(Test Bank) Pharmacology For Nurses A Pathophysiologic Approach

Adams,Holland,Urban, 5

Nursing

Test Bank

5th Edition

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Test Bank for Pharmacology For Nurses A Pathophysiologic Approach, The downloadable file consists of 1344 pages, and the total size of the file is 10.92 MB. Purchase now only for highly discounted price.

Author(s): Adams, Holland, Urban

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Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and e ducation; physical comfort and emotional support; involvement of family and friends; and transition and community. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Pharmacology for Nurses A Pathophysiologic Approach 5th Edition Adams Test Bank Chapter 1 Question 1 Type: MCMA The nurse is teaching a pharmacology class to student nurses. What does the nurse include as key events in the history of pharmacology? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Initial drugs included morphine, cocaine, and penicillin. 2. Early researchers used themselves as test subjects. 3. The initial intention of pharmacology was to relieve human suffering. 4. Modern pharmacology began in the early 1600s. 5. Pharmacologists synthesized drugs in the laboratory in the twentieth century. Correct Answer: 2,3,5 Rationale 1: Initial drugs isolated from complex mixtures included morphine, colchicines, curare, and cocaine, but not penicillin. Rationale 2: Some early researchers, such as Friedrich Serturner, used themselves as test subjects. Rationale 3: The early roots of pharmacology included the application of products to relieve human suffering. Rationale 4: Modern pharmacology began in th e early 1800s, not the 1600s. Rationale 5: By the twentieth century, pharmacologists could synthesize drugs in the laboratory. Global Rationale: The early roots of pharmacology included the application of products to relieve human suffering, and early researchers used themselves as test subjects. Initial drugs included morphine, colchicines, curare, and cocaine, but not penicillin. Modern pharmacol ogy began in the early 1800s, not the 1600s. By the twentieth century, pharmacologists could synthesize drugs in the laboratory. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and e ducation; physical comfort and emotional support; involvement of family and friends; and transition and community. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-1 Identify key events in the history of pharmacology. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 3 Question 2 Type: MCSA The student nurse asks the nursing instructor why he needs to take anatomy and physiology, as well as microbiology, when he only wants to learn about pharmacology. What is the best response by the instructor? 1. "Because pharmacology is an outgrowth of those subjects." 2. "You must learn all, since those subjects, as well as pharmacology, are part of the curriculum." 3. "Knowledge of all those subjects will prepare you to provide the best patient care, including the administration of medications." 4. "Because an understanding of those subjects is essential to understanding pharmacology." Correct Answer: 4 Rationale 1 : Pharmacology is an outgrowth of anatomy, physiology, and microbiology, but this is not the most complete reason for the nurse to learn them. Rationale 2 : The nurse must learn anatomy, physiology, and microbiology to understand pharmacology, not because they are part of the curriculum. Rationale 3 : Knowledge of anatomy, physiology, and microbiology prepares the nurse to understand pharmacology, not to pro vide care such as administration of medications. Rationale 4 : It is essential for the nurse to have a broad knowledge base of many sciences in order to learn pharmacology. Global Rationale: It is essential for the nurse to have a broad knowledge base of many sciences in order to learn pharmacology. The nurse must learn anatomy, physiology, and microbiology to understand pharmacology, not because they are part of the curriculum. Pharmacology is an outgrowth of anatomy, physiology, and microbiology, but this is not the reason for the nurse to learn them. Knowledge of anatomy, physiology, and microbiology prepares the nurse to understand pharmacology, not to provide care such as administration of medications. Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvemen t of family and friends; and transition and community. Learning Outcom e: 1-2 Explain the interdisciplinary nature of pharmacology, giving an example of how knowledge from different sciences impacts the nurse’s role in drug administration. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 3 Question 3 Type: MCMA The nursing instructor is teaching a pharmacology class to student nurses. The current focus is pharmacology and therapeutics. The nursing instructor determines that learning has occurred when the students make which comments? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Pharmacology is the development of medicines." 2. "Pharmacology is the study of medicines." 3. "Therapeutics relates to drug use to treat suffering." 4. "Therapeutics is the study of drug interactions." 5. "Pharmacology is the study of drugs to prevent disease." Correct Answer: 2,3,5 Rationale 1: Pharmacology is not the development of medicines Rationale 2: Pharmacology is the study of medicines. Rationale 3: Therapeutics is the use of drugs in the treatment of suffering. Rationale 4: Therapeutics is not related to study of drug interactions. Rationale 5: Pharmacotherapy is the application of drugs for the purpose of disease prevention. Global Rationale: Pharmacology is the study of medicines and the use of drugs to relieve suffering. Therapeutics is the study of disease prevention and treatment of suffering. Pharmacotherapy is the application of drugs for the purpose of disease prevention. Cognitive Level: Applying AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 1-3 Compare and contrast therapeutics and pharmacology. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 4 Question 4 Type: MCSA The nurse administers a vaccine to a child. What is the best understanding of the nurse as it relates to the manufacture of this vaccine? 1. The vaccine is produced by natural plant extracts in the laboratory. 2. The vaccine is naturally produced in animal cells or microorganisms. 3. The vaccine is produced by a combination of animal and plant products. 4. The vaccine is most commonly synthesized in a laboratory. Correct Answer: 2 Rationale 1: Vaccines are not produced by natural plant extracts. Rationale 2: Vaccines are naturally produced in animal cells, microorganisms, or by the body itself. Rationale 3: Vaccines are not produced by a combination of animal and plant products. Rationale 4: Vaccines are not synthesized in a laboratory. Global Rationale: Vaccines are naturally produced in animal cells, microorganisms, or by the body itself. Vaccines are not synthesized in a laboratory. Vaccines are not produced by natural plant extracts. Vaccines are not produced by a combination of animal and plant products. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: IX.3 Implement holistic, patient -centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health -illness continuum, across lifespan, and in all healthcare settings. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 1-4 Compare and contrast traditional drugs, biologics, and complementary and alternative medicine therapies. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 4 Question 5 Type: MCSA The older adult client has gastrointestinal bleeding. The client says to the nurse, "I don't understand this. All I did was take ibuprofen (Advil) for my arthritis." Which plan would be best as it relates to the nurse's education of this client? 1. A plan to teach the client to use drugs that bypass the gastrointestinal system, like topical drugs 2. A plan to teach the client to substitute safer drugs like acetaminophen (Tylenol) 3. A plan to teach the client to obtain physician approval prior to the use of over-the-counter (OTC) medications 4. A plan to teach the advantages and disadvantages of ibuprofen (Advil) Correct Answer: 4 Rationale 1 : The use of topical drugs may be an option, but the drug a client needs may not be available in this form. Rationale 2: Substitution of other drugs may be beneficial, but this cannot be done in all situations. Rationale 3 : It is not a realistic plan to expect clients to contact their physician prior to taking any over -the- counter (OTC) medication. Rationale 4 : Since elderly clients account for the use of about 40% of all over -the-counter (OTC) medications, it is essential for the nurse to teach clients about the advantages, and the disadvantages, of these medications. Global Rationale: Since older adult clients account for the use of about 40% of all over -the-counter (OTC) medications, it is essential for the nurse to teach clients about the advantages, and the disadvantages, of these medications. Substitution of other drugs may be benef icial, but this cannot be done in all situations. The use of topical drugs may be an option, but the drug a client needs may not be available in this form. It is not a realistic plan to expect clients to contact their physician prior to taking any over-the-counter (OTC) medication. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: II.7 Promote factors that create a culture of safety and caring. NLN Competencies: Context and Environment: Health promotion/disease prevention. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1-9 Outline the major differences between prescription and over-the-counter drugs. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 6 Question 6 Type: MCSA The nursing instructor teaches the student nurses about the pharmacological classification of drugs. The instructor evaluates that learning has occurred when the students make which response? 1. "An anti-anginal treats angina." 2. "A calcium channel blocker blocks heart calcium channels." 3. "An antihypertensive lowers blood pressure." 4. "An anticoagulant influences blood clotting." Correct Answer: 2 Rationale 1 : To say that a drug treats angina addresses the therapeutic usefulness of the drug, not the pharmacological classification. Rationale 2: The pharmacological classification addresses a drug's mechanism of action, or how a drug produces its effect in the body. Rationale 3 : To say that a drug lowers blood pressure addresses the therapeutic usefulness of the drug, not the pharmacological classification. Rationale 4: To say that a drug influences blood clotting addresses the therapeutic useful ness of the drug, not the pharmacological classification. Global Rationale: The pharmacological classification addresses a drug's mechanism of action, or how a drug produces its effect in the body. To say that a drug influences blood clotting addresses th e therapeutic usefulness of the drug, not the pharmacological classification. To say that a drug treats angina addresses the therapeutic usefulness of the drug, not the pharmacological classification. To say that a drug lowers blood pressure addresses the therapeutic usefulness of the drug, not the pharmacological classification. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 1-5 Explain the basis for placing drugs into therapeutic and pharmacologic class. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 5 Question 7 Type: MCSA The nurse is providing medication education to a client with hypertension. The nurse teaches the client that the physician ordered a diuretic to decrease the amount of fluid in the client’s body. Which statement best describes the nurse's instruction? 1. The nurse provided appropriate medication education. 2. The nurse explained the drug's mechanism of action. 3. The nurse taught the client about a prototype drug. 4. The nurse explained the consequences of not using the drug. Correct Answer: 2 Rationale 1 : The education was most likely appropriate, but this response is too vague. Rationale 2 : A drug's mechanism of action explains how a drug produces its effect in the body. Rationale 3 : There is no drug name present, so it is not known whether this is a prototype drug. Rationale 4: The nurse did not explain the consequences of not using the drug. Global Rationale: A drug's mechanism of action explains how a drug produces its eff ect in the body. The nurse did not explain the consequences of not using the drug. There is no drug name present, so it is not known whether this is a prototype drug. The education was most likely appropriate, but this response is too vague. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 1-7 Describe what is meant by a drug’s mechanism of action. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 5 Question 8 Type: MCSA During pharmacology class, the student nurse asks the nursing instructor how students will ever learn about the individual antibiotic drugs since there are so many. What is the best response by the nursing instructor? 1. "You will learn a little trick called mnemonics." 2. "You will learn how to do a flow chart to enhance memory." 3. "You will learn how to categorize the individual drugs." 4. "You will learn a representative drug from each class." Correct Answer: 4 Rationale 1: Using mnemonics is not the best way to learn about drugs. Rationale 2: Flow charts are not the best way to learn about drugs. Rationale 3: Categorizing individual drugs is not the best way to learn about drugs. Rationale 4: A prototype, or representative, drug is the well-understood drug model from which other drugs in a pharmacological class are compared. Global Rationale: A prototype, or representative, drug is the well-understood drug model from which other drugs in a pharmacological class are compared. Categorizing individual drugs is not the best way to learn about drugs. Using mnemonics is not the best way to learn about drugs. Flow charts are not the best way to learn about drugs. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-6 Discuss the prototype approach to drug classification. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 5 Question 9 Type: MCSA The physician ordered a brand name drug for the client, paroxetine (Paxil). After taking this medication for a year, the client tells the nurse that it is no longer working. What is the best assessment of the nurse at this time? 1. "This sounds like your medication needs changing." 2. "Let's look for interactions with other medications you are taking." 3. "Are you taking Paxil or paroxetine?" 4. "It is time for us to do the Beck Depression assessment again." Correct Answer: 3 Rationale 1: Considering a change in medication is appropriate, but another assessment takes priority. Rationale 2: Assessing for interactions with other drugs is appropriate, but another assessment takes priority. Rationale 3 : The bioavailability of a generic drug may not be the same as the bioavailability of a brand name drug. Rationale 4: Assessing for worsening of depression is appropriate, but another assessment takes priority. Global Rationale: The bioavailability of a generic drug may not be the same as the bioavailability of a brand name drug. Assessing for worsening of depression is appropriate, but the nurse should first assess if the client has changed to a generic form of the drug. Assessing for interactions with other drugs is appropriate, but the nurse should first assess if the client has changed to a generic form of the drug. Considering a change in medication is appropriate, but the nurse should first assess if the client has changed to a generic form of the drug. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-10 Explain the differences between trade -name drugs and their generic equivalents. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 7 Question 10 Type: MCSA The student nurse has completed an initial pharmacology course and tells the nursing instructor that it was difficult and she is glad it is over. What is the best response by the nursing instructor? 1. "It may be over, but now you must apply what you have learned to patient care." 2. "Learning is gradual and continuous; we never completely master all areas of pharmacology." 3. "Learning is always painful, but we must continue anyway." 4. "It really isn't over; you should take a graduate course next." Correct Answer: 2 Rationale 1 : It is true that the student must apply what has been learned to patient care, but this response implies that learning is over. Rationale 2: Learning pharmacology is a gradual, continuous process that does not end with graduation. Rationale 3: Learning is not always painful. Rationale 4: There is no reason for the student nurse to take a graduate level pharmacology course at this time. Global Rationale: Learning pharmacology is a gradual, continuous process that does not end with graduation. Never does one completely master every facet of drug action and application. There is no reason for the student nurse to take a graduate level pharmacology course at this time. It is true that the student must apply what has been learned to patient care, but this response implies that learning is over. Learning is not always painful. Cognitive Level: Applying Clien t Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integ ration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and community. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-2 Explain the interdisciplinary nature of pharmacology, giving an example of how knowledge from different sciences impacts the nurse’s role in drug administration. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 4 Question 11 Type: MCSA The client says to the nurse, "My wife and I take the same drug, but we have different side effects. Are we doing something wrong?" What is the best response by the nurse? 1. "No. Differences such as your sex can result in different side effects." 2. "I'll have to check. What is the name of the drug you were using?" 3. "Possibly. This could happen if one uses generic or brand name drugs." 4. "I'm not sure. Maybe the drug is not the same; you should check it." Correct Answer: 1 Rationale 1 : Drugs may elicit different responses depending on individual client factors such as age, sex, body mass, health status, and genetics. Rationale 2: The nurse should not have to check the drug; basic knowledge should include knowing that the sex of clients can result in different side effects. Rationale 3: There are differences between some generic and brand name drugs, but this is not the best answer. Rationale 4: Asking the client to check a medication is fine, but this does not answer the client's question. Global Rationale: Drugs may elicit different responses depending on individual client factors such as age, sex, body mass, health status, and genetics. Asking the client to check a medication is fine, but this does not answer the client's question. There are differences between some generic and brand name drugs, but this is not the best answer. The nurse should not have to check the drug; basic knowledge should include knowing that the sex of clients can result in different side effects. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Comp etencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and community. AACN Essential Competencies: II.7 Promote factors that create a culture of safety and caring. NLN Competencies: Relationship Centered Care: Knowledge: Effective communication. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-2 Explain the interdisciplinary nature of pharmacology, giving an example of how knowledge from different sciences impacts the nurse’s role in drug administration. MNL Learni ng Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 4 Question 12 Type: MCSA The client comes to the emergency department with a myocardial infarction. The client's husband tells the nurse that his wife has been taking calcium carbonate (Tums) for years for what she thought was indigestion. What is the best response by the nurse? 1. "Your wife should not have self-diagnosed herself. I hope she will be okay." 2. "Why did you let her do that? She should have seen a doctor." 3. "Well, I am glad she is here, as it certainly wasn't indigestion." 4. "Your wife was self-diagnosing, which is generally not a good idea." Correct Answer: 4 Rationale 1 : Telling the husband "I hope she will be okay" is a very frightening response that implies she might die, and this is non -therapeutic. Rationale 2 : Asking the husband why he let his wife take Tums is non -therapeutic and too accusatory; do not ask "why" questions. Rationale 3 : Telling the husband that "it certainly wasn't indigestion" is judgmental and will alienate the client and husband. Rational e 4: Clients take over -the-counter (OTC) drugs for many reasons. Self -treatment is sometimes ineffective, and the potential for harm may increase if the disease is allowed to progress. Global Rationale: Clients take over -the-counter (OTC) drugs for many r easons. Self -treatment is sometimes ineffective, and the potential for harm may increase if the disease is allowed to progress. Asking the husband why he let his wife take Tums is non -therapeutic and too accusatory; do not ask "why" questions. Telling the husband that "it certainly wasn't indigestion" is judgmental and will alienate the client and husband. Telling the husband "I hope she will be okay" is a very frightening response that implies she might die, and this is non-therapeutic. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.C.1 Value seeing health care situations “through patient’s eyes.” AACN Essential Competencies: IX.4 Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network. NLN Competencies: Relationship Centered Care: Knowledge: Effective communication. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-9 Outline the major differences between prescription and over -the-counter drugs. MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction. Page Number: 6 Question 13 Type: MCSA The nurse is teaching a class for clients about over -the-counter (OTC) medications. The nurse determines that education has been effective when the clients make which statement? 1. "We should not take any over-the-counter (OTC) medicine without first calling and checking with the doctor's office." 2. "We should always ask the pharmacist about how to take the over-the-counter (OTC) medicine." 3. "We must read all the directions on the label and call the doctor's office if they are not clear." 4. "Medicines that are available over-the-counter (OTC) are really safe, or they would be prescription medicines." Correct Answer: 3 Rationale 1 : It is not realistic to expect clients to call the doctor's office befo re taking any over -the-counter (OTC) medicine. Rationale 2 : Asking the pharmacist is a good idea, but does not replace reading the label directions. Also, the pharmacist might not always be in the store when the medicine is purchased. Rationale 3: In most cases, clients may treat themselves safely if they carefu lly follow instructions included with the medication. Rationale 4: Most OTC medicines have a high margin of safety, but none is considered completely safe. Global Rationale: In most cases, clients may treat themselves safely if they carefully follow inst ructions included with the medication. It is not realistic to expect clients to call the doctor's office before taking any over -the- counter (OTC) medicine. Most OTC medicines have a high margin of safety, but none is considered completely safe. Asking the pharmacist is a good idea, but does not replace reading the label directions. Also, the pharmacist might not always be in the store when the medicine is purchased. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.4 Examine how the safety, quality, and cost effectiveness of health care can be improved through the active involvement of patients and families. AACN Essential Competencies: IX.7 Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. NLN Competencies: Quality and Safety: Commit to a generative safety culture. Nursing/Integrat ed Concepts: Nursing Process: Evaluation Learning Outcome: 1-9 Outline the major differences between prescription and over-the-counter drugs. MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction. Page Number: 6 Question 14 Type: MCSA The physician has prescribed a brand name drug for the client. The client tells the nurse that the medication is too expensive. What is the best plan by the nurse? 1. Help the client receive free medicine through a "patient assistance" program. 2. Ask the physician if a cheaper brand name drug may be substituted. 3. Ask the physician if a generic drug may be substituted. 4. Maintain the client on samples of the brand name drug from the physician's office. Correct Answer: 3 Rationale 1 : A patient assistance program is a good idea, but since the client may not qualify for this, it is not the best plan. Rationale 2: Another brand name drug may not be what the client needs for the illness. Rationale 3: Generic drugs are much less costly than brand name drugs. Rationale 4 : Providing samples is an option, but the office may temporarily run out of samples and the client will not receive the medication. Global Rationale: Generic drugs are much less costly than brand name drugs. A patient assistance program is a good idea, but since the client may not qualify for this, it is not the best plan. Another brand name drug may not be what the client needs for the illness. Providing samples is an option, but the office may temporarily run out of samples and the client will not receive the medication. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1-10 Explain the differences between trade -name drugs and their generic equivalents. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 7 Question 15 Type: MCSA The client is receiving a very expensive medication. The client asks the nurse why the medicine is so expensive. What is the best response by the nurse? 1. "It is expensive, but your insurance covers it and you have a low co-pay." 2. "Drug companies are allowed to advertise medications and this adds to the cost." 3. "Drug companies must recoup the cost of developing and producing the drug." 4. "I think the drug companies should be more accountable for lowering costs." Correct Answer: 3 Rationale 1: Telling the client that insurance covers the drug doesn't answer the client’s question. Rationale 2 : Advertising costs are expensive, but this answer implies the drug company is raising costs unnecessarily. Rationale 3 : If the cost of developing a new dr ug is not recouped by the drug company, there is no impetus for the company to continue drug development. Rationale 4 : It is non -therapeutic for the nurse to introduce her own beliefs, such as accountability of drug companies, into a conversation with the client. Global Rationale: Telling the client that insurance covers the drug doesn't answer the client’s question. It is non - therapeutic for the nurse to introduce her own beliefs, such as accountability of drug companies, into a conversation with the client. Cognitive Level: Appl ying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1-8 Distinguish among a drug’s chemical name, generic name, and trade name. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 6 Question 16 Type: MCSA Modern pharmacology was introduced to the United States by the opening of the first department of pharmacology at the University of Michigan in which year? 1. 1805 2. 1890 3. 1847 4. 1908 Correct Answer: 2 Rationale 1: This event occurred after 1805. Rationale 2 : John Jacob Abel, who is considered the father of American pharmacology owing to his many contributions to the field, founded the first pharmacology department in the United States at the University of Michigan in 1890. Rationale 3: This event did not occur in 1847. Rationale 4: This event occurred earlier than 1908. Global Rationale: John Jacob Abel, who is considered the father of American pharmacology owing to his many contributions to the field, founded the first pharmacology d epartment in the United States at the University of Michigan in 1890. Cognitive Level: Remembering Client Need: Health Promotion and Maintenance Client Need Sub: QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvemen t of family and friends; and transition and community. AACN Essential Competencies: I.7 Integrate the knowledge and methods of a variety of disciplines to inform decision making. NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-1 Identify key events in the history of pharmacology. MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology. Page Number: 3 Question 17 Type: MCSA The application of drugs for the purpose of treating diseases and treatment of suffering is known as 1. biologics. 2. pharmacotherapeutics. 3. alternative therapies. 4. therapeutics. Correct Answer: 2 Rationale 1: Biologics are agents naturally produced in animal cells, by microorganisms, or by the body itself. Rationale 2 : Pharmacotherapeutics is the application of drugs for the purpose of treating disease and the treatment of suffering. Rationale 3 : Alternative therapies include natural plant extracts, herbs, vitamins, minerals, dietary supplements, and additional techni ques outside the realm of conventional therapeutics. Rationale 4: Therapeutics is concerned with the prevention of disease and treatment of sufferings. Global Rationale: Pharmacotherapeutics is the application of drugs for the purpose of treating disease and the treatment of suffering.