Week 1 Sherpath Questions Flashcards by Monica Galvan-Valencia

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.”

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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

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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

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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

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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

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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.

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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

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

Which percentage would be the bioavailability of atropine administered intravenously to a patient with a cardiac dysthymia? -50% -60% -100% -70%

100%

Which route of administration will cause a drug to be altered by the first-pass effect? -oral -sublingual -intravenous -subcutaneous

oral

Drug half-life is defined as the amount of time for 50% of a drug to do which response? -exert a response -be absorbed by the body -reach a therapeutic level -be eliminated by the body

be eliminated by the body

A nurse is educating a patient who is prescribed warfarin to avoid taking aspirin and explains that taking both drugs together may cause excessive bleeding. Which phenomenon is the nurse teaching about? -additive -incompatibility -synergistic -antagonistic

additive

Which type of pharmacotherapeutics is needed to sustain life and treat disease? -Supplemental -acute -maintenance -supportive

acute

Which type of therapy has been prescribed when a patient is prescribed an oral antidiabetic drug? -acute -palliative -maintenance -supplemental

maintenance

Which term is sed when some medications may not be safe for a patient because she is breastfeeding? -allergy -drug interaction -contraindication -idiosyncratic reaction

contraindication

which enzyme is responsible for the metabolism of drugs in the liver during first-pass metabolism? -Ptyalin -gastric lipase -P450 Enzymes -Pancreatic lipase

P450 Enzymes

Which form of a drug requires slow absorption in the body in a high pH(alkaline) environment? -syrup -aerosol -suppository -enteric-coated tablet

enteric-coated tablet

Which phenomenon is characteristic of highly protein bound drugs? -the risk of drug-drug interactions is increased -the duration of action is typically short -administration with 8 ounces of water is required -the effect is decreased in patients with a low albumin level

the risk of drug-drug interactions is increased

Which enhanced therapeutic effect describes combination therapy of hydrochlorothiazide and lisinopril? -adverse -additive -antagonistic -synergistic

synergistic

Which condition interferes with the optimum therapeutic effect of a drug given by the oral route? -seizure disorder -left lower leg amputation -coronary artery bypass graft -resection of the small intestine

resection of the small intestine

Which route of administration would be ideal for a patient with acute angina-like chest pain who is to receive nitroglycerin? -Oral -Rectal -Sublingual -Subcutaneous

Sublingual

Drug exert their actions on the body by performing which action? (choose all that apply) -interacting with receptors -altering metabolic chemical process -making the cell perform a new function -inhibiting the action of a specific enzyme

interacting with receptors altering metabolic chemical process inhibiting the action of a specific enzyme

A patient diagnosed with thyroid cancer undergoes a thyroidectomy and is prescribed 75mcg levothyroxine sodium. which type of therapy has the patient been prescribed? -Palliative -prophylactic -maintenance -supplemental

supplemental

Which term would best describe a possible drug reaction resulting in very low blood glucose levels that can cause lightheadedness and profuse sweating? -allergic -drug interaction -idiosyncratic -pharmacologic

pharmacologic

Which type of cells are destroyed s a result of an idiosyncratic reaction in a patient with glucose-6- phosphate dehydrogenase(G6PD) deficiency with certain medication? -Platelets -Mucosal Cells -Red blood cells -White Blood Cells

Red blood cells

If a drug has a high first-pass effect, which statement about the drug is appropriate? -formation of active metabolites is high in bile -formation of inactive metabolites is high in feces -formation of inactive metabolites is high in the liver -formation of inactive metabolites is low in the kidney

formation of inactive metabolites is high in the liver

Which drug formulation will have fastest onset of action for an oral drug available in various formulations? -Elixir -powder -suspension -oral soluble wafer

oral soluble wafer

Which mechanism of action is being described when an antibiotic drug causes the destruction of bacterial cell walls? -Enzyme interaction -selective interaction -receptor interaction -nonselective interaction

nonselective interaction

Which process is being described when a drug followed from oral absorption through to finding traces of the drug in urine? -pharmaceutics -pharmacokinetics -pharmacodynamics -pharmacotherapeutics

pharmacokinetics

To achieve the most rapid onset of action, the health care provider would prescribe medication to be administered by which route? -intrathecally -intravenously -subcutaneously -intramuscularly

intravenously

A patient is given a drug that has a half-life of 8 hours. The peak level of this drug is 100mg/L. What would be the concentration of the drug after two half-lives? (answer in whole number)

25mg/L

The nurse administers a drug to a patient that has a half-life of 6 hours. If the dose of the drug is 200mg/L, what would the concentration o the drug be after 12 hours?

50 mg/L

Which fact would the nurse explain to a patient taking amiodarone and consuming grapefruit juice? -t chemically binds to the drug -it negates the action of the drug -it increases excretion of the drug -it reduces the metabolism of the drug

it reduces the metabolism of the drug

Which instructions would the nurse provide regarding the properties of an enteric coated drug preparation? (choose all that apply) - anticholinergic drugs may negate of the enteric coating -the drug should be crushed before administration -absorption of the drug in the intestine is prevented -Dissolution of the drug in the stomach is prevented -the drug should be taken with large amounts of food

-anticholinergic drugs may negate of the enteric coating -Dissolution of the drug in the stomach is prevented

Which information would the nurse draw upon to explain to a patient why a lower dose of intravenous pains medication be being given than the oral dose? - Medications given orally bypass the portal circulatory system - medications given intravenously are not affected by the first-pass effect - drugs administered intravenously enter the portal system before systemic distribution - a large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver

- medications given intravenously are not affected by the first-pass effect

Which factor associated with a drug that has a low therapeutic index would the nurse be aware of? - there is less possibility of developing dependence - there is a high possibility that overdose events will occur -the drug will have low tolerance when compared with other drugs - the chances of side effects are low with this drug relative to other drugs

- there is a high possibility that overdose events will occur

Which instruction would a nurse give a patient to a patient who has been prescribed ciprofloxacin to prevent antagonistic effects? -Avoid taking the drug with milk -take an antacid with the drug -take the drug with vitamin supplements -take the drug with iron-rich foods like spinach

Avoid taking the drug with milk

The nurse is caring for a patient with Parkinson's disease who is receiving monoamine oxidase inhibitors and teaches dietary guidelines to the patient caregiver. Which statement by the patients caregiver indicates effective learning? -I should avoid giving the patient milk -I should avoid giving the patient orange juice -I should avoid giving the patient aged cheese -I should avoid giving the patient green leafy vegetables

-I should avoid giving the patient aged cheese

Which advice would the nurse give a patient who has been prescribed an antibiotic capsule to treat pharyngitis and is reluctant to swallow the capsule? -Crush the capsule -Chew the granules in the capsule -dissolve the granules in a beverage -open the capsule and sprinkle the granules on soft food

open the capsule and sprinkle the granules on soft food

Which drug would the nurse alert the provider about when the patient is regularly taking it and is newly prescribed amiodarone? -warfarin -ibuprofen -amoxicillin -acetaminophen

-warfarin

When reviewing a patients medical records, the nurse finds that the patient had developed an idiosyncratic reactions to aspirin. Which information would the nurse inter? -The therapeutic index of the drug may have been high. -the patient may have taken an excess dose of the drug -the patient may have taken the drug with grapefruit juice -The patient may have a deficiency of drug-metabolizing enzymes

The patient may have a deficiency of drug-metabolizing enzymes

Which action performed by the nurse will increase the absorption of a medication administered intramuscularly? -massaging the site after injection -applying cold packs to the injection site -lowering the extremity below the level of the heart -administering the medication via the Z-track method

-massaging the site after injection

Which oral preparation should be administered to ensure fast absorption of an antacid used to treat severe gastric burning for prompt symptomatic relief? -Elixir -capsule -oral suspension -enteric-coated tablet

-Elixir

Which food item would the nurse recommend the parents avoid serving their child who has been prescribed carbamazepine for a generalized seizure disorder? -yogurt -cheese -spinach -grapefruit

-yogurt

Which action would the nurse expect the health care provider to take when prescribing antibiotic therapy to a patient who has end-stage renal disease? -Increase the dose from the recommended dose -administer the antibiotic with diuretic medications -prescribe and antibiotic with a low therapeutic index -initiate therapy with a lower-than-recommended dose

-initiate therapy with a lower-than-recommended dose

When it is necessary for a drug to circumvent first-pass metabolism in the liver which route of administration is recommended? (choose all that apply) -oral -intranasal -intraocular -transdermal -injection into the portal vein

-intranasal -intraocular -transdermal

A patient has taken an enteric-coated medication with a large amount of food. Which effect will this have on the bioavailability of the drug? -It will be increased -it will become 0 -it will be decreased -it will be increased

-it will be decreased

A patient is to receive an intramuscular injection of a drug that has a high first-pass effect but asks for an oral preparation of the drug instead. Which action would the nurse choose in this situation? (choose all that apply) -Obtain a prescription for an oral formation without altering the dose -Explain to the patient that the drug becomes inactive if it taken orally -explain tp the patient the drug causes toxic effects if it is taken orally -explain to the patient that the drug will have a reduced effect if taken orally -obtain a prescription for an enteric-coated oral formation to prevent inactivation in the liver

-Explain to the patient that the drug becomes inactive if it taken orally -explain to the patient that the drug will have a reduced effect if taken orally

Which patient finding would the nurse to be concerned that the pharmacologic action of an antihypertensive drug is extended? -rash -urticaria -hypotension -anaphylactic shock

-hypotension

The health care provider has prescribed erythromycin to a patient with chronic alcoholism resulting in cirrhosis of the liver. Which phenomenon would the nurse be aware of when administering additional drugs? -delay in drug absorption - development of drug toxicity -shortened duration of drug actions -decreased pharmacologic effects of drugs

- development of drug toxicity

Which type of therapy is is utilized when a patient with lower respiratory tract symptoms is prescribed both antibiotics and laboratory testing concurrently? -Empiric -prophylactic -maintenance -supplemental

-Empiric

A patient prescribed amoxicillin and probenecid wants to know the reason for the prescription of two drugs. Which explanation by the nurse is accurate? (choose all that apply) -Combination therapy is beneficial to the patient -probenecid reduces allergic reactions to amoxicillin -Probenecid prevents the renal extraction of amoxicillin -probenecid increases the duration of action of amoxicillin -probenecid enhances the antibacterial action of amoxicillin

-Combination therapy is beneficial to the patient -Probenecid prevents the renal extraction of amoxicillin -probenecid increases the duration of action of amoxicillin

Which measure could be taken to reverse the toxic effects of acetaminophen after overdose? (choose all that apply) -Obtain blood work -administer anesthesia -ensure a patient airway -administer acetylcysteine -administer activated charcoal -administer intravenous calcium

-Obtain blood work -ensure a patient airway -administer acetylcysteine -administer activated charcoal

Which adverse effect might a patient with glucose-6-phosphate 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

Which instruction would the nurse provide to the patient regarding administration of a long-acting propranolol tablet? (choose all that apply) - crush the tablet -swallow the tablet -take the tablet on a full stomach -take the tablet with a glass of water -avoid eating grapefruit while taking the drug

-swallow the tablet -take the tablet on a full stomach -take the tablet with a glass of water

Which prophylactic therapy would the nurse expect to initiate before a patient has surgery? -Start preoperative antibiotics -check blood glucose levels daily -empty bowels as per the prescription -type and cross-match blood for transfusion

-Start preoperative antibiotics

Which source does a manufacturer use to obtain information about drugs and their side effects? (choose all that apply) -Patient and their families -nurses and nurse managers -health care providers -researchers and clinical trails -postmarking safety surveillance data

-researchers and clinical trails -postmarking safety surveillance data

Which category is classified as complementary and alternative medicine according to the National Center for Complementary and alternative Medicine? (choose all that apply) -chemotherapy -energy therapies -psychopharmacology -mind-body intervention -biologically based therapies

-energy therapies -mind-body intervention -biologically based therapies

Which term describes the use of herbal products and other nontraditional remedies for treating illness? -Alternative medicine -Conventional medicine -Complementary Medicine -Integrative medicine

-Alternative medicine

Which side is effect is associated with the use if nonsteroidal anti-inflammatory drugs? (choose all that apply) -Grand mal seizure -myocardial infarction -cerebrovascular accident - gastrointestinal accident -development of hepatic toxicity

-myocardial infarction -cerebrovascular accident - gastrointestinal accident

Which statements is accurate when discussing the use of herbal and over the counter medications with patients? -Over the counter medications are not as potent as prescription drugs -herbal remedies have not demonstrated any adverse effects with their use -the use of the counter medications is gradually decreasing with the increased availability of more effective prescription medication -It is important to discuss the use of over the counter medications with your health care provider

-It is important to discuss the use of over the counter medications with your health care provider

Which condition would cause the nurse to question the patient use of kava? -anxiety -hepatitis -hypertension -cardiovascular disease

-hepatitis

When the nurse is monitoring several patients to receive warfarin which indicates a high risk for hemorrhage with standard dosing? -African ancestry using ginger supplements -Asian ancestry using gingko supplements -African American and European ancestry using kava -European ancestry using cranberry supplements

-Asian ancestry using gingko supplements

When Information requires another source than the label for the nurse to properly review an over the counter herbal product for a patient looking for options to improve memory? -Uses for the product for memory improvement -specific curative factors for memory loss -signs of illness to report when taking the product -inactive ingredients added to the product

specific curative factors for memory loss

Which point would the nurse include in the teaching plan related to the use if herbal therapy for a patient who is prescribed an oral contraceptive? -it is safe to drink cranberry juice -avoid taking saw palmetto with oral contraceptives -echinacea does not typically interact with prescription drugs -herbal therapy is often as effective as prescription drugs and should be tried first

-avoid taking saw palmetto with oral contraceptives

Which diagnostic assessment would the nurse discuss with the health care provider for a patient who report taking high doses of acetaminophen to treat fever for the past week? -Lung spirometry -chest radiograph -liver function test -renal function test

-liver function test

Which patient is at high risk for developing adverse effects from over the counter drugs? (choose all that apply) -a 1 year old child -a young women with glaucoma -a women with diabetes mellitus - a 75 year old man in good health -a young man with cold symptoms

-a 1 year old child -a young women with glaucoma -a women with diabetes mellitus - a 75 year old man in good health

Which assessment would the nurse preform to determine the potential for experiencing adverse effects for a patient who takes several herbal and over the counter medications? -neutrophil count -bowel movements -thyroid stimulating hormone -cognitive level and motor abilities

-cognitive level and motor abilities

Which information is important for the nurse to obtain from a patient who is admitted to the emergency department with signs of liver toxicity? -use of tobacco products -recent travel -sun exposure -use of herbal therapy

-use of herbal therapy

Which criterion must a medication meet to be assigned over the counter? -be easy to use -be easy to monitor -be evaluated for side effects -have a low therapeutic index - have no drug to drug interactions

-be easy to use -be easy to monitor -be evaluated for side effects

Which cue suggests a potential complication in a patient who uses the maximum recommended number of cranberry supplements daily? -history of past urinary tract infections -drug allergies to antibiotics -consumers one alcohol beverage daily -reduced renal function

-reduced renal function

Which action will the nurse teach a patient as the best guide when considering the use of over the counter supplements to improve sleep? -Encourage researching supplements before use -inform the patient of appropriate supplements to use -emphasis on reporting adverse events promptly to the health care provider -discuss monitoring sleep patterns for improvement after use

-Encourage researching supplements before use

which assessment would the nurse perform to determine the potential for experiencing adverse effects for a patient who takes several herbal and over the counter medication? -Neutrophil count -bowel movements -thyroid stimulating hormone -cognitive level and motor abilities

-cognitive level and motor abilities

which term is used to describe abusing the use of cough syrup contain dextromethorphan? -Robotripping -Reye's syndrome herbal impairment couch suppression abuse

-Robotripping

Who is responsible for submitting medication related information to the U.S food and drug administration? - The registered nurse -the drug manufacturer -the patients caregivers -the health care provider

-the drug manufacturer

Which medication can be manufactured as the street drug methamphetamine? - calcium carbonate -naproxen -pseudoephedrine -dextromethorphan

-pseudoephedrine

Which herbal medication was banned by the US food and drug administration in April 2004 because of its cardiovascular side effects? -caffeine -cocoa -ephedra -aloe Vera

-ephedra

Which term describes the use of medications prescribed by the health care provider as well as herbs from the local health food store? -Conventional medicine -western medicine -traditional medicine -complementary medicine

-complementary medicine

Which statement would the nurse make to parents who report they frequently give aspirin to their child for fever? -Everything in moderation -you should have your Childs kidney function tested -have you talked to the health care provider about fevers -aspirin should not be administered to children

aspirin should not be administered to children

Which statement is a possible consequence of reclassifying prescription drugs as over the counter mediations? -The pharmacy dispensing fees will dramatically increase -the medications will be available at a higher cast to the patient -Third party health insurance will pay the cost OTC medication -Visits by patients to their health care providers will increase

-the medications will be available at a higher cast to the patient

Which agent requires no proof of efficacy according to the dietary supplement and health educational Act of 1994? -legend drugs -dietary supplements -over the counter drugs -generic drugs

-dietary supplements

Which statement by the nursing student indicates a need for future teaching about over the counter medication? -Be aware of overdosing when using OTC products -read specific warning labels before taking OTC products -do not use OTC products if you have cardiovascular disease -OTC cold products are safe in children older than 1 year of age

-OTC cold products are safe in children older than 1 year of age

Which herbal supplement would the nurse instruct a patient who is taking an antiplatelet medication to avoid? -Ginkgo -valerian -hawthorn -evening primrose

-Ginkgo

Which medication is a commonly used over the counter product? (choose all that apply) -analgesics -antidepressants -antihypertensive -histamine blockers -topical medications

-analgesics -histamine blockers -topical medications

Which source does a manufacturer use to obtain information about drugs and their side effects? (choose all that apply) -patient and their families -nurses and nurse mangers -health care providers -researchers and clinical trails -postmarking safety surveillance data

-researchers and clinical trails -postmarking safety surveillance data

which information about the risk of over the counter medications for cough and cold would the nurse include in patient teaching? -The out of pocket cost is less than that for prescription medications -these products rarely work -these products interact with many prescriptions drugs -these products work just as well as prescription drugs

-these products interact with many prescriptions drugs

Which complication would the nurse discuss with a patient with arthritis who self medicates with nonsteroidal anti-inflammatory drugs? -tetany -constipation -hypotension -gastrointestinal ulcers

gastrointestinal ulcers

which statement made by a patent indicates the need for further teaching? I should abstain from giving any aspirin product to my children -over the counter medications are always safe for children - I should not give over the counter cough and cold products to my toddler -I should always double check the dose before giving my children medication

over the counter medications are always safe for children

Which statement would the nurse make to the patient who is taking acetaminophen for pain relief? -Acetaminophen is safer than other medications used to treat headache -acetaminophen is an over the counter drug and is generally not effective -acetaminophen can lead to liver toxicity and should be used in recommended doses -acetaminophen should taken only after consulting the health care provider

-acetaminophen can lead to liver toxicity and should be used in recommended doses

Which term is used for over the counter products that are considered to be ineffective but not unsafe? -legend products -dietary supplements -placebo medicines -grandfathered products

-grandfathered products

Which assessments would the nurse perform for a patient who has been taking over the counter antacids for more than 1 month? -lung sounds -heart sounds -bowel sounds -complete blood count

-bowel sounds

Which statement indicates effective learning about herbal therapy? -herbal medications are very safe to use for all age groups -clinical trials are being conducted for all herbal medications -insurance plans offer reimbursements for alterative treatments -the use of herbal medications is decreased by 25% every year

-insurance plans offer reimbursements for alterative treatments

Which instruction would the nursing give a patient who takes warfarin and reports drinking chamomile tea every evening? -Limit your intake to one cup per day -chamomile is safe and has no side effects -chamomile may have an interaction with your warfarin -ask your health care provider to assess your bleeding time more frequently

chamomile may have an interaction with your warfarin

Which instructions is appropriate for a patient who will begin taking a medication to treat erectile dysfunction? -Consume a low-calorie diet -restrict the intake of grapefruit -it is safe to use herbal medications -start with a low dose of the prescribed medication

restrict the intake of grapefruit

Which concern would the nurse have about a patient reporting the usage of over the counter cough suppressants several times a day? -substance misuse -risk of hemorrhage -immunosuppression -rebound headaches

-substance misuse

Which statement made by the patient after commenting that fluticasone nasal spray is and over the counter medication indicates an understanding of OTC regulations? -insurance will approve the medication -the medication is of low quality -a pharmacist will review my purchase -I may decide when to use the medication

I may decide when to use the medication

When action would the nurse take when a patient diagnosed with erectile dysfunction tells the nurse he takes his medication with grapefruit every morning? -instruct the patient to avoid grapefruit -praise the patient for eating a healthy diet -refer the patient to a dietitian for counseling -request a grapefruit from dietary before administering medication

instruct the patient to avoid grapefruit

Which food would the nurse teach a patient who is taking estrogen replacement therapy to avoid? -Garlic shrimp for dinner -cranberry juice at breakfast -sugar substitute on grapefruit -chamomile tea in the afternoon

-sugar substitute on grapefruit

Which herb or dietary supplement would the nurse teach a patient who had a lung transplant to avoid? -kava -valerian -echinacea -evening primrose

-echinacea

Which herb or dietary supplement would the nurse teach a patient is acute renal failure to avoid? -Kava -Garlic -cranberry -saw palmetto

-cranberry

Which condition would require teaching about the use of over the counter drugs because of the potential for increased adverse reactions? -Cold symptoms -a chronic illness -a fungal infection -gastric acidity problems

-a chronic illness

Which action will the nurse take for a patient with a history of gastrointestinal ulcers who has been using ibuprofen for several weeks and reports abdominal pain? -further assess the patients pain -instruct the patient to use an herbal drug -report the adverse event to the manufacturer -report the adverse event to Medwatch immediately

-further assess the patients pain

Which assessments will the nurse review for the patient who has been taking high doses of over the counter acetaminophen for many years? -heart rate -liver enzymes -bowel movements creatinine and BUN

-liver enzymes

Which potential adverse effect would the nurse assess for in a toddler who has been taking an over the counter cold product for the past week? -Yellow sclera -rapid heart rate -onset of seizures -increased lethargy -charge in fingernail shape

-rapid heart rate -onset of seizures -increased lethargy

Which action by the patient indicates a positive use of complementary or alternative therapy? -limits water intake to size glasses per day using herbal medications -declines to discuss the adverse effects of the medications with the nurse -eliminates the use of painkillers and uses hot packs for the relief of acute pain -chooses medications by reading the label rather than consulting the pharmacy

-eliminates the use of painkillers and uses hot packs for the relief of acute pain

Which conditions would require the nurse to advise the patient to avoid the use of over the counter drugs? (choose all that apply) -renal failure -liver disease -bone fractures -common cold -cardiac dysfunction

-renal failure -liver disease -cardiac dysfunction

Which statement made by the nurse is appropriate for a patient who been taking kava for 2 years for anxiety? (choose all that apply) -the food and rug administration has banned the sale of kava -you need to talk to your health care provider about liver function testing because it can cause liver toxicity kava enhances the effects of alcohol you need to abstain from alcohol -kava enhances the effects of alcohol you to abstain from alcohol -the food and drug administration has issued a warning as to the effects of kava -kava can reduce the effect of the sleep medication prescribed by your health care provider

-you need to talk to your health care provider about liver function testing because it can cause liver toxicity kava enhances the effects of alcohol you need to abstain from alcohol -kava enhances the effects of alcohol you to abstain from alcohol -the food and drug administration has issued a warning as to the effects of kava

Which question will assist the nurse in obtaining a complete assessment of the patients use of nonprescription therapy? (choose all that apply) -do you use any herbal supplements. -do you have any cultural food preferences -how often do you take over the counter products -do you have any home remedies you use regularly - what kind of food do you prefer to eat when dinning out

-do you use any herbal supplements. -do you have any cultural food preferences -how often do you take over the counter products -do you have any home remedies you use regularly

Which point would the nurse include in the teaching plan related to the use of herbal therapy for a patient who is prescribed an oral contraceptive? -it is safe to drink cranberry juice -avoid taking saw palmetto with oral contraceptives -echinacea does not typically interact with prescription drugs -herbal therapy is often as effective as prescription as prescription drug and should be tired first

-avoid taking saw palmetto with oral contraceptives

Which diagnostic assessment would the nurse discuss with the health care provider for a patient who reports taking high doses of acetaminophen to treat fever for the past week? -lung spirometry -chest radiograph -liver function test -renal function test

-liver function test

which supplement found on a patient list of medication would warrant concern for a patient newly admitted with a pulmonary embolism? -Kava -echinacea -chamomile -evening primrose

chamomile

Which complication needs to be assessed for immediately in a patient who self administered over 5 grams per day of acetaminophen for the past week? -liver toxicity -Reye's syndrome -drug dependency rebound congestion

-liver toxicity

Which dietary supplement increases the risk for bleedung due to the interaction with anticoagulants? (choose all that apply) -basil -ginkgo -digitalis -green tea -chamomile

-ginkgo -chamomile

Which would the nurse include to teach a patient about the consequences of using over the counter drugs for long periods without medical consultation? -prevention of worsening disease -prompt diagnosis and treatment of disease -ineffective management of chronic disease -timely treatment of life-threatening disease

-ineffective management of chronic disease

Which clinical condition could result from a patient taking selective serotonin reuptake inhibitor and self medicating with St. johns wort? -hypertensive crisis -migraine headache -serotonin syndrome -postural hypotension

-serotonin syndrome

Which teaching is priority when a nurse is providing education to parents about acetaminophen administration to their child that has otitis medica? -nothing side effects -accurate dose -potential drug interactions -problems with delaying doses

-accurate dose

Which information will the nurse discuss with a parent who carefully washed an oral syringe and places it in the container with the family medications after administering an oral liquid medication? -saving the oral syringe to use for other products -using a teaspoon for easier cleaning in a dishwasher - the importance of separately storing medication -applying a disinfectant to the oral syringe to reduce bacterial growth

the importance of separately storing medication

Which information is appropriate to teach an older adult who is being treated for several chronic conditions and wants to use an over the counter medication for cold symptoms? -ask the pharmacist to recommend theraphy -read the label carefully before purchasing the medications -any over the counter therapy should be safe in moderation -consult your health care provider before taking any over the counter medications

-consult your health care provider before taking any over the counter medications

Which statement made by the nurse is appropriate for a patient with chronic obstructive pulmonary diseases who wants to use herbal medications for a cold rather then conventional medications? -Herbal supplements have fewer side effects than conventional medications -many herbal preparations are very expensive compared to conventional medications -herbal products may work but you still should discuss this when your health care provider -you will need a prescription from your health care provider for herbal therapy

-herbal products may work but you still should discuss this when your health care provider

Which cue suggest a potential complication in a patient who uses the maximum recommended number of cranberry supplements daily? -history of urinary tract infections -drug allergies to antibiotics -consumes on alcohol beverage daily -reduced renal function

reduced renal function

Which term describes the use of herbal products and other nontraditional remedies for treating illness? -alternative medicine -convectional medicine -complementary medicine -integrative medicine

-alternative medicine