(Test Bank) Focus On Nursing Pharmacology

Karch, 7

Nursing

Test Bank

7th Edition

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TEST BANK FOR FOCUS ON NURSING PHARMACOLOGY 7TH EDITION BY KARCH Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 1: Introduction to Drugs Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process 1.A nurse working in radiol ogy administers iodine to a patient who is having a computerized axial tomography (CAT) scan. A nurse working on an oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles -mumps -rubella (MMR) vaccine to a 14 - month -old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses? A) Pharmacoeconomics B) Pharmacotherapeutics C) Pharmacodynamics D) Pharmacokinetics Ans: B Response: Pharmacology is th e study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The nurse working in radiolog y is administering a drug to help diagnose a disease. The nurse working on an oncology unit is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is how the body acts on the drug. Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Nursing process 2.A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug; therefore, morphine is categorized as a: A) Schedule I drug B) Schedule II drug C) Schedule III drug D) Schedule IV drug Ans: B Response: Narcotics such as morphin e are considered schedule II drugs because of the high abuse potential with severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than schedule II drugs and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability. Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Communication and documentation 3.A nurse working for a drug company is involved in pha se III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development? Chapter 1: Introduction to Drugs A) Working with animals who are given experimental drugs B) Monitoring drug effects in patients who are selected to participate in a study, who have the disease that the drug is meant to treat C) Collecting records of symptoms that participants experience while taking a drug and determining whether they are caused by the disease or the drug D) Informing healthy, young volunteer participants of possible risks that could occur from taking an experimental drug Ans: C Response: Phase III studies involve use of a drug in a vast clinical market where patients are asked to record any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect and analyze the information to be shared with the Food and Drug Administration (FDA). Use of animals in drug testing is done in the preclinical trials. A select group of patients who are invol ved in phase II studies participate in studies where the participants have the disease the drug is intended to treat. These patients are monitored closely for drug effects. Phase I studies involve healthy human volunteers who are usually paid for their par ticipation. Nurses may observe for adverse effects and toxicity. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process 4.Which of the following concepts is considered when generic drugs are substituted for brand -name dru gs? A) Bioavailability B) Critical concentration C) Distribution D) Half-life Ans: A Response: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand -name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect. Distribution is the phase of pharmacokinetics that involves the movement of a drug to the body's tissues. A drug's half -life is the time it takes for the amount of drug to decrease to one -half of the peak level. Cognitive Level: Analysis Difficulty: Difficult Integra ted Process: Teaching/learning 5.A nurse is teaching her patient about the use of over -the-counter (OTC) drugs. Which of the following statements best informs the patient about their safe use? A) ―OTC drugs are products that are available without prescription for self - treatment of minor complaints.‖ B) ―OTC drugs are considered medications and should be reported on a drug history.‖ Chapter 1: Introduction to Drugs C) ―OTC drugs were approved as prescription drugs but later were found to be safe without the need for a prescription.‖ D) ―OTC drugs need to be taken with caution. They can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy.‖ Ans: D Response: OTC drugs are considered medications and should be reported. OTC dr ugs are available without a prescription, although some were first approved as prescription drugs. The most important teaching should relate to their safe use and that OTC drugs can mask symptoms of disease and interfere with prescribed drugs. Cognitive Level: Knowledge Difficulty: Easy Integrated Process: Nursing Process 6.Which of the following legislative acts allowed the Food and Drug Administration (FDA) to tighten control over the quality of drugs and required that safety and efficacy standards be established? A) Pure Food and Drug Act of 1906 B) Federal Food, Drug, and Cosmetic Act of 1938 C) Durham Humphrey Amendment of 1951 D) Kefauver -Harris Act of 1962 Ans: D Response: The Kefauver -Harris Act was the result of the use of the 1960s drug thalidomide (Thalomid ). The public concern led to the legislation that gave the FDA regulatory control over testing and evaluating of drugs and allowed it to set standards for efficacy and safety. The Pure Food and Drug Act required labeling to eliminate false claims. The Fede ral Food, Drug, and Cosmetic Act gave the FDA the power to enforce standards for testing drug toxicity and monitoring labeling. The Durham - Humphrey Amendment enforced prescriptions for distribution. Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/learning 7.A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a pregnancy category B drug. The nurse would inform the patient that: A) ―Adequate studies in pregnant women have demonstrated there is no risk to the fetus.‖ B) ―Animal studies have not demonstrated a risk to the fetus but there have been no adequate studies in pregnant women.‖ C) ―Animal studies have shown an adverse effect on the fetus but there are no adequate studies in pregnant women.‖ D) ―There is evidence of human fetal risk but the potential benefits from use of the drug may be acceptable despite potential risks.‖ Ans: B Response: Category B indicates that animal studies have not demonstrated a risk to the fetus but This study source was downloaded by 100000825977768 from CourseHero.co mPaogne054-17-2021 16:27:50 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837937/Chapter -1-Introdu cDtiiosntr-itbou-Dtiorungos/f this document is illegal Chapter 1: Introduc tion to Drugs there have been no adequate studies in pregnant women. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Categ ory A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus but there have been no adequ ate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh the risks. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Teaching/learning 8. Discharge planning for patients leaving the hospital should include instructions on the use of over -the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs? A) ―OTC drugs are always safe and will not cause bad effects.‖ B) ―OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).‖ C) ―OTC drugs are different from any drugs available by prescription and cost less.‖ D) ―OTC drugs are thought to be safe when taken as directed. ‖ Ans: D Response: OTC drugs are drugs that have been determined to be safe when taken as directed. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC educatio n should always be included as a part of the hospital discharge instructions. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Teaching/Learning 9. Which of the following would be the best source of drug information for a nurse? A) Drug Facts and Comparisons book B) A nurse's drug guide C) A drug package insert D) The Physician's Drug Reference (PDR) Ans: B Response: The most user -friendly drug source for a nurse is a nurse's drug guidebook. A guide provides nursing implications and patient teachi ng points that are most useful to nurses. The Drug Facts and Comparisons book provides a wide range of drug information but is hard to manipulate and is very expensive. A package insert contains all of the chemical and drug company research information abo ut a drug; however, the information can be difficult to understand and the print is very small. The PDR is heavily cross -referenced and difficult to use. Cognitive Level: Comprehension Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source wa s downloaded by 100000825977768 from CourseHero.co mPaogne055-17-2021 16:27:50 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837937/Chapter -1-Introdu cDtiiosntr-itbou-Dtiorungos/f this document is illegal Chapter 1: Introduction to Drugs Difficulty: Moderate Integrated Process: Nursing Process 10. Which of the following statements best defines how a chemical becomes a drug? A) A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug. B) A chemical becomes a drug when it is introduced into the body to cause a change. C) A chemical is considered a drug when the Food and Drug Administration (FDA) approves its release to be marketed. D) A chemical must have demonstrated therapeutic value to become a drug. Ans: A Response: A chemical must undergo a series of tests to determine its therapeutic value and efficacy without severe toxicity or damaging properties before it is termed a drug. Test results are reported to the FDA, which may or may not give approval. Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne051-17-2021 16:28:00 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837942/Chapter -2-Drugs -aDndis-ttrhibe-uBtioodny/of this document is illegal Chapter 2: Drugs and the Body Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 1. In which of the following patients would a nurse expect to see an alteration in drug metabolism? A) A 35-year-old female with cervi cal cancer B) A 41-year-old male with kidney stones C) A 50-year-old male with cirrhosis of the liver D) A 62-year-old female in acute renal failure Ans: C Response: The liver is the most important site of drug metabolism. If the liver is not functioning effectivel y, as in patients with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. In cirrhosis patients the drug dosage will need to be altered to ensure normal levels in the body. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 2.A patient has a drug level of 50 units/mL and the drug's half -life is 1 hour. If concentrations above 25 units/mL are considered toxic and no more drug is given, how long will it take for the blood level to reach the non toxic range? A) 30 minutes B) 1 hour C) 2 hours D) 3 hours Ans: C Response: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours, the serum concentrat ion would be 12.5 units/mL (25/2) and reach the nontoxic range. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 3.A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has be en on the same antihypertensive drug for 6 years and has had stable blood pressures and no side effects. Since her move, however, she reports having ―dizzy spells and weakness‖ and feels that the drug is no longer effective. The nurse knows that one possib le reason for the change in the effectiveness of the drug could be which of the following? A) The impact of the placebo effect on the patient's response B) The accumulative effect of the drug if it has been taken for many years C) The impact of the warmer environme nt on the patient's physical state D) Problems with patient compliance with the drug regimen while on vacation Ans: C Response: Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100 000825977768 from CourseHero.co mPaogne052-17-2021 16:28:00 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837942/Chapter -2-Drugs -aDndis-ttrhibe-uBtioodny/of this document is illegal Chapter 2: Drugs and the Body Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and fe elings of weakness. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen while on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process 4. During which phase of pharmacokinetics could a significant drug -drug interaction occur, resulting in one drug stimulating or blocking the metabolism of the other drug? A) Absorption B) Distribution C) Biotransformation D) Excretion Ans: C Response: During biotransformation, a drug may be metabolized quicker if taken at the same time as another drug, and higher doses of the drug will be needed to achieve the desired effect. During absorption, one drug can prevent or accelerate absorption of the other drug. During distribution, one drug competes for the protein -binding site of another drug so the second drug cannot be transported to the reactive tissue. During excretion, one drug competes for excretion with the other drug, leading to accumulation and toxic effects of one of the drugs. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process 5. Which statement accurately describes a drug agonist? A) A drug that reacts with specific receptor sites on a cell and prevents the reaction of another chemical with a different receptor site on that cell B) A drug that interferes with the enzyme systems that act as catalysts for different chemical reactions C) A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site D) A drug that reacts with receptor sites to block normal stimulation, producing no effect Ans: C Response: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with certain receptor si tes, preventing the reaction of another chemical with a different receptor site. Drug - enzyme interactions interfere with the enzyme systems that stimulate various Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne053-17-2021 16:28:00 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837942/Chapter -2-Drugs -aDndis-ttrhibe-uBtioodny/of this document is illegal Chapter 2: Drugs and the Body chemical reactions. Cognitive Level: Analysis Difficulty : Difficult Integrated Process: Nursing process 6.A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this is due to: A) Passive diffusion B) Active transport C) Glomerular filtration D) First-pass effect Ans: D Response: The first -pass effect involves drugs that are absorbed from the small intestine d irectly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbe d into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water -soluble components from the plasma into the renal tubule. Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Nursing process 7.A nurse working as a member of a research team is exploring the unique differences in drug response that each individual possesses based on his or her genetic makeup. This area of study is called: A) Pharmacotherapeutics B) Pharmacodynamics C) Pharmacoeconomics D) Pharmacogenomics Ans: D Response: Pharmacogenomics is the area of study that includes mapping of the human genome. In the future, medical care and drug regimens may be personally designed based on a person's unique genetic makeup. Pharmacotherapeutics is the branch of pharmacology that deals with the use of drugs to treat, prevent, and diagnose disease. Pharmacodynamics involves how a drug affect s the body. Pharmacoeconomics includes any costs involved in drug therapy. Cognitive Level: Comprehension Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero .comPaogne054-17-2021 16:28:00 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.courseher o.com/file/15837942/Chapter -2-Drugs -aDndis-ttrhibe-uBtioodny/of this document is illegal Chapter 2: Drugs and the Body Difficulty: Easy Integrated Process: Nursing process 8.The nurse is aware that for a drug to work properly on reac tive tissues, a sufficient amount of the drug is needed to cause the therapeutic effect. The term used for this amount is: A) Critical concentration B) Dynamic equilibrium C) Selective toxicity D) Active transport Ans: A Response: A critical concentration of a drug mu st be present before a reaction occurs within our cells. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical conce ntration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 9.A nurse has received an order to administer two drugs at the same time of the day. The nurse should first: A) Wash her hands before handling the medications B) Cons ult a drug guide for compatibility C) Question the patient concerning drug allergies D) Identify the patient by checking the armband and asking the patient to state his name Ans: B Response: A nurse should always first consult a drug guide for compatibility when two or more drugs are being given at the same time. Once she is certain the drugs are compatible, she should wash her hands and prepare the medication. She should identify the patient appropriately and ask about drug allergies prior to administering the medication. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process 10.Which of the following factors affects absorption of intramuscular (IM) administration of drugs? A) Perfusion of blood to the subcutaneous tissue B) Integrity of the mucous membranes C) Environmental temperature D) Blood flow to the gastrointestinal tract Ans: C Response: Stuvia.com - The Mar ketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne055-17-2021 16:28:00 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837942/Chapter -2-Drugs -aDndis-ttrhibe-uBtioodny/of this document is illegal Chapter 2: Drugs and the Body A cold environmental temperature can cause muscles to vasoconstrict and decreases absorption; a hot environment can cause vasodilation and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection, and blood flow to the gastrointestinal tract causes alterations in absorption for oral medications. The conditi on of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs. Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne051-17-2021 16:28: 09 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837930/ Chapter -3-Toxic -EDffiesctrtisb-ouft-ioDnruogfst/his document is illegal Chapter 3: Toxic Effects of Drugs Cognitive Level: Application Difficulty: Difficult Integrated Process: Teaching/learning 1.A nurse is instructing her patient about a newly prescribed drug. Which of the following should be included in the teaching to help improve patient compliance and safety? A) List of pharmacies where the drug can be obtained B) Measures to alleviate any discomfort associated with adverse effects C) The cost of the brand -name drug compared to the generic form D) Statistics related to phase III of testing for the prescribed drug Ans: B Response: If patients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication. A list of pharmacies can be useful information but will not improve safety or compliance. Knowing the cost of the brand -name versus the generic drug could also be helpful to the patient; however, a substitution may not be allowable and the cost of a drug does not improve patient safety. Most patients are not concerned with the statistics related to drug testing and the results are therefore not shared with the patient. Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing process 2.A patient has been taking an oral antibiotic for 10 days. She reports to the nurse that she has developed vaginal itching and a clear discharge. The n urse is aware that the patient is experiencing which of the following? A) An adverse reaction from the antibiotic B) A stomatitis, which has caused an inflammation of the mucous membranes C) An overdose of the drug that is damaging to more than one body system D) A superinfection caused by the antibiotic, which has destroyed normal flora Ans: D Response: Superinfections often occur with antibiotic use because the drug kills normal flora bacteria. Vaginal itching and a clear discharge are signs and symptoms of a yeast infection and not stomatitis. Vaginal itching and a clear discharge are not considered adverse effects of an antibiotic. An overdose of a drug that damages more than one body system is considered poisoning. Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing process 3.A male patient is admitted to the emergency room in distress. The nurse suspects an anaphylactic reaction from oral penicillin. Which assessment findings are important in making this diagnosis? A) Blood pressure: 186/100, difficulty breathing B) Hematocrit (Hct): 32%, decreased urine output C) Temperature: 102ºF, swollen joints D) Profuse sweating, blood pressure: 92/58 Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne052-17-2021 16:28:09 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837930/Chapter -3-Toxic -EDffiesctrtisb-ouft-ioDnruogfst/his document is illegal Chapter 3: Toxic Effects of Drugs Ans: A Response: An anaphylactic reaction is an immune reaction that causes a massive release of histamine, resulting in edema and swelling, which can lead to respiratory distress and increased blood pressure. A decreased Hct and decreased urine output suggest a cytotoxic reaction. An increased temperature and swollen joints could suggest serum sickness. Profuse sweating and a blood pressure of 92/58 may indicate cardiac - related issues Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/learning 4.A patient is taking an antihistamine to relieve itchy, watery eyes and a runny nose associated with seasonal allergies. A good nursing intervention would be to advise the patient to: A) Limit fluid intake to dry mucous membranes B) Avoid driving or operating machinery C) Report strange dreams or nightmares D) Decrease dietary fat Ans: B Response: An adverse effect of antihistamines is drowsiness, and injury can occur if the patient drives or operates machinery. An increase in fluids would be indicated to help keep nasal membranes moist. It is common for dreams to occur wh en taking medication and it is not necessary to report them. Dietary fat should not interfere with the drug metabolism of antihistamines. Cognitive Level: Application Difficulty: Difficult Integrated Process: Teaching/learning 5.A nurse is teaching a gro up of five patients who are beginning drug therapy for AIDS. Which of the following should be included in her instructions to the group? A) ―Take your medications as indicated. Poisoning can occur when an overdose damages more than one body system.‖ B) ―Renal injury is common and can be caused by the first-pass effect.‖ C) ―A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellow.‖ D) ―Most drugs are metabolized in the liver. You should report dark red papules immediately.‖ Ans: A Respons e: Poisoning can lead to the potential for fatal reactions when more than one body system is affected. Liver injury can be caused by the first-pass effect and can cause the skin to have a yellow appearance. Most drugs are metabolized in the liver. However, dark red papules appearing on extremities are characteristic of Stevens - Johnson syndrome, a potentially fatal erythema multiforme exudativum. Stuvia.com - The Marketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne053-17-2021 16:28:09 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file /15837930/Chapter -3-Toxic -EDffiesctrtisb-ouft-ioDnruogfst/his document is illegal Chapter 3: Toxic Effects of Drugs Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursin g process 6.Potassium -sparing diuretics can lead to potassium retention. Which assessment finding could indicate hyperkalemia? A) Urine output of 1500 mL/24 hours B) Blood pressure of 98/60 C) Potassium level of 5.9 mEq/L D) Pulse: 60 and weak Ans: C Response: The nor mal range of serum potassium for an adult is 3.5 to 5.0 mEq/L. A level higher than 5.0 mEq/L can indicate hyperkalemia. Normal urinary output is between 1500 and 2000 mL per day. Urinary output below 1000 mL per day would include oliguria and would indicat e hyperkalemia. A decrease in blood pressure and pulse can indicate hypokalemia. Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/learning 7.A nurse is talking with family members of an 80 -year-old patient who is experiencin g tinnitus from taking a macrolide antibiotic. Which of the following should the nurse include in her instructions regarding home care? A) Keep the patient in the prone position when in bed. B) Eliminate salt from the patient's diet. C) Provide protective measures to prevent falling or injury. D) Monitor exposure to sunlight. Ans: C Response: Macrolide antibiotics can cause severe auditory nerve damage, which can cause dizziness, ringing in the ears (tinnitus), and loss of balance and hearing. The patient would be at high risk for injury due to falls. Usually a person who is dizzy is unable to lie flat and needs to recline with the head elevated. Salt may be decreased but not entirely eliminated from the diet. Sunlight is usually not an issue because clients who experi ence tinnitus are inside their homes in a quiet environment or on bed rest. Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process 8.Alterations in glucose metabolism can occur from use of oral antidiabetic drugs. A nurse will observe patients who are taking these drugs for which of the following? A) Increased urination B) Deep Kussmaul's respirations C) Increased hunger D) Tremors and lack of coordination Ans: D Response: Lowering the blood glucose is an immediate problem for the nervo us system, and Stuvia.com - The Ma rketplace to Buy and Sell your Study Material This study source was downloaded by 100000825977768 from CourseHero.co mPaogne054-17-2021 16:28:09 GMT -05:00 Downloaded by: Bestn | kalesi2541@gmail.com https://www.coursehero.com/file/15837930/Chapter -3-Toxic -EDffiesctrtisb-ouft-ioDnruogfst/his document is illegal Chapter 3: Toxic Effects of Drugs tremors and lack of coordination may be observed in the patient. When high blood glucose levels occur, the patient may report increased hunger, urination, and thirst. Prolonged high blood glucose levels may result in Kussmaul's respirations as the patient tries to expel the excess CO 2. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 9.A patient is being seen in the clinic for rheumatoid arthritis. Which of the followi ng statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen )? A) ―I have to urinate all the time.‖ B) ―Sometimes I have blurred vision.‖ C) ―I have tingling and numbness in my arms and legs.‖ D) ―Sometimes I feel like I am losing my balance when I walk.‖ Ans: B Response: Chloroquine ( Aralen ) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyper kalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity. Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process 10.A 68-year-old patient who must take antihistamines for severe allergie s is planning a vacation to Mexico. The nurse will encourage the patient to: A) Avoid sightseeing during the hottest part of the day B) Discontinue the antihistamines if he becomes extremely restless C) Decrease the dosage of the drugs if he experiences excessive thirst D) Continue taking the antihistamines even if he begins to hallucinate Ans: A Response: Antihistamines can cause anticholinergic effects, which block the parasympathetic nervous system by blocking cholinergic receptors, and decrease sweating, placing the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson -like syndrome not usually associated with antihistamines. Excessive thirst is cha racteristic of hyperglycemia, and hallucinations are associated with drugs that affect neurologic functioning. Nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.