug that remains bound is active.
The portion of drug that remains unbound is active.
The portion of the drug that remains unbound cannot exit blood vessels.
The portion of drug that is bound cannot exit blood vessels.
Only unbound drugs can exert pharmacologic responses.
The portion of drug that remains unbound is active.
The portion of drug that is bound cannot exit blood vessels.
Only unbound drugs can exert pharmacologic responses.
Which drugs are able to cross the blood-brain barrier (BBB)?
Water-soluble drugs
Highly lipid-soluble drugs
Low molecular weight drugs
Drugs bound to transport proteins
Drugs not bound to transport proteins
Highly lipid-soluble drugs
Low molecular weight drugs
Drugs bound to transport proteins
The liver metabolizes drugs into which component for renal excretion?
Prodrugs
Lipid-soluble drug
Active metabolites
Water-soluble substance
Water-soluble substance
Only (blank) of the 12 closely related cytochrome P450 enzyme families metabolize drugs
3
Which factors decrease drug metabolism?
(choose all that apply)
Malnutrition
Fast acetylator
Kidney disease
Use of phenytoin
Cardiovascular disease
Malnutrition
Kidney disease
Cardiovascular disease
Match each step in renal drug excretion to its definition.
Moves drugs from blood to urine
Lipid-soluble drugs move back into the blood
“Pumps” for organic acids and bases move drugs from blood to urine
Answer choices
Passive Tubular Reabsorption, Glomerular Filtration, Active Tubular Secretion
Moves drugs from blood to urine
Glomerular Filtration
Lipid-soluble drugs move back into the blood
Passive Tubular Reabsorption
“Pumps” for organic acids and bases move drugs from blood to urine
Active Tubular Secretion
Which organ accounts for most drug excretion, thereby limiting the duration of action of many drugs?
Skin
Lungs
Kidneys
Gallbladder
Kidneys
Drugs are excreted by which routes?
(choose all that apply)
Feces
Lungs
Placenta
Breast milk
Lymph system
Feces
Lungs
Break milk
Which route of drug administration is most likely to be reversible?
Oral
Buccal
Intravenous
Subcutaneous
oral
Which route of drug administration delivers drugs directly to the tissue where they exert their actions?
Sublingual
Inhalational
Intramuscular
Transdermal patch
Inhalational
Which factors may affect drug absorption?
Select all that apply.
Surface area
Lipid solubility
Therapeutic index
Rate of dissolution
Receptor interactions
Surface area
Lipid solubility
Rate of dissolution
Which conditions decrease blood flow to tissues, thereby reducing the effectiveness of drug therapy?
Select all that apply.
Abscess
Solid tumor
Amputation
Hemangioma
Adipose tissue
Abscess
Solid tumor
The nurse knows that warfarin is 99% protein bound, whereas bupropion is 84% protein bound. If both of these drugs are administered concurrently, which events could occur?
Select all that apply.
Warfarin could displace bupropion from its binding site.
Bupropion could displace warfarin from its binding site.
Bupropion could accumulate to toxic levels.
Warfarin could accumulate to toxic levels.
Warfarin and bupropion could bind to the same protein.
Warfarin could displace bupropion from its binding site.
Bupropion could accumulate to toxic levels.
To safely administer drugs, nurses must understand that only certain drugs can cross the blood-brain barrier (BBB), including those that are highly lipid soluble and of low molecular weight. Which drug can cross the BBB?
Diazepam
Atenolol
Penicillin
Nadolol
Diazepam
Match the possible consequence of drug metabolism to its example.
Conversion of procaine into para-aminobenzoic acid (PABA)
Conversion of codeine into morphine
Conversion of acetaminophen into metabolite
Conversion of lipid-soluble drugs into water-soluble drugs
Answer choices
Increased renal excretion , Drug inactivation, Increased therapeutic action , increased toxicity, activation prodrug
Conversion of procaine into para-aminobenzoic acid (PABA)
Drug inactivation
Conversion of codeine into morphine
Increased therapeutic action
Conversion of acetaminophen into metabolite
increased toxicity
Conversion of lipid-soluble drugs into water-soluble drugs
Increased renal excretion
Which routes of administration can be used to avoid the first-pass effect?
(choose all that apply)
Oral
Topical
Intranasal
Intravenous
Inhalational
Topical
Intranasal
Intravenous
Inhalational
Which factors alter drug metabolism in older adults?
(choose all that apply)
Liver immaturity
Decreased liver mass
Decreased total body water
Decreased hepatic blood flow
Reduced active tubular secretion
Decreased Liver mass
Decreased hepatic blood flow
Kidney stones and urinary obstruction alter which pharmacokinetic principle?
Absorption
Distribution
Metabolism
Excretion
Excretion
Certain drugs must undergo which process before enterohepatic recirculation can occur?
Elimination
Conjugation
Hydrolysis
Glucuronidation
Glucuronidation
Drugs with which property are excreted in breast milk?
Polar
Ionized
Lipid soluble
Protein bound
Lipid soluble
Which statement most clearly defines an error in drug administration?
Preventable event that leads to inappropriate drug use or patient harm
Sentinel event that leads to patient harm or death
Preventable event that leads to patient harm or death
Sentinel event that leads to inappropriate drug use
Preventable event that leads to inappropriate drug use or patient harm
A drug administration error occurred; after investigation, it was determined the error was category D. Which statement accurately describes the error?
An error occurred, but the medication did not reach the patient
An error occurred that reached the patient but did not cause patient harm
An error occurred that resulted in the need for increased patient monitoring but no patient harm
An error occurred and caused temporary patient harm
An error occurred that resulted in the need for increased patient monitoring but no patient harm
A nurse administers metoprolol 100 mg to a patient with hypertension but does not check the patient’s apical pulse before administration. The patient develops bradycardia, becomes dizzy with standing, and falls, resulting in a fractured lumbar vertebra. Which process of drug delivery does this involve?
Monitoring
Prescribing
Administering
Documenting
Monitoring
Drug administration errors can result from which factors in the process of drug administration?
(choose all that apply)
Social factors
Human factors
Individual factors
System-level factors
Environmental factors
Human factors
Individual factors
System-level factors
Match the type of error to the example.
Patient given written drug information but does not admit they cannot read
Nurse administers an antihypertensive without checking blood pressure
Nurse does not enter patient response to analgesic in EHR
Nurse does not assess patient after administering PRN drug
Answer choices
Errors in baseline assessment , Errors in patient education , Errors in evaluation of patient response to drug , Errors in documentation
Patient given written drug information but does not admit they cannot read
Errors in patient education
Nurse administers an antihypertensive without checking blood pressure
Errors in baseline assessment
Nurse does not enter patient response to analgesic in EHR
Errors in documentation
Nurse does not assess patient after administering PRN drug
Errors in evaluation of patient response to drug
System-level failures leading to drug administration errors include which factors?
(Choose all that apply)
Heavy workload
Distractions
Fatigue
Miscalculation
Unclear order
Heavy workload
Distractions
Fatigue
Computerized health care provider order entry in place of handwritten orders is an example of which strategy for preventing errors in drug administration?
Dispensing
Prescribing
Transcribing
Administration
Transcribing
Which rights are part of the six rights for nurses to ensure safe drug administration?
(choose all that apply)
Right to a complete and clear order
Right to have access to information
Right to have smart infusion pumps
Right to adhere to the five rights of drug administration
Right to administer drugs safely and to identify problems in the system
Right to a complete and clear order
Right to have access to information
Right to administer drugs safely and to identify problems in the system
Match the concept to its definition.
Encourages health care personnel who make errors to report them
Encourages everyone in the organization to keep patients free from harm
Unanticipated event that results in death or serious harm
Identifies opportunities for learning
Answer choices
Root cause analysis ,Culture of safety ,Sentinel event ,Just Culture
Encourages health care personnel who make errors to report them
Just Culture
Encourages everyone in the organization to keep patients free from harm
Culture of safety
Unanticipated event that results in death or serious harm
Sentinel event
Identifies opportunities for learning
Root cause analysis
A drug administration error occurred resulting in myocardial infarction; after investigation, it was determined the error was category H. Which statement accurately describes the error?
An error occurred that resulted in a near-death event
An error occurred that resulted in permanent patient harm
An error occurred that resulted in initial or prolonged hospitalization and caused temporary patient harm
An error occurred that resulted in the need for treatment or intervention and caused temporary patient harm
An error occurred that resulted in a near-death event
A nurse listens to the patient’s lungs before administering albuterol for asthma control. The nurse notes wheezing on expiration. After drug administration, the nurse checks the electronic health record (EHR) to see what the patient’s lungs sounded like last shift before the administration of the drug. Nothing is noted. Which process of drug delivery does this involve?
Monitoring
Prescribing
Administering
Documenting
Documenting
The nurse caring for a patient receiving cisplatin notes extravasation of the intravenous (IV) fluid when the patient reported IV site pain. Even though the antidote (sodium thiosulfate) to cisplatin was administered, the patient experienced extensive tissue necrosis around the insertion site and required multiple skin grafts. Which feelings might the nurse experience after the drug administration error?
(choose all that apply)
Self-doubt
Blamelessness
Suicidal ideation
Self-assurance
Posttraumatic stress disorder (PTSD)
Self-doubt
Suicidal ideation
Posttraumatic stress disorder (PTSD)
The electronic health record indicates that a patient’s continuous infusion of heparin intravenously was to be stopped at 1000. At 1900, the nurse notices that the heparin is still running. Which type of error in drug administration is this?
Wrong drug
Wrong dose
Wrong time
Wrong route
Wrong dose
After 10 hours on the job, a novice nurse struggles to program the intravenous (IV) pump; to avoid hanging the IV drug late, the nurse decides to let the drug run in by gravity, after calculating the drip rate then adjusting the roller clamp on the tubing. Which individual factors set the situation up for a drug error?
(choose all that apply)
Long workdays
Difficulty using equipment
Poorly designed equipment
Lack of uniform procedures
Clinical experience of the nurse
Long workdays
Difficulty using equipment
Clinical experience of the nurse
The nurse draws up insulin into a syringe and calls across the nurses’ station for a coworker to double-check. The second nurse, who is charting, looks up from across the room and says, “It’s okay”; the first nurse notes the initials for the second nurse in the electronic health record (EHR). In this situation, which factor may contribute to an error in drug administration?
Human factors
Individual factors
System-level factors
Environmental factors
Human factors
Match the stage of drug delivery to its safety strategy.
Drug reconciliation at times of transitions in care
Computerized order entry
Use of “tall man” lettering
Smart infusion pumps
answer choices
Administration, Transcribing , Prescribing, Dispensing
Drug reconciliation at times of transitions in care
Prescribing
Computerized order entry
Transcribing
Use of “tall man” lettering
Dispensing
Smart infusion pumps
Administration
Which orders are written inappropriately according to the Joint Commission’s official “Do Not Use” list?
(choose all that apply)
Digoxin .25 mg PO daily
Levofloxacin 500 mg PO daily x 10 days
Mirtazapine 15.0 mg PO every day at bedtime
Heparin 10,000 units subcut twice a day
Lisinopril 10 mg PO daily
Digoxin .25 mg PO daily
Mirtazapine 15.0 mg PO every day at bedtime
Which statement describes how drug errors are addressed in a system that operates according to principles associated with Just Culture?
Individuals are encouraged to report drug errors so that the system may be repaired.
Individuals are discouraged from reporting drug errors so that the facility will not be cited.
Individuals are encouraged to report only the major drug errors that result in patient harm.
Individuals are encouraged to report drug errors of their coworkers to hold coworkers accountable.
Individuals are encouraged to report drug errors so that the system may be repaired.
Which Route of drug administration decreases the likelihood of systemic drugs?
- Transdermal
- rectal
-oral
-topical
Topical
Pharmacokinetics involves the study of which factor?
-Physiologic interactions of drugs
-interactions among various drugs
-adverse reactions to medication
-distribution rates among various body compartments
-distribution rates among various body compartments
Which adverse effect might a patient with glucose-6-phospate dehydrogenase deficiency develop if treated with primaquine?
-Hemolysis of platelets
-bone marrow suppression
-hemolysis of red blood cells
-hemolysis of white blood cells
hemolysis of red blood cells
A swab of a wound infection is sent for culture and pending culture results the health care provider starts an intravenous antibiotic. Which type has been prescribed for this patient?
-Empiric
-palliative
-prophylactic
-maintenance
Empiric
Which route of administration is most likely to be used when a patient provider prescribes fentanyl as pain relief for palliative care?
-oral
-buccal
-intravenous
-transdermal
transdermal
Which body system triggers an allergic reaction to a medication?
-immune
-Nervous
-circulatory
-dermatologic
immune
Which term is an alternate for biotransformation of a drug?
-Dilution
-Execration
-Absorption
-Metabolism
Metabolism
Which term is attributed to a condition in which drugs are increasingly ineffective?
-Addiction
-Tolerance
-Dependence
-Therapeutic Index
Tolerance
Which animals is the other main source of natural insulin besides humans?
-pig
-mouse
-horse
-rabbit
pig
