Pharmacology Chapters 1 And 2

1. LIver and kidney function can effect half-life.

True

False

The statement is stating that liver and kidney function can affect the half-life. This means that the efficiency and health of the liver and kidney can impact the time it takes for half of a substance to be eliminated from the body. If the liver and kidney function properly, they can efficiently process and eliminate substances, resulting in a shorter half-life. Conversely, if the liver and kidney function is impaired, the elimination process may be slower, leading to a longer half-life. Therefore, the statement is true.

Explanation

The statement is stating that liver and kidney function can affect the half-life. This means that the efficiency and health of the liver and kidney can impact the time it takes for half of a substance to be eliminated from the body. If the liver and kidney function properly, they can efficiently process and eliminate substances, resulting in a shorter half-life. Conversely, if the liver and kidney function is impaired, the elimination process may be slower, leading to a longer half-life. Therefore, the statement is true.

2. To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route?

Subcutaneously

Intravenously

Intramuscularly

Intrathecally

Intravenous administration allows for the most rapid onset of action because the medication is directly injected into the bloodstream. This bypasses the need for absorption through tissues or organs, allowing the medication to quickly reach its target site and exert its effects. Subcutaneous, intramuscular, and intrathecal routes may also be used depending on the medication and its intended effects, but they generally have slower onset times compared to intravenous administration.

Explanation

Intravenous administration allows for the most rapid onset of action because the medication is directly injected into the bloodstream. This bypasses the need for absorption through tissues or organs, allowing the medication to quickly reach its target site and exert its effects. Subcutaneous, intramuscular, and intrathecal routes may also be used depending on the medication and its intended effects, but they generally have slower onset times compared to intravenous administration.

3. The nursing process is important as a well-established, research-supported framework for professional nursing practice. Which is the correct order for the steps of the nursing process?

Evaluation, Planning, Diagnoses, Assessment, Implementation

Planning, Assessment, Diagnoses, Implementation, Evaluation

Diagnoses, Assessment, Planning, Evaluation, Implementation

Assessment, Diagnoses, Planning, Implementation, Evaluation

The correct order for the steps of the nursing process is assessment, diagnoses, planning, implementation, and evaluation. This order allows nurses to gather information about the patient's health status, identify any health problems or needs, create a plan of care, carry out interventions, and then evaluate the effectiveness of those interventions. This systematic approach ensures that nurses provide comprehensive and individualized care to their patients.

Explanation

The correct order for the steps of the nursing process is assessment, diagnoses, planning, implementation, and evaluation. This order allows nurses to gather information about the patient's health status, identify any health problems or needs, create a plan of care, carry out interventions, and then evaluate the effectiveness of those interventions. This systematic approach ensures that nurses provide comprehensive and individualized care to their patients.

4. A 77 year old has a diagnosis of upper respiratory tract infection. He tells the LPN that he is allergic to Penicillin. Which of the following is the most appropriate response?

"that's to be expected, lost of people are allergic to penicillin."

"what type of reaction did you have when you took penicillin?"

"Drug allergies don't usually occur in older individuals because they ahve built up resistance."

Asking about the type of reaction the patient had when taking penicillin is the most appropriate response because it allows the LPN to gather more information about the patient's allergy. This information is crucial in determining the appropriate course of action and alternative medications that can be used for the upper respiratory tract infection. It also shows that the LPN is attentive to the patient's concerns and is taking their allergy seriously.

Explanation

Asking about the type of reaction the patient had when taking penicillin is the most appropriate response because it allows the LPN to gather more information about the patient's allergy. This information is crucial in determining the appropriate course of action and alternative medications that can be used for the upper respiratory tract infection. It also shows that the LPN is attentive to the patient's concerns and is taking their allergy seriously.

5. The nurse should check a medication how many times before administration of a medication under the "right drug" part of the Six Rights?

One time

Three times

Five times

Depends on the drug being administered

The nurse should check a medication three times before administration of a medication under the "right drug" part of the Six Rights. This ensures that the nurse verifies the medication label and compares it with the medication order or prescription. Checking the medication three times helps to minimize the risk of medication errors and ensures patient safety.

Explanation

The nurse should check a medication three times before administration of a medication under the "right drug" part of the Six Rights. This ensures that the nurse verifies the medication label and compares it with the medication order or prescription. Checking the medication three times helps to minimize the risk of medication errors and ensures patient safety.

6. Which of the following must occur for a goal statement to be patient centered?

Family input must be considered in developing a goal

The patient must be involved in establishing the goal

The nurse must develop the goal

The doctor must be involved in establishing the goal

For a goal statement to be patient-centered, it is essential that the patient is involved in establishing the goal. This means that the patient's input, preferences, and needs should be taken into consideration when developing the goal. By involving the patient in the goal-setting process, healthcare professionals can ensure that the goals align with the patient's values and desires, ultimately leading to a more personalized and patient-centered approach to care.

Explanation

For a goal statement to be patient-centered, it is essential that the patient is involved in establishing the goal. This means that the patient's input, preferences, and needs should be taken into consideration when developing the goal. By involving the patient in the goal-setting process, healthcare professionals can ensure that the goals align with the patient's values and desires, ultimately leading to a more personalized and patient-centered approach to care.

7. While the nurse is taking an admission history, the patient reports having a previous allergic reaction to penicillins. What will the nurse document as part of the patient's allergic reaction response to penicillins?

Hives

Dry eyes

Frequent urination

Constipation

The nurse will document hives as part of the patient's allergic reaction response to penicillins. Hives are a common symptom of an allergic reaction and are characterized by raised, itchy, and red welts on the skin. This response occurs when the immune system releases histamine, causing blood vessels to leak fluid into the skin. It is important for the nurse to document this information accurately to ensure that the patient is not prescribed penicillins in the future and is provided with appropriate alternative medications.

Explanation

The nurse will document hives as part of the patient's allergic reaction response to penicillins. Hives are a common symptom of an allergic reaction and are characterized by raised, itchy, and red welts on the skin. This response occurs when the immune system releases histamine, causing blood vessels to leak fluid into the skin. It is important for the nurse to document this information accurately to ensure that the patient is not prescribed penicillins in the future and is provided with appropriate alternative medications.

8. The nurse recognizes that drugs given by which route will be altered by the first-pass effect?

Oral

Sublingual

Subcutaneously

Intravenous

Drugs given orally are subject to the first-pass effect, which refers to the metabolism of a drug in the liver before it reaches systemic circulation. When a drug is taken orally, it is absorbed through the gastrointestinal tract and transported to the liver through the portal vein. In the liver, the drug may be metabolized, partially or completely, before it enters the systemic circulation. This process can significantly alter the concentration and effectiveness of the drug. Therefore, drugs given orally are more likely to be affected by the first-pass effect compared to drugs given through other routes such as sublingual, subcutaneous, or intravenous.

Explanation

Drugs given orally are subject to the first-pass effect, which refers to the metabolism of a drug in the liver before it reaches systemic circulation. When a drug is taken orally, it is absorbed through the gastrointestinal tract and transported to the liver through the portal vein. In the liver, the drug may be metabolized, partially or completely, before it enters the systemic circulation. This process can significantly alter the concentration and effectiveness of the drug. Therefore, drugs given orally are more likely to be affected by the first-pass effect compared to drugs given through other routes such as sublingual, subcutaneous, or intravenous.

9. When developing a plan of care, which nursing action ensures the goal statement is patient-centered?

Considering family input

Involving the patient

Developing the goal first, and then sharing it with the patient

Including the physician

Involving the patient ensures that the goal statement in the plan of care is patient-centered. By actively involving the patient in the decision-making process, the nurse can gather the patient's preferences, values, and needs, which will help in developing a plan that is tailored to the patient's specific circumstances. This patient-centered approach promotes autonomy, collaboration, and patient satisfaction, ultimately leading to better outcomes and improved patient experience.

Explanation

Involving the patient ensures that the goal statement in the plan of care is patient-centered. By actively involving the patient in the decision-making process, the nurse can gather the patient's preferences, values, and needs, which will help in developing a plan that is tailored to the patient's specific circumstances. This patient-centered approach promotes autonomy, collaboration, and patient satisfaction, ultimately leading to better outcomes and improved patient experience.

10. A drug given by which route is altered by the first-pass effect?

Sublingual

Subcutaneous

Oral

Intravenous

The drug given orally is altered by the first-pass effect. When a drug is taken orally, it is absorbed through the gastrointestinal tract and enters the portal circulation, which carries it to the liver. In the liver, the drug may undergo metabolism or be partially or completely inactivated before it reaches the systemic circulation. This first-pass metabolism can significantly reduce the bioavailability of the drug, meaning that a smaller amount of the drug is available to produce its desired effects. Therefore, the oral route of administration is particularly susceptible to the first-pass effect.

Explanation

The drug given orally is altered by the first-pass effect. When a drug is taken orally, it is absorbed through the gastrointestinal tract and enters the portal circulation, which carries it to the liver. In the liver, the drug may undergo metabolism or be partially or completely inactivated before it reaches the systemic circulation. This first-pass metabolism can significantly reduce the bioavailability of the drug, meaning that a smaller amount of the drug is available to produce its desired effects. Therefore, the oral route of administration is particularly susceptible to the first-pass effect.

11. How many times do you check a medication before giving it?

1

2

3

4

Before giving a medication, it is important to check it three times. This is to ensure accuracy and prevent medication errors. The first check is when retrieving the medication from the storage area, comparing it with the medication order or prescription. The second check is when preparing the medication, verifying the correct dosage and form. The final check is before administering the medication to the patient, confirming the medication, dosage, and patient identification. These three checks help to ensure patient safety and reduce the risk of medication errors.

Explanation

Before giving a medication, it is important to check it three times. This is to ensure accuracy and prevent medication errors. The first check is when retrieving the medication from the storage area, comparing it with the medication order or prescription. The second check is when preparing the medication, verifying the correct dosage and form. The final check is before administering the medication to the patient, confirming the medication, dosage, and patient identification. These three checks help to ensure patient safety and reduce the risk of medication errors.

12. Which organ is most responsible for the metabolism of drugs?

Spleen

Stomach

Liver

Kidney

The liver is the organ most responsible for the metabolism of drugs. It contains enzymes that break down drugs into smaller molecules, which can then be eliminated from the body. The liver plays a crucial role in metabolizing drugs to ensure their effectiveness and prevent potential toxicity. It is responsible for metabolizing a wide range of drugs, including prescription medications, over-the-counter drugs, and even substances like alcohol. The liver's high metabolic activity and its ability to detoxify and eliminate drugs make it the primary organ involved in drug metabolism.

Explanation

The liver is the organ most responsible for the metabolism of drugs. It contains enzymes that break down drugs into smaller molecules, which can then be eliminated from the body. The liver plays a crucial role in metabolizing drugs to ensure their effectiveness and prevent potential toxicity. It is responsible for metabolizing a wide range of drugs, including prescription medications, over-the-counter drugs, and even substances like alcohol. The liver's high metabolic activity and its ability to detoxify and eliminate drugs make it the primary organ involved in drug metabolism.

13. You prepare and administer an antibiotic injection the nurse practitioner in the clinic ordered. Which phase of the nursing process would this be?

Assessment

Nursing diagnosis

Plan (goals)

Implementation

Evaluation

The administration of an antibiotic injection that has been ordered by a nurse practitioner in a clinic falls under the implementation phase of the nursing process. This phase involves carrying out the planned interventions and providing the necessary care to the patient. In this case, the nurse is implementing the treatment plan by administering the antibiotic injection as prescribed.

Explanation

The administration of an antibiotic injection that has been ordered by a nurse practitioner in a clinic falls under the implementation phase of the nursing process. This phase involves carrying out the planned interventions and providing the necessary care to the patient. In this case, the nurse is implementing the treatment plan by administering the antibiotic injection as prescribed.

14. The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient?

"do you depend on sleeping pills to get to sleep?"

"do you have a family history of heart disease?"

"When you have pain, what do you do to relieve it?"

"What childhood diseases did you have."

The question "When you have pain, what do you do to relieve it?" will obtain the most information from the patient because it directly addresses their pain management strategies. By asking this question, the nurse can gather information about the patient's use of analgesics or other methods they employ to alleviate pain, which can be crucial in developing an effective treatment plan. This question focuses specifically on the patient's pain management techniques, while the other options inquire about different aspects of the patient's medical history.

Explanation

The question "When you have pain, what do you do to relieve it?" will obtain the most information from the patient because it directly addresses their pain management strategies. By asking this question, the nurse can gather information about the patient's use of analgesics or other methods they employ to alleviate pain, which can be crucial in developing an effective treatment plan. This question focuses specifically on the patient's pain management techniques, while the other options inquire about different aspects of the patient's medical history.

15. For which activity is the nurse responsible during the evaluation phase of drug administration?

Preparing and administering prescribed medications safely

Planning measurable outcomes for the patient related to drug therapy

Monitoring the patient continuously for therapeutic as well as adverse effects

Gathering data in a drug and dietary history

During the evaluation phase of drug administration, the nurse is responsible for monitoring the patient continuously for therapeutic as well as adverse effects. This involves closely observing the patient's response to the medication, assessing for any positive or negative effects, and documenting any changes or concerns. By monitoring the patient, the nurse can ensure the effectiveness and safety of the drug therapy and make any necessary adjustments or interventions.

Explanation

During the evaluation phase of drug administration, the nurse is responsible for monitoring the patient continuously for therapeutic as well as adverse effects. This involves closely observing the patient's response to the medication, assessing for any positive or negative effects, and documenting any changes or concerns. By monitoring the patient, the nurse can ensure the effectiveness and safety of the drug therapy and make any necessary adjustments or interventions.

16. Place the steps of the nursing process in order, with (1) being the first step and (5) being the last step.

1

2

3

4

5

Submit

17. Drug half-life is defined as the amount of time required for 50% of a drug to

Be absorbed by the body

Exert a response

Be eliminated by the body

Reach a therapeutic level

Drug half-life is the time it takes for half of a drug to be eliminated from the body. This means that after one half-life, 50% of the drug is gone. The elimination of a drug from the body can occur through various processes such as metabolism, excretion, or both. Understanding the half-life of a drug is important for determining the dosing frequency and duration of therapy.

Explanation

Drug half-life is the time it takes for half of a drug to be eliminated from the body. This means that after one half-life, 50% of the drug is gone. The elimination of a drug from the body can occur through various processes such as metabolism, excretion, or both. Understanding the half-life of a drug is important for determining the dosing frequency and duration of therapy.

18. When clients take two medications that have the same adverse effect, the risk of these effects ________.

Decrease

Increase

No change in risk

When clients take two medications that have the same adverse effect, the risk of these effects increases. This is because the medications may have a synergistic effect, meaning that their combined use can intensify the adverse effects. Additionally, taking multiple medications increases the likelihood of drug-drug interactions, which can further contribute to an increased risk of adverse effects. Therefore, when clients take two medications with the same adverse effect, the overall risk of experiencing these effects is higher.

Explanation

When clients take two medications that have the same adverse effect, the risk of these effects increases. This is because the medications may have a synergistic effect, meaning that their combined use can intensify the adverse effects. Additionally, taking multiple medications increases the likelihood of drug-drug interactions, which can further contribute to an increased risk of adverse effects. Therefore, when clients take two medications with the same adverse effect, the overall risk of experiencing these effects is higher.

19. What is the most appropriate response to a patient who informs the nurse that he or she does not want to share information about the drugs he or she takes at home?

"It sounds like you are taking something that you don't want us to know about."

"We are just asking to make sure you don't have any drug allergies."

The correct answer emphasizes the importance of knowing the patient's home medications for safe administration of drugs while in the healthcare facility. It assures the patient that this information will be kept confidential, addressing any concerns about privacy. Additionally, it acknowledges the inclusion of herbal products, indicating a comprehensive understanding of the patient's medication regimen.

Explanation

The correct answer emphasizes the importance of knowing the patient's home medications for safe administration of drugs while in the healthcare facility. It assures the patient that this information will be kept confidential, addressing any concerns about privacy. Additionally, it acknowledges the inclusion of herbal products, indicating a comprehensive understanding of the patient's medication regimen.

20. The nurse monitors the fulfillment of goals, and may revise them, during which phase of the nursing process?

Assessment

Planning

Implementation

Evaluation

During the evaluation phase of the nursing process, the nurse monitors the fulfillment of goals and may revise them. This phase involves assessing whether the interventions and care plans have been effective in achieving the desired outcomes. The nurse evaluates the patient's response to the interventions and makes any necessary adjustments to the plan of care. This phase is crucial in ensuring that the patient's needs are being met and that the care provided is appropriate and effective.

Explanation

During the evaluation phase of the nursing process, the nurse monitors the fulfillment of goals and may revise them. This phase involves assessing whether the interventions and care plans have been effective in achieving the desired outcomes. The nurse evaluates the patient's response to the interventions and makes any necessary adjustments to the plan of care. This phase is crucial in ensuring that the patient's needs are being met and that the care provided is appropriate and effective.

21. The nurse prepares and administers prescribed medications during which phase of the nursing process?

Assessment

Planning

Implementation

Evaluation

The nurse prepares and administers prescribed medications during the implementation phase of the nursing process. This phase involves carrying out the planned interventions and providing the necessary care to the patient. In this case, the nurse is implementing the medication administration as prescribed by the healthcare provider. The implementation phase focuses on taking action to meet the patient's healthcare needs and follows the planning phase where the nurse develops a plan of care based on the assessment findings. The evaluation phase comes after implementation to assess the effectiveness of the interventions.

Explanation

The nurse prepares and administers prescribed medications during the implementation phase of the nursing process. This phase involves carrying out the planned interventions and providing the necessary care to the patient. In this case, the nurse is implementing the medication administration as prescribed by the healthcare provider. The implementation phase focuses on taking action to meet the patient's healthcare needs and follows the planning phase where the nurse develops a plan of care based on the assessment findings. The evaluation phase comes after implementation to assess the effectiveness of the interventions.

22. Patients with renal failure would most likely have problems with drug

Excretion

Absorption

Metabolism

Distribution

Patients with renal failure would most likely have problems with drug excretion. Renal failure refers to the inability of the kidneys to adequately filter waste products from the blood and eliminate them through urine. Since many drugs are eliminated from the body through the kidneys, impaired kidney function can result in a decreased ability to excrete drugs. This can lead to drug accumulation in the body, potentially causing toxicity or adverse effects. Therefore, patients with renal failure are more likely to experience problems with drug excretion.

Explanation

Patients with renal failure would most likely have problems with drug excretion. Renal failure refers to the inability of the kidneys to adequately filter waste products from the blood and eliminate them through urine. Since many drugs are eliminated from the body through the kidneys, impaired kidney function can result in a decreased ability to excrete drugs. This can lead to drug accumulation in the body, potentially causing toxicity or adverse effects. Therefore, patients with renal failure are more likely to experience problems with drug excretion.

23. A patient's chart includes an order that reads as follows: "Lanoxin 250mcg once daily at 0900." Which action by the nurse is correct?

The nurse give the drug via transdermal route

The nurse gives the drug orally

The nurse give the drug intravenously

The nurse contacts the provider to specify the dosage route

The order for Lanoxin does not specify the route of administration. Therefore, the nurse should contact the provider to clarify whether the drug should be given orally, via transdermal route, or intravenously. This is important because different routes of administration can have different absorption rates and effects on the patient. It is crucial to ensure that the correct route is chosen to ensure the safe and effective administration of the medication.

Explanation

The order for Lanoxin does not specify the route of administration. Therefore, the nurse should contact the provider to clarify whether the drug should be given orally, via transdermal route, or intravenously. This is important because different routes of administration can have different absorption rates and effects on the patient. It is crucial to ensure that the correct route is chosen to ensure the safe and effective administration of the medication.

24. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following is an appropriate nursing action?

Administer the prescribed dose

Withhold the medication

Ask the provider to change the prescription to an oral form

Administer an oral antihistamine at the same time.

Based on the client's history of developing a rash after taking penicillin, it is appropriate for the nurse to withhold the medication. This is because the client may have developed an allergic reaction to penicillin, and administering the medication again could potentially lead to a more severe reaction. It is important for the nurse to inform the healthcare provider about the client's history so that an alternative medication can be prescribed if necessary.

Explanation

Based on the client's history of developing a rash after taking penicillin, it is appropriate for the nurse to withhold the medication. This is because the client may have developed an allergic reaction to penicillin, and administering the medication again could potentially lead to a more severe reaction. It is important for the nurse to inform the healthcare provider about the client's history so that an alternative medication can be prescribed if necessary.

25. During the implementation phase of the nursing process, which action will the nurse perform when administering medications?

Switch the route of administration based on drug availability.

Call the patient by name when entering the room to verify the drug is for the right person.

Check the patient’s armband before administering the medication.

Prepare medications for all patients first, then administer by room to manage time

The nurse will check the patient's armband before administering the medication to ensure that it is being given to the right person. This is an important safety measure to prevent medication errors and ensure that the patient receives the correct medication. By verifying the patient's identity before administering the medication, the nurse can ensure that the medication is appropriate for the patient and avoid any potential harm.

Explanation

The nurse will check the patient's armband before administering the medication to ensure that it is being given to the right person. This is an important safety measure to prevent medication errors and ensure that the patient receives the correct medication. By verifying the patient's identity before administering the medication, the nurse can ensure that the medication is appropriate for the patient and avoid any potential harm.

26. A nurse is reviewing a client's health record and nots a new prescription by the provider for lisinopril (Zestril) 10 mg PO every day. The nurse should recognize this a which of the following types of prescription?

Single prescription

Stat prescription

Routine prescription

PRN prescription

The nurse should recognize this as a routine prescription because it is a medication that is prescribed to be taken every day without any specific timing or as-needed basis. A routine prescription is a medication order that is given on a regular basis to maintain a client's health or manage a chronic condition. In contrast, a single prescription is for a one-time dose, a stat prescription is for an immediate dose, and a PRN prescription is for medication to be taken as needed.

Explanation

The nurse should recognize this as a routine prescription because it is a medication that is prescribed to be taken every day without any specific timing or as-needed basis. A routine prescription is a medication order that is given on a regular basis to maintain a client's health or manage a chronic condition. In contrast, a single prescription is for a one-time dose, a stat prescription is for an immediate dose, and a PRN prescription is for medication to be taken as needed.

27. A patient who has advanced cancer is receiving opioid medications around the clock to "keep him comfortable" as he nears the end of his life. Which term best describes this type of therapy?

Palliative therapy

Maintenance therapy

Supportive therapy

Supplemental therapy

Palliative therapy is the best term to describe the type of therapy the patient is receiving. Palliative therapy focuses on providing relief from symptoms, pain, and stress associated with a serious illness, with the goal of improving the patient's quality of life. In this case, the opioids are being used to keep the patient comfortable as he nears the end of his life, which aligns with the principles of palliative care. Maintenance therapy typically refers to ongoing treatment to manage a chronic condition, supportive therapy provides emotional and psychological support, and supplemental therapy implies an additional treatment used alongside the primary therapy.

Explanation

Palliative therapy is the best term to describe the type of therapy the patient is receiving. Palliative therapy focuses on providing relief from symptoms, pain, and stress associated with a serious illness, with the goal of improving the patient's quality of life. In this case, the opioids are being used to keep the patient comfortable as he nears the end of his life, which aligns with the principles of palliative care. Maintenance therapy typically refers to ongoing treatment to manage a chronic condition, supportive therapy provides emotional and psychological support, and supplemental therapy implies an additional treatment used alongside the primary therapy.

28. Match the definition with the correct dosage form

drug delivered directly into the circulation, where it is distributed with the blood thoughout the body

ABSORBED INTO THE SYSTEMIC CIRCULATION THROUGH THE MUCOSA OF THE STOMACH AND/OR SMALL OR LARGE INTESTINE

Can be applied to the skin, yes, ears, nose, lungs, rectum or vagina

Submit

29. Which phase of the nursing process requires the nurse to establish a comprehensive baseline of data concerning a particular patient?

Assessment

Planning

Implementation

Evaluation

The phase of the nursing process that requires the nurse to establish a comprehensive baseline of data concerning a particular patient is assessment. During the assessment phase, the nurse collects information about the patient's physical, psychological, social, and environmental status. This includes gathering data through interviews, observations, and physical examinations. By establishing a comprehensive baseline of data, the nurse is able to identify the patient's needs, problems, and strengths, which will then guide the planning and implementation of nursing care. Evaluation, on the other hand, involves determining the effectiveness of the nursing interventions implemented.

Explanation

The phase of the nursing process that requires the nurse to establish a comprehensive baseline of data concerning a particular patient is assessment. During the assessment phase, the nurse collects information about the patient's physical, psychological, social, and environmental status. This includes gathering data through interviews, observations, and physical examinations. By establishing a comprehensive baseline of data, the nurse is able to identify the patient's needs, problems, and strengths, which will then guide the planning and implementation of nursing care. Evaluation, on the other hand, involves determining the effectiveness of the nursing interventions implemented.

30. Which information is of highest priority when obtaining a pharmacologic history from a patient?

Allergies

Use of over-the-counter medications

Home remedy use

Alcohol intake

When obtaining a pharmacologic history from a patient, the highest priority information is allergies. This is because allergies can have serious and potentially life-threatening reactions when exposed to certain medications. Knowing about a patient's allergies allows healthcare providers to avoid prescribing or administering medications that could cause an allergic reaction. It helps ensure patient safety and prevents adverse drug reactions. Therefore, allergies are crucial information that healthcare providers need to prioritize when obtaining a pharmacologic history.

Explanation

When obtaining a pharmacologic history from a patient, the highest priority information is allergies. This is because allergies can have serious and potentially life-threatening reactions when exposed to certain medications. Knowing about a patient's allergies allows healthcare providers to avoid prescribing or administering medications that could cause an allergic reaction. It helps ensure patient safety and prevents adverse drug reactions. Therefore, allergies are crucial information that healthcare providers need to prioritize when obtaining a pharmacologic history.

31. What is the primary organ responsible for elimination?

LIver

Kidney

Large Intestine

Lungs

The kidney is the primary organ responsible for elimination. It plays a crucial role in filtering waste products, toxins, and excess water from the blood to produce urine. The kidneys also help regulate the body's electrolyte balance and maintain proper blood pressure. The liver, large intestine, and lungs also have elimination functions, but the kidney is specifically designed for this purpose.

Explanation

The kidney is the primary organ responsible for elimination. It plays a crucial role in filtering waste products, toxins, and excess water from the blood to produce urine. The kidneys also help regulate the body's electrolyte balance and maintain proper blood pressure. The liver, large intestine, and lungs also have elimination functions, but the kidney is specifically designed for this purpose.

32. Drug half-life is defined as the amount of time required for 50% of a drug to:

Be absorbed by the body

Reach therapeutic level

Exert a response

Be removed by the body

Drug half-life refers to the time it takes for 50% of the drug to be eliminated from the body. This means that after one half-life, half of the drug has been removed. The half-life is an important pharmacokinetic parameter as it helps determine dosing intervals and the duration of drug action. It is unrelated to the drug's absorption, therapeutic level, or response.

Explanation

Drug half-life refers to the time it takes for 50% of the drug to be eliminated from the body. This means that after one half-life, half of the drug has been removed. The half-life is an important pharmacokinetic parameter as it helps determine dosing intervals and the duration of drug action. It is unrelated to the drug's absorption, therapeutic level, or response.

33. A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation?

Activity intolerance

Risk for injury

Disturbed body image

Self-care deficit

The best nursing diagnosis for this situation is "risk for injury." This is because the patient is at risk of getting injured due to feeling dizzy as a side effect of the new blood pressure medication. The dizziness may affect the patient's balance and coordination, increasing the chances of falls or accidents. Therefore, the nursing priority should be to assess the patient's risk for injury and implement measures to prevent any potential harm.

Explanation

The best nursing diagnosis for this situation is "risk for injury." This is because the patient is at risk of getting injured due to feeling dizzy as a side effect of the new blood pressure medication. The dizziness may affect the patient's balance and coordination, increasing the chances of falls or accidents. Therefore, the nursing priority should be to assess the patient's risk for injury and implement measures to prevent any potential harm.

34. A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement?

"take the tablet with 2 to 3 ounces of orange juice

"avoid taking all other medications with any enteric coated tablet"

"Crush the tablet before swallowing if you have problems with swallowing."

"Be sure to swallow the tablet whole without chewing it."

The correct answer is "Be sure to swallow the tablet whole without chewing it." This is because enteric-coated tablets are designed to dissolve in the small intestine rather than the stomach. Chewing or crushing the tablet can interfere with the enteric coating and may cause the medication to be released too early, potentially causing stomach irritation or reducing its effectiveness.

Explanation

The correct answer is "Be sure to swallow the tablet whole without chewing it." This is because enteric-coated tablets are designed to dissolve in the small intestine rather than the stomach. Chewing or crushing the tablet can interfere with the enteric coating and may cause the medication to be released too early, potentially causing stomach irritation or reducing its effectiveness.

35. A doctor orders a medication to be given one time every day. You would write this as:

QD

QID

Once a day

Every A.M.

The correct answer is "Once a day" because it accurately represents the doctor's order for the medication to be given once daily. The other options, QD and QID, are abbreviations that stand for different frequencies of medication administration. "Every A.M." does not specify the frequency, but only the time of day when the medication should be given.

Explanation

The correct answer is "Once a day" because it accurately represents the doctor's order for the medication to be given once daily. The other options, QD and QID, are abbreviations that stand for different frequencies of medication administration. "Every A.M." does not specify the frequency, but only the time of day when the medication should be given.

36. The nurse notes that a medication was scheduled to be administered at 0900. A medication error has occurred if the medication was administered at which time?

0800

0830

0900

0930

If the medication was scheduled to be administered at 0900 and it was actually administered at 0800, a medication error has occurred. This is because the medication was given earlier than the scheduled time, which could potentially affect the effectiveness and safety of the medication.

Explanation

If the medication was scheduled to be administered at 0900 and it was actually administered at 0800, a medication error has occurred. This is because the medication was given earlier than the scheduled time, which could potentially affect the effectiveness and safety of the medication.

37. A pain medication is ordered to be given every 4 hours prn. What does prn mean?

The term "prn" stands for "pro re nata," which means "as needed" or "when needed." It indicates that the pain medication should be administered whenever the patient requires it, based on their pain levels or discomfort. This allows for flexibility in dosing, ensuring that the medication is given only when necessary and not on a fixed schedule.

Explanation

The term "prn" stands for "pro re nata," which means "as needed" or "when needed." It indicates that the pain medication should be administered whenever the patient requires it, based on their pain levels or discomfort. This allows for flexibility in dosing, ensuring that the medication is given only when necessary and not on a fixed schedule.

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38. Which part of the nursing process should be realistic, timed, and measurable?

Assessment

Nursing diagnosis

Plan (goals)

Implementation

Evaluation

The part of the nursing process that should be realistic, timed, and measurable is the plan (goals). This is because the goals set in the plan should be achievable and specific, with a clear timeline for completion. They should also be measurable, meaning that progress towards the goals can be objectively assessed and evaluated. This ensures that the plan is effective and allows for adjustments to be made if necessary.

Explanation

The part of the nursing process that should be realistic, timed, and measurable is the plan (goals). This is because the goals set in the plan should be achievable and specific, with a clear timeline for completion. They should also be measurable, meaning that progress towards the goals can be objectively assessed and evaluated. This ensures that the plan is effective and allows for adjustments to be made if necessary.

39. You receive an order to give Benadryl (diphenhydramine). Benadryl would be the

Chemical name

Generic name

Trade name

The correct answer is "Trade name." In this context, Benadryl refers to the trade name of the medication rather than its chemical or generic name. Trade names are brand names given to medications by the pharmaceutical companies that manufacture them. They are used for marketing and identification purposes, while chemical names and generic names are more standardized and used in scientific and medical contexts.

Explanation

The correct answer is "Trade name." In this context, Benadryl refers to the trade name of the medication rather than its chemical or generic name. Trade names are brand names given to medications by the pharmaceutical companies that manufacture them. They are used for marketing and identification purposes, while chemical names and generic names are more standardized and used in scientific and medical contexts.

40. A nurse is reviewing a client's health record and notes that the previous medication caused permanent extrapyramidal effects. The nurse recognizes that the medication affected the client's

Cardiovascular system

Immune system

Central nervous system

Gastrointestinal system

The nurse recognizes that the medication affected the client's central nervous system. This is because extrapyramidal effects refer to a group of movement disorders that are caused by certain medications, particularly antipsychotic drugs. These effects include symptoms such as tremors, muscle stiffness, and involuntary movements, which are all related to the central nervous system. The cardiovascular system, immune system, and gastrointestinal system are not typically affected by medications causing extrapyramidal effects.

Explanation

The nurse recognizes that the medication affected the client's central nervous system. This is because extrapyramidal effects refer to a group of movement disorders that are caused by certain medications, particularly antipsychotic drugs. These effects include symptoms such as tremors, muscle stiffness, and involuntary movements, which are all related to the central nervous system. The cardiovascular system, immune system, and gastrointestinal system are not typically affected by medications causing extrapyramidal effects.

41. What is an alternate name for biotransformation of a drug?

Absorption

Dilution

Excretion

Metabolism

Biotransformation of a drug refers to the process by which a drug is metabolized or broken down in the body. Metabolism is the correct answer because it accurately describes the alternate name for this process. Absorption refers to the process by which a drug enters the bloodstream, dilution refers to the process of reducing the concentration of a drug, and excretion refers to the process of eliminating a drug from the body. None of these terms accurately describe the biotransformation of a drug.

Explanation

Biotransformation of a drug refers to the process by which a drug is metabolized or broken down in the body. Metabolism is the correct answer because it accurately describes the alternate name for this process. Absorption refers to the process by which a drug enters the bloodstream, dilution refers to the process of reducing the concentration of a drug, and excretion refers to the process of eliminating a drug from the body. None of these terms accurately describe the biotransformation of a drug.

42. The nurse is preparing to administer morning doses of medications to a patient and has just checked the patient's name on the identification band. The patient has stated his name. Which is the nurse's next appropriate action?

Administer the medications

Ask the patient's wife to verify the patient's identity

Ask the patient to verify his date of birth

Check the chart for the patient's date of birth

The nurse's next appropriate action would be to ask the patient to verify his date of birth. This is an important step to ensure that the nurse is administering the medications to the correct patient. Verifying the patient's date of birth adds an extra layer of confirmation and helps prevent medication errors.

Explanation

The nurse's next appropriate action would be to ask the patient to verify his date of birth. This is an important step to ensure that the nurse is administering the medications to the correct patient. Verifying the patient's date of birth adds an extra layer of confirmation and helps prevent medication errors.

43. The LPN is assigned to a patient who is newly diagnosed with type 1 mellitus. Which of the following best illustrates an outcome critierion for this patient?

The patient will follow instructions

The patient will not experience complications

The patient adheres to the new insulin treatment regimen

The patient demonstrates safe insulin self-administration techniques after 3 lessons

The correct answer illustrates an outcome criterion for a patient newly diagnosed with type 1 mellitus. It focuses on the patient's ability to demonstrate safe insulin self-administration techniques after receiving three lessons. This outcome criterion is specific, measurable, achievable, relevant, and time-bound (SMART), as it sets a clear expectation for the patient's skill development within a specific timeframe. It also reflects a desired outcome for the patient's successful management of their condition.

Explanation

The correct answer illustrates an outcome criterion for a patient newly diagnosed with type 1 mellitus. It focuses on the patient's ability to demonstrate safe insulin self-administration techniques after receiving three lessons. This outcome criterion is specific, measurable, achievable, relevant, and time-bound (SMART), as it sets a clear expectation for the patient's skill development within a specific timeframe. It also reflects a desired outcome for the patient's successful management of their condition.

44. When a patient asks the nurse why a lower dose of intravenous pain medication is being given than the previous oral dose, what knowledge will the nurse draw on to respond to the patient?

Medications given intravenously are not affected by the first-pass effect.

Medications given orally bypass the portal circulatory system

A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver.

Drugs administered intravenously enter the portal system prior to systemic distribution.

The nurse will draw on their knowledge of pharmacokinetics to explain to the patient that medications given intravenously are not affected by the first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver before it reaches systemic circulation. When a medication is given orally, it must pass through the liver first, where it may be partially metabolized before reaching the bloodstream. However, when a medication is given intravenously, it bypasses the liver and goes directly into the bloodstream, avoiding the first-pass effect and resulting in a higher bioavailability and potentially requiring a lower dose.

Explanation

The nurse will draw on their knowledge of pharmacokinetics to explain to the patient that medications given intravenously are not affected by the first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver before it reaches systemic circulation. When a medication is given orally, it must pass through the liver first, where it may be partially metabolized before reaching the bloodstream. However, when a medication is given intravenously, it bypasses the liver and goes directly into the bloodstream, avoiding the first-pass effect and resulting in a higher bioavailability and potentially requiring a lower dose.

45. When considering the various routes of drug elimination, the nurse is aware that elimination occurs mainly by which routes?

Renal tubules and skin

Skin and lungs

Bowel and renal tubules

Lungs and gastrointestinal tract

The correct answer is bowel and renal tubules. Drug elimination refers to the process by which drugs are removed from the body. The two main routes of drug elimination are through the bowel (via feces) and the renal tubules (via urine). The bowel eliminates drugs that are not absorbed into the bloodstream and are excreted in the feces. The renal tubules eliminate drugs that are filtered out of the blood by the kidneys and excreted in the urine.

Explanation

The correct answer is bowel and renal tubules. Drug elimination refers to the process by which drugs are removed from the body. The two main routes of drug elimination are through the bowel (via feces) and the renal tubules (via urine). The bowel eliminates drugs that are not absorbed into the bloodstream and are excreted in the feces. The renal tubules eliminate drugs that are filtered out of the blood by the kidneys and excreted in the urine.

46. What is the ratio between a drug's therapeutic effects and toxic effects called?

Tolerance

Cumulative effect

Therapeutic index

Affinity

The ratio between a drug's therapeutic effects and toxic effects is called the therapeutic index. This index is used to measure the safety and effectiveness of a drug by comparing the amount needed to produce therapeutic effects with the amount that could cause toxic effects. A higher therapeutic index indicates a safer drug, as the therapeutic effects are more pronounced compared to the toxic effects.

Explanation

The ratio between a drug's therapeutic effects and toxic effects is called the therapeutic index. This index is used to measure the safety and effectiveness of a drug by comparing the amount needed to produce therapeutic effects with the amount that could cause toxic effects. A higher therapeutic index indicates a safer drug, as the therapeutic effects are more pronounced compared to the toxic effects.

47. The nurse should include which information when evaluating the outcome after a patient's medication has been administered?

Dose of medication administered

Time medication administered

Patient allergies to medications

Therapeutic effect of patient

When evaluating the outcome after a patient's medication has been administered, it is important for the nurse to include the information about the therapeutic effect of the patient. This information helps the nurse determine whether the medication is achieving the desired effect and if it is helping the patient's condition improve. By evaluating the therapeutic effect, the nurse can assess the effectiveness of the medication and make any necessary adjustments to the treatment plan. The dose of medication administered, time of administration, and patient allergies are also important factors to consider, but they do not directly provide information about the medication's effectiveness in achieving the desired therapeutic effect.

Explanation

When evaluating the outcome after a patient's medication has been administered, it is important for the nurse to include the information about the therapeutic effect of the patient. This information helps the nurse determine whether the medication is achieving the desired effect and if it is helping the patient's condition improve. By evaluating the therapeutic effect, the nurse can assess the effectiveness of the medication and make any necessary adjustments to the treatment plan. The dose of medication administered, time of administration, and patient allergies are also important factors to consider, but they do not directly provide information about the medication's effectiveness in achieving the desired therapeutic effect.

48. Examples of Parenteral dosage routes

Transdermal

Intradermal

Tablets

Inhaled

Rectal

The given answer, "Intradermal," is correct because it is a parenteral dosage route. Parenteral refers to any route of administration that does not involve the digestive tract, such as injections. Intradermal administration involves injecting a substance into the dermis layer of the skin, just below the epidermis. This route is commonly used for skin testing, such as tuberculin tests or allergy tests, where a small amount of the substance is injected into the skin and observed for a reaction.

Explanation

The given answer, "Intradermal," is correct because it is a parenteral dosage route. Parenteral refers to any route of administration that does not involve the digestive tract, such as injections. Intradermal administration involves injecting a substance into the dermis layer of the skin, just below the epidermis. This route is commonly used for skin testing, such as tuberculin tests or allergy tests, where a small amount of the substance is injected into the skin and observed for a reaction.

49. While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur?

Absorption

Distribution

Metabolism

Excretion

Abnormalities in metabolism may occur in patients with cirrhosis or hepatitis. Cirrhosis is a condition in which the liver is scarred and cannot function properly, while hepatitis is inflammation of the liver. The liver plays a crucial role in drug metabolism, where drugs are broken down into metabolites that can be eliminated from the body. In patients with liver disease, the liver's ability to metabolize drugs may be impaired, leading to an accumulation of drugs in the body or altered drug effects. Therefore, abnormalities in metabolism are likely to occur in patients with cirrhosis or hepatitis.

Explanation

Abnormalities in metabolism may occur in patients with cirrhosis or hepatitis. Cirrhosis is a condition in which the liver is scarred and cannot function properly, while hepatitis is inflammation of the liver. The liver plays a crucial role in drug metabolism, where drugs are broken down into metabolites that can be eliminated from the body. In patients with liver disease, the liver's ability to metabolize drugs may be impaired, leading to an accumulation of drugs in the body or altered drug effects. Therefore, abnormalities in metabolism are likely to occur in patients with cirrhosis or hepatitis.

50. Which of the following questions is most helpful in compiling a drug history for a patient?

"Do you have a family history of heart disease?"

"What medication relieves your pain?"

"What childhood diseases have you had?"

"What surgeries have you had?"

The question "What medication relieves your pain?" is the most helpful in compiling a drug history for a patient because it directly asks about the medications the patient is taking to manage their pain. This information is important for understanding the patient's current drug regimen and any potential interactions or contraindications with other medications that may be prescribed. It provides insight into the patient's pain management strategy and helps the healthcare provider make informed decisions about their treatment plan.

Explanation

The question "What medication relieves your pain?" is the most helpful in compiling a drug history for a patient because it directly asks about the medications the patient is taking to manage their pain. This information is important for understanding the patient's current drug regimen and any potential interactions or contraindications with other medications that may be prescribed. It provides insight into the patient's pain management strategy and helps the healthcare provider make informed decisions about their treatment plan.

51. A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed:

Once a day

Twice a day

Three times a day

Four times a day

Phenobarbital sodium has a long half-life of 4 days, meaning it takes 4 days for the concentration of the drug in the body to decrease by half. Because of this long half-life, the medication can be prescribed once a day. This is because the drug remains in the body for an extended period of time, providing a sustained therapeutic effect. Taking the medication once a day ensures that the drug concentration remains at a therapeutic level throughout the day, reducing the need for multiple daily doses.

Explanation

Phenobarbital sodium has a long half-life of 4 days, meaning it takes 4 days for the concentration of the drug in the body to decrease by half. Because of this long half-life, the medication can be prescribed once a day. This is because the drug remains in the body for an extended period of time, providing a sustained therapeutic effect. Taking the medication once a day ensures that the drug concentration remains at a therapeutic level throughout the day, reducing the need for multiple daily doses.

52. An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experience which type of reaction or effect?

Allergic reaction

Idiosyncratic reaction

Mutagenic effect

Synergistic effect

The elderly woman's experience of feeling restless all night and not being able to sleep after taking the prescription medicine suggests that she is experiencing an idiosyncratic reaction. An idiosyncratic reaction is a rare and unpredictable response to a medication that is not related to the drug's known pharmacological effects. In this case, the medicine intended to help her sleep had the opposite effect, causing restlessness and insomnia. This type of reaction is not common and can vary from person to person.

Explanation

The elderly woman's experience of feeling restless all night and not being able to sleep after taking the prescription medicine suggests that she is experiencing an idiosyncratic reaction. An idiosyncratic reaction is a rare and unpredictable response to a medication that is not related to the drug's known pharmacological effects. In this case, the medicine intended to help her sleep had the opposite effect, causing restlessness and insomnia. This type of reaction is not common and can vary from person to person.

53. When the LPN is transcribing orders and considering when to correctly administer a medication, the following factors listed would be the most important to assess:

If the patient is male or female

The patients last meal

The patients weight

Patient's identification.

When transcribing orders and considering when to correctly administer a medication, the most important factor to assess is the patient's identification. This is crucial to ensure that the medication is given to the correct patient, preventing any potential harm or errors. The patient's gender, last meal, and weight may be important factors to consider for other aspects of care, but they are not directly relevant to the administration of medication.

Explanation

When transcribing orders and considering when to correctly administer a medication, the most important factor to assess is the patient's identification. This is crucial to ensure that the medication is given to the correct patient, preventing any potential harm or errors. The patient's gender, last meal, and weight may be important factors to consider for other aspects of care, but they are not directly relevant to the administration of medication.

54. A nurse is completing discharge teaching to a client who has a new prescription for a transdermal medication. Which of the following statements be the client indicates understanding of the teaching?

"I will clean the site with an alcohol swab prior to applying the patch"

"I will rotate the application sites weekly"

"I will apply the patch to an area of the skin with no hair"

"I will place the new patch on the site of the old patch"

The correct answer is "I will apply the patch to an area of the skin with no hair." This statement indicates that the client understands the proper technique for applying a transdermal medication. Applying the patch to an area of the skin with no hair ensures better adhesion and absorption of the medication.

Explanation

The correct answer is "I will apply the patch to an area of the skin with no hair." This statement indicates that the client understands the proper technique for applying a transdermal medication. Applying the patch to an area of the skin with no hair ensures better adhesion and absorption of the medication.

55. A Nurse is reviewing a client's health record and notes a new prescription by the provider to verify the trough level of the client's medication. Which of the following actions should the nurses take?

Have a blood specimen obtained immediately prior to the next dose of medication

Verify that the client has been on the medication for 24hr before ordering a blood specimen

Ask the client to provide a urine specimen after the next dose of medication

Begin administering the medication, and obtain a blood specimen

The nurse should have a blood specimen obtained immediately prior to the next dose of medication. This is because the provider has prescribed to verify the trough level of the client's medication. The trough level refers to the lowest concentration of the medication in the client's bloodstream, which is typically measured just before the next dose is administered. By obtaining a blood specimen at this time, the nurse can accurately assess the trough level and ensure that the medication is within the therapeutic range.

Explanation

The nurse should have a blood specimen obtained immediately prior to the next dose of medication. This is because the provider has prescribed to verify the trough level of the client's medication. The trough level refers to the lowest concentration of the medication in the client's bloodstream, which is typically measured just before the next dose is administered. By obtaining a blood specimen at this time, the nurse can accurately assess the trough level and ensure that the medication is within the therapeutic range.

56. After how many half-live are most drugs considered to be effectively removed from the body?

Five

Three

Eight

Two

Most drugs are considered to be effectively removed from the body after approximately five half-lives. This is because after each half-life, the concentration of the drug in the body decreases by half. By the time five half-lives have passed, the drug concentration is reduced to a negligible amount, making it effectively eliminated from the body.

Explanation

Most drugs are considered to be effectively removed from the body after approximately five half-lives. This is because after each half-life, the concentration of the drug in the body decreases by half. By the time five half-lives have passed, the drug concentration is reduced to a negligible amount, making it effectively eliminated from the body.

57. Pharmacokinetics involves the study of

Physiologic interactions of drugs

Distribution rates among various body compartments

Interactions between various drugs

Adverse reactions to medications

Pharmacokinetics is the study of how drugs are distributed within the body, including the rates at which they move between different compartments. This involves understanding how drugs are absorbed, distributed, metabolized, and eliminated by the body. By studying the distribution rates among various body compartments, pharmacokinetics helps to determine how drugs are distributed throughout the body and how they are affected by factors such as blood flow, tissue binding, and drug interactions.

Explanation

Pharmacokinetics is the study of how drugs are distributed within the body, including the rates at which they move between different compartments. This involves understanding how drugs are absorbed, distributed, metabolized, and eliminated by the body. By studying the distribution rates among various body compartments, pharmacokinetics helps to determine how drugs are distributed throughout the body and how they are affected by factors such as blood flow, tissue binding, and drug interactions.

58. A newly hired nurse asks another nurse about how to accept a telephone prescription. Which of the following statements by the newly hired nurse indicates understanding of the discussion?

"A second nurse enter the prescription into the client's health record."

"Another nurse should listen to the phone call."

"The provider can clarify the prescription when he signs the health record."

"The ''read back' is omitted if this is a one-time prescription."

The correct answer indicates understanding of the discussion because it acknowledges the importance of having another nurse listen to the phone call when accepting a telephone prescription. This is crucial for ensuring accuracy and preventing any potential errors or miscommunication.

Explanation

The correct answer indicates understanding of the discussion because it acknowledges the importance of having another nurse listen to the phone call when accepting a telephone prescription. This is crucial for ensuring accuracy and preventing any potential errors or miscommunication.

59. Examples of enteral dosage routes (select all that apply)

Sublingual

Subcutaneous

Buccal

Time released tablets

Transdermal

The question asks for examples of enteral dosage routes, which are routes of administration where the medication is absorbed through the gastrointestinal tract. Sublingual and buccal routes involve placing the medication under the tongue and against the cheek, respectively, allowing for absorption through the mucous membranes in the mouth. Time released tablets are also an example of an enteral dosage route, as they are designed to release the medication slowly over an extended period of time in the gastrointestinal tract.

Explanation

The question asks for examples of enteral dosage routes, which are routes of administration where the medication is absorbed through the gastrointestinal tract. Sublingual and buccal routes involve placing the medication under the tongue and against the cheek, respectively, allowing for absorption through the mucous membranes in the mouth. Time released tablets are also an example of an enteral dosage route, as they are designed to release the medication slowly over an extended period of time in the gastrointestinal tract.

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60. For dosages greater than 1, round to the nearest

Hundredth

Tenth

Whole number

Thousandth

Dosages greater than 1 should be rounded to the nearest tenth. This means that if the dosage is between two whole numbers, it should be rounded to the closest tenth. For example, if the dosage is 1.45, it should be rounded to 1.5. This ensures that the dosage is a more precise measurement and avoids any potential errors or inaccuracies in the dosage calculation.

Explanation

Dosages greater than 1 should be rounded to the nearest tenth. This means that if the dosage is between two whole numbers, it should be rounded to the closest tenth. For example, if the dosage is 1.45, it should be rounded to 1.5. This ensures that the dosage is a more precise measurement and avoids any potential errors or inaccuracies in the dosage calculation.

61. A nurse is reinforcing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following is an appropriate statement by the nurse?

"Be sure to limit your potassium intake while taking the medication"

"You should check your blood pressure every 8 hr while taking the medication"

"Your medication dosage will be increased if you develop tachycardia"

"Change positions slowly when you move from sitting to standing"

Changing positions slowly when moving from sitting to standing is an appropriate statement by the nurse for a client who has a new prescription for an antihypertensive medication. Antihypertensive medications can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. By advising the client to change positions slowly, the nurse is helping to prevent dizziness, lightheadedness, and potential falls that can occur due to a sudden drop in blood pressure.

Explanation

Changing positions slowly when moving from sitting to standing is an appropriate statement by the nurse for a client who has a new prescription for an antihypertensive medication. Antihypertensive medications can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. By advising the client to change positions slowly, the nurse is helping to prevent dizziness, lightheadedness, and potential falls that can occur due to a sudden drop in blood pressure.

62. During which phase of the nursing process does the nurse prioritize the nursing diagnosis?

Assessment

Planning

Implementation

Evaluation

During the planning phase of the nursing process, the nurse prioritizes the nursing diagnosis. This is because during this phase, the nurse identifies the client's problems, sets goals and develops a plan of care. Prioritizing the nursing diagnosis helps the nurse determine which problems are most urgent and need immediate attention. By prioritizing, the nurse ensures that the client's needs are addressed in a systematic and effective manner, improving the overall quality of care provided.

Explanation

During the planning phase of the nursing process, the nurse prioritizes the nursing diagnosis. This is because during this phase, the nurse identifies the client's problems, sets goals and develops a plan of care. Prioritizing the nursing diagnosis helps the nurse determine which problems are most urgent and need immediate attention. By prioritizing, the nurse ensures that the client's needs are addressed in a systematic and effective manner, improving the overall quality of care provided.

63. IV medications should never infuse through tubing that is infusing what?

IV medications should never infuse through tubing that is infusing blood products, blood, or parenteral nutritional solutions because it can lead to contamination or incompatibility. Medications and blood products have different components that can interact and cause adverse reactions or affect the effectiveness of the medication. Similarly, parenteral nutritional solutions have specific compositions that can be altered or compromised by the introduction of medications. Therefore, it is crucial to use separate tubing for infusing IV medications to ensure patient safety and maintain the integrity of the medications and other infusions.

Explanation

IV medications should never infuse through tubing that is infusing blood products, blood, or parenteral nutritional solutions because it can lead to contamination or incompatibility. Medications and blood products have different components that can interact and cause adverse reactions or affect the effectiveness of the medication. Similarly, parenteral nutritional solutions have specific compositions that can be altered or compromised by the introduction of medications. Therefore, it is crucial to use separate tubing for infusing IV medications to ensure patient safety and maintain the integrity of the medications and other infusions.

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64. The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. The nurse knows that the factor that most influences the decision about which route to use is the patient's

Altered biliary function

Increased glomerular filtration

Reduced liver metabolism

Diminished circulation

The nurse chose the intravenous route instead of the intramuscular route for giving medications to a patient in heart failure because the factor that most influences the decision about which route to use is the patient's diminished circulation. In heart failure, the heart is unable to pump blood effectively, resulting in reduced blood flow to various organs and tissues. By choosing the intravenous route, the medication can be directly delivered into the bloodstream, bypassing the need for absorption through the muscles, which may be compromised in a patient with diminished circulation.

Explanation

The nurse chose the intravenous route instead of the intramuscular route for giving medications to a patient in heart failure because the factor that most influences the decision about which route to use is the patient's diminished circulation. In heart failure, the heart is unable to pump blood effectively, resulting in reduced blood flow to various organs and tissues. By choosing the intravenous route, the medication can be directly delivered into the bloodstream, bypassing the need for absorption through the muscles, which may be compromised in a patient with diminished circulation.

65. An 86-year-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities?

The patient and patient's daughter will state the proper way to take the drug.

The patient will state all the symptoms of digitalis toxicity

The patient will call the prescriber if adverse effects occur

The correct answer suggests that the outcome of patient teaching activities will result in the patient and their daughter being able to correctly state the proper way to take the drug. This implies that the patient has been educated on the correct dosage, administration, and any specific instructions or precautions associated with taking digitalis therapy. It also indicates that the patient's daughter has been included in the teaching process, which can help ensure proper adherence to the medication regimen.

Explanation

The correct answer suggests that the outcome of patient teaching activities will result in the patient and their daughter being able to correctly state the proper way to take the drug. This implies that the patient has been educated on the correct dosage, administration, and any specific instructions or precautions associated with taking digitalis therapy. It also indicates that the patient's daughter has been included in the teaching process, which can help ensure proper adherence to the medication regimen.

66. The order of Bill Smith's chart reads, "give demerol 75mg. now". what "right" is missing for you to give this medication safely? (just one)

The correct answer is "Route." In order to give medication safely, it is important to know the specific route of administration. The order only states the medication and the dosage, but it does not provide information on how the medication should be given (e.g. orally, intravenously, intramuscularly). Without knowing the route, it would not be possible to administer the medication correctly and safely.

Explanation

The correct answer is "Route." In order to give medication safely, it is important to know the specific route of administration. The order only states the medication and the dosage, but it does not provide information on how the medication should be given (e.g. orally, intravenously, intramuscularly). Without knowing the route, it would not be possible to administer the medication correctly and safely.

Submit

67. If a prescriber gives a verbal order, the order on the chart should be signed by the prescriber within _______hours.

If a prescriber gives a verbal order, it is important for the order to be signed by the prescriber within 24 hours. This ensures that the order is properly documented and authorized. Signing the order within this timeframe also helps to maintain accurate and up-to-date patient records, as well as ensuring accountability and traceability in the prescribing process. Failing to sign the order within the specified time may result in delays or errors in patient care, and may also be a violation of legal and regulatory requirements.

Explanation

If a prescriber gives a verbal order, it is important for the order to be signed by the prescriber within 24 hours. This ensures that the order is properly documented and authorized. Signing the order within this timeframe also helps to maintain accurate and up-to-date patient records, as well as ensuring accountability and traceability in the prescribing process. Failing to sign the order within the specified time may result in delays or errors in patient care, and may also be a violation of legal and regulatory requirements.

Submit

68. Which action, when performed by the nurse, will increase the absorption of a medication administered intramuscularly?

Applying cold packs to the injection site

Lowering the extremity below the level of the heart

Administering the medication via the Z-track method

Massaging the site after injection

Massaging the site after injection can increase the absorption of a medication administered intramuscularly. Massaging helps to disperse the medication and increase blood flow to the area, which can enhance absorption. This technique is commonly used to promote absorption and prevent the formation of medication pockets or nodules at the injection site.

Explanation

Massaging the site after injection can increase the absorption of a medication administered intramuscularly. Massaging helps to disperse the medication and increase blood flow to the area, which can enhance absorption. This technique is commonly used to promote absorption and prevent the formation of medication pockets or nodules at the injection site.

69. A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?

Use a disposable razor to remove excess hair on the extremity

Select the back of the client's hand to insert the IV catheter

Distend the vein by using blood pressure cuff

Direct the client to raise his arm above his heart

The nurse should plan to distend the vein by using a blood pressure cuff. This is done to make the veins more visible and easier to access for inserting the IV catheter. By inflating the blood pressure cuff above the client's systolic pressure, the veins will become engorged with blood, making them easier to see and palpate. This technique helps to ensure a successful and accurate insertion of the IV catheter.

Explanation

The nurse should plan to distend the vein by using a blood pressure cuff. This is done to make the veins more visible and easier to access for inserting the IV catheter. By inflating the blood pressure cuff above the client's systolic pressure, the veins will become engorged with blood, making them easier to see and palpate. This technique helps to ensure a successful and accurate insertion of the IV catheter.

70. The nurse is aware that excessive drug dosages, poor circulation, impaired metabolism, or inadequate excretion may result in which drug effect?

Tolerance

Cumulative effect

Incompatibility

Antagonistic effec

Excessive drug dosages, poor circulation, impaired metabolism, or inadequate excretion can lead to a cumulative effect of a drug. This means that the drug will build up in the body over time, causing a stronger or more prolonged effect than intended. This can be dangerous as it increases the risk of toxicity and adverse reactions. The nurse needs to be aware of these factors and monitor patients closely to prevent or detect a cumulative effect.

Explanation

Excessive drug dosages, poor circulation, impaired metabolism, or inadequate excretion can lead to a cumulative effect of a drug. This means that the drug will build up in the body over time, causing a stronger or more prolonged effect than intended. This can be dangerous as it increases the risk of toxicity and adverse reactions. The nurse needs to be aware of these factors and monitor patients closely to prevent or detect a cumulative effect.

71. What is the study of the physiochemical properties of drugs and how they influence the body called?

Pharmacokinetics

Pharmacotherapeutics

Pharmacodynamics

Pharmacology

Pharmacodynamics is the study of the physiochemical properties of drugs and how they influence the body. It focuses on understanding how drugs interact with the body's receptors and enzymes to produce therapeutic effects. This field of study helps in determining the dosage, effectiveness, and safety of drugs, as well as understanding the mechanisms of drug action and potential side effects.

Explanation

Pharmacodynamics is the study of the physiochemical properties of drugs and how they influence the body. It focuses on understanding how drugs interact with the body's receptors and enzymes to produce therapeutic effects. This field of study helps in determining the dosage, effectiveness, and safety of drugs, as well as understanding the mechanisms of drug action and potential side effects.

72. Match these prescription types

identifies medications to give on a regular schedule. It can have a termination date. Without a specified termination date, the prescription will be in effect until the provider discontinues or the client is discharged.

specifies giving a medicaiton once at a specified time or as soon as possible

specifies giving a medication only once, and immediately

stipulates at what dosage, what frequency, and under what conditions a medication can be give. Nurse uses clinial judgment to determine the client's need for the medication.

Submit

73. A nurse manager is reviewing facility policies for IV therapy management with the members of his team. The nurse manager should inform the team members that which of the following techniques will minimize the risk of catheter embolism?

Perform hand hygiene before and after IV insertion

Rotate the IV sites at least every 72 hr

Minimize tourniquet time

Avoid reinserting the needle into an IV catheter

Avoiding reinsertion of the needle into an IV catheter will minimize the risk of catheter embolism. When the needle is reinserted into the catheter, it can cause damage to the catheter, leading to the potential dislodgement of small fragments. These fragments can then travel into the bloodstream and cause an embolism. By avoiding reinsertion, the nurse can reduce the risk of this complication. Performing hand hygiene, rotating IV sites, and minimizing tourniquet time are important practices for IV therapy management but do not directly address the risk of catheter embolism.

Explanation

Avoiding reinsertion of the needle into an IV catheter will minimize the risk of catheter embolism. When the needle is reinserted into the catheter, it can cause damage to the catheter, leading to the potential dislodgement of small fragments. These fragments can then travel into the bloodstream and cause an embolism. By avoiding reinsertion, the nurse can reduce the risk of this complication. Performing hand hygiene, rotating IV sites, and minimizing tourniquet time are important practices for IV therapy management but do not directly address the risk of catheter embolism.

74. A nurse is preparing to administer D5W 200 mL IV to infuse over 5hr. The nurse should set the IV pump to deliver how many mL/hr?

To administer D5W 200 mL IV over 5 hours, the nurse needs to calculate the rate at which the IV pump should deliver the solution. By dividing the total volume (200 mL) by the total time (5 hours), we get 40 mL/hr. Therefore, the IV pump should be set to deliver 40 mL/hr to infuse the solution over the desired time period.

Explanation

To administer D5W 200 mL IV over 5 hours, the nurse needs to calculate the rate at which the IV pump should deliver the solution. By dividing the total volume (200 mL) by the total time (5 hours), we get 40 mL/hr. Therefore, the IV pump should be set to deliver 40 mL/hr to infuse the solution over the desired time period.

Submit

75. A drug that delivers 500 mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after 1 half-life?

After one half-life, the drug will have decayed by half of its original amount. Since the drug initially delivers 500 mg, after one half-life, only 250 mg will remain in the body.

Explanation

After one half-life, the drug will have decayed by half of its original amount. Since the drug initially delivers 500 mg, after one half-life, only 250 mg will remain in the body.

Submit

76. A nurse is reviewing a new prescription for for ondansetron (Zofran) 4mg PO PRN nausea and vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?

Name

Dosage

Route

Time

The nurse should clarify the time part of the prescription with the provider. The prescription states that the medication is to be taken "PRN" (as needed) for nausea and vomiting. However, it does not specify the specific time intervals or frequency at which the medication can be taken. This lack of clarity could lead to confusion and potential overuse or underuse of the medication. Therefore, the nurse should clarify the time aspect of the prescription with the provider to ensure safe and appropriate administration of the medication.

Explanation

The nurse should clarify the time part of the prescription with the provider. The prescription states that the medication is to be taken "PRN" (as needed) for nausea and vomiting. However, it does not specify the specific time intervals or frequency at which the medication can be taken. This lack of clarity could lead to confusion and potential overuse or underuse of the medication. Therefore, the nurse should clarify the time aspect of the prescription with the provider to ensure safe and appropriate administration of the medication.

77. A nurse is preparing to administer furosemide (Lasix) 80mg PO daily. The amount available is furosemide oral solution 40mg/5mL. How many mL should the nurse administer (round answer to the nearest whole number)

The nurse is preparing to administer furosemide 80mg PO daily. The available concentration of the oral solution is 40mg/5mL. To calculate the amount of mL to administer, we can set up a proportion. Since the concentration is 40mg/5mL, we can set up the proportion as 80mg/x mL = 40mg/5mL. Cross-multiplying, we get 40mg * x mL = 80mg * 5mL. Simplifying, we get 40x = 400. Dividing both sides by 40, we find that x = 10 mL. Therefore, the nurse should administer 10 mL of the furosemide oral solution.

Explanation

The nurse is preparing to administer furosemide 80mg PO daily. The available concentration of the oral solution is 40mg/5mL. To calculate the amount of mL to administer, we can set up a proportion. Since the concentration is 40mg/5mL, we can set up the proportion as 80mg/x mL = 40mg/5mL. Cross-multiplying, we get 40mg * x mL = 80mg * 5mL. Simplifying, we get 40x = 400. Dividing both sides by 40, we find that x = 10 mL. Therefore, the nurse should administer 10 mL of the furosemide oral solution.

Submit

78. How many patient identifiers did the Joint Commission state a nurse needs to check before giving a medication or doing a procedure on a patient?

1

2

3

4

The Joint Commission stated that a nurse needs to check two patient identifiers before giving a medication or doing a procedure on a patient. This is important to ensure that the right medication or procedure is given to the right patient, reducing the risk of errors and promoting patient safety. Checking two identifiers helps to verify the patient's identity and minimize the chances of mistaken identity.

Explanation

The Joint Commission stated that a nurse needs to check two patient identifiers before giving a medication or doing a procedure on a patient. This is important to ensure that the right medication or procedure is given to the right patient, reducing the risk of errors and promoting patient safety. Checking two identifiers helps to verify the patient's identity and minimize the chances of mistaken identity.

79. A nurse is preparing to administer acetaminophen (Tylenol) 650 mg PO every 6 hr PRN for pain. The amount available is actaminophen liquid 500mg/5mL. How many mL should the nurse administer per dose? (round the answer to the nearest tenth)

The nurse should administer 6.5 mL of acetaminophen per dose. This is calculated by dividing the desired dose (650 mg) by the concentration of the liquid (500 mg/5 mL) and then multiplying by the volume per dose (5 mL). This results in 6.5 mL, which is the amount the nurse should administer.

Explanation

The nurse should administer 6.5 mL of acetaminophen per dose. This is calculated by dividing the desired dose (650 mg) by the concentration of the liquid (500 mg/5 mL) and then multiplying by the volume per dose (5 mL). This results in 6.5 mL, which is the amount the nurse should administer.

Submit

80. Mechanisms of action

joining of the drug molecule with a reactive site on the surface of a cell or tissue

drug chemically binds to an enzyme molecule in such a way that it alters the enzyme's interaction with its normal target molecules in the body.

targets are cell membranes and various cellular processes such as metabolic activities.

Submit

81. The nurse is administering a medication and the order reads: Give 0.125 mg PO now. The tablets in pixis are in microgram strength. What is the right dose of the drug in micrograms?

The order states to give 0.125 mg of the medication orally. Since the tablets in the pixis are in microgram strength, we need to convert milligrams to micrograms. There are 1000 micrograms in 1 milligram. Therefore, the right dose of the drug in micrograms is 125 mcg.

Explanation

The order states to give 0.125 mg of the medication orally. Since the tablets in the pixis are in microgram strength, we need to convert milligrams to micrograms. There are 1000 micrograms in 1 milligram. Therefore, the right dose of the drug in micrograms is 125 mcg.

Submit

82. Number the following drug forms in order of speed of dissolution and absorption, with (1) being the fastest and (4) being the slowest

capsules

Enteric-coated tablets

Elixirs

Powders

Submit

83. When one medication increases the metabolism of a second medication, it causes the therapeutic effects to ___________ in the second medication.

Decrease

Increase

Remain the same

When one medication increases the metabolism of a second medication, it means that the second medication is being broken down and eliminated from the body at a faster rate. This can result in lower levels of the second medication in the bloodstream, leading to a decrease in its therapeutic effects. Therefore, the correct answer is "Decrease."

Explanation

When one medication increases the metabolism of a second medication, it means that the second medication is being broken down and eliminated from the body at a faster rate. This can result in lower levels of the second medication in the bloodstream, leading to a decrease in its therapeutic effects. Therefore, the correct answer is "Decrease."

84. A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6hr. The nurse should set the IV pump to deliver how many mL/hr? (round to the nearest whole number)

The nurse is preparing to administer dextrose 5% in water (D5W) at a rate of 750 mL over 6 hours. To calculate the mL/hr rate, we divide the total volume (750 mL) by the total time (6 hours). This gives us a rate of 125 mL/hr. Therefore, the nurse should set the IV pump to deliver 125 mL/hr.

Explanation

The nurse is preparing to administer dextrose 5% in water (D5W) at a rate of 750 mL over 6 hours. To calculate the mL/hr rate, we divide the total volume (750 mL) by the total time (6 hours). This gives us a rate of 125 mL/hr. Therefore, the nurse should set the IV pump to deliver 125 mL/hr.

Submit

85. A drug has a half life of 4 hours. If at 0800 the drug level is measure as 200 mg/L, at what time would the drug level be 50mg/L?

The half-life of a drug is the time it takes for the concentration of the drug in the body to decrease by half. In this case, the drug has a half-life of 4 hours. This means that every 4 hours, the concentration of the drug will decrease by half.

At 0800, the drug level is measured as 200 mg/L. To find out at what time the drug level would be 50mg/L, we need to determine how many half-lives it would take for the concentration to decrease from 200 mg/L to 50 mg/L.

Since the half-life is 4 hours, it would take 4 hours for the concentration to decrease by half from 200 mg/L to 100 mg/L. Another 4 hours would be needed for the concentration to decrease from 100 mg/L to 50 mg/L.

Therefore, it would take a total of 8 hours, which is equivalent to 1600, for the drug level to be 50mg/L.

Explanation

The half-life of a drug is the time it takes for the concentration of the drug in the body to decrease by half. In this case, the drug has a half-life of 4 hours. This means that every 4 hours, the concentration of the drug will decrease by half.

At 0800, the drug level is measured as 200 mg/L. To find out at what time the drug level would be 50mg/L, we need to determine how many half-lives it would take for the concentration to decrease from 200 mg/L to 50 mg/L.

Since the half-life is 4 hours, it would take 4 hours for the concentration to decrease by half from 200 mg/L to 100 mg/L. Another 4 hours would be needed for the concentration to decrease from 100 mg/L to 50 mg/L.

Therefore, it would take a total of 8 hours, which is equivalent to 1600, for the drug level to be 50mg/L.

Submit

86. When multiple medications are infusing through the same tubing they must be _________

When multiple medications are infusing through the same tubing, they must be compatible. This means that the medications should not interact with each other and cause any adverse effects or changes in their properties. Compatibility ensures that the medications can be safely administered together without compromising their effectiveness or causing harm to the patient.

Explanation

When multiple medications are infusing through the same tubing, they must be compatible. This means that the medications should not interact with each other and cause any adverse effects or changes in their properties. Compatibility ensures that the medications can be safely administered together without compromising their effectiveness or causing harm to the patient.

Submit

87. The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? Select all that apply

Metformin (Glucophage) 1000mg PO twice a day

Sitagliptin (Januvia) 50mg daily

Simvastatin (Zocor) 20mg PO every evening

Irbesartan (Avapro) 300 mg PO once a day

Docusate (Colace) as needed for constipation

The nurse will need to clarify the orders for Sitagliptin (Januvia) 50mg daily and Docusate (Colace) as needed for constipation because these orders require further clarification. It is important to determine the specific instructions for Sitagliptin (Januvia) as the frequency and timing of administration are not specified. Additionally, the order for Docusate (Colace) as needed for constipation needs clarification regarding the specific criteria for administration, such as the dosage and frequency based on the patient's condition.

Explanation

The nurse will need to clarify the orders for Sitagliptin (Januvia) 50mg daily and Docusate (Colace) as needed for constipation because these orders require further clarification. It is important to determine the specific instructions for Sitagliptin (Januvia) as the frequency and timing of administration are not specified. Additionally, the order for Docusate (Colace) as needed for constipation needs clarification regarding the specific criteria for administration, such as the dosage and frequency based on the patient's condition.

Submit

88. A nurse is reinforcing teaching for a client who has a new prescription for a tetracycline antibiotic to treat Lyme disease. The nurse should remind the client to eliminate which of the following from her diet for the duration of treatment?

Milk products

Green, leafy vegetables

Grapefruit juice

Processed meats

Tetracycline antibiotics can form chelates with calcium, magnesium, iron, and aluminum ions, which can reduce the absorption of the medication and decrease its effectiveness. Milk products, such as milk, cheese, and yogurt, contain calcium and should be avoided while taking tetracycline antibiotics. Therefore, the nurse should remind the client to eliminate milk products from her diet for the duration of treatment.

Explanation

Tetracycline antibiotics can form chelates with calcium, magnesium, iron, and aluminum ions, which can reduce the absorption of the medication and decrease its effectiveness. Milk products, such as milk, cheese, and yogurt, contain calcium and should be avoided while taking tetracycline antibiotics. Therefore, the nurse should remind the client to eliminate milk products from her diet for the duration of treatment.

89. You are transcribing an order that reads, "give ceftriaxone one milligram orally now". How would you write the amount correctly?

The correct way to write the amount is "1 mg". This is because "1 mg" is the standard abbreviation for one milligram, which is the unit of measurement for the medication ceftriaxone in this case.

Explanation

The correct way to write the amount is "1 mg". This is because "1 mg" is the standard abbreviation for one milligram, which is the unit of measurement for the medication ceftriaxone in this case.

Submit

90. A nurse is caring for a client who is taking oral oxycodone (Percolone), an opioid analgesic. The client states he is also taking ibuprofen (Advil), an NSAID, in three recommended doses daily. The interaction between these two medications will cause which of the following?

A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication

A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication

An increase in the expected therapeutic effect of both medications

An increase in expected adverse effects for both medications

Taking oral oxycodone and ibuprofen together can lead to an increase in the expected therapeutic effect of both medications. This is because ibuprofen can enhance the analgesic effects of opioids like oxycodone. The combination of these medications may result in better pain relief for the client. It is important for the nurse to monitor the client closely for any signs of increased sedation or respiratory depression, as these are potential adverse effects of opioids. However, the question does not mention any increase in adverse effects, so it can be inferred that the expected therapeutic effect is increased.

Explanation

Taking oral oxycodone and ibuprofen together can lead to an increase in the expected therapeutic effect of both medications. This is because ibuprofen can enhance the analgesic effects of opioids like oxycodone. The combination of these medications may result in better pain relief for the client. It is important for the nurse to monitor the client closely for any signs of increased sedation or respiratory depression, as these are potential adverse effects of opioids. However, the question does not mention any increase in adverse effects, so it can be inferred that the expected therapeutic effect is increased.

91. If a drug binds with an enzyme and thereby prevents the enzyme from binding to its normal target cell, it will produce which effect?

Receptor interaction

Enzyme affinity

Enzyme interaction

Nonspecific interaction

If a drug binds with an enzyme and prevents it from binding to its normal target cell, it will produce an enzyme interaction. This means that the drug is directly affecting the enzyme's ability to interact with its intended target, potentially inhibiting or altering its normal function. This can have various effects on the enzyme's activity and the overall biological processes it is involved in.

Explanation

If a drug binds with an enzyme and prevents it from binding to its normal target cell, it will produce an enzyme interaction. This means that the drug is directly affecting the enzyme's ability to interact with its intended target, potentially inhibiting or altering its normal function. This can have various effects on the enzyme's activity and the overall biological processes it is involved in.

92. When inserting an IV into an older adult client, client tkaing anticoagulants, or client who have fragile veins, you should instruct the client to hold his hand __________the level of his heart

Below

Above

Even with

When inserting an IV into an older adult client, a client taking anticoagulants, or a client with fragile veins, instructing the client to hold his hand below the level of his heart helps to reduce the pressure in the veins and prevent excessive bleeding. Holding the hand below the heart level promotes venous return and minimizes the risk of blood pooling or clotting at the IV insertion site. This position also helps to ensure a steady flow of blood into the veins, making it easier to insert the IV and reducing the chances of complications.

Explanation

When inserting an IV into an older adult client, a client taking anticoagulants, or a client with fragile veins, instructing the client to hold his hand below the level of his heart helps to reduce the pressure in the veins and prevent excessive bleeding. Holding the hand below the heart level promotes venous return and minimizes the risk of blood pooling or clotting at the IV insertion site. This position also helps to ensure a steady flow of blood into the veins, making it easier to insert the IV and reducing the chances of complications.

93. HIghly protein-bound drugs

Increase the risk of drug-drug interactions

Typically provide a short duration of action

Must be administered with 8 ounces of water

Have a decreased effect in patients with a low albumin level

Highly protein-bound drugs have a tendency to bind to plasma proteins in the blood, which can limit their availability for interaction with other drugs. However, when two or more highly protein-bound drugs are administered together, there is a higher chance of competition for binding sites on the proteins, leading to potential drug-drug interactions. This can result in altered drug levels, efficacy, and safety. Therefore, highly protein-bound drugs increase the risk of drug-drug interactions.

Explanation

Highly protein-bound drugs have a tendency to bind to plasma proteins in the blood, which can limit their availability for interaction with other drugs. However, when two or more highly protein-bound drugs are administered together, there is a higher chance of competition for binding sites on the proteins, leading to potential drug-drug interactions. This can result in altered drug levels, efficacy, and safety. Therefore, highly protein-bound drugs increase the risk of drug-drug interactions.

94. The nurse is administering a medication and the order reads: Give 250 mcg PO now. The tablets in the medication dispensing cabinet are in milligram strength. What is the right does of the drug in milligrams?

The order specifies to give 250 mcg (micrograms) of the medication orally. However, the tablets available in the medication dispensing cabinet are in milligram strength. To calculate the right dose in milligrams, we need to convert micrograms to milligrams. Since 1 milligram is equal to 1000 micrograms, 250 mcg is equal to 0.25 mg. Therefore, the correct dose of the drug in milligrams is 0.25 mg.

Explanation

The order specifies to give 250 mcg (micrograms) of the medication orally. However, the tablets available in the medication dispensing cabinet are in milligram strength. To calculate the right dose in milligrams, we need to convert micrograms to milligrams. Since 1 milligram is equal to 1000 micrograms, 250 mcg is equal to 0.25 mg. Therefore, the correct dose of the drug in milligrams is 0.25 mg.

Submit

95. Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last.

Choice 1Enzymes in the liver transform the drug into an inactive metabolite

Drug meatabolites are secreted through passive glomerular filtration intothe renal tubules

A drug binds to the plasma protein albumin and circulates throught the body

A drug moves from the intestinallumen into the mesenteric blood system.

Submit

96. The nurse needs to be aware that which factors will affect the absorption of orally administered medications? (Select all that apply.)

Presence of food in the stomach

PH of the stomach

Patient position upon intake of the medication

Form of drug preparation

Time of day

The nurse needs to be aware of the presence of food in the stomach, pH of the stomach, and form of drug preparation as factors that can affect the absorption of orally administered medications. The presence of food in the stomach can slow down the absorption process, as it may interfere with the dissolution of the drug. The pH of the stomach can also affect the absorption, as certain drugs are better absorbed in an acidic environment. The form of drug preparation, such as tablets, capsules, or liquids, can also impact the absorption rate.

Explanation

The nurse needs to be aware of the presence of food in the stomach, pH of the stomach, and form of drug preparation as factors that can affect the absorption of orally administered medications. The presence of food in the stomach can slow down the absorption process, as it may interfere with the dissolution of the drug. The pH of the stomach can also affect the absorption, as certain drugs are better absorbed in an acidic environment. The form of drug preparation, such as tablets, capsules, or liquids, can also impact the absorption rate.

Submit

97. Consuming foods that contain tyramine while taking MAOIs can lead to ___________.

Liver failure

Kidney failure

Hypertensive crisis

Toxicity

Taking MAOIs (monoamine oxidase inhibitors) can affect the breakdown of tyramine, a substance found in certain foods. Tyramine normally gets broken down by the enzyme MAO in the liver, but when MAOIs are present, the breakdown process is inhibited. This can cause a buildup of tyramine in the body, leading to a sudden increase in blood pressure known as a hypertensive crisis. This can be a dangerous situation and can potentially result in serious health complications if not addressed promptly.

Explanation

Taking MAOIs (monoamine oxidase inhibitors) can affect the breakdown of tyramine, a substance found in certain foods. Tyramine normally gets broken down by the enzyme MAO in the liver, but when MAOIs are present, the breakdown process is inhibited. This can cause a buildup of tyramine in the body, leading to a sudden increase in blood pressure known as a hypertensive crisis. This can be a dangerous situation and can potentially result in serious health complications if not addressed promptly.

98. The nurse has an order for administering a medication to the patient. Which providers have legal authority to prescribe medications for patients? (Select all that apply.)

Physician

Physical therapist

Pharmacist

Dentist

Physician assistant

Nurse practitioner

The nurse has an order for administering a medication to the patient. In order to legally prescribe medications for patients, the providers must have the legal authority to do so. Among the options given, physicians, dentists, physician assistants, and nurse practitioners have the legal authority to prescribe medications for patients. Physical therapists and pharmacists do not have the legal authority to prescribe medications.

Explanation

The nurse has an order for administering a medication to the patient. In order to legally prescribe medications for patients, the providers must have the legal authority to do so. Among the options given, physicians, dentists, physician assistants, and nurse practitioners have the legal authority to prescribe medications for patients. Physical therapists and pharmacists do not have the legal authority to prescribe medications.

Submit

99. For dosages less than 1, round to the nearest

Hundredth

Tenth

Whole number

Thousandth

For dosages less than 1, rounding to the nearest hundredth means rounding to the nearest two decimal places. This means that the number will be rounded to the nearest value that is two places after the decimal point. For example, if the dosage is 0.036, rounding to the nearest hundredth would give 0.04.

Explanation

For dosages less than 1, rounding to the nearest hundredth means rounding to the nearest two decimal places. This means that the number will be rounded to the nearest value that is two places after the decimal point. For example, if the dosage is 0.036, rounding to the nearest hundredth would give 0.04.

100. A nurse preparing to administer eye drops to a client. Which of the following are appropriate nursing interventions related to this procedure?

Using medical aseptic technique

Asking the client to look up at the ceiling

Having the client lie in a side-lying position

Dropping medication into the center of the client's conjunctival sac

Instructing the client to close the eye gently

The appropriate nursing interventions related to administering eye drops to a client include asking the client to look up at the ceiling, dropping the medication into the center of the client's conjunctival sac, and instructing the client to close the eye gently. Looking up at the ceiling helps to expose the conjunctival sac, making it easier to administer the eye drops. Dropping the medication into the center of the conjunctival sac ensures proper absorption. Instructing the client to close the eye gently helps to distribute the medication and prevent it from leaking out.

Explanation

The appropriate nursing interventions related to administering eye drops to a client include asking the client to look up at the ceiling, dropping the medication into the center of the client's conjunctival sac, and instructing the client to close the eye gently. Looking up at the ceiling helps to expose the conjunctival sac, making it easier to administer the eye drops. Dropping the medication into the center of the conjunctival sac ensures proper absorption. Instructing the client to close the eye gently helps to distribute the medication and prevent it from leaking out.

Submit

101. A nurse is preparing to administer heparin 15000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the nurse administer per dose? (round the answer to the nearest tenth)

The nurse needs to administer 15,000 units of heparin per dose. The concentration of heparin in the injection is 20,000 units/mL. To calculate the amount of mL needed, divide the desired dose (15,000 units) by the concentration (20,000 units/mL). This gives a result of 0.75 mL. Since the answer needs to be rounded to the nearest tenth, the nurse should administer 0.8 mL per dose.

Explanation

The nurse needs to administer 15,000 units of heparin per dose. The concentration of heparin in the injection is 20,000 units/mL. To calculate the amount of mL needed, divide the desired dose (15,000 units) by the concentration (20,000 units/mL). This gives a result of 0.75 mL. Since the answer needs to be rounded to the nearest tenth, the nurse should administer 0.8 mL per dose.

Submit

102. A nurse is caring for a client who is receiving cefotaxime (Claforan) 1g by intermittent IV bolus. The amount available is cefotaxime 1g in dextrose 5% in water (D5W) 100mL to infuse over 45 min. The drop factor shown on the package of IV tubing is 10gtt/mL. The nurse should make sure the manual IV infusion deliver how many gtt/min? Round to the nearest whole number

The nurse should make sure the manual IV infusion delivers 22 gtt/min because the client is receiving cefotaxime 1g in dextrose 5% in water (D5W) 100mL to infuse over 45 min. The drop factor shown on the package of IV tubing is 10gtt/mL. To calculate the infusion rate in gtt/min, we can use the formula: (Volume to be infused in mL / Time in min) x Drop factor. Plugging in the values, we get (100 mL / 45 min) x 10 gtt/mL = 22 gtt/min.

Explanation

The nurse should make sure the manual IV infusion delivers 22 gtt/min because the client is receiving cefotaxime 1g in dextrose 5% in water (D5W) 100mL to infuse over 45 min. The drop factor shown on the package of IV tubing is 10gtt/mL. To calculate the infusion rate in gtt/min, we can use the formula: (Volume to be infused in mL / Time in min) x Drop factor. Plugging in the values, we get (100 mL / 45 min) x 10 gtt/mL = 22 gtt/min.

Submit

103. Examples of topical dosage routes

Inhaled

Intramuscular

Sublingual

Nitroglycerin ointment

Elixir

The examples provided in the question are all different topical dosage routes. Inhaled refers to medications that are administered through inhalation, typically through a device like an inhaler. Nitroglycerin ointment is a topical medication that is applied directly to the skin. These examples demonstrate different ways in which medications can be delivered to the body through topical routes.

Explanation

The examples provided in the question are all different topical dosage routes. Inhaled refers to medications that are administered through inhalation, typically through a device like an inhaler. Nitroglycerin ointment is a topical medication that is applied directly to the skin. These examples demonstrate different ways in which medications can be delivered to the body through topical routes.

Submit

104. A nurse is caring for a client who is receiving clindamycin (Cleocin) 200mg by intermittent IV bolus. The amount available is clindamycin injection 200mg in 100mL 0.9% NaCL to infuse over 30 min. The nurse should make sure the IV pump delivers how many mL/hr? Round the answer to the nearest whole number.

The nurse should make sure the IV pump delivers 200 mL/hr because the client is receiving clindamycin 200mg over 30 minutes. The medication is available as 200mg in 100mL, so the entire dose needs to be infused over 30 minutes. To calculate the infusion rate in mL/hr, divide the volume (100mL) by the time (30 minutes) and multiply by 60 to convert minutes to hours. This gives a rate of 200 mL/hr.

Explanation

The nurse should make sure the IV pump delivers 200 mL/hr because the client is receiving clindamycin 200mg over 30 minutes. The medication is available as 200mg in 100mL, so the entire dose needs to be infused over 30 minutes. To calculate the infusion rate in mL/hr, divide the volume (100mL) by the time (30 minutes) and multiply by 60 to convert minutes to hours. This gives a rate of 200 mL/hr.

Submit

105. Match medication categories based on risk to the fetus

There is no evidence of risk to anmial fetuses based on studies, but there are no adequate and well-controlled studies in pregnant women.

Adverse effects have been demonstrated on animal and human fetuses based on studies and data from investigational or marketing experience. The use of the medication is contraindicated during pregnancy because the risks outweigh the potential benefits

Adverse effects have been demonstrated on animal fetuses. There are no adequate and wellcontrolled studies in pregnant women, but use of the medication during pregnancy can be warranted based on the potential benefits

There is no evidence of risk to the fetus during pregnancy based on adequate and well-controlled studies

Adverse effects have been demonstrated on human fetuses based on data from investigational or marketing experience, but use of the medicationduring pregnancy canb be warranted based on the potential benefits

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106. A nurse is caring for a client receiving D5W IV at 250 mL/hr. Which of the following finding indicate fluid overload? (select all that apply)

Hypotension

Bradycardia

Shortness of breath

Crackles heard in lungs

Distended neck veins

Shortness of breath, crackles heard in lungs, and distended neck veins are all signs of fluid overload. Shortness of breath occurs when there is excess fluid in the lungs, causing difficulty in breathing. Crackles heard in the lungs are abnormal lung sounds that indicate fluid accumulation in the airways. Distended neck veins are a result of increased pressure in the veins due to fluid overload. Hypotension and bradycardia are not indicative of fluid overload, as they are more commonly associated with hypovolemia or low fluid volume.

Explanation

Shortness of breath, crackles heard in lungs, and distended neck veins are all signs of fluid overload. Shortness of breath occurs when there is excess fluid in the lungs, causing difficulty in breathing. Crackles heard in the lungs are abnormal lung sounds that indicate fluid accumulation in the airways. Distended neck veins are a result of increased pressure in the veins due to fluid overload. Hypotension and bradycardia are not indicative of fluid overload, as they are more commonly associated with hypovolemia or low fluid volume.

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107. Match the correct size catheter to the client

16 gauge

18 gauge

20 gauge

22-24 gauge

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108. A nurse is preparing to administer haloperidol (Haldol) 2mg PO every 12 hr. The amount available is haloperidol 1mg/tablet/ How many tablet should the nurse administer? (round answer to the nearest whole number)

The nurse is preparing to administer haloperidol 2mg every 12 hours. The available dosage of haloperidol is 1mg per tablet. To administer 2mg, the nurse would need to give 2 tablets, as each tablet contains 1mg of haloperidol.

Explanation

The nurse is preparing to administer haloperidol 2mg every 12 hours. The available dosage of haloperidol is 1mg per tablet. To administer 2mg, the nurse would need to give 2 tablets, as each tablet contains 1mg of haloperidol.

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109. A nurse is preparing to administer amoxicillin (Amoxil) 20mg/kg/day PO divided in equal doses every 12 hr to a preschool child who weighs 44lb. The amount available is amoxicillin suspension 250 mg/5 mL. How many mL should the nurse administer per dose?

To calculate the amount of amoxicillin the nurse should administer per dose, we need to determine the total daily dose for the child. The child weighs 44 lb, so we need to convert this to kg by dividing by 2.2 (1 kg = 2.2 lb). Thus, the child weighs approximately 20 kg. The prescribed dose is 20 mg/kg/day, so the total daily dose for the child would be 20 mg/kg x 20 kg = 400 mg/day. Since the amoxicillin suspension is 250 mg/5 mL, we can calculate the mL per dose by dividing the total daily dose by the concentration of the suspension: 400 mg/250 mg x 5 mL = 8 mL. However, the question asks for the dose to be divided in equal doses every 12 hours, so the nurse should administer 8 mL divided by 2 = 4 mL per dose.

Explanation

To calculate the amount of amoxicillin the nurse should administer per dose, we need to determine the total daily dose for the child. The child weighs 44 lb, so we need to convert this to kg by dividing by 2.2 (1 kg = 2.2 lb). Thus, the child weighs approximately 20 kg. The prescribed dose is 20 mg/kg/day, so the total daily dose for the child would be 20 mg/kg x 20 kg = 400 mg/day. Since the amoxicillin suspension is 250 mg/5 mL, we can calculate the mL per dose by dividing the total daily dose by the concentration of the suspension: 400 mg/250 mg x 5 mL = 8 mL. However, the question asks for the dose to be divided in equal doses every 12 hours, so the nurse should administer 8 mL divided by 2 = 4 mL per dose.

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110. A nurse is observing a client's IV site. Which of the following findings indicate phlebitis? (select all that apply)

Tingling sensation below insertion site

Tachycardia

Palpable, hard mass above insertion site

Cool, pale skin

Pain at site

Phlebitis is the inflammation of a vein, often caused by an infection or irritation. The presence of a palpable, hard mass above the insertion site and pain at the site are both indicative of phlebitis. This suggests that there may be inflammation and possibly a clot forming at the site. The other options, tingling sensation below the insertion site, tachycardia, and cool, pale skin, are not specific to phlebitis and may be indicative of other conditions or reactions.

Explanation

Phlebitis is the inflammation of a vein, often caused by an infection or irritation. The presence of a palpable, hard mass above the insertion site and pain at the site are both indicative of phlebitis. This suggests that there may be inflammation and possibly a clot forming at the site. The other options, tingling sensation below the insertion site, tachycardia, and cool, pale skin, are not specific to phlebitis and may be indicative of other conditions or reactions.

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111. A nurse is preparing a client's medications. Which of the following are legal responsibilities of the nurse? (select all that apply)

Maintaining skill competency

Determining the dosage

Monitoring for adverse effects

Safeguarding medications

Identifying the client's diagnosis

The nurse has a legal responsibility to maintain skill competency to ensure that they are able to safely administer medications to clients. They are also responsible for monitoring for adverse effects of the medications to ensure the client's safety. Additionally, the nurse must safeguard medications to prevent unauthorized access or use. Identifying the client's diagnosis is not a legal responsibility of the nurse, but rather a part of the nursing assessment and care planning process.

Explanation

The nurse has a legal responsibility to maintain skill competency to ensure that they are able to safely administer medications to clients. They are also responsible for monitoring for adverse effects of the medications to ensure the client's safety. Additionally, the nurse must safeguard medications to prevent unauthorized access or use. Identifying the client's diagnosis is not a legal responsibility of the nurse, but rather a part of the nursing assessment and care planning process.

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112. The nurse includes which information as part of a complete medication history? (select all that apply)

Use of street drugs

Current laboratory work

History of surgeries

Use of alcohol

Use of herbal products

Family history

A complete medication history should include information about the patient's use of street drugs, history of surgeries, use of alcohol, use of herbal products, and family history. This information is important for the nurse to assess potential drug interactions, allergies, and any other factors that may impact the patient's medication regimen. Current laboratory work, although important for monitoring medication effectiveness and safety, is not specifically part of a medication history.

Explanation

A complete medication history should include information about the patient's use of street drugs, history of surgeries, use of alcohol, use of herbal products, and family history. This information is important for the nurse to assess potential drug interactions, allergies, and any other factors that may impact the patient's medication regimen. Current laboratory work, although important for monitoring medication effectiveness and safety, is not specifically part of a medication history.

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113. The nurse understands that drugs exert their actions on the body by (Select all that apply.)

Interacting with receptors

Making the cell perform a new function

Inhibiting the action of a specific enzyme

Altering metabolic chemical processes

Drugs exert their actions on the body by interacting with receptors and inhibiting the action of a specific enzyme. Interacting with receptors allows drugs to bind to specific sites on cells, triggering a response or blocking a response. Inhibiting the action of a specific enzyme can prevent or slow down certain chemical reactions in the body, affecting various processes and functions. However, drugs do not make the cell perform a new function or directly alter metabolic chemical processes.

Explanation

Drugs exert their actions on the body by interacting with receptors and inhibiting the action of a specific enzyme. Interacting with receptors allows drugs to bind to specific sites on cells, triggering a response or blocking a response. Inhibiting the action of a specific enzyme can prevent or slow down certain chemical reactions in the body, affecting various processes and functions. However, drugs do not make the cell perform a new function or directly alter metabolic chemical processes.

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114. A nurse on a medical unit is collecting data from a client before administration of medications. Which of the following data should the nurse include? (select all that apply)

Use of herbal teas

Daily fluid intake

Current health status

Previous surgical history

Food allergies

The nurse should include the data about the client's use of herbal teas, current health status, and food allergies before administering medications. The use of herbal teas is important to know as they may interact with certain medications and cause adverse effects. The current health status is necessary to assess the client's overall condition and determine if any precautions or adjustments need to be made in medication administration. Food allergies are crucial to identify to prevent any potential allergic reactions to medications.

Explanation

The nurse should include the data about the client's use of herbal teas, current health status, and food allergies before administering medications. The use of herbal teas is important to know as they may interact with certain medications and cause adverse effects. The current health status is necessary to assess the client's overall condition and determine if any precautions or adjustments need to be made in medication administration. Food allergies are crucial to identify to prevent any potential allergic reactions to medications.

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115. What factors can influence the rate of medication metabolism

Age

Gender

First-pass effect

Nutritional status

Increase in certain medication-metabolizing enzymes

Bowel obstuction

Similar metabolic pathways

The rate of medication metabolism can be influenced by various factors. Age plays a role as metabolism tends to slow down with age. The first-pass effect refers to the initial metabolism of a drug in the liver before it reaches the systemic circulation, which can affect the rate of metabolism. Nutritional status is important as certain nutrients are required for proper metabolism. An increase in certain medication-metabolizing enzymes can enhance the rate of metabolism. Similar metabolic pathways between drugs can also affect the rate of metabolism.

Explanation

The rate of medication metabolism can be influenced by various factors. Age plays a role as metabolism tends to slow down with age. The first-pass effect refers to the initial metabolism of a drug in the liver before it reaches the systemic circulation, which can affect the rate of metabolism. Nutritional status is important as certain nutrients are required for proper metabolism. An increase in certain medication-metabolizing enzymes can enhance the rate of metabolism. Similar metabolic pathways between drugs can also affect the rate of metabolism.

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116. A nurse educator is reviewing medications dosages and factors that influence medication metabolism with a group of nurses. Medication dosages may need to be decreased for which of the following reasons? (choose all that apply)

Increased renal excretion

Increased medication-metabolizing enzymes

Liver failure

Peripheral vascular disease

Concurrent use of medication metabolized by the same pathway

Medication dosages may need to be decreased in the case of liver failure because the liver is responsible for metabolizing medications, and if it is not functioning properly, the medication may not be metabolized effectively, leading to potential toxicity. Concurrent use of medication metabolized by the same pathway can also require a decrease in dosage as it can lead to competition for the same metabolic pathway, potentially resulting in higher levels of the medication in the body. Increased renal excretion, increased medication-metabolizing enzymes, and peripheral vascular disease do not directly impact medication metabolism and therefore would not require a decrease in dosage.

Explanation

Medication dosages may need to be decreased in the case of liver failure because the liver is responsible for metabolizing medications, and if it is not functioning properly, the medication may not be metabolized effectively, leading to potential toxicity. Concurrent use of medication metabolized by the same pathway can also require a decrease in dosage as it can lead to competition for the same metabolic pathway, potentially resulting in higher levels of the medication in the body. Increased renal excretion, increased medication-metabolizing enzymes, and peripheral vascular disease do not directly impact medication metabolism and therefore would not require a decrease in dosage.

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117. Match the types of therapies with their definitions

Often needed to sustain life or treat disease; involves more intensive drug treatment and is implemented in the acutely ill

will prevent progression of a disease or condition; used for the treatment of chronic illnesses

supplies the body with a substance needed to maintain normal function

makes the patient as comfortable as possible; focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness

maintain the integrity of body functions while teh paient is rcovering from illness or trauma.

drug therapy provided to prevent illness or otherundesirable outcome during planned events

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118. Match the IV therapy complications with the findings

pallor, local swelling at the site, decreased skin temperature around the site, damp dressing, slowed infusion

Pain, burning, redness, swelling

Edema; throbbing burning or pain at the site; increased skin temperature; erythema; a red line up the arm with a palpable band at the vein site, slowed infusion

Ecchymosis at site

pain; warmth; edema; induraition; red streaking; fever, chells, and malaise

distended necke veins, increased blood pressure, tachycardia, shortness of breath, cracklesin the lungs, edema

missing catheter tip when discontinued, sever pain at the site with migration, or no symptoms if no migration

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