(Test Bank) Pharmacology Success NCLEX-Style Q&A Review by Kathryn Cadenced Colgrove, Christi Doherty

Colgrove,Doherty, 1

Pharmacology

Test Bank

1st Edition

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Test Bank for Pharmacology Success NCLEX-Style Q&A Review by Kathryn Cadenced Colgrove, Christi Doherty, The downloadable file consists of 513 pages, and the total size of the file is 4.47 MB. Purchase now only for highly discounted price.

Author(s): Colgrove, Doherty

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Colgrove Doherty Pharmacology THIRD EDITION NCLEX~Style Q&A Review Pharmacology Success NCLEX®-Style Q&A Review THIRD EDITION Kathryn Cadenhead Colgrove, RN, MS, CNS Christi Doherty, DNP, MSN, RNC-OB, CNE 6924_FM_i-xii.indd i6924_FM_i-xii.indd i 7/11/18 5:41 PM7/11/18 5:41 PMF .A. Davis Company 1915 Arch StreetPhiladelphia, PA 19103www.fadavis.com Copyright © 2019 by F .A. Davis Company All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Acquisitions Editor: Jacalyn Sharp Senior Content Project Manager: Julia L. CurcioElectronic Project Editor: Sandra A. GlennieDesign and Illustrations Manager: Carolyn O’Brien As new scientifi c information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not respon-sible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and con-traindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. ISBN: 978-0-8036-6924-6 Authorization to photocopy items for internal or personal use, or the internal or personal use of specifi c clients, is granted by F .A. Davis Company for users registered with the Copyright Clearance Center (CCC) T ransactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organi-zations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the T ransactional Reporting Service is: 978-0-8036-6924-6/19 0 + $.25. 6924_FM_i-xii.indd ii6924_FM_i-xii.indd ii 7/11/18 5:41 PM7/11/18 5:41 PMThank you to all the nursing students, nursing faculty, and nursing colleagues we have had the privilege to work with during our careers. We would like to recognize Ray Ann Hargrove-Huttel, PhD, RN, the author of this and other Success series books for her contributions to all of the books. Dr. Huttel lost her battle to cancer December 23, 2012. I would like to dedicate this book to the memory of my mother, Mary Cadenhead, and grandmother, Elsie Rogers. They always told me I could accomplish anything I wanted to accomplish. I would also like to dedicate this book to my husband, Larry; children, Laurie and T odd and Larry Jr. and Mai; and grandchildren, Chris and Melissa, Ashley and Martin, Justin C., Justin A., Connor, Sawyer, and Carson. Without their support and patience, this book would not have been possible. —Kathryn Cadenhead Colgrove This book is dedicated to my mother, Ellen Shomette, who showed me that hard work and perseverance can make dreams come true; to my mother-in-law, Clara June Doherty, RN, who lived her life with such kindness and generosity, an inspiration for self-improvement every day; and to my husband and best friend, Kevin Doherty, thank you for all the support and encouragement in all my endeavors. You make everything worthwhile. —Christi Doherty 6924_FM_i-xii.indd iii6924_FM_i-xii.indd iii 7/11/18 5:41 PM7/11/18 5:41 PMBE PREPARED FOR SUCCESS SAVE 20% + FREE SHIPPING Order today online at www.FADavis.comUse Promo Code: REVIEW20 Promotion sub ject to chan ge without notice. Valid for purchases from www.FADavis.com by individuals in the U.S. only.“The most essential facts you will ever need from a trusted series.” —Amazon student reviewerDon’t have time to read your textbook? Try the Essential Nursing Content + Practice Questions series Content Review | Case Studies | NCLEX®-Prep 6924_FM_i-xii.indd iv6924_FM_i-xii.indd iv 7/11/18 5:41 PM7/11/18 5:41 PMvBeth Batturs Martin, RN, MSN Director of Nursing and Healthcare Initiatives Anne Arundel Community CollegeArnold, Maryland Susan Fowler, MS(N), MHS, RN Lead Nursing InstructorT ri-County Community CollegeMurphy, North Carolina Reviewers 6924_FM_i-xii.indd v6924_FM_i-xii.indd v 7/11/18 5:41 PM7/11/18 5:41 PM6924_FM_i-xii.indd vi6924_FM_i-xii.indd vi 7/11/18 5:41 PM7/11/18 5:41 PMvii1 Basic Concepts in Medication Administration . . . . . . . . . . . .1 PHARMACOLOGY TEST-TAKING HINTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 POPULATION-SPECIFIC INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Pediatric Clients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Elderly Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Females of Childbearing Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 IMPORTANT DATA TO REMEMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Medication Memory Jogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 Neurological System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 QUESTIONS 7 A Client With a Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7A Client W ith Seizures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 A Client With a Cerebrovascular Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . 10A Client With a Brain Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11A Client With Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13A Client With Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14A Client With a Migraine Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 ANSWERS AND RATIONALES 18 A Client With a Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18A Client W ith Seizures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 A Client With a Cerebrovascular Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . 21A Client With a Brain Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23A Client With Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25A Client With Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27A Client With a Migraine Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 NEUROLOGICAL SYSTEM COMPREHENSIVE EXAMINATION 31NEUROLOGICAL SYSTEM COMPREHENSIVE EXAMINA TION ANSWERS AND RATIONALES 35 3 Cardiovascular System. . . . . . . . . . . . . . . . . . . . . . . . . . . .39 QUESTIONS 39 A Client With Angina/Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . 39A Client W ith Coronary Artery Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 A Client With Congestive Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42A Client With Dysrhythmias and Conduction Problems . . . . . . . . . . . . . . . . . . 44A Client With Infl ammatory Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . 47A Client With Arterial Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48A Client With Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49A Client With Deep Vein Thrombosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51A Client With Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 ANSWERS AND RATIONALES 55 A Client With Angina/Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . 55A Client W ith Coronary Artery Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 A Client With Congestive Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58A Client With Dysrhythmias and Conduction Problems . . . . . . . . . . . . . . . . . . 60A Client With Infl ammatory Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . 62Table of Contents 6924_FM_i-xii.indd vii6924_FM_i-xii.indd vii 7/11/18 5:41 PM7/11/18 5:41 PMviii T ABLE OF CONTENTS A Client With Arterial Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 A Client With Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65A Client With Deep Vein Thrombosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67A Client With Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 CARDIOVASCULAR SYSTEM COMPREHENSIVE EXAMINATION 72CARDIOV ASCULAR SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 76 4 Pulmonary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 QUESTIONS 81 A Client With an Upper Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . 81A Client W ith a Lower Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . . 82 A Client With Reactive Airway Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84A Child With Reactive Airway Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85A Client With a Pulmonary Embolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 ANSWERS AND RATIONALES 89 A Client With an Upper Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . 89A Client W ith a Lower Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . . 90 A Client With Reactive Airway Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92A Child With Reactive Airway Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94A Client With a Pulmonary Embolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 PULMONARY SYSTEM COMPREHENSIVE EXAMINATION 99PULMONAR Y SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 102 5 Gastrointestinal System . . . . . . . . . . . . . . . . . . . . . . . . . .107 QUESTIONS 107 A Client With Gastroesophageal Refl ux . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 A Client With Infl ammatory Bowel Disease (IBD) . . . . . . . . . . . . . . . . . . . . . 108A Client With Peptic Ulcer Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109An Elderly Client With Diverticulosis/Diverticulitis . . . . . . . . . . . . . . . . . . . . 111A Client With Liver Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112A Client With Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113A Child With Gastroenteritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115A Client With Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116A Client Experiencing Constipation or Diarrhea . . . . . . . . . . . . . . . . . . . . . . 117A Client Undergoing Abdominal Surgery With General Anesthesia . . . . . . . . . 118A Client Receiving Total Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . 120A Client Experiencing Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 ANSWERS AND RATIONALES 124 A Client With Gastroesophageal Refl ux . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 A Client With Infl ammatory Bowel Disease (IBD) . . . . . . . . . . . . . . . . . . . . . 125A Client With Peptic Ulcer Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127An Elderly Client With Diverticulosis/Diverticulitis . . . . . . . . . . . . . . . . . . . . 129A Client With Liver Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131A Client With Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133A Child With Gastroenteritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135A Client With Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137A Client Experiencing Constipation or Diarrhea . . . . . . . . . . . . . . . . . . . . . . 138A Client Undergoing Abdominal Surgery With General Anesthesia . . . . . . . . . 140A Client Receiving Total Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . 142A Client Experiencing Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 GASTROINTESTINAL SYSTEM COMPREHENSIVE EXAMINATION 146GASTROINTESTINAL SYSTEM COMPREHENSIVE EXAMINA TION ANSWERS AND RATIONALES 151 6924_FM_i-xii.indd viii6924_FM_i-xii.indd viii 7/11/18 5:41 PM7/11/18 5:41 PM TABLE OF CONTENTS ix 6 Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157 QUESTIONS 157 A Client With Type 1 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 A Client With Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 A Client With Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160A Client With Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161A Client With Pituitary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163A Client With Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 ANSWERS AND RATIONALES 166 A Client With Type 1 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 A Client With Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168A Client With Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170A Client With Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172A Client With Pituitary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174A Client With Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 ENDOCRINE SYSTEM COMPREHENSIVE EXAMINATION 179ENDOCRINE SYSTEM COMPREHENSIVE EXAMINA TION ANSWERS AND RATIONALES 183 7 Genitourinary System . . . . . . . . . . . . . . . . . . . . . . . . . . .187 QUESTIONS 187 A Client With Chronic Kidney Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187A Client W ith a Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 A Client With Benign Prostatic Hypertrophy. . . . . . . . . . . . . . . . . . . . . . . . . 190A Client With Renal Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191An Adolescent With a Sexually Transmitted Infection . . . . . . . . . . . . . . . . . . 192 ANSWERS AND RATIONALES 194 A Client With Chronic Kidney Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194A Client W ith a Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 A Client With Benign Prostatic Hypertrophy. . . . . . . . . . . . . . . . . . . . . . . . . 197A Client With Renal Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199An Adolescent With a Sexually Transmitted Infection . . . . . . . . . . . . . . . . . . 200 GENITOURINARY SYSTEM COMPREHENSIVE EXAMINATION 203GENITOURINAR Y SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 206 8 Reproductive System. . . . . . . . . . . . . . . . . . . . . . . . . . . .209 QUESTIONS 209 A Client Experiencing Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209The Newborn Client T ransitioning to Extrauterine Life . . . . . . . . . . . . . . . . . 214 A Client Experiencing Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215A Client Using Birth Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216A Client Experiencing Reproductive Hormone Changes. . . . . . . . . . . . . . . . . 217 ANSWERS AND RATIONALES 219 A Client Experiencing Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219The Newborn Client T ransitioning to Extrauterine Life . . . . . . . . . . . . . . . . . 223 A Client Experiencing Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224A Client Using Birth Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225A Client Experiencing Reproductive Hormone Changes. . . . . . . . . . . . . . . . . 227 REPRODUCTIVE SYSTEM COMPREHENSIVE EXAMINATION 228REPRODUCTIVE SYSTEM COMPREHENSIVE EXAMINA TION ANSWERS AND RATIONALES 231 9 Musculoskeletal System. . . . . . . . . . . . . . . . . . . . . . . . . .235 QUESTIONS 235 A Client With Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235A Client W ith Renal Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 6924_FM_i-xii.indd ix6924_FM_i-xii.indd ix 7/11/18 5:41 PM7/11/18 5:41 PMx T ABLE OF CONTENTS A Client With Renal Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 A Client Undergoing Orthopedic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 ANSWERS AND RATIONALES 241 A Client With Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241A Client W ith Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242 A Client With Osteoporosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245A Client Undergoing Orthopedic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 MUSCULOSKELETAL SYSTEM COMPREHENSIVE EXAMINATION 250MUSCULOSKELET AL SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 254 10 Integumentary System. . . . . . . . . . . . . . . . . . . . . . . . . . .259 QUESTIONS 259 A Client With Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259A Client W ith Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 A Client With a Skin Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262 ANSWERS AND RATIONALES 264 A Client With Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264A Client W ith Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 A Client With a Skin Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 INTEGUMENTARY SYSTEM COMPREHENSIVE EXAMINATION 269INTEGUMENT ARY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 272 11 Immune Infl ammatory System . . . . . . . . . . . . . . . . . . . . .277 QUESTIONS 277 A Client With an Autoimmune Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277A Client W ith HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 A Client With Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280A Client With Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281A Child Receiving Immunizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 ANSWERS AND RATIONALES 285 A Client With an Autoimmune Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285A Client W ith HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 A Client With Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288A Client With Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290A Child Receiving Immunizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 IMMUNE INFLAMMATORY SYSTEM COMPREHENSIVE EXAMINATION 294IMMUNE INFLAMMA TORY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 297 12 Cancer Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 QUESTIONS 301 A Client Receiving Chemotherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301A Client Receiving a Biologic Response Modifi er . . . . . . . . . . . . . . . . . . . . . 304 A Client Receiving Hormone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305A Client Receiving an Investigational Protocol . . . . . . . . . . . . . . . . . . . . . . . 306A Client Undergoing Surgery for Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 308A Client With Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 ANSWERS AND RATIONALES 312 A Client Receiving Chemotherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312A Client Receiving a Biologic Response Modifi er . . . . . . . . . . . . . . . . . . . . . 313 A Client Receiving Hormone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316A Client Receiving an Investigational Protocol . . . . . . . . . . . . . . . . . . . . . . . 317A Client Undergoing Surgery for Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 319A Client With Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321 CANCER TREATMENTS COMPREHENSIVE EXAMINATION 323CANCER TREA TMENTS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 328 6924_FM_i-xii.indd x6924_FM_i-xii.indd x 7/11/18 5:41 PM7/11/18 5:41 PM TABLE OF CONTENTS xi 13 Mental Health Disorders . . . . . . . . . . . . . . . . . . . . . . . . .333 QUESTIONS 333 A Client With a Major Depressive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . 333 A Client W ith Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334 A Client With Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336A Client With an Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337A Child With Attention Defi cit-Hyperactivity Disorder . . . . . . . . . . . . . . . . . . 339A Client With a Sleep Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340A Client With Substance Abuse Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 ANSWERS AND RATIONALES 344 A Client With a Major Depressive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . 344A Client W ith Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346 A Client With Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348A Client With an Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350A Child With Attention Defi cit-Hyperactivity Disorder . . . . . . . . . . . . . . . . . . 352A Client With a Sleep Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353A Client With Substance Abuse Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355 MENTAL HEALTH DISORDERS COMPREHENSIVE EXAMINATION 358MENT AL HEALTH DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 362 14 Sensory Defi cits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367 QUESTIONS 367 A Client With an Eye Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367A Child W ith an Ear Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 ANSWERS AND RATIONALES 371 A Client With an Eye Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371A Child W ith an Ear Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372 SENSORY DEFICITS COMPREHENSIVE EXAMINATION 375SENSOR Y DEFICITS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 378 15 Emergency Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . .381 QUESTIONS 381 A Client Experiencing Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381A Community Facing Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382 A Client Experiencing a Code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384A Child Experiencing Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385 ANSWERS AND RATIONALES 387 A Client Experiencing Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387A Community Facing Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 A Client Experiencing a Code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390A Child Experiencing Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392 EMERGENCY NURSING COMPREHENSIVE EXAMINATION 394EMERGENCY NURSING COMPREHENSIVE EXAMINA TION ANSWERS AND RATIONALES 397 16 Nonprescribed Medications . . . . . . . . . . . . . . . . . . . . . . .401 QUESTIONS 401 A Client Taking Herbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401A Client T aking Vitamins/Minerals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402 A Client Self-Prescribing Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403 ANSWERS AND RATIONALES 405 A Client Taking Herbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405A Client T aking Vitamins/Minerals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406 A Client Self-Prescribing Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407 NONPRESCRIBED MEDICATIONS COMPREHENSIVE EXAMINATION 410NONPRESCRIBED MEDICA TIONS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 413 6924_FM_i-xii.indd xi6924_FM_i-xii.indd xi 7/11/18 5:41 PM7/11/18 5:41 PMxii T ABLE OF CONTENTS 17 Administration of Medications . . . . . . . . . . . . . . . . . . . . .417 QUESTIONS 417 The Nurse Administering Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 The Nurse Computing Math to Administer Medications . . . . . . . . . . . . . . . . 418 ANSWERS AND RATIONALES 421 The Nurse Administering Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421The Nurse Computing Math to Administer Medications . . . . . . . . . . . . . . . . 422 ADMINISTRATION OF MEDICATIONS COMPREHENSIVE EXAMINATION 424ADMINISTRA TION OF MEDICATIONS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 427 18 Comprehensive Examination. . . . . . . . . . . . . . . . . . . . . . .431 QUESTIONS 431ANSWERS AND RATIONALES 445 Appendix A: Drug Charts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461 Glossary of English Words Commonly Encountered on Nursing Examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . 483 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487 6924_FM_i-xii.indd xii6924_FM_i-xii.indd xii 7/11/18 5:41 PM7/11/18 5:41 PM1The nurse should never put a medication in any client’s orifi ce, man-made or natural, if the nurse does not know what the medication is, how it acts in the body, and what the safe administration guidelines for that medication are. —Ray A. Hargrove-Huttel PHARMACOLOGY TEST-TAKING HINTS The test taker must know medications, and memorization is part of administering medica- tions safely. This chapter contains some tips to assist the test taker in learning about medi-cations. These tips apply to all the questions in this book. First, learn the specifi c classifi cation of a medication, including the actions, side effects, and adverse effects. Also, learn how to safely administer a medication in the classifi cation. Generally speaking, medications in a classifi cation share characteristics. However, be sure not to be too broad in the classifi cation. For example, do not combine all medications administered for hypertension in the same category. Angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and calcium channel blockers do not work in the same manner and are not in the same classifi cation, even though they may all be used to treat hyperten-sion. Similarly, medications for diabetes mellitus and diuretics fall into several classifi cation groups, and the facts about each specifi c classifi cation must be learned. This knowledge will assist the nurse in administering medications, as medications in a specifi c class will have similar safety requirements and similar effects/side effects. For example, ALL beta blocker medications require the nurse to monitor the blood pressure and apical pulse (AP) prior to administering the medication. The biggest change for a nursing student regarding learning to administer medications and being able to pass the RN-NCLEX is that the RN-NCLEX examination no longer pro-vides the test taker with the classifi cation or the trade name of the medication. This requires the test taker to recognize the medication and its effects and side effects by memorization of the generic name. Because of this change, all medications in the stems of the questions will list only the generic names. The classifi cation of the medication and a trade name will be provided in the answers section so the test taker will become familiar with several ways to recognize the medications. The exception to this will be when the test taker is required to use a medication administration record (MAR). In some clinical facilities, MARs contain both the generic names and trade names of the medications, so some MARs will contain both in this book. When administering medications for a group of clients, the test taker must realize that time is a realistic issue. It is not feasible for the nurse to look up 50 to 60 medications and administer them all within the dosing time frame, so it is imperative that the nurse learn about the most common medications. One tip for learning about medications is for the test taker to complete handmade drug cards. This is better than buying ready-made cards because in completing the drug cards the test taker uses more than one method of learning—reading, deciding which information to put on the card, and writing the pertinent information on the card. All of this assists the test taker in memorizing the information.1Basic Concepts in Medication Administration 6924_Ch01_001-006.indd 16924_Ch01_001-006.indd 1 7/11/18 4:33 PM7/11/18 4:33 PM2 P HARMACOLOGY SUCCESS When the test taker is deciding which information is the most important to write on a drug card, the following fi ve questions can be used as a guide. The test taker should always ask why an intervention is being implemented. That is the key to critical thinking. 1. What classifi cation is the medication that the nurse is administering to the client, and why specifi cally is this client receiving this medication? Many medications are categorized in one classifi cation group, but the client is receiving the medication for a different reason. For example, the medication trazodone is labeled as an antidepressant, but in reality it is prescribed as a sedative medication (sleeper) because its sedating effects are more powerful than its antidepressant effects. What action does the medication have on the body? This is known as the scientifi c rationale for administering the medication. Example #1: digoxin (Lanoxin) 0.25 mg po generic name (T rade Name)• The classifi cation of this medication is a cardiac glycoside. • The medication is administered to clients with congestive heart failure (CHF) or rapid atrial fi brillation. • Cardiac glycosides increase the contractility of the heart and decrease the heart rate. (In heart failure, the medication is administered to increase the contractility of the heart, but in atrial fi brillation, the medication is administered to slow the heart rate.) Example #2:furosemide (Lasix) 40 mg IV push (IVP) generic name (Common T rade Name)• The classifi cation of the medication is a loop diuretic. • The medication is administered to clients with essential hypertension or CHF or with any other condition in which there is excess fl uid in the body. • This medication helps remove excess fl uid from the body. • Loop diuretics remove water from the kidneys along with potassium. 2. When should the nurse question administering this medication? Does the medication have a therapeutic serum level? Which vital signs must be monitored? Which physiological param-eters should be monitored when the medication is being administered? Example #1: digoxin (Lanoxin)• Is the AP less than 60 beats per minute (bpm)? • Is the digoxin level within the therapeutic range? • Is the potassium level within normal range? Example #2:furosemide (Lasix)• Is the potassium level within normal range? • Does the client have signs/symptoms of dehydration? • Is the client’s blood pressure below 90/60? 3. What interventions must be taught to the client to ensure the medication is administered safely in the hospital setting? What interventions must be taught for taking the medication safely at home? Example #1: digoxin (Lanoxin)• Explain the importance of having serum levels checked regularly. • T each the client to take his or her radial pulse and not to take the medication if the pulse is less than 60 bpm. • Inform the client to take the medication daily and to notify the HCP if not taking the medication. Example #2:furosemide (Lasix)• T each about orthostatic hypotension. • Instruct the client to drink a limited amount of water to replace insensible fl uid loss. • Because the medication is IVP , inform the client about how many minutes the medication should be pushed, what primary IV is hanging, and whether the IV is compatible with Lasix. 6924_Ch01_001-006.indd 26924_Ch01_001-006.indd 2 7/11/18 4:33 PM7/11/18 4:33 PM