(Test Bank) Pharmacology for Nurses A Pathophysiologic Approach

Adams,Holland,Urban, 6

Pharmacology

Test Bank

6th Edition

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Test Bank for Pharmacology for Nurses A Pathophysiologic Approach, The downloadable file consists of 1452 pages, and the total size of the file is 8.02 MB. Purchase now only for highly discounted price.

Author(s): Adams, Holland, Urban

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1 Copyright © 2020 Pearson Education, Inc. Pharmacology for Nurses, 6e (Adams) Chapter 1 Introduction to Pharmacology 1) A nurse is reviewing key events in the history of pharmacology with a student nurse. Which student comment indicates an understanding? 1. "Early researchers used themselves as test subjects." 2. "A primary goal of pharmacology is to prevent disease." 3. "Penicillin is one of the initial drugs isolated from a natural source." 4. "Pharmacologists began synthesizing drugs in the laboratory in the nineteenth century." Answer: 1 Explanation: 1. Some early researchers, like Friedrich Serturner, used themselves as test subjects. 2. An early goal of pharmacology was to relieve human suffering. 3. Initial drugs isolated from complex mixtures included morphine, colchicine, curare, and cocaine, but not penicillin. 4. By the twentieth century, pharmacologists could synthesize drugs in the laboratory. Page Ref: 3 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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: 1-1 Identify key events in the history of pharmacology. MNL Learning Outcome: 1.1 Examine the relationship between medicine and pharmacology. 2 Copyright © 2020 Pearson Education, Inc. 2) A student nurse asks a nursing instructor why anatomy and physiology as well as microbiology are required courses when the student 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 all of those subjects are part of the curriculum." 3. "Knowledge of all those subjects will prepare you to administer medication." 4. "An understanding of those subjects is essential to understand pharmacology." Answer: 4 Explanation: 1. Pharmacology is an outgrowth of anatomy, physiology, and microbiology, but this is not the most essential reason for the nurse to learn them. 2. The nurse must learn anatomy, physiology, and microbiology to understand pharmacology, not because they are part of the curriculum. 3. Knowledge of anatomy, physiology, and microbiology prepares the nurse to understand pharmacology, not to provide care such as administration of medications. 4. It is essential for the nurse to have a broad knowledge base of many sciences in order to learn pharmacology. Page Ref: 3 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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 Examine the relationship between medicine and pharmacology. 3 Copyright © 2020 Pearson Education, Inc. 3) A nurse is teaching a group of nurses about the differences between pharmacology and therapeutics. The nurse determines that learning has occurred when which statements are made? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 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." Answer: 2, 3, 5 Explanation: 1. Pharmacology is not the development of medicines. 2. Pharmacology is the study of medicines. 3. Therapeutics is the use of drugs in the treatment of suffering. 4. Therapeutics is not related to study of drug interactions. 5. Pharmacotherapy is the application of drugs for the purpose of disease prevention. Page Ref: 4 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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 Examine the relationship between medicine and pharmacology. 4 Copyright © 2020 Pearson Education, Inc. 4) A nurse administers a vaccine to a client. What is the nurse's best understanding as it relates to the manufacture of a 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. Answer: 2 Explanation: 1. Vaccines are not produced by natural plant extracts. 2. Vaccines are naturally produced in animal cells, microorganisms, or by the body itself. 3. Vaccines are not produced by a combination of animal and plant products. 4. Vaccines are not synthesized in a laboratory. Page Ref: 4 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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 Examine the relationship between medicine and pharmacology. 5 Copyright © 2020 Pearson Education, Inc. 5) An older client is admitted with gastrointestinal bleeding. The client says to the nurse, "I don't understand this. All I did was take ibuprofen (Advil) for my arthritis." What is the nurse's best response? 1. Review nonpharmacologic methods to relieve joint pain. 2. Encourage the client to substitute safer drugs, such as acetaminophen (Tylenol). 3. Remind the client to contact their healthcare provider before taking any over-the-counter (OTC) medications. 4. Teach the client about the side effects of ibuprofen (Advil). Answer: 4 Explanation: 1. Reviewing nonpharmacologic methods to relieve joint pain is appropriate for this client, but it's not the highest priority. It doesn't address the client's current concern about how ibuprofen may have increased the risk of having a GI bleed. 2. Substitution of other drugs may be beneficial, but this cannot be done in all situations. In addition, it doesn't address the client's current concern about how ibuprofen may have increased the risk of having a GI bleed. 3. It is not a realistic plan to expect clients to contact their physician prior to taking any over-the-counter (OTC) medication. In addition, it doesn't address the client's current concern about how ibuprofen may have increased the risk of having a GI bleed. 4. It is essential for the nurse to teach clients about the advantages, and the disadvantages (including side effects), of all medications and supplements the client is taking. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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: 1.4 Examine the nurse's role and responsibilities in drug administration. 6 Copyright © 2020 Pearson Education, Inc. 6) A nurse teaches a student nurse about the pharmacological classification of drugs. The nurse evaluates that learning has occurred when the student makes 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." Answer: 2 Explanation: 1. To say that a drug treats angina addresses the therapeutic usefulness of the drug, not the pharmacological classification. 2. The pharmacological classification addresses a drug's mechanism of action, or how a drug produces its effect in the body. 3. To say that a drug lowers blood pressure addresses the therapeutic usefulness of the drug, not the pharmacological classification. 4. To say that a drug influences blood clotting addresses the therapeutic usefulness of the drug, not the pharmacological classification. Page Ref: 5 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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 classes. MNL Learning Outcome: 1.2 Identify how drugs are named and classified. 7 Copyright © 2020 Pearson Education, Inc. 7) A nurse is providing medication education to a client with hypertension. The nurse teaches the client that the healthcare provider 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. Answer: 2 Explanation: 1. The education was most likely appropriate, but this response is too vague. 2. A drug's mechanism of action explains how a drug produces its effect in the body. 3. There is no drug name present, so it is not known whether this is a prototype drug. 4. The nurse did not explain the consequences of not using the drug. Page Ref: 5 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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: 1.2 Identify how drugs are named and classified. 8) A student nurse asks a nursing instructor how to remember all of the antibiotic drugs since there are so many. What is the best response by the nursing instructor? 1. "Mnemonics will help you tell the difference between drugs." 2. "A flow chart will help enhance your memory." 3. "Categorize the individual drugs by therapeutic effect." 4. "Focus on a representative drug from each class." Answer: 4 Explanation: 1. Using mnemonics is not the best way to learn about drugs. 2. Flow charts are not the best way to learn about drugs. 3. Categorizing individual drugs is not the best way to learn about drugs. 4. A prototype, or representative, drug is the well-understood drug model from which other drugs in a pharmacological class are compared. Page Ref: 5 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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: 8 Copyright © 2020 Pearson Education, Inc. Nursing Process: Implementation Learning Outcome: 1-6 Discuss the prototype approach to drug classification. MNL Learning Outcome: 1.2 Identify how drugs are named and classified. 9 Copyright © 2020 Pearson Education, Inc. 9) A client has been taking paroxetine (Paxil) for a year and tells a nurse it is no longer working. What is the best response by the nurse? 1. "This sounds like your medication needs changing." 2. "Let's look for interactions with other medications you are taking." 3. "Are you taking name brand Paxil or the generic version paroxetine?" 4. "It is time for us to do the Beck Depression assessment again." Answer: 3 Explanation: 1. Considering a change in medication is appropriate, but another assessment takes priority. 2. Assessing for interactions with other drugs is appropriate, but another assessment takes priority. 3. The bioavailability of a generic drug may not be the same as the bioavailability of a brand name drug. 4. Assessing for worsening of depression is appropriate, but another assessment takes priority. Page Ref: 7 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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: 1.3 Recognize features of generic and trade-name equivalent drugs, and biosimilar drugs. 10 Copyright © 2020 Pearson Education, Inc. 10) A student nurse has completed an initial pharmacology course and tells a nurse that it was difficult. What is the best response by the nurse? 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." Answer: 2 Explanation: 1. It is true that the student must apply what has been learned to patient care, but this response implies that learning is over. 2. Learning pharmacology is a gradual, continuous process that does not end with graduation. 3. Learning is not always painful. 4. There is no reason for the student nurse to take a graduate level pharmacology course at this time. Page Ref: 4 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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: 1-7 Describe what is meant by a drug's mechanism of action. MNL Learning Outcome: 1.4 Examine the nurse's role and responsibilities in drug administration. 11 Copyright © 2020 Pearson Education, Inc. 11) A 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. "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." Answer: 1 Explanation: 1. Drugs may elicit different responses depending on individual client factors such as age, sex, body mass, health status, and genetics. 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. 3. There are differences between some generic and brand name drugs, but this is not the best answer. 4. Asking the client to check a medication is fine, but this does not answer the client's question. Page Ref: 7 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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: 1-10 Explain the differences between trade name drugs and their generic equivalents. MNL Learning Outcome: 1.3 Recognize features of generic and trade-name equivalent drugs, and biosimilar drugs. 12 Copyright © 2020 Pearson Education, Inc. 12) A 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 physician." 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." Answer: 4 Explanation: 1. Telling the husband "I hope she will be okay" is a very frightening response that implies she might die, and this is nontherapeutic. 2. Asking the husband why he let his wife take Tums is nontherapeutic and too accusatory; do not ask "why" questions. 3. Telling the husband that "it certainly wasn't indigestion" is judgmental and will alienate the client and husband. 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. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.1 Value seeing healthcare situations "through patients' 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: Caring Learning Outcome: 1-9 Outline the major differences between prescription and over-the-counter drugs. MNL Learning Outcome: 1.4 Examine the nurse's role and responsibilities in drug administration. 13 Copyright © 2020 Pearson Education, Inc. 13) A 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 of the below statements? 1. "I will check with my provider first before I take any over-the-counter (OTC) medicine." 2. "A pharmacist can tell me how to take the over-the-counter (OTC) medicine." 3. "After reading all the directions on the label, I will call the healthcare provider'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." Answer: 3 Explanation: 1. It is not realistic to expect clients to call the doctor's office before taking any over-the-counter (OTC) medicine. 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. 3. In most cases, clients may treat themselves safely if they carefully follow instructions included with the medication. 4. Most OTC medicines have a high margin of safety, but none is considered completely safe. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.A.4 Examine how the safety, quality, and cost effectiveness of healthcare 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/Integrated Concepts: Nursing Process: Teaching/Learning Learning Outcome: 1-9 Outline the major differences between prescription and over-the-counter drugs. MNL Learning Outcome: 1.4 Examine the nurse's role and responsibilities in drug administration. 14 Copyright © 2020 Pearson Education, Inc. 14) A client asks a nurse why a prescribed medication is very expensive. What is the best response by the nurse? 1. Help the client receive free medicine through a "patient assistance" program. 2. Ask the healthcare provider if a cheaper brand name drug may be substituted. 3. Contact the healthcare provider to ask if a generic drug may be substituted. 4. Maintain the client on samples of the brand name drug from the physician's office. Answer: 3 Explanation: 1. A patient assistance program is a good idea, but since the client may not qualify for this, it is not the best plan. 2. Another brand name drug may not be what the client needs for the illness. 3. Generic drugs are much less costly than brand name drugs. 4. Providing samples is an option, but the office may temporarily run out of samples and the client will not receive the medication. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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: 1-10 Explain the differences between trade name drugs and their generic equivalents. MNL Learning Outcome: 1.3 Recognize features of generic and trade-name equivalent drugs, and biosimilar drugs. 15 Copyright © 2020 Pearson Education, Inc. 15) A 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." Answer: 3 Explanation: 1. Telling the client that insurance covers the drug doesn't answer the client's question. 2. Advertising costs are expensive, but this answer implies the drug company is raising costs unnecessarily. 3. If the cost of developing a new drug is not recouped by the drug company, there is no impetus for the company to continue drug development. 4. It is nontherapeutic for the nurse to introduce her own beliefs, such as accountability of drug companies, into a conversation with the client. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: 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; involvement of family and friends; and transition and continuity. | 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: 1.4 Examine the nurse's role and responsibilities in drug administration.