Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57)
Prepare effectively with Test Bank for Pharmacology and the Nursing Process, 10th Edition (Chapters 1-57)—a comprehensive set of questions to help you ace your exams.
Seller Steve
Contributor
4.2
79
about 2 months ago
Preview (31 of 296)
Sign in to access the full document!
Chapter 01: The Nursing Process and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is developing a human needs statement for a patient who has a new diagnosis of
heart failure. Identification of human needs statements occur with which of these activities?
a. Collection of patient data
b. Administering interventions
c. Deciding on patient outcomes
d. Documenting the patient‘s behavior
ANS: A
Identification of human needs occurs with the collection of patient data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Human Needs Statement
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The patient is to receive oral guaifenesin twice a day. Today, the nurse was busy and gave the
medication 2 hours after the scheduled dose was due. What type of problem does this
represent?
a. ―Right time‖
b. ―Right dose‖
c. ―Right route‖
d. ―Right medication‖
ANS: A
―Right time‖ is correct because the medication was given more than 30 minutes after the
scheduled dose was due. ―Dose‖ is incorrect because the dose is not related to the time the
medication administration is scheduled. ―Route‖ is incorrect because the route is not affected.
―Medication‖ is incorrect because the medication ordered will not change.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. The nurse has been monitoring the patient‘s progress on a new drug regimen since the first
dose and documenting the patient‘s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
a. Human needs statement
b. Planning
c. Implementation
d. Evaluation
ANS: D
Monitoring the patient‘s progress, including the patient‘s response to the medication, is part of
the evaluation phase. Planning, implementation, and human needs statement are not illustrated
by this example.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is developing a human needs statement for a patient who has a new diagnosis of
heart failure. Identification of human needs statements occur with which of these activities?
a. Collection of patient data
b. Administering interventions
c. Deciding on patient outcomes
d. Documenting the patient‘s behavior
ANS: A
Identification of human needs occurs with the collection of patient data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Human Needs Statement
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The patient is to receive oral guaifenesin twice a day. Today, the nurse was busy and gave the
medication 2 hours after the scheduled dose was due. What type of problem does this
represent?
a. ―Right time‖
b. ―Right dose‖
c. ―Right route‖
d. ―Right medication‖
ANS: A
―Right time‖ is correct because the medication was given more than 30 minutes after the
scheduled dose was due. ―Dose‖ is incorrect because the dose is not related to the time the
medication administration is scheduled. ―Route‖ is incorrect because the route is not affected.
―Medication‖ is incorrect because the medication ordered will not change.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. The nurse has been monitoring the patient‘s progress on a new drug regimen since the first
dose and documenting the patient‘s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
a. Human needs statement
b. Planning
c. Implementation
d. Evaluation
ANS: D
Monitoring the patient‘s progress, including the patient‘s response to the medication, is part of
the evaluation phase. Planning, implementation, and human needs statement are not illustrated
by this example.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation
Chapter 01: The Nursing Process and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is developing a human needs statement for a patient who has a new diagnosis of
heart failure. Identification of human needs statements occur with which of these activities?
a. Collection of patient data
b. Administering interventions
c. Deciding on patient outcomes
d. Documenting the patient‘s behavior
ANS: A
Identification of human needs occurs with the collection of patient data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Human Needs Statement
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The patient is to receive oral guaifenesin twice a day. Today, the nurse was busy and gave the
medication 2 hours after the scheduled dose was due. What type of problem does this
represent?
a. ―Right time‖
b. ―Right dose‖
c. ―Right route‖
d. ―Right medication‖
ANS: A
―Right time‖ is correct because the medication was given more than 30 minutes after the
scheduled dose was due. ―Dose‖ is incorrect because the dose is not related to the time the
medication administration is scheduled. ―Route‖ is incorrect because the route is not affected.
―Medication‖ is incorrect because the medication ordered will not change.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. The nurse has been monitoring the patient‘s progress on a new drug regimen since the first
dose and documenting the patient‘s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
a. Human needs statement
b. Planning
c. Implementation
d. Evaluation
ANS: D
Monitoring the patient‘s progress, including the patient‘s response to the medication, is part of
the evaluation phase. Planning, implementation, and human needs statement are not illustrated
by this example.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is developing a human needs statement for a patient who has a new diagnosis of
heart failure. Identification of human needs statements occur with which of these activities?
a. Collection of patient data
b. Administering interventions
c. Deciding on patient outcomes
d. Documenting the patient‘s behavior
ANS: A
Identification of human needs occurs with the collection of patient data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Human Needs Statement
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The patient is to receive oral guaifenesin twice a day. Today, the nurse was busy and gave the
medication 2 hours after the scheduled dose was due. What type of problem does this
represent?
a. ―Right time‖
b. ―Right dose‖
c. ―Right route‖
d. ―Right medication‖
ANS: A
―Right time‖ is correct because the medication was given more than 30 minutes after the
scheduled dose was due. ―Dose‖ is incorrect because the dose is not related to the time the
medication administration is scheduled. ―Route‖ is incorrect because the route is not affected.
―Medication‖ is incorrect because the medication ordered will not change.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. The nurse has been monitoring the patient‘s progress on a new drug regimen since the first
dose and documenting the patient‘s therapeutic response to the medication. Which phase of
the nursing process do these actions illustrate?
a. Human needs statement
b. Planning
c. Implementation
d. Evaluation
ANS: D
Monitoring the patient‘s progress, including the patient‘s response to the medication, is part of
the evaluation phase. Planning, implementation, and human needs statement are not illustrated
by this example.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Evaluation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient will adhere to the new insulin treatment regimen.
d. The patient will demonstrate correct blood glucose testing technique.
ANS: D
―Demonstrating correct blood glucose testing technique‖ is a specific and measurable
outcome criterion. ―Following instructions‖ and ―not experiencing complications‖ are not
specific criteria. ―Adhering to new regimen‖ would be difficult to measure.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?
a. Providing education on keeping a journal of blood pressure readings
b. Setting goals and outcome criteria with the patient‘s input
c. Recording a drug history regarding over-the-counter medications used at home
d. Formulating human needs statements regarding deficient knowledge related to the
new treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcomes reflects the planning phase. Recording a drug history reflects the assessment phase.
Formulating human needs statements reflects analysis of data as part of planning.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
6. The medication order reads, ―Give ondansetron 4 mg, 30 minutes before beginning
chemotherapy to prevent nausea.‖ The nurse notes that the route is missing from the order.
What is the nurse‘s best action?
a. Give the medication intravenously because the patient might vomit.
b. Give the medication orally because the tablets are available in 4-mg doses.
c. Contact the prescriber to clarify the route of the medication ordered.
d. Hold the medication until the prescriber returns to make rounds.
ANS: C
A complete medication order includes the route of administration. If a medication order does
not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral
routes are not interchangeable. Holding the medication until the prescriber returns would
mean that the patient would not receive a needed medication.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus.
Which statement best illustrates an outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient will adhere to the new insulin treatment regimen.
d. The patient will demonstrate correct blood glucose testing technique.
ANS: D
―Demonstrating correct blood glucose testing technique‖ is a specific and measurable
outcome criterion. ―Following instructions‖ and ―not experiencing complications‖ are not
specific criteria. ―Adhering to new regimen‖ would be difficult to measure.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. Which activity best reflects the implementation phase of the nursing process for the patient
who is newly diagnosed with hypertension?
a. Providing education on keeping a journal of blood pressure readings
b. Setting goals and outcome criteria with the patient‘s input
c. Recording a drug history regarding over-the-counter medications used at home
d. Formulating human needs statements regarding deficient knowledge related to the
new treatment regimen
ANS: A
Education is an intervention that occurs during the implementation phase. Setting goals and
outcomes reflects the planning phase. Recording a drug history reflects the assessment phase.
Formulating human needs statements reflects analysis of data as part of planning.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
6. The medication order reads, ―Give ondansetron 4 mg, 30 minutes before beginning
chemotherapy to prevent nausea.‖ The nurse notes that the route is missing from the order.
What is the nurse‘s best action?
a. Give the medication intravenously because the patient might vomit.
b. Give the medication orally because the tablets are available in 4-mg doses.
c. Contact the prescriber to clarify the route of the medication ordered.
d. Hold the medication until the prescriber returns to make rounds.
ANS: C
A complete medication order includes the route of administration. If a medication order does
not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral
routes are not interchangeable. Holding the medication until the prescriber returns would
mean that the patient would not receive a needed medication.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider
when deciding when to give a drug?
a. The patient‘s ability to swallow
b. The patient‘s height
c. The patient‘s last meal
d. The patient‘s allergies
ANS: C
The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may
be affected by the timing of the last meal. The patient‘s ability to swallow, height, and
allergies are not factors to consider regarding the timing of the drug‘s administration.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
8. The nurse is performing an assessment of a newly admitted patient. Which is an example of
subjective data?
a. Weight 155 pounds
b. Pulse 72 beats/minute
c. The patient reports that he uses the herbal product ginkgo
d. The patient‘s complete blood count results
ANS: C
Subjective data include information shared through the spoken word by any reliable source,
such as the patient. Objective data may be defined as any information gathered through the
senses or that which is seen, heard, felt, or smelled. A patient‘s pulse, weight, and laboratory
tests are all examples of objective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. When giving medications, the nurse will follow the rights of medication administration. The
rights include the right documentation, the right reason, the right response, and the patient‘s
right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
d. Right diagnosis
e. Right time
f. Right patient
ANS: A, B, C, E, F
Additional rights of medication administration must always include the right drug, right dose,
right time, right route, and right patient. The right diagnosis is incorrect.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
when deciding when to give a drug?
a. The patient‘s ability to swallow
b. The patient‘s height
c. The patient‘s last meal
d. The patient‘s allergies
ANS: C
The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may
be affected by the timing of the last meal. The patient‘s ability to swallow, height, and
allergies are not factors to consider regarding the timing of the drug‘s administration.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
8. The nurse is performing an assessment of a newly admitted patient. Which is an example of
subjective data?
a. Weight 155 pounds
b. Pulse 72 beats/minute
c. The patient reports that he uses the herbal product ginkgo
d. The patient‘s complete blood count results
ANS: C
Subjective data include information shared through the spoken word by any reliable source,
such as the patient. Objective data may be defined as any information gathered through the
senses or that which is seen, heard, felt, or smelled. A patient‘s pulse, weight, and laboratory
tests are all examples of objective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. When giving medications, the nurse will follow the rights of medication administration. The
rights include the right documentation, the right reason, the right response, and the patient‘s
right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
d. Right diagnosis
e. Right time
f. Right patient
ANS: A, B, C, E, F
Additional rights of medication administration must always include the right drug, right dose,
right time, right route, and right patient. The right diagnosis is incorrect.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
Loading page 4...
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
OTHER
1. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as
the last phase.
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Human needs statement
ANS:
C, E, A, D, B
The nursing process is an ongoing process that begins with assessing and continues with
human needs statement, planning, implementing, and evaluating.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: General
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Chapter 02: Pharmacologic Principles
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs
have the same concentration of the active ingredient. Which term is used to identify this
principle?
a. Bioequivalent
b. Synergistic
c. Prodrugs
d. Steady state
ANS: A
Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. A drug‘s steady state is the physiologic
state in which the amount of drug removed via elimination is equal to the amount of drug
absorbed from each dose. The term synergistic refers to two drugs, given together, with a
resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug
is an inactive drug dosage form that is converted to an active metabolite by various
biochemical reactions once it is inside the body.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. When given an intravenous medication, the patient says to the nurse, ―I usually take pills.
Why does this medication have to be given in the arm?‖ What is the nurse‘s best answer?
OTHER
1. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as
the last phase.
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Human needs statement
ANS:
C, E, A, D, B
The nursing process is an ongoing process that begins with assessing and continues with
human needs statement, planning, implementing, and evaluating.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: General
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Chapter 02: Pharmacologic Principles
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs
have the same concentration of the active ingredient. Which term is used to identify this
principle?
a. Bioequivalent
b. Synergistic
c. Prodrugs
d. Steady state
ANS: A
Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have
the same bioavailability; thus, they are bioequivalent. A drug‘s steady state is the physiologic
state in which the amount of drug removed via elimination is equal to the amount of drug
absorbed from each dose. The term synergistic refers to two drugs, given together, with a
resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug
is an inactive drug dosage form that is converted to an active metabolite by various
biochemical reactions once it is inside the body.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. When given an intravenous medication, the patient says to the nurse, ―I usually take pills.
Why does this medication have to be given in the arm?‖ What is the nurse‘s best answer?
Loading page 5...
a. ―The medication will cause fewer adverse effects when given intravenously.‖
b. ―The intravenous medication will have delayed absorption into the body‘s tissues.‖
c. ―The action of the medication will begin sooner when given intravenously.‖
d. ―There is a lower chance of allergic reactions when drugs are given intravenously.‖
ANS: C
An intravenous (IV) injection provides the fastest route of absorption. The IV route does not
affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in
faster absorption). The IV route does not affect the number of allergic reactions.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral
drugs?
a. Parenteral drugs bypass the first-pass effect.
b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
c. Absorption of parenteral drugs is faster when the stomach is empty.
d. Parenteral drugs exert their effects while circulating in the bloodstream.
ANS: A
Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the
stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to
parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation
before they can exert their effects; they do not exert their effects while circulating in the
bloodstream.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the
nurse notes that the patient‘s blood pressure is extremely low, and the patient is lethargic and
difficult to awaken. This would be classified as which type of adverse drug reaction?
a. Adverse effect
b. Allergic reaction
c. Idiosyncratic reaction
d. Pharmacologic reaction
ANS: D
A pharmacologic reaction is an extension of a drug‘s normal effects in the body. In this case,
the antihypertensive drug lowered the patient‘s blood pressure levels too much. The other
options do not describe a pharmacologic reaction. An adverse effect is a predictable,
well-known adverse drug reaction that results in minor or no changes in patient management.
An allergic reaction (also known as a hypersensitivity reaction) involves the patient‘s immune
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined
abnormal response to normal dosages of a drug.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
b. ―The intravenous medication will have delayed absorption into the body‘s tissues.‖
c. ―The action of the medication will begin sooner when given intravenously.‖
d. ―There is a lower chance of allergic reactions when drugs are given intravenously.‖
ANS: C
An intravenous (IV) injection provides the fastest route of absorption. The IV route does not
affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in
faster absorption). The IV route does not affect the number of allergic reactions.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is administering parenteral drugs. Which statement is true regarding parenteral
drugs?
a. Parenteral drugs bypass the first-pass effect.
b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
c. Absorption of parenteral drugs is faster when the stomach is empty.
d. Parenteral drugs exert their effects while circulating in the bloodstream.
ANS: A
Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the
stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to
parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation
before they can exert their effects; they do not exert their effects while circulating in the
bloodstream.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the
nurse notes that the patient‘s blood pressure is extremely low, and the patient is lethargic and
difficult to awaken. This would be classified as which type of adverse drug reaction?
a. Adverse effect
b. Allergic reaction
c. Idiosyncratic reaction
d. Pharmacologic reaction
ANS: D
A pharmacologic reaction is an extension of a drug‘s normal effects in the body. In this case,
the antihypertensive drug lowered the patient‘s blood pressure levels too much. The other
options do not describe a pharmacologic reaction. An adverse effect is a predictable,
well-known adverse drug reaction that results in minor or no changes in patient management.
An allergic reaction (also known as a hypersensitivity reaction) involves the patient‘s immune
system. An idiosyncratic reaction is unexpected and is defined as a genetically determined
abnormal response to normal dosages of a drug.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Loading page 6...
5. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which
sentence defines a drug‘s half-life?
a. The time it takes for the drug to cause half of its therapeutic response
b. The time it takes for one half of the original amount of a drug to reach the target
cells
c. The time it takes for one half of the original amount of a drug to be removed from
the body
d. The time it takes for one half of the original amount of a drug to be absorbed into
the circulation
ANS: C
A drug‘s half-life is the time it takes for one half of the original amount of a drug to be
removed from the body. It is a measure of the rate at which drugs are removed from the body.
The other options are incorrect definitions of half-life.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. When administering drugs, the nurse remembers that the duration of action of a drug is
defined as which of these?
a. The time it takes for a drug to elicit a therapeutic response
b. The amount of time needed to remove a drug from circulation
c. The time it takes for a drug to achieve its maximum therapeutic response
d. The time period at which a drug‘s concentration is sufficient to cause a therapeutic
response
ANS: D
Duration of action is the time during which drug‘s concentration is sufficient to elicit a
therapeutic response. The other options do not define duration of action. A drug‘s onset of
action is the time it takes for the drug to elicit a therapeutic response. A drug‘s peak effect is
the time it takes for the drug to reach its maximum therapeutic response. Elimination is the
length of time it takes to remove a drug from circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug
works by selective enzyme interaction. Which of these processes describes selective enzyme
interaction?
a. The drug alters cell membrane permeability.
b. The drug‘s effectiveness within the cell walls of the target tissue is enhanced.
c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from
binding to that receptor.
d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme‘s
action with the normal target cell.
ANS: D
With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead
of allowing the enzymes to bind with their normal target cells. As a result, the target cells are
protected from the action of the enzymes. This results in a drug effect. The actions described
in the other options do not occur with selective enzyme interactions.
sentence defines a drug‘s half-life?
a. The time it takes for the drug to cause half of its therapeutic response
b. The time it takes for one half of the original amount of a drug to reach the target
cells
c. The time it takes for one half of the original amount of a drug to be removed from
the body
d. The time it takes for one half of the original amount of a drug to be absorbed into
the circulation
ANS: C
A drug‘s half-life is the time it takes for one half of the original amount of a drug to be
removed from the body. It is a measure of the rate at which drugs are removed from the body.
The other options are incorrect definitions of half-life.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. When administering drugs, the nurse remembers that the duration of action of a drug is
defined as which of these?
a. The time it takes for a drug to elicit a therapeutic response
b. The amount of time needed to remove a drug from circulation
c. The time it takes for a drug to achieve its maximum therapeutic response
d. The time period at which a drug‘s concentration is sufficient to cause a therapeutic
response
ANS: D
Duration of action is the time during which drug‘s concentration is sufficient to elicit a
therapeutic response. The other options do not define duration of action. A drug‘s onset of
action is the time it takes for the drug to elicit a therapeutic response. A drug‘s peak effect is
the time it takes for the drug to reach its maximum therapeutic response. Elimination is the
length of time it takes to remove a drug from circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. When reviewing the mechanism of action of a specific drug, the nurse reads that the drug
works by selective enzyme interaction. Which of these processes describes selective enzyme
interaction?
a. The drug alters cell membrane permeability.
b. The drug‘s effectiveness within the cell walls of the target tissue is enhanced.
c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from
binding to that receptor.
d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme‘s
action with the normal target cell.
ANS: D
With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead
of allowing the enzymes to bind with their normal target cells. As a result, the target cells are
protected from the action of the enzymes. This results in a drug effect. The actions described
in the other options do not occur with selective enzyme interactions.
Loading page 7...
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. When administering a new medication to a patient, the nurse reads that it is highly protein
bound. Assuming that the patient‘s albumin levels are normal, the nurse would expect which
result, as compared to a medication, that is not highly protein bound?
a. Renal excretion will be faster.
b. The drug will be metabolized quickly.
c. The duration of action of the medication will be shorter.
d. The duration of action of the medication will be longer.
ANS: D
Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein
binding does not make renal excretion faster, does not speed up drug metabolism, and does
not cause the duration of action to be shorter.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The patient is experiencing chest pain and needs to take a buccal form of nitroglycerin. Where
does the nurse instruct the patient to place the tablet?
a. Under the tongue
b. On top of the tongue
c. At the back of the throat
d. In the space between the cheek and the gum
ANS: D
Drugs administered via the buccal route are placed in the space between the cheek and the
gum. Drugs administered via the sublingual route are placed under the tongue. The other
options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
10. The nurse is administering medications to the patient who is in renal failure resulting from
end-stage renal disease. The nurse is aware that patients with kidney failure would most likely
have problems with which pharmacokinetic phase?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
ANS: D
The kidneys are the organs that are most responsible for drug excretion. Renal function does
not affect the absorption and distribution of a drug. Renal function may affect metabolism of
drugs to a small extent.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. When administering a new medication to a patient, the nurse reads that it is highly protein
bound. Assuming that the patient‘s albumin levels are normal, the nurse would expect which
result, as compared to a medication, that is not highly protein bound?
a. Renal excretion will be faster.
b. The drug will be metabolized quickly.
c. The duration of action of the medication will be shorter.
d. The duration of action of the medication will be longer.
ANS: D
Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein
binding does not make renal excretion faster, does not speed up drug metabolism, and does
not cause the duration of action to be shorter.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The patient is experiencing chest pain and needs to take a buccal form of nitroglycerin. Where
does the nurse instruct the patient to place the tablet?
a. Under the tongue
b. On top of the tongue
c. At the back of the throat
d. In the space between the cheek and the gum
ANS: D
Drugs administered via the buccal route are placed in the space between the cheek and the
gum. Drugs administered via the sublingual route are placed under the tongue. The other
options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
10. The nurse is administering medications to the patient who is in renal failure resulting from
end-stage renal disease. The nurse is aware that patients with kidney failure would most likely
have problems with which pharmacokinetic phase?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
ANS: D
The kidneys are the organs that are most responsible for drug excretion. Renal function does
not affect the absorption and distribution of a drug. Renal function may affect metabolism of
drugs to a small extent.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Loading page 8...
11. A patient who has advanced cancer is receiving opioid medications around the clock to keep
him comfortable as he nears the end of his life. Which term best describes this type of
therapy?
a. Palliative therapy
b. Maintenance therapy
c. Empiric therapy
d. Supplemental therapy
ANS: A
The goal of palliative therapy is to make the patient as comfortable as possible. It is typically
used in the end stages of illnesses when all attempts at curative therapy have failed.
Maintenance therapy is used for the treatment of chronic illnesses such as hypertension.
Empiric therapy is based on clinical probabilities and involves drug administration when a
certain pathologic condition has an uncertain but high likelihood of occurrence based on the
patient‘s initial presenting symptoms. Supplemental therapy (or replacement therapy) supplies
the body with a substance needed to maintain normal function.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. The patient is stating that he has a headache and asks the nurse which over-the-counter
medication form would work the fastest to help reduce the pain. Which medication form will
the nurse suggest?
a. A capsule
b. A tablet
c. A powder
d. An enteric-coated tablet
ANS: C
Of the types of oral medications listed, the powder form would be absorbed the fastest, thus
having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be
absorbed next, in that order.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
13. The nurse will be injecting a drug into the superficial skin layers immediately underneath the
epidermal layer of skin. Which route does this describe?
a. Intradermal
b. Subcutaneous
c. Intramuscular
d. Transdermal
ANS: A
him comfortable as he nears the end of his life. Which term best describes this type of
therapy?
a. Palliative therapy
b. Maintenance therapy
c. Empiric therapy
d. Supplemental therapy
ANS: A
The goal of palliative therapy is to make the patient as comfortable as possible. It is typically
used in the end stages of illnesses when all attempts at curative therapy have failed.
Maintenance therapy is used for the treatment of chronic illnesses such as hypertension.
Empiric therapy is based on clinical probabilities and involves drug administration when a
certain pathologic condition has an uncertain but high likelihood of occurrence based on the
patient‘s initial presenting symptoms. Supplemental therapy (or replacement therapy) supplies
the body with a substance needed to maintain normal function.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. The patient is stating that he has a headache and asks the nurse which over-the-counter
medication form would work the fastest to help reduce the pain. Which medication form will
the nurse suggest?
a. A capsule
b. A tablet
c. A powder
d. An enteric-coated tablet
ANS: C
Of the types of oral medications listed, the powder form would be absorbed the fastest, thus
having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be
absorbed next, in that order.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
13. The nurse will be injecting a drug into the superficial skin layers immediately underneath the
epidermal layer of skin. Which route does this describe?
a. Intradermal
b. Subcutaneous
c. Intramuscular
d. Transdermal
ANS: A
Loading page 9...
Injections under the more superficial skin layers immediately underneath the epidermal layer
of skin and into the dermal layer are known as intradermal injections. Injections into the fatty
subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections.
Injections into the muscle beneath the subcutaneous fatty tissue are referred to as
intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
1. Which drugs would be affected by the first-pass effect when administered? (Select all that
apply.)
a. Morphine given by IV push injection
b. Sublingual nitroglycerin tablet
c. Diphenhydramine elixir
d. Levothyroxine (Synthroid) tablet
e. Transdermal nicotine patches
f. Esomeprazole capsule
g. Penicillin given by IV piggyback infusion
ANS: C, D, F
Orally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect, because
they are metabolized in the liver after being absorbed into the portal circulation from the small
intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do
not go directly to the liver. Sublingual tablets and transdermal patches also enter the
bloodstream without going directly to the liver, thus avoiding the first-pass effect.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
COMPLETION
1. A drug dose that delivers 10 mg has a half-life of 5 hours. Identify how much drug will
remain in the body after one half-life. _______
ANS:
5 mg
A drug‘s half-life is the time required for one half of an administered dose of a drug to be
eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%.
Therefore, one half of 10 mg equals 5 mg.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 03: Lifespan Considerations
Lilley: Pharmacology and the Nursing Process, 10th Edition
of skin and into the dermal layer are known as intradermal injections. Injections into the fatty
subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections.
Injections into the muscle beneath the subcutaneous fatty tissue are referred to as
intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
1. Which drugs would be affected by the first-pass effect when administered? (Select all that
apply.)
a. Morphine given by IV push injection
b. Sublingual nitroglycerin tablet
c. Diphenhydramine elixir
d. Levothyroxine (Synthroid) tablet
e. Transdermal nicotine patches
f. Esomeprazole capsule
g. Penicillin given by IV piggyback infusion
ANS: C, D, F
Orally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect, because
they are metabolized in the liver after being absorbed into the portal circulation from the small
intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do
not go directly to the liver. Sublingual tablets and transdermal patches also enter the
bloodstream without going directly to the liver, thus avoiding the first-pass effect.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
COMPLETION
1. A drug dose that delivers 10 mg has a half-life of 5 hours. Identify how much drug will
remain in the body after one half-life. _______
ANS:
5 mg
A drug‘s half-life is the time required for one half of an administered dose of a drug to be
eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%.
Therefore, one half of 10 mg equals 5 mg.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 03: Lifespan Considerations
Lilley: Pharmacology and the Nursing Process, 10th Edition
Loading page 10...
MULTIPLE CHOICE
1. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which
reason?
a. Decreased fetal surface area
b. Increased placental surface area
c. Enhanced blood flow to the fetus
d. Increased amount of protein-bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of
enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area,
not decreased, is a factor that affects drug transfer to the fetus. The placenta‘s surface area
does not increase during this time. Drug transfer is increased because of an increased amount
of free drug, not protein-bound drug, in the mother‘s circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed
gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk,
but the potential benefits may warrant the use of the medications in her situation. The nurse
recognizes that these medications are in which U.S. Food and Drug Administration pregnancy
safety category?
a. Category A
b. Category B
c. Category C
d. Category D
ANS: D
Pregnancy category D fits the description given. Category A indicates no risk to the human
fetus; Category B indicates no risk to animal fetus; information for humans is not available.
Category C indicates adverse effects reported in animal fetus; information for humans is not
available.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse
notes that which type of dosage calculation is used most commonly in pediatric calculations?
a. West nomogram
b. Clark rule
c. Height-to-weight ratio
d. Milligram per kilogram of body weight formula
ANS: D
The milligram per kilogram formula, based on body weight, is the most common method of
calculating doses for pediatric patients. Height-to-weight ratio is not used. The other options
are available methods but are not the most commonly used.
1. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which
reason?
a. Decreased fetal surface area
b. Increased placental surface area
c. Enhanced blood flow to the fetus
d. Increased amount of protein-bound drug in maternal circulation
ANS: C
Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of
enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area,
not decreased, is a factor that affects drug transfer to the fetus. The placenta‘s surface area
does not increase during this time. Drug transfer is increased because of an increased amount
of free drug, not protein-bound drug, in the mother‘s circulation.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed
gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk,
but the potential benefits may warrant the use of the medications in her situation. The nurse
recognizes that these medications are in which U.S. Food and Drug Administration pregnancy
safety category?
a. Category A
b. Category B
c. Category C
d. Category D
ANS: D
Pregnancy category D fits the description given. Category A indicates no risk to the human
fetus; Category B indicates no risk to animal fetus; information for humans is not available.
Category C indicates adverse effects reported in animal fetus; information for humans is not
available.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
3. When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse
notes that which type of dosage calculation is used most commonly in pediatric calculations?
a. West nomogram
b. Clark rule
c. Height-to-weight ratio
d. Milligram per kilogram of body weight formula
ANS: D
The milligram per kilogram formula, based on body weight, is the most common method of
calculating doses for pediatric patients. Height-to-weight ratio is not used. The other options
are available methods but are not the most commonly used.
Loading page 11...
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
4. The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is
experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
a. The patient is experiencing multiple illnesses.
b. The patient uses one medication for an illness several times per day.
c. The patient uses over-the-counter drugs for an illness.
d. The patient uses multiple medications simultaneously.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications for
each of them, possibly prescribed by different specialists who may be unaware of other
treatments the patient is undergoing. The other options are incorrect. Polypharmacy addresses
the medications taken, not just the illnesses. Polypharmacy means the patient is taking several
different medications, not just one, and can include prescription drugs, over-the-counter
medications, and herbal products.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common
responses in an elderly patient who is taking which type of drug?
a. Laxatives
b. Anticoagulants
c. Sedatives
d. Antidepressants
ANS: C
Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy,
forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and
antidepressants may cause adverse effects in the elderly, but not the ones specified in the
question.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
6. For accurate medication administration to pediatric patients, the nurse must consider which of
these factors?
a. Organ maturity
b. Renal output
c. Body temperature
d. Height
ANS: A
To administer medications to pediatric patients accurately, one must take into account organ
maturity, body surface area, age, and weight. The other options are incorrect; renal output and
body temperature are not considerations, and height alone is not sufficient.
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
4. The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is
experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
a. The patient is experiencing multiple illnesses.
b. The patient uses one medication for an illness several times per day.
c. The patient uses over-the-counter drugs for an illness.
d. The patient uses multiple medications simultaneously.
ANS: D
Polypharmacy usually occurs when a patient has several illnesses and takes medications for
each of them, possibly prescribed by different specialists who may be unaware of other
treatments the patient is undergoing. The other options are incorrect. Polypharmacy addresses
the medications taken, not just the illnesses. Polypharmacy means the patient is taking several
different medications, not just one, and can include prescription drugs, over-the-counter
medications, and herbal products.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common
responses in an elderly patient who is taking which type of drug?
a. Laxatives
b. Anticoagulants
c. Sedatives
d. Antidepressants
ANS: C
Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy,
forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and
antidepressants may cause adverse effects in the elderly, but not the ones specified in the
question.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
6. For accurate medication administration to pediatric patients, the nurse must consider which of
these factors?
a. Organ maturity
b. Renal output
c. Body temperature
d. Height
ANS: A
To administer medications to pediatric patients accurately, one must take into account organ
maturity, body surface area, age, and weight. The other options are incorrect; renal output and
body temperature are not considerations, and height alone is not sufficient.
Loading page 12...
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
7. The nurse recognizes that an elderly patient may experience a reduction in the stomach‘s
ability to produce hydrochloric acid. This change may result in which effect?
a. Delayed gastric emptying
b. Increased gastric acidity
c. Decreased gastrointestinal motility
d. Altered absorption of some drugs
ANS: D
Reduction in the stomach‘s ability to produce hydrochloric acid is an aging-related change
that results in a decrease in gastric acidity and may alter the absorption of some drugs. The
other options are not results of reduced hydrochloric acid production.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
8. The nurse is administering drugs to neonates and will consider which factor may contribute
the most to drug toxicity?
a. The lungs are immature.
b. The kidneys are small.
c. The liver is not fully developed.
d. Excretion of the drug occurs quickly.
ANS: C
A neonate‘s liver is not fully developed and cannot detoxify many drugs. The other options
are incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renal
excretion is slow, not fast, because of organ immaturity, but this is not the factor that
contributes the most to drug toxicity.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Planning dosage has been double-checked and updated
MSC: NCLEX: Health Promotion and Maintenance
9. An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her
caregiver should be told to watch for which problems?
a. Constipation and anorexia
b. Fatigue, leg cramps, and dehydration
c. Daytime sedation and lethargy
d. Edema, nausea, and blurred vision
ANS: B
Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when
thiazide diuretics are given to elderly patients. The other options do not describe
complications that occur when these drugs are given to the elderly.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
7. The nurse recognizes that an elderly patient may experience a reduction in the stomach‘s
ability to produce hydrochloric acid. This change may result in which effect?
a. Delayed gastric emptying
b. Increased gastric acidity
c. Decreased gastrointestinal motility
d. Altered absorption of some drugs
ANS: D
Reduction in the stomach‘s ability to produce hydrochloric acid is an aging-related change
that results in a decrease in gastric acidity and may alter the absorption of some drugs. The
other options are not results of reduced hydrochloric acid production.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
8. The nurse is administering drugs to neonates and will consider which factor may contribute
the most to drug toxicity?
a. The lungs are immature.
b. The kidneys are small.
c. The liver is not fully developed.
d. Excretion of the drug occurs quickly.
ANS: C
A neonate‘s liver is not fully developed and cannot detoxify many drugs. The other options
are incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renal
excretion is slow, not fast, because of organ immaturity, but this is not the factor that
contributes the most to drug toxicity.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Planning dosage has been double-checked and updated
MSC: NCLEX: Health Promotion and Maintenance
9. An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her
caregiver should be told to watch for which problems?
a. Constipation and anorexia
b. Fatigue, leg cramps, and dehydration
c. Daytime sedation and lethargy
d. Edema, nausea, and blurred vision
ANS: B
Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when
thiazide diuretics are given to elderly patients. The other options do not describe
complications that occur when these drugs are given to the elderly.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Loading page 13...
10. An elderly patient with a new diagnosis of hypertension will be receiving a new prescription
for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug
therapy?
a. Drug therapy will be based on the patient‘s weight.
b. Drug therapy will be based on the patient‘s age.
c. The patient will receive the maximum dose that is expected to reduce the blood
pressure.
d. The patient will receive the lowest possible dose at first, and then the dose will be
increased as needed.
ANS: D
As a general rule, dosing for elderly patients should follow the admonition, ―Start low, and go
slow,‖ which means to start with the lowest possible dose (often less than an average adult
dose) and increase the dose slowly, if needed, based on patient response. The other responses
are incorrect.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. The nurse is trying to give a liquid medication to a 2 1/2-year-old child and notes that the
medication has a strong taste. Which technique is the best way for the nurse to give the
medication to this child?
a. Give the medication with a spoonful of ice cream.
b. Add the medication to the child‘s bottle.
c. Tell the child you have candy for him.
d. Add the medication to a cup of milk.
ANS: A
Ice cream or another nonessential food disguises the taste of the medication. The other options
are incorrect. If the child does not drink the entire contents of the bottle, medication is wasted
and the full dose is not administered. Using the word candy with drugs may lead to the child
thinking that drugs are actually candy. If the medication is mixed with a cup of milk, the child
may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse
milk in the future.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age
appropriate for this child?
a. Give the injection without any advanced preparation.
b. Give the injection, and then explain the reason for the procedure afterward.
c. Offer a brief, concrete explanation of the procedure at the patient‘s level and with
the parent or caregiver present.
d. Prepare the child in advance with details about the procedure without the parent or
caregiver present.
ANS: C
for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug
therapy?
a. Drug therapy will be based on the patient‘s weight.
b. Drug therapy will be based on the patient‘s age.
c. The patient will receive the maximum dose that is expected to reduce the blood
pressure.
d. The patient will receive the lowest possible dose at first, and then the dose will be
increased as needed.
ANS: D
As a general rule, dosing for elderly patients should follow the admonition, ―Start low, and go
slow,‖ which means to start with the lowest possible dose (often less than an average adult
dose) and increase the dose slowly, if needed, based on patient response. The other responses
are incorrect.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. The nurse is trying to give a liquid medication to a 2 1/2-year-old child and notes that the
medication has a strong taste. Which technique is the best way for the nurse to give the
medication to this child?
a. Give the medication with a spoonful of ice cream.
b. Add the medication to the child‘s bottle.
c. Tell the child you have candy for him.
d. Add the medication to a cup of milk.
ANS: A
Ice cream or another nonessential food disguises the taste of the medication. The other options
are incorrect. If the child does not drink the entire contents of the bottle, medication is wasted
and the full dose is not administered. Using the word candy with drugs may lead to the child
thinking that drugs are actually candy. If the medication is mixed with a cup of milk, the child
may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse
milk in the future.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age
appropriate for this child?
a. Give the injection without any advanced preparation.
b. Give the injection, and then explain the reason for the procedure afterward.
c. Offer a brief, concrete explanation of the procedure at the patient‘s level and with
the parent or caregiver present.
d. Prepare the child in advance with details about the procedure without the parent or
caregiver present.
ANS: C
Loading page 14...
For a 4-year-old child, offering a brief, concrete explanation about a procedure just
beforehand, with the parent or caregiver present, is appropriate. The other options are
incorrect for any age group.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
MULTIPLE RESPONSE
1. Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that
apply.)
a. The levels of microsomal enzymes are decreased.
b. Perfusion to the kidneys may be decreased and may result in reduced renal
function.
c. First-pass elimination is increased because of higher portal circulation.
d. First-pass elimination is reduced because of the immaturity of the liver.
e. Total body water content is much less than in adults.
f. Gastric emptying is slowed because of slow or irregular peristalsis.
g. Gastric emptying is more rapid because of increased peristaltic activity.
ANS: A, B, D, F
In children, first-pass elimination by the liver is reduced because of the immaturity of the
liver, and microsomal enzymes are decreased. In addition, gastric emptying is reduced
because of slow or irregular peristalsis. Perfusion to the kidneys may be decreased, resulting
in reduced renal function. The other options are incorrect. In addition, remember that total
body water content is greater in children than in adults.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
2. Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)
a. The levels of microsomal enzymes are decreased.
b. Fat content is increased because of decreased lean body mass.
c. Fat content is decreased because of increased lean body mass.
d. The number of intact nephrons is increased.
e. The number of intact nephrons is decreased.
f. Gastric pH is less acidic.
g. Gastric pH is more acidic.
ANS: A, B, E, F
In the elderly, levels of microsomal enzymes are decreased because the aging liver is less able
to produce them; fat content is increased because of decreased lean body mass; the number of
intact nephrons is decreased as the result of aging; and gastric pH is less acidic because of a
gradual reduction of the production of hydrochloric acid. The other options are incorrect
statements.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
COMPLETION
beforehand, with the parent or caregiver present, is appropriate. The other options are
incorrect for any age group.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
MULTIPLE RESPONSE
1. Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that
apply.)
a. The levels of microsomal enzymes are decreased.
b. Perfusion to the kidneys may be decreased and may result in reduced renal
function.
c. First-pass elimination is increased because of higher portal circulation.
d. First-pass elimination is reduced because of the immaturity of the liver.
e. Total body water content is much less than in adults.
f. Gastric emptying is slowed because of slow or irregular peristalsis.
g. Gastric emptying is more rapid because of increased peristaltic activity.
ANS: A, B, D, F
In children, first-pass elimination by the liver is reduced because of the immaturity of the
liver, and microsomal enzymes are decreased. In addition, gastric emptying is reduced
because of slow or irregular peristalsis. Perfusion to the kidneys may be decreased, resulting
in reduced renal function. The other options are incorrect. In addition, remember that total
body water content is greater in children than in adults.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
2. Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)
a. The levels of microsomal enzymes are decreased.
b. Fat content is increased because of decreased lean body mass.
c. Fat content is decreased because of increased lean body mass.
d. The number of intact nephrons is increased.
e. The number of intact nephrons is decreased.
f. Gastric pH is less acidic.
g. Gastric pH is more acidic.
ANS: A, B, E, F
In the elderly, levels of microsomal enzymes are decreased because the aging liver is less able
to produce them; fat content is increased because of decreased lean body mass; the number of
intact nephrons is decreased as the result of aging; and gastric pH is less acidic because of a
gradual reduction of the production of hydrochloric acid. The other options are incorrect
statements.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
COMPLETION
Loading page 15...
1. A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses.
The child weighs 55 pounds. The medication, once reconstituted, is available as an oral
suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose.
_______
ANS:
25 mL per dose
Convert pounds to kilograms: 55 pounds = 25 kg. 25 kg 50 mg/kg/day = 1250 mg/day. To
get the amount per dose, divide 1250 by 2, which equals 625 mg/dose. To calculate the
milliliters: 125 mg:5 mL:: 625 mg:x mL. (125 x) = (5 625); 125x = 3125; x = 25 mL/dose.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 04: Cultural, Legal, and Ethical Considerations
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. During the development of a new drug, which would be included in the study by the
researcher to prevent any bias or unrealistic expectations of the new drug‘s usefulness?
a. A placebo
b. FDA approval
c. Informed consent
d. Safety information
ANS: A
To prevent bias that may occur as a result of unrealistic expectations of an investigational new
drug, a placebo is incorporated into the study. The other options are incorrect. FDA approval,
if given, does not occur until after phase III. Informed consent is required in all drug studies.
Safety information is not determined until the study is under way.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
2. A member of an investigational drug study team is working with healthy volunteers whose
participation will help to determine the optimal dosage range and pharmacokinetics of the
drug. The team member is participating in what type of study?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
ANS: A
Phase I studies involve small numbers of healthy volunteers to determine optimal dosage
range and the pharmacokinetics of the drug. The other phases progressively involve
volunteers who have the disease or ailment that the drug is designed to diagnose or treat.
The child weighs 55 pounds. The medication, once reconstituted, is available as an oral
suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose.
_______
ANS:
25 mL per dose
Convert pounds to kilograms: 55 pounds = 25 kg. 25 kg 50 mg/kg/day = 1250 mg/day. To
get the amount per dose, divide 1250 by 2, which equals 625 mg/dose. To calculate the
milliliters: 125 mg:5 mL:: 625 mg:x mL. (125 x) = (5 625); 125x = 3125; x = 25 mL/dose.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 04: Cultural, Legal, and Ethical Considerations
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. During the development of a new drug, which would be included in the study by the
researcher to prevent any bias or unrealistic expectations of the new drug‘s usefulness?
a. A placebo
b. FDA approval
c. Informed consent
d. Safety information
ANS: A
To prevent bias that may occur as a result of unrealistic expectations of an investigational new
drug, a placebo is incorporated into the study. The other options are incorrect. FDA approval,
if given, does not occur until after phase III. Informed consent is required in all drug studies.
Safety information is not determined until the study is under way.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
2. A member of an investigational drug study team is working with healthy volunteers whose
participation will help to determine the optimal dosage range and pharmacokinetics of the
drug. The team member is participating in what type of study?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV
ANS: A
Phase I studies involve small numbers of healthy volunteers to determine optimal dosage
range and the pharmacokinetics of the drug. The other phases progressively involve
volunteers who have the disease or ailment that the drug is designed to diagnose or treat.
Loading page 16...
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During discharge patient teaching, the nurse reviews prescriptions with a patient. Which
statement is correct about refills for an analgesic that is classified as Schedule C-III?
a. No prescription refills are permitted.
b. Refills are allowed only by written prescription.
c. The patient may have no more than five refills in a 6-month period.
d. Written prescriptions expire in 12 months.
ANS: C
Schedule C-III medications may be refilled no more than five times in a 6-month period. The
patient should be informed of this regulation. No prescription refills are permitted for
Schedule C-II drugs. Requiring refills by written prescription only applies to Schedule C-II
drugs. Schedule C-III prescriptions (written or oral) expire in 6 months.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient has been selected as a potential recipient of an experimental drug for multiple
sclerosis. The nurse knows that when informed consent has been obtained, it indicates which
of these?
a. The patient has been informed that he or she will need to stay in the study until it
ends.
b. The patient will be informed of the details of the study as the research continues.
c. The patient will receive the actual drug during the experiment.
d. The patient has had the study‘s purpose, procedures, and possible benefits as well
as risks involved explained to him.
ANS: D
Informed consent involves the careful explanation of the purpose of the study, the procedures
to be used, and the risks involved. The other options do not describe informed consent.
Participation in studies is voluntary and patients have the right to end participation at any
time.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. For which cultural group must the health care provider respect the value placed on preserving
harmony with nature and the belief that disease is a result of ill spirits?
a. Hispanics
b. Asian Americans
c. Native Americans
d. African Americans
ANS: C
Some Native Americans believe in preserving harmony with nature and that disease is a result
of ill spirits. The groups listed in the other options do not typically reflect these practices.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During discharge patient teaching, the nurse reviews prescriptions with a patient. Which
statement is correct about refills for an analgesic that is classified as Schedule C-III?
a. No prescription refills are permitted.
b. Refills are allowed only by written prescription.
c. The patient may have no more than five refills in a 6-month period.
d. Written prescriptions expire in 12 months.
ANS: C
Schedule C-III medications may be refilled no more than five times in a 6-month period. The
patient should be informed of this regulation. No prescription refills are permitted for
Schedule C-II drugs. Requiring refills by written prescription only applies to Schedule C-II
drugs. Schedule C-III prescriptions (written or oral) expire in 6 months.
DIF: Cognitive Level: Remembering (Knowledge)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient has been selected as a potential recipient of an experimental drug for multiple
sclerosis. The nurse knows that when informed consent has been obtained, it indicates which
of these?
a. The patient has been informed that he or she will need to stay in the study until it
ends.
b. The patient will be informed of the details of the study as the research continues.
c. The patient will receive the actual drug during the experiment.
d. The patient has had the study‘s purpose, procedures, and possible benefits as well
as risks involved explained to him.
ANS: D
Informed consent involves the careful explanation of the purpose of the study, the procedures
to be used, and the risks involved. The other options do not describe informed consent.
Participation in studies is voluntary and patients have the right to end participation at any
time.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. For which cultural group must the health care provider respect the value placed on preserving
harmony with nature and the belief that disease is a result of ill spirits?
a. Hispanics
b. Asian Americans
c. Native Americans
d. African Americans
ANS: C
Some Native Americans believe in preserving harmony with nature and that disease is a result
of ill spirits. The groups listed in the other options do not typically reflect these practices.
DIF: Cognitive Level: Remembering (Knowledge)
Loading page 17...
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
6. The nurse is assessing an elderly Hispanic woman who is being treated for hypertension.
During the assessment, what is important for the nurse to remember about cultural aspects?
a. The patient should be discouraged from using folk remedies and rituals.
b. The nurse will expect the patient to value protective bracelets and ―root doctors‖ as
healers.
c. The nurse will remember that the balance among body, mind, and environment is
important for this patient‘s health beliefs.
d. The nurse‘s assessment needs to include gathering information regarding religious
practices and beliefs regarding medication, treatment, and healing.
ANS: D
All beliefs need to be considered clearly so as to prevent a conflict from arising between the
goals of nursing and health care and the dictates of a patient‘s cultural background. Assessing
religious practices and beliefs is part of a thorough cultural assessment. The other options are
incorrect. The nurse should not ignore a patient‘s cultural practices. The concept of balance
among body, mind, and environment and the valuing of protective bracelets and root doctors
reflect beliefs or practices that usually do not apply to the Hispanic cultural group.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
7. When reviewing the various schedules of controlled drugs, the nurse knows that which
description correctly describes Schedule II drugs?
a. Drugs with high potential for abuse that have accepted medical use
b. Drugs with high potential for abuse that do not have accepted medical use
c. Medically accepted drugs that may cause moderate physical or psychologic
dependence
d. Medically accepted drugs with limited potential for causing physical or
psychologic dependence
ANS: A
Schedule II drugs are those with high potential for abuse but that have accepted medical use.
Drugs that have high potential for abuse but do not have accepted medical use are Schedule I
drugs. Medically accepted drugs that have moderate physical or high psychologic dependence
potential are Schedule III drugs. Medically accepted drugs with limited potential for causing
physical or psychologic dependence are Schedule IV and V drugs.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. The nurse is reviewing facts about pharmacology for a review course. The term legend drug
refers to which item?
a. Over-the-counter drugs
b. Prescription drugs
c. Orphan drugs
d. Older drugs
ANS: B
6. The nurse is assessing an elderly Hispanic woman who is being treated for hypertension.
During the assessment, what is important for the nurse to remember about cultural aspects?
a. The patient should be discouraged from using folk remedies and rituals.
b. The nurse will expect the patient to value protective bracelets and ―root doctors‖ as
healers.
c. The nurse will remember that the balance among body, mind, and environment is
important for this patient‘s health beliefs.
d. The nurse‘s assessment needs to include gathering information regarding religious
practices and beliefs regarding medication, treatment, and healing.
ANS: D
All beliefs need to be considered clearly so as to prevent a conflict from arising between the
goals of nursing and health care and the dictates of a patient‘s cultural background. Assessing
religious practices and beliefs is part of a thorough cultural assessment. The other options are
incorrect. The nurse should not ignore a patient‘s cultural practices. The concept of balance
among body, mind, and environment and the valuing of protective bracelets and root doctors
reflect beliefs or practices that usually do not apply to the Hispanic cultural group.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
7. When reviewing the various schedules of controlled drugs, the nurse knows that which
description correctly describes Schedule II drugs?
a. Drugs with high potential for abuse that have accepted medical use
b. Drugs with high potential for abuse that do not have accepted medical use
c. Medically accepted drugs that may cause moderate physical or psychologic
dependence
d. Medically accepted drugs with limited potential for causing physical or
psychologic dependence
ANS: A
Schedule II drugs are those with high potential for abuse but that have accepted medical use.
Drugs that have high potential for abuse but do not have accepted medical use are Schedule I
drugs. Medically accepted drugs that have moderate physical or high psychologic dependence
potential are Schedule III drugs. Medically accepted drugs with limited potential for causing
physical or psychologic dependence are Schedule IV and V drugs.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. The nurse is reviewing facts about pharmacology for a review course. The term legend drug
refers to which item?
a. Over-the-counter drugs
b. Prescription drugs
c. Orphan drugs
d. Older drugs
ANS: B
Loading page 18...
The term legend drug refers to prescription drugs, which were differentiated from
over-the-counter drugs by the 1951 Durham-Humphrey Amendment. Orphan drugs are drugs
that are developed for rare diseases. The other options are not examples of legend drugs.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. Nurses have the ethical responsibility of doing or actively promoting good. What is this
principle known as?
a. Justice
b. Veracity
c. Beneficence
d. Autonomy
ANS: C
Veracity is defined as the duty to tell the truth. Justice is the ethical principle of being fair or
equal in one‘s actions. Beneficence is the ethical principle of doing or actively promoting
good. Autonomy is self-determination, or the ability to make one‘s own decisions.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
10. A patient is undergoing major surgery and asks the nurse about a living will. He states, ―I
don‘t want anybody else making decisions for me. And I don‘t want to prolong my life.‖ The
patient is demonstrating which ethical term?
a. Autonomy
b. Beneficence
c. Justice
d. Veracity
ANS: A
Autonomy includes self-determination, or the ability to act on one‘s own, including making
one‘s own decisions about health care. Veracity is defined as the duty to tell the truth. Justice
is the ethical principle of being fair or equal in one‘s actions. Beneficence is the ethical
principle of doing or actively promoting good.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
11. The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on
the list. Which is a characteristic of Schedule C-I drugs?
a. No refills are permitted.
b. They may be obtained over-the-counter with a signature.
c. They are available only by written prescription.
d. They are used only with approved protocols.
ANS: D
Schedule C-I drugs are used only with approved protocols. Schedule C-II drugs are available
only by written prescription, and refills are not permitted. Being available over-the-counter
with a signature may be true of Schedule C-V drugs in certain states.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
over-the-counter drugs by the 1951 Durham-Humphrey Amendment. Orphan drugs are drugs
that are developed for rare diseases. The other options are not examples of legend drugs.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. Nurses have the ethical responsibility of doing or actively promoting good. What is this
principle known as?
a. Justice
b. Veracity
c. Beneficence
d. Autonomy
ANS: C
Veracity is defined as the duty to tell the truth. Justice is the ethical principle of being fair or
equal in one‘s actions. Beneficence is the ethical principle of doing or actively promoting
good. Autonomy is self-determination, or the ability to make one‘s own decisions.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
10. A patient is undergoing major surgery and asks the nurse about a living will. He states, ―I
don‘t want anybody else making decisions for me. And I don‘t want to prolong my life.‖ The
patient is demonstrating which ethical term?
a. Autonomy
b. Beneficence
c. Justice
d. Veracity
ANS: A
Autonomy includes self-determination, or the ability to act on one‘s own, including making
one‘s own decisions about health care. Veracity is defined as the duty to tell the truth. Justice
is the ethical principle of being fair or equal in one‘s actions. Beneficence is the ethical
principle of doing or actively promoting good.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
11. The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on
the list. Which is a characteristic of Schedule C-I drugs?
a. No refills are permitted.
b. They may be obtained over-the-counter with a signature.
c. They are available only by written prescription.
d. They are used only with approved protocols.
ANS: D
Schedule C-I drugs are used only with approved protocols. Schedule C-II drugs are available
only by written prescription, and refills are not permitted. Being available over-the-counter
with a signature may be true of Schedule C-V drugs in certain states.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General
Loading page 19...
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
12. During a busy night shift, a new nurse administered an unfamiliar medication without
checking it in a drug handbook. Later that day, the patient had a severe reaction because he
has renal problems, which was a contraindication to that drug. The nurse may be liable for
which of these?
a. Medical negligence
b. Nursing negligence
c. Nonmaleficence
d. Autonomy
ANS: B
Negligence is the failure to act in a reasonable and prudent manner or failure of the nurse to
give the care that a reasonably prudent (cautious) nurse would render or use under similar
circumstances. Nurses are expected to assess patients thoroughly before medications are
given, and to be familiar with medications they are administering (see Box 4-2). In this case,
nursing negligence applies to nurses, not medical negligence. Nonmaleficence is defined as
the duty to do no harm; autonomy is defined as the right to make one‘s own decisions, or
self-determination.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
MULTIPLE RESPONSE
1. The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drug
polymorphism? (Select all that apply.)
a. The number of drugs ordered by the physician
b. Inherited factors
c. The patient‘s diet and nutritional status
d. Different dosage forms of the same drug
e. The patient‘s cultural practices
f. The patient‘s drug history
g. The various available forms of a drug
ANS: B, C, E
Inherited factors, diet and nutritional status, and cultural practices are some of the factors that
contribute to drug polymorphism. The other options are not factors that contribute to drug
polymorphism.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is performing an admission assessment. Which findings reflect components of a
cultural assessment? (Select all that apply.)
a. The patient uses aspirin as needed for pain.
b. The patient has a history of hypertension.
c. The patient uses herbal tea to relax in the evenings.
d. The patient does not speak English.
12. During a busy night shift, a new nurse administered an unfamiliar medication without
checking it in a drug handbook. Later that day, the patient had a severe reaction because he
has renal problems, which was a contraindication to that drug. The nurse may be liable for
which of these?
a. Medical negligence
b. Nursing negligence
c. Nonmaleficence
d. Autonomy
ANS: B
Negligence is the failure to act in a reasonable and prudent manner or failure of the nurse to
give the care that a reasonably prudent (cautious) nurse would render or use under similar
circumstances. Nurses are expected to assess patients thoroughly before medications are
given, and to be familiar with medications they are administering (see Box 4-2). In this case,
nursing negligence applies to nurses, not medical negligence. Nonmaleficence is defined as
the duty to do no harm; autonomy is defined as the right to make one‘s own decisions, or
self-determination.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
MULTIPLE RESPONSE
1. The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drug
polymorphism? (Select all that apply.)
a. The number of drugs ordered by the physician
b. Inherited factors
c. The patient‘s diet and nutritional status
d. Different dosage forms of the same drug
e. The patient‘s cultural practices
f. The patient‘s drug history
g. The various available forms of a drug
ANS: B, C, E
Inherited factors, diet and nutritional status, and cultural practices are some of the factors that
contribute to drug polymorphism. The other options are not factors that contribute to drug
polymorphism.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is performing an admission assessment. Which findings reflect components of a
cultural assessment? (Select all that apply.)
a. The patient uses aspirin as needed for pain.
b. The patient has a history of hypertension.
c. The patient uses herbal tea to relax in the evenings.
d. The patient does not speak English.
Loading page 20...
e. The patient is allergic to shellfish.
f. The patient does not eat pork products because of religious beliefs.
ANS: A, C, D, F
The past use of medicines, use of herbal treatments, languages spoken, and religious practices
and beliefs are components of a cultural assessment. The other options reflect components of
a general medication assessment or health history.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
Chapter 05: Medication Errors: Preventing and Responding
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing medication errors. Which situation is an example of a medication
error?
a. A patient refuses her morning medications.
b. A patient receives a double dose of a medication because the nurse did not cut the
pill in half.
c. A patient develops hives after having started an IV antibiotic 24 hours earlier.
d. A patient complains of severe pain still present 60 minutes after a pain medication
was given.
ANS: B
A medication error is defined as a preventable adverse drug event that involves inappropriate
medication use by a patient or health care provider. The other options are not preventable. The
patient‘s refusing to take medications and complaining of pain after a medication is given are
patient behaviors, and the development of hives is a possible allergic reaction.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the
dose of the drug ordered?
a. Levothyroxine .75 mg
b. Levothyroxine .750 mg
c. Levothyroxine 0.75 mg
d. Levothyroxine 0.750 mg
ANS: C
Levothyroxine 0.75 mg illustrates the correct notation with a leading zero before the decimal
point. Omitting the leading zero may cause the order to be misread, resulting in a large drug
overdose. Levothyroxine .75 mg and Levothyroxine .750 mg do not have the leading zero
before the decimal point. Levothyroxine 0.750 mg has trailing zero, which also is incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
f. The patient does not eat pork products because of religious beliefs.
ANS: A, C, D, F
The past use of medicines, use of herbal treatments, languages spoken, and religious practices
and beliefs are components of a cultural assessment. The other options reflect components of
a general medication assessment or health history.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
Chapter 05: Medication Errors: Preventing and Responding
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing medication errors. Which situation is an example of a medication
error?
a. A patient refuses her morning medications.
b. A patient receives a double dose of a medication because the nurse did not cut the
pill in half.
c. A patient develops hives after having started an IV antibiotic 24 hours earlier.
d. A patient complains of severe pain still present 60 minutes after a pain medication
was given.
ANS: B
A medication error is defined as a preventable adverse drug event that involves inappropriate
medication use by a patient or health care provider. The other options are not preventable. The
patient‘s refusing to take medications and complaining of pain after a medication is given are
patient behaviors, and the development of hives is a possible allergic reaction.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the
dose of the drug ordered?
a. Levothyroxine .75 mg
b. Levothyroxine .750 mg
c. Levothyroxine 0.75 mg
d. Levothyroxine 0.750 mg
ANS: C
Levothyroxine 0.75 mg illustrates the correct notation with a leading zero before the decimal
point. Omitting the leading zero may cause the order to be misread, resulting in a large drug
overdose. Levothyroxine .75 mg and Levothyroxine .750 mg do not have the leading zero
before the decimal point. Levothyroxine 0.750 mg has trailing zero, which also is incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Loading page 21...
3. When given a scheduled morning medication, the patient states, ―I haven‘t seen that pill
before. Are you sure it‘s correct?‖ The nurse checks the medication administration record and
verifies that it is listed. Which is the nurse‘s best response?
a. ―It‘s listed here on the medication sheet, so you should take it.‖
b. ―Go ahead and take it, and then I‘ll check with your doctor about it.‖
c. ―It wouldn‘t be listed here if it were not ordered for you!‖
d. ―Let me check on the order first before you take it.‖
ANS: D
When giving medications, the nurse should always listen to and honor any concerns or doubts
expressed by the patient. If the patient doubts an order, the nurse should check the written
order and/or check with the prescriber. The other options illustrate that the nurse is not
listening to the patient‘s concerns.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. During a period of time when the computerized medication order system was down, the
prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having
difficulty transcribing one order because of the prescriber‘s handwriting. Which is the best
action for the nurse to take at this time?
a. Ask a colleague what the order says.
b. Contact the prescriber to clarify the order.
c. Wait until the prescriber makes rounds again to clarify the order.
d. Ask the patient what medications he takes at home.
ANS: B
If a prescriber writes an order that is illegible, the nurse should contact the prescriber for
clarification. Asking a colleague is not useful because the colleague did not write the order.
Waiting for the prescriber to return is incorrect because it would delay implementation of the
order. Asking the patient about medications is incorrect because this question will not clarify
the current order written by the prescriber.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. When taking a telephone order for a medication, which action by the nurse is most
appropriate?
a. Verify the order with the charge nurse.
b. Call back the prescriber to review the order.
c. Repeat the order to the prescriber before hanging up the telephone.
d. Ask the pharmacist to double-check the order.
ANS: C
For telephone or verbal orders, repeat the order back to the prescriber before hanging up the
telephone. The other options are incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
before. Are you sure it‘s correct?‖ The nurse checks the medication administration record and
verifies that it is listed. Which is the nurse‘s best response?
a. ―It‘s listed here on the medication sheet, so you should take it.‖
b. ―Go ahead and take it, and then I‘ll check with your doctor about it.‖
c. ―It wouldn‘t be listed here if it were not ordered for you!‖
d. ―Let me check on the order first before you take it.‖
ANS: D
When giving medications, the nurse should always listen to and honor any concerns or doubts
expressed by the patient. If the patient doubts an order, the nurse should check the written
order and/or check with the prescriber. The other options illustrate that the nurse is not
listening to the patient‘s concerns.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. During a period of time when the computerized medication order system was down, the
prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having
difficulty transcribing one order because of the prescriber‘s handwriting. Which is the best
action for the nurse to take at this time?
a. Ask a colleague what the order says.
b. Contact the prescriber to clarify the order.
c. Wait until the prescriber makes rounds again to clarify the order.
d. Ask the patient what medications he takes at home.
ANS: B
If a prescriber writes an order that is illegible, the nurse should contact the prescriber for
clarification. Asking a colleague is not useful because the colleague did not write the order.
Waiting for the prescriber to return is incorrect because it would delay implementation of the
order. Asking the patient about medications is incorrect because this question will not clarify
the current order written by the prescriber.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. When taking a telephone order for a medication, which action by the nurse is most
appropriate?
a. Verify the order with the charge nurse.
b. Call back the prescriber to review the order.
c. Repeat the order to the prescriber before hanging up the telephone.
d. Ask the pharmacist to double-check the order.
ANS: C
For telephone or verbal orders, repeat the order back to the prescriber before hanging up the
telephone. The other options are incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Loading page 22...
6. During morning medication administration, the nurse discovered an error on the electronic
MAR before the medication was given. Which action by the nurse is appropriate for this
―near-miss‖?
a. Correct the MAR error but say nothing because nothing happened.
b. Notify the pharmacy about the error they almost caused.
c. Report the near-miss using the facility‘s recommended protocol, and correct the
error on the MAR.
d. Report the near-miss to the next shift before the next dose is due.
ANS: C
If a ―near-miss‖ occurs, report using the health care facility‘s policies and procedures for
reporting, regardless of whether an error occurred. The other responses are not appropriate
actions.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. When reviewing pediatric medication administration, the nurse recognizes that which type of
medication error is most common with children?
a. Oral medication administration errors
b. Wrong route errors
c. Incorrect dosage form errors
d. Dosing errors
ANS: D
The most common medication errors in pediatrics are dosing errors. The other responses are
possible, but are not the most common medication errors in pediatrics.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
MULTIPLE RESPONSE
1. The nurse can prevent medication errors by following which principles? (Select all that
apply.)
a. Assess for allergies after giving medications.
b. Use two patient identifiers before giving medications.
c. Always following the rights of medication administration.
d. Minimize the use of verbal and telephone orders.
e. Use trade names instead of generic names to avoid confusion.
ANS: B, C, D
Measures that prevent medication errors include using two patient identifiers, minimizing the
use of verbal and telephone orders, and always following the rights of medication
administration. Assessment for allergies should be done before medications are given. Generic
names should be used to avoid the many sound-alike trade names of medications.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MAR before the medication was given. Which action by the nurse is appropriate for this
―near-miss‖?
a. Correct the MAR error but say nothing because nothing happened.
b. Notify the pharmacy about the error they almost caused.
c. Report the near-miss using the facility‘s recommended protocol, and correct the
error on the MAR.
d. Report the near-miss to the next shift before the next dose is due.
ANS: C
If a ―near-miss‖ occurs, report using the health care facility‘s policies and procedures for
reporting, regardless of whether an error occurred. The other responses are not appropriate
actions.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. When reviewing pediatric medication administration, the nurse recognizes that which type of
medication error is most common with children?
a. Oral medication administration errors
b. Wrong route errors
c. Incorrect dosage form errors
d. Dosing errors
ANS: D
The most common medication errors in pediatrics are dosing errors. The other responses are
possible, but are not the most common medication errors in pediatrics.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control
MULTIPLE RESPONSE
1. The nurse can prevent medication errors by following which principles? (Select all that
apply.)
a. Assess for allergies after giving medications.
b. Use two patient identifiers before giving medications.
c. Always following the rights of medication administration.
d. Minimize the use of verbal and telephone orders.
e. Use trade names instead of generic names to avoid confusion.
ANS: B, C, D
Measures that prevent medication errors include using two patient identifiers, minimizing the
use of verbal and telephone orders, and always following the rights of medication
administration. Assessment for allergies should be done before medications are given. Generic
names should be used to avoid the many sound-alike trade names of medications.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
Loading page 23...
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
COMPLETION
1. Levothyroxine is available in 88-mcg tablet form. Convert this dose to milligram strength. (do
not round)
ANS:
0.088 mg
One mg equals 1000 mcg. To convert 88 mcg to mg, divide 88 by 1000 to equal 0.088 mg, or
move the decimal point to the left three spaces. Do not forget to include the leading zero in
front of the decimal point.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. Digoxin is available in 0.25-mg tablet form. Convert this dose to microgram strength. (do not
round)
ANS:
250 mcg
One mg equals 1000 mcg. To convert 0.25 mg to mcg, multiply by 1000 to equal 250 mcg, or
move the decimal point to the right three spaces.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 06: Patient Education and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus
infection. Which of these outcomes reflect the affective domain of learning?
a. The patient will take the prescribed antibiotic for the full 14 days of the
prescription.
b. The patient will demonstrate correct nasal spray self-administration.
c. The patient will list signs and symptoms that need to be reported immediately if
they occur.
d. The patient will list measures to take to reduce allergy triggers at home.
ANS: A
COMPLETION
1. Levothyroxine is available in 88-mcg tablet form. Convert this dose to milligram strength. (do
not round)
ANS:
0.088 mg
One mg equals 1000 mcg. To convert 88 mcg to mg, divide 88 by 1000 to equal 0.088 mg, or
move the decimal point to the left three spaces. Do not forget to include the leading zero in
front of the decimal point.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. Digoxin is available in 0.25-mg tablet form. Convert this dose to microgram strength. (do not
round)
ANS:
250 mcg
One mg equals 1000 mcg. To convert 0.25 mg to mcg, multiply by 1000 to equal 250 mcg, or
move the decimal point to the right three spaces.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 06: Patient Education and Drug Therapy
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus
infection. Which of these outcomes reflect the affective domain of learning?
a. The patient will take the prescribed antibiotic for the full 14 days of the
prescription.
b. The patient will demonstrate correct nasal spray self-administration.
c. The patient will list signs and symptoms that need to be reported immediately if
they occur.
d. The patient will list measures to take to reduce allergy triggers at home.
ANS: A
Loading page 24...
The affective domain is the most intangible component of the learning process. Affective
behavior is conduct that expresses feelings, needs, beliefs, values, and opinions. Adhering to
the prescribed medication regimen is an example of the affective domain. Demonstrating
nasal spray self-administration reflects the psychomotor domain; listing signs and symptoms
or measures to take both reflect the cognitive domain.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is developing a care plan for a patient who will be self-administering a
metered-dose inhaler. Which statement reflects a measurable outcome?
a. The patient will know about self-administration of a metered-dose inhaler.
b. The patient will understand the principles of self-administration of a metered-dose
inhaler.
c. The patient will demonstrate the proper technique of self-administering a
metered-dose inhaler.
d. The patient will comprehend the proper technique of self-administering a
metered-dose inhaler.
ANS: C
The word demonstrate is a measurable verb, and measurable terms should be used when
developing goals and outcome criteria statements. The other options are incorrect because the
terms know, understand, and comprehend are not measurable terms.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
3. During a nursing assessment, which question by the nurse allows for greater clarification and
additional discussion with the patient?
a. ―Are you allergic to iodine?‖
b. ―What type of reaction did you have to penicillin?‖
c. ―Have you had a reaction to this drug?‖
behavior is conduct that expresses feelings, needs, beliefs, values, and opinions. Adhering to
the prescribed medication regimen is an example of the affective domain. Demonstrating
nasal spray self-administration reflects the psychomotor domain; listing signs and symptoms
or measures to take both reflect the cognitive domain.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is developing a care plan for a patient who will be self-administering a
metered-dose inhaler. Which statement reflects a measurable outcome?
a. The patient will know about self-administration of a metered-dose inhaler.
b. The patient will understand the principles of self-administration of a metered-dose
inhaler.
c. The patient will demonstrate the proper technique of self-administering a
metered-dose inhaler.
d. The patient will comprehend the proper technique of self-administering a
metered-dose inhaler.
ANS: C
The word demonstrate is a measurable verb, and measurable terms should be used when
developing goals and outcome criteria statements. The other options are incorrect because the
terms know, understand, and comprehend are not measurable terms.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
3. During a nursing assessment, which question by the nurse allows for greater clarification and
additional discussion with the patient?
a. ―Are you allergic to iodine?‖
b. ―What type of reaction did you have to penicillin?‖
c. ―Have you had a reaction to this drug?‖
Loading page 25...
d. ―Are you taking this medication with meals?‖
ANS: B
Asking ―What type of reaction did you have?‖ is an open-ended question that will encourage
greater clarification and additional discussion with the patient. The other options are examples
of closed-ended questions, which prompt only a ―yes‖ or ―no‖ answer and provide limited
information.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. The nurse is setting up a teaching session with an 85-year-old patient who will be going home
on anticoagulant therapy. Which educational strategy would reflect consideration of the
age-related changes that may exist with this patient?
a. Show a video about anticoagulation therapy.
b. Present all the information in one session just before discharge.
c. Give the patient pamphlets about the medications to read at home.
d. Develop large-print handouts that reflect the verbal information presented.
ANS: D
Developing large-print handouts addresses altered perception in two ways. First, by using
visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to
hear high-frequency sounds. By developing the handouts in large print, one addresses the
possibility of decreased visual acuity. Showing a video does not allow discussion of the
information; furthermore, the text and print may be small and difficult to read and understand.
Presenting all the information in one session before discharge also does not allow for
discussion, and the patient may not be able to hear or see the information sufficiently. Because
of the possibility of decreased short-term memory and slowed cognitive function, simply
giving pamphlets to read without other teaching strategies may not be appropriate.
ANS: B
Asking ―What type of reaction did you have?‖ is an open-ended question that will encourage
greater clarification and additional discussion with the patient. The other options are examples
of closed-ended questions, which prompt only a ―yes‖ or ―no‖ answer and provide limited
information.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. The nurse is setting up a teaching session with an 85-year-old patient who will be going home
on anticoagulant therapy. Which educational strategy would reflect consideration of the
age-related changes that may exist with this patient?
a. Show a video about anticoagulation therapy.
b. Present all the information in one session just before discharge.
c. Give the patient pamphlets about the medications to read at home.
d. Develop large-print handouts that reflect the verbal information presented.
ANS: D
Developing large-print handouts addresses altered perception in two ways. First, by using
visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to
hear high-frequency sounds. By developing the handouts in large print, one addresses the
possibility of decreased visual acuity. Showing a video does not allow discussion of the
information; furthermore, the text and print may be small and difficult to read and understand.
Presenting all the information in one session before discharge also does not allow for
discussion, and the patient may not be able to hear or see the information sufficiently. Because
of the possibility of decreased short-term memory and slowed cognitive function, simply
giving pamphlets to read without other teaching strategies may not be appropriate.
Loading page 26...
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
5. When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best
way to set up the teaching/learning session?
a. Provide written pamphlets for instruction.
b. Show a video, and allow the patient to practice as needed on his own.
c. Verbally explain the procedure, and provide written handouts for reinforcement.
d. After demonstrating the procedure, allow the patient to do several return
demonstrations.
ANS: D
Return demonstration allows the nurse to evaluate the patient‘s newly learned skills. The
techniques in the other options are incorrect because those suggestions do not allow for
evaluation of the patient‘s technique.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
6. A patient with a new prescription for a diuretic has just reviewed with the nurse how to
include more potassium in her diet. This reflects learning in which domain?
a. Cognitive
b. Affective
c. Physical
d. Psychomotor
ANS: A
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
5. When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best
way to set up the teaching/learning session?
a. Provide written pamphlets for instruction.
b. Show a video, and allow the patient to practice as needed on his own.
c. Verbally explain the procedure, and provide written handouts for reinforcement.
d. After demonstrating the procedure, allow the patient to do several return
demonstrations.
ANS: D
Return demonstration allows the nurse to evaluate the patient‘s newly learned skills. The
techniques in the other options are incorrect because those suggestions do not allow for
evaluation of the patient‘s technique.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
6. A patient with a new prescription for a diuretic has just reviewed with the nurse how to
include more potassium in her diet. This reflects learning in which domain?
a. Cognitive
b. Affective
c. Physical
d. Psychomotor
ANS: A
Loading page 27...
The cognitive domain refers to problem-solving abilities and may involve recall and
knowledge of facts. The affective domain refers to values and beliefs. The term physical does
not refer to one of the learning domains. The psychomotor domain involves behaviors such as
learning how to perform a procedure.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. During an admission assessment, the nurse discovers that the patient does not speak English.
Which is considered the ideal resource for translation?
a. A family member of the patient
b. A close family friend of the patient
c. A translator who does not know the patient
d. Prewritten note cards with both English and the patient‘s language
ANS: C
The nurse should communicate with the patient in the patient‘s native language if at all
possible. If the nurse is not able to speak the patient‘s native language, a translator should be
made available so as to prevent communication problems, minimize errors, and help boost the
patient‘s level of trust and understanding of the nurse. In practice, this translator may be
another nurse or health care professional, a nonprofessional member of the health care team,
or a layperson, family member, adult friend, or religious leader or associate. However, it is
best to avoid family members as translators, if possible, because of issues with bias,
misinterpretation, and potential confidentiality issues.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
8. A 60-year-old patient is on several new medications and expresses worry that she will forget
to take her pills. Which action by the nurse would be most helpful in this situation?
knowledge of facts. The affective domain refers to values and beliefs. The term physical does
not refer to one of the learning domains. The psychomotor domain involves behaviors such as
learning how to perform a procedure.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
7. During an admission assessment, the nurse discovers that the patient does not speak English.
Which is considered the ideal resource for translation?
a. A family member of the patient
b. A close family friend of the patient
c. A translator who does not know the patient
d. Prewritten note cards with both English and the patient‘s language
ANS: C
The nurse should communicate with the patient in the patient‘s native language if at all
possible. If the nurse is not able to speak the patient‘s native language, a translator should be
made available so as to prevent communication problems, minimize errors, and help boost the
patient‘s level of trust and understanding of the nurse. In practice, this translator may be
another nurse or health care professional, a nonprofessional member of the health care team,
or a layperson, family member, adult friend, or religious leader or associate. However, it is
best to avoid family members as translators, if possible, because of issues with bias,
misinterpretation, and potential confidentiality issues.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
8. A 60-year-old patient is on several new medications and expresses worry that she will forget
to take her pills. Which action by the nurse would be most helpful in this situation?
Loading page 28...
a. Teaching effective coping strategies
b. Asking the patient‘s prescriber to reduce the number of drugs prescribed
c. Assuring the patient that she will not forget once she is accustomed to the routine
d. Assisting the patient with obtaining and learning to use a calendar or pill container
ANS: D
Calendars, pill containers, or diaries may be helpful to patients who may forget to take
prescribed drugs as scheduled. The nurse must ensure that the patient knows how to use these
reminder tools. Teaching coping strategies is a helpful suggestion but will not help with
remembering to take medications. Asking the prescriber to reduce the number of drugs that
are prescribed is not an appropriate action by the nurse. Assuring the patient that she will not
forget is false reassurance by the nurse and inappropriate when education is needed.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
MULTIPLE RESPONSE
1. Which are appropriate considerations when the nurse is assessing the learning needs of a
patient? (Select all that apply.)
a. Cultural background
b. Family history
c. Level of education
d. Readiness to learn
e. Health beliefs
ANS: A, C, D, E
Family history is not a part of what the nurse considers when assessing learning needs. The
other options are appropriate to consider when the nurse is assessing learning needs.
b. Asking the patient‘s prescriber to reduce the number of drugs prescribed
c. Assuring the patient that she will not forget once she is accustomed to the routine
d. Assisting the patient with obtaining and learning to use a calendar or pill container
ANS: D
Calendars, pill containers, or diaries may be helpful to patients who may forget to take
prescribed drugs as scheduled. The nurse must ensure that the patient knows how to use these
reminder tools. Teaching coping strategies is a helpful suggestion but will not help with
remembering to take medications. Asking the prescriber to reduce the number of drugs that
are prescribed is not an appropriate action by the nurse. Assuring the patient that she will not
forget is false reassurance by the nurse and inappropriate when education is needed.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
MULTIPLE RESPONSE
1. Which are appropriate considerations when the nurse is assessing the learning needs of a
patient? (Select all that apply.)
a. Cultural background
b. Family history
c. Level of education
d. Readiness to learn
e. Health beliefs
ANS: A, C, D, E
Family history is not a part of what the nurse considers when assessing learning needs. The
other options are appropriate to consider when the nurse is assessing learning needs.
Loading page 29...
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is teaching an older patient about the use of an incentive spirometer after surgery.
Which of these age-related changes are appropriate for the nurse to consider when teaching
older patients? (Select all that apply.)
a. Decreased sense of touch
b. Increased conduction of sound
c. Decreased cognitive function
d. Decreased short-term memory
e. Increased ability to concentrate
ANS: A, C, D
Age-related changes in older adults that may affect learning include a decreased sense of
touch, decreased cognitive function, and decreased short-term memory. Sound conduction and
ability to concentrate are also decreased. Refer to Table 6-1.
DIF: Cognitive Level: Analyzing (Analysis)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
COMPLETION
1. A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mg
strength. Identify how many tablets will the patient receive. _______
ANS:
3 tablets
1 tablet:2.5 mg::x tablet:7.5 mg. (1 7.5) = (2.5 x); 7.5 = 2.5x; x = 3; therefore 7.5 mg = 3
tablets.
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. The nurse is teaching an older patient about the use of an incentive spirometer after surgery.
Which of these age-related changes are appropriate for the nurse to consider when teaching
older patients? (Select all that apply.)
a. Decreased sense of touch
b. Increased conduction of sound
c. Decreased cognitive function
d. Decreased short-term memory
e. Increased ability to concentrate
ANS: A, C, D
Age-related changes in older adults that may affect learning include a decreased sense of
touch, decreased cognitive function, and decreased short-term memory. Sound conduction and
ability to concentrate are also decreased. Refer to Table 6-1.
DIF: Cognitive Level: Analyzing (Analysis)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
COMPLETION
1. A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mg
strength. Identify how many tablets will the patient receive. _______
ANS:
3 tablets
1 tablet:2.5 mg::x tablet:7.5 mg. (1 7.5) = (2.5 x); 7.5 = 2.5x; x = 3; therefore 7.5 mg = 3
tablets.
Loading page 30...
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go
―natural‖ with her pregnancy. She shows the nurse a list of herbal remedies that she wants to
buy so that she can ―avoid taking any drugs.‖ Which statement by the nurse is correct?
a. ―Most herbal remedies are not harmful and are safe for use during pregnancy.‖
b. ―Please read each label carefully before use to check for cautionary warnings.‖
c. ―Keep in mind that products from different manufacturers are required to contain
consistent amounts of the herbal products.‖
d. ―It‘s important to remember that herbal remedies do not have proven safety ratings
for pregnant women.‖
ANS: D
The fact that a drug is an herbal or a dietary supplement does not mean that it can be safely
administered to children, infants, or pregnant or lactating women. Many herbal products have
not been tested for safety during pregnancy. Simply reading the labels may not provide
enough information for use during pregnancy. Last, manufacturers of herbal products are not
required to guarantee the reliability of the contents.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is giving a lecture about current U.S. laws and regulations of herbal products.
According to the United States Dietary Supplement and Health Education Act of 1994, which
statement is true?
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go
―natural‖ with her pregnancy. She shows the nurse a list of herbal remedies that she wants to
buy so that she can ―avoid taking any drugs.‖ Which statement by the nurse is correct?
a. ―Most herbal remedies are not harmful and are safe for use during pregnancy.‖
b. ―Please read each label carefully before use to check for cautionary warnings.‖
c. ―Keep in mind that products from different manufacturers are required to contain
consistent amounts of the herbal products.‖
d. ―It‘s important to remember that herbal remedies do not have proven safety ratings
for pregnant women.‖
ANS: D
The fact that a drug is an herbal or a dietary supplement does not mean that it can be safely
administered to children, infants, or pregnant or lactating women. Many herbal products have
not been tested for safety during pregnancy. Simply reading the labels may not provide
enough information for use during pregnancy. Last, manufacturers of herbal products are not
required to guarantee the reliability of the contents.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is giving a lecture about current U.S. laws and regulations of herbal products.
According to the United States Dietary Supplement and Health Education Act of 1994, which
statement is true?
Loading page 31...
30 more pages available. Scroll down to load them.
Preview Mode
Sign in to access the full document!
100%
Study Now!
XY-Copilot AI
Unlimited Access
Secure Payment
Instant Access
24/7 Support
AI Assistant
Document Details
Subject
Nursing