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Chapter 4, The Nursing Process in Drug
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1.
An older adult client who lives independently has just been prescribed a drug that can cause sedation. What would be the priority nursing diagnosis for this client?
A)
Risk for vascular trauma
B)
Wandering
C)
Risk for injury
D)
Risk for suffocation
2.
The nurse is preparing to administer scheduled medications to a client in the community. What are responsibilities of the nurse related to the client's drug therapy? Select all that apply.
A)
Teaching the client how to participate in therapy to ensure best outcomes
B)
Providing therapeutic interventions that complement the medications
C)
Evaluating the effectiveness of the client's drug therapy
D)
Altering the drug regimen to optimize the client's outcomes
E)
Recommending appropriate over-the-counter medications as alternatives to prescription drug therapy
3.
The nurse is gathering assessment data from a client who is the sole caregiver for four children. What assessment information should the nurse prioritize when providing care for this client?
A)
The children's history of recreational drug use
B)
The name and location of the client's preferred pharmacy
C)
The client's level of social and financial support
D)
The last time the client was hospitalized
4.
The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is now preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action?
A)
Assessment
B)
Nursing diagnosis
C)
Interventions
D)
Evaluation
5.
Before administering a new medication, the nurse has consulted a drug guide to confirm the recommended dosage range. When interpreting this information, the nurse should consider what principle?
A)
Recommendations are based on clients of Caucasian ethnicity.
B)
Recommendations are made by the manufacturer based on the most likely recipient population.
C)
Recommendations are based on 68-kg adult male.
D)
Recommendations are based on a young adult male with good health.
6.
A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what should the nurse do?
A)
Compare the dose to the child's body surface area
B)
Cross-reference the dose with the child's height
C)
Calculate the safe dose range based on the child's weight
D)
Divide the median adult dosage by the child's age in months
7.
The nurse is evaluating the discharge teaching provided to a client concerning drug therapy. What statement from the client would indicate that teaching had been effective?
A)
?I have to take three pills each day and I can take them at the time that fits my schedule.?
B)
?I should take the white pill because the doctor wants me to take it.?
C)
?I'll add the names and dosages of these new drugs to my medication list in my wallet.?
D)
?I have prescriptions at different pharmacies. I shop around for the best price for each drug.?
8.
The nurse has consulted a drug guide to confirm the recommended dose range of a drug. The nurse should expect to see an adjusted dosage for what clients? Select all that apply.
A)
A 22-year-old female
B)
A 39-year-old male
C)
A 6-month-old infant
D)
A 2-day-old neonate
E)
A 79-year-old male
9.
The nurse is taking a medication history on a client. What action by the nurse best reduces the possibility of adverse interactions?
A)
Assess the client's ability to pay for medications
B)
Ask the client about the use of any complementary or alternative therapies
C)
Assess the client's nutritional status and preferred diet
D)
Perform a head-to-toe physical assessment
10.
The nurse is reviewing the client's medication orders and finds an order stating ?amoxicillin 250 mg every 8 hours.? What is the nurse's best action?
A)
Confirm the client's allergy status
B)
Ask the prescriber to confirm the route
C)
Assess the client for signs of infection
D)
Confirm with the prescriber whether a generic version is mandatory
11.
The home health nurse is caring for a 77-year-old client with congestive heart failure. What action should the nurse prioritize to develop the most effective plan of care related to medication administration?
A)
Inspect the client's living environment
B)
Clearly explain any required lifestyle changes
C)
Assess the client's level of social support
D)
Assess the integrity of the client's skin and mucous membranes
12.
The nurse has weighed a new client during the admission assessment. This action will best contribute to safe medication administration by:
A)
allowing the care team to prescribe the correct medication dosage.
B)
providing a baseline for any change in fluid balance.
C)
identifying nutritional deficiencies that may affect the drug regimen.
D)
confirming whether subcutaneous or intramuscular injections are more appropriate.
13.
A nurse is providing health education to a client in the community in an effort to prevent administration errors or adverse effects. What teaching points should the nurse provide? Select all that apply.
A)
?Feel free to ask questions if there's anything that's not clear to you.?
B)
?Unless you're told otherwise, store your medications in a warm humid place.?
C)
?Keep any adjustments to your medication doses to a minimum, even if you're not feeling well.?
D)
?Keep an updated list of your prescribed medications with you.?
E)
?Take all of your medications within 5 minutes of the time you're instructed.?
14.
A client's prescriber has suggested 10 mL of guaifenesin PO q4h as needed. What dose should the nurse recommend measured in teaspoons?
15.
The nurse is conducting the evaluation phase of the nursing process. The nurse should perform evaluation primarily based on what data?
A)
The absence of adverse medication effects
B)
The client's adherence to the drug regimen
C)
The client's knowledge of the drug regimen
D)
Whether the client is achieving health outcomes
16.
The nurse is conducting an admission assessment on a client. When collecting data related to medications, the nurse asks, ?What medications are you currently taking?? After collecting this information, what other questions should the nurse ask? Select all that apply.
A)
?Do you feel like you take enough medication, too much, or too little??
B)
?What over-the-counter (OTC) medications do you take??
C)
?Do you take any herbs, vitamins, or supplements??
D)
?Do you take medications safely when you take them??
E)
?Who prescribed these medications??
17.
The nurse in the intensive care unit is providing care for a client who was just admitted with multiple trauma. What action should the nurse prioritize with relation to drug therapy?
A)
Advocate for the lowest effective dose
B)
Assess the client's likelihood of adherence to treatment
C)
Educate the client and family about medications
D)
Monitor the client's response to treatment closely
18.
When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?
A)
Assess the client's nutritional and hydration status
B)
Weigh the client and measure the client's abdominal girth
C)
Review laboratory values indicative of kidney function
D)
Review the client's AST, ALT, bilirubin, and albumin levels
19.
A nurse is caring for an 84-year-old client. The nurse should plan care in the knowledge of what physiologic difference between this client and younger adult clients?
A)
Decreased blood volume
B)
Thickening of subcutaneous tissue
C)
Increased total body water
D)
Decreased urine output
20.
The nurse is caring for a client who takes several drugs. What client should the nurse monitor most closely for adverse medication effects?
A)
A 7-year-old child with type 2 diabetes
B)
A middle-aged man who is morbidly obese
C)
A 17-year-old female who takes oral contraceptives
D)
The newborn infant who has no known health problems
21.
Which client should the nurse assess most closely for swallowing difficulties prior to administering an oral medication?
A)
A client who is emotionally distraught after receiving a negative prognosis
B)
An older adult diagnosed with Parkinson's disease
C)
An older adult client who has an active lower gastrointestinal bleed
D)
A client who expressed a preference for alternative and complementary therapies
22.
A 7-year-old child has been admitted to the intensive care unit with internal bleeding following a motor vehicle accident. What should the nurse know about drug therapy in a client of this age and health status?
A)
Excretion will be accelerated.
B)
Therapeutic effects may be unattainable.
C)
Pharmacodynamics may be altered.
D)
Pharmacokinetics cannot be accurately predicted.
23.
After admitting a client to the unit, the nurse is organizing times to administer ordered medications. In addition to the prescriber's orders, what factor should the nurse prioritize?
A)
The client's comfort
B)
The client's ethnicity
C)
The client's gender
D)
The client's age
24.
The nurse is preparing to administer a medication to an older adult. The nurse should consider what factor that could affect therapeutic dosing in an older adult?
A)
Changes in the gastrointestinal (GI) system can reduce drug absorption.
B)
In older adults, drugs enter into circulation more quickly.
C)
In older adults, drugs are distributed to a smaller portion of the tissues.
D)
Drugs are likely to have decreased therapeutic effect.
25.
The nurse provides care in a setting where there is more contact between the client and the nurse than between the client and the physician. The nurse should anticipate what effect on drug therapy?
A)
The nurse may be better able to select medications to treat the client's condition.
B)
The nurse can provide a second opinion for the client about the physician's decisions.
C)
The nurse may be better able to gauge therapeutic success of drug therapy.
D)
The nurse can readily reduce drug dosage if the client's needs change.
26.
The nurse admits a client to the unit and learns the client has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
A)
Administer medications ordered immediately
B)
Maintain the client's confidentiality
C)
Call the admitting physician immediately
D)
Provide teaching about chronic renal failure
27.
In an effort to promote safety, the nurse is collecting baseline data prior to initiating a client's drug therapy. What domains should the nurse assess when collecting the client's baseline data? Select all that apply.
A)
Education level
B)
Allergies
C)
Current medication regimen
D)
Height and weight
E)
Name of insurer
28.
A client is admitted to the medical unit for the treatment of an abscess resulting from intravenous drug use. When planning this client's discharge education with regard to medication use, what nursing diagnosis is most likely?
A)
Unilateral neglect
B)
Ineffective self-health maintenance
C)
Risk for impaired liver function
D)
Deficient fluid volume
29.
The nurse's main rationale for applying the nursing process in medication therapy is to:
A)
provide opportunities for clients to express their preferences.
B)
ensure that care is safe and effective.
C)
provide a framework for documenting nursing actions.
D)
promote interprofessional collaboration.
30.
A client was prescribed a 10-day course of antibiotics for the treatment of sinusitis. The client experienced symptoms relief after 3 days and stopped taking the antibiotic at that time. What is a priority nursing diagnosis for this client?
A)
Deficient knowledge
B)
Noncompliance
C)
Risk for injury
D)
Acute confusion
31.
The nurse is reviewing the client's admission medication orders. What order should the nurse question?
A)
Digoxin .5 mg orally now?give one dose only
B)
Furosemide 20 mg IV every 4 hours times 3
C)
Gentamicin 80 mg IV to infuse over 1 hour every 12 hours
D)
Acetaminophen 650 mg PO every 6 hours as needed for pain
32.
The nursing instructor observes several nursing students administer medications to their assigned clients. What students are demonstrating safe practice? Select all that apply.
A)
The student checks the label on the medication against the administration record three times.
B)
The student enters the client's room and asks the client ?Are you Mr. Lopez??
C)
The student checks the drug's brand name and generic name before taking it to the client.
D)
The student documents the medication upon exiting the client's room.
E)
The student inspects the client's arm band prior to giving a medication.
33.
The nurse is caring for a client scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the client has an important medication due but it is supposed to be given orally. What is the nurse's best action?
A)
Give the medication with a small sip of water.
B)
Give the medication via a different route.
C)
Hold the medication and put a note on the front of the chart for the surgeon.
D)
Call the ordering health care provider and clarify administration.
34.
The nurse admits an older adult client to the emergency room with reports of shortness of breath on exertion and a productive cough. The nurse reviews the client's current medications and the client says, ?I take one pink pill every morning.? The nurse asks the name and purpose of the drug and the client says she doesn't know. What is an appropriate nursing diagnosis for this client?
A)
Acute confusion
B)
Risk-prone health behavior
C)
Ineffective health maintenance
D)
Noncompliance
35.
The nurse is performing the intervention stage of the nursing process related to drug therapy? What actions should the nurse perform? Select all that apply.
A)
Administer the medication.
B)
Determine medication effectiveness.
C)
Document the medication.
D)
Analyze the data collected.
E)
Collect a nursing history.
Answer Key
1.
C
2.
A, B, C
3.
C
4.
D
5.
C
6.
A
7.
C
8.
C, D, E
9.
B
10.
B
11.
B
12.
A
13.
A, D
14.
2 teaspoons
15.
D
16.
B, C
17.
D
18.
C
19.
A
20.
D
21.
B
22.
C
23.
A
24.
A
25.
C
26.
C
27.
A, B, C, D
28.
B
29.
B
30.
B
31.
A
32.
A, C, D, E
33.
D
34.
C
35.
A, C
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