Chapter 8 My Nursing Test Banks

 

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E
Chapter 8

Question 1

Type: MCSA

The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a patient makes which response?

1. The baby can only be harmed by medications during the first trimester.

2. It is important to not take over-the-counter (OTC) drugs during my pregnancy.

3. Exposure to teratogens can result in my babys death or in malformations.

4. If I breastfeed my baby, drugs can come through my breast milk.

Correct Answer: 1

Rationale 1: A baby can be harmed by medication used throughout the period of gestation. Over-the-counter (OTC) drugs should be avoided during pregnancy. Many drugs are transferred through breast milk. Teratogens can cause fetal demise and congenital malformations.

Rationale 2: A baby can be harmed by medication used throughout the period of gestation. Over-the-counter (OTC) drugs should be avoided during pregnancy. Many drugs are transferred through breast milk. Teratogens can cause fetal demise and congenital malformations.

Rationale 3: A baby can be harmed by medication used throughout the period of gestation. Over-the-counter (OTC) drugs should be avoided during pregnancy. Many drugs are transferred through breast milk. Teratogens can cause fetal demise and congenital malformations.

Rationale 4: A baby can be harmed by medication used throughout the period of gestation. Over-the-counter (OTC) drugs should be avoided during pregnancy. Many drugs are transferred through breast milk. Teratogens can cause fetal demise and congenital malformations.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-6

Question 2

Type: MCSA

The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse?

1. Be sure to check the label to see if the herbal product could be used during breastfeeding.

2. Most drugs can be transferred to the infant during breastfeeding, so this is not recommended.

3. Herbal products are considered natural, so it should be fine to use them during breastfeeding .

4. This should be fine, as long as there is at least 12 hours between the time you use the product and when you breastfeed.

Correct Answer: 2

Rationale 1: It is best to avoid as many drugs as possible during breastfeeding. The bottle may not be labeled for breastfeeding, so the patient should check with the nurse. There is no safety time limit established between the use of the product and breastfeeding. Herbal products are drugs.

Rationale 2: It is best to avoid as many drugs as possible during breastfeeding. The bottle may not be labeled for breastfeeding, so the patient should check with the nurse. There is no safety time limit established between the use of the product and breastfeeding. Herbal products are drugs.

Rationale 3: It is best to avoid as many drugs as possible during breastfeeding . The bottle may not be labeled for breastfeeding , so the patient should check with the nurse. There is no safety time limit established between the use of the product and breastfeeding . Herbal products are drugs.

Rationale 4: It is best to avoid as many drugs as possible during breastfeeding. The bottle may not be labeled for breastfeeding, so the patient should check with the nurse. There is no safety time limit established between the use of the product and breastfeeding. Herbal products are drugs.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-4

Question 3

Type: MCMA

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What will the best plan of the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Keep the toddler awake and observe for side effects of the medication.

2. Keep all medications locked up and stored out of reach of the toddler.

3. Use syrup of ipecac immediately if the toddler has ingested medication.

4. Call the Poison Control Center for guidance with any medication ingested.

5. Teach the toddler that medications are for adult use only.

Correct Answer: 2,4

Rationale 1: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

Rationale 2: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

Rationale 3: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

Rationale 4: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

Rationale 5: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8-6

Question 4

Type: MCMA

The nursing instructor teaches student nurses about the Food and Drug Administration (FDA) Pregnancy Categories. What is the best information to include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Food and Drug Administration (FDA) Pregnancy Category C is safe to use during pregnancy.

2. Food and Drug Administration (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women.

3. Food and Drug Administration (FDA) Pregnancy categories for individual drugs seldom change once they are established.

4. Food and Drug Administration (FDA) Pregnancy categories are based on studies using clinical human research trials.

5. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects.

Correct Answer: 2,5

Rationale 1: Food and Drug Administration (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily safe, it just means that animal studies have shown an adverse effect, but well-controlled studies in pregnant women have not been done. Food and Drug Administration (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

Rationale 2: Food and Drug Administration (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily safe, it just means that animal studies have shown an adverse effect, but well-controlled studies in pregnant women have not been done. Food and Drug Administration (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

Rationale 3: Food and Drug Administration (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily safe, it just means that animal studies have shown an adverse effect, but well-controlled studies in pregnant women have not been done. Food and Drug Administration (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

Rationale 4: Food and Drug Administration (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily safe, it just means that animal studies have shown an adverse effect, but well-controlled studies in pregnant women have not been done. Food and Drug Administration (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

Rationale 5: Food and Drug Administration (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily safe, it just means that animal studies have shown an adverse effect, but well-controlled studies in pregnant women have not been done. Food and Drug Administration (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-3

Question 5

Type: MCSA

The nurse plans to administer medication to the preschool child. Which approach indicates the nurse has an understanding of growth and development?

1. The child is often more cooperative if the parent is not in the room.

2. The child does better with verbal instruction than with play instruction.

3. There should be no need to restrain a child of this age.

4. Use a brief rationale, followed by quick administration of the medication.

Correct Answer: 4

Rationale 1: A brief rationale, followed by quick administration, decreases the childs anxiety and promotes cooperation with the medication process. It may be necessary to restrain a preschool child for medication administration. Having a parent in the room usually promotes more cooperation from the preschool child. Preschool children do better with play instruction.

Rationale 2: A brief rationale, followed by quick administration, decreases the childs anxiety and promotes cooperation with the medication process. It may be necessary to restrain a preschool child for medication administration. Having a parent in the room usually promotes more cooperation from the preschool child. Preschool children do better with play instruction.

Rationale 3: A brief rationale, followed by quick administration, decreases the childs anxiety and promotes cooperation with the medication process. It may be necessary to restrain a preschool child for medication administration. Having a parent in the room usually promotes more cooperation from the preschool child. Preschool children do better with play instruction.

Rationale 4: A brief rationale, followed by quick administration, decreases the childs anxiety and promotes cooperation with the medication process. It may be necessary to restrain a preschool child for medication administration. Having a parent in the room usually promotes more cooperation from the preschool child. Preschool children do better with play instruction.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8-1

Question 6

Type: MCSA

The nurse will administer medication to a school-age child. What is the preferred action by the nurse?

1. Teach the child the action and expected side effects of the medication.

2. Tell the child he will not be allowed to go to recess if the medication is not taken.

3. Offer the child a choice of beverage with which to take the medication.

4. Offer to play with the child prior to medication administration.

Correct Answer: 3

Rationale 1: Offering the child a choice fosters cooperation and compliance. Playing with the child is a preschool child activity. Teaching the child the action and expected side effects of the medication is too advanced for the school-age child. Threatening a school-age child will antagonize him; he will most likely not take the medication.

Rationale 2: Offering the child a choice fosters cooperation and compliance. Playing with the child is a preschool child activity. Teaching the child the action and expected side effects of the medication is too advanced for the school-age child. Threatening a school-age child will antagonize him; he will most likely not take the medication.

Rationale 3: Offering the child a choice fosters cooperation and compliance. Playing with the child is a preschool child activity. Teaching the child the action and expected side effects of the medication is too advanced for the school-age child. Threatening a school-age child will antagonize him; he will most likely not take the medication.

Rationale 4: Offering the child a choice fosters cooperation and compliance. Playing with the child is a preschool child activity. Teaching the child the action and expected side effects of the medication is too advanced for the school-age child. Threatening a school-age child will antagonize him; he will most likely not take the medication.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-2

Question 7

Type: MCSA

An adolescent patient comes to the school nurse with complaints of vague abdominal pain. What assessment data would help to confirm the nurses suspicion that the adolescent has body image concerns?

1. The adolescent says, Everyone makes a big deal about what I eat, so dont ask.

2. The adolescent tells the nurse, I have been sexually active with my boyfriend.

3. The adolescent reports, My periods are irregular. Should I see a doctor?

4. The adolescent tells the nurse, I just cant seem to get along with my parents.

Correct Answer: 1

Rationale 1: The adolescent could have an eating disorder, which may result from altered body image. Being sexually active with her boyfriend does not necessarily indicate an altered body image. Irregular menses do not necessarily indicate an altered body image. Arguments with parents do not necessarily indicate an altered body image.

Rationale 2: The adolescent could have an eating disorder, which may result from altered body image. Being sexually active with her boyfriend does not necessarily indicate an altered body image. Irregular menses do not necessarily indicate an altered body image. Arguments with parents do not necessarily indicate an altered body image.

Rationale 3: The adolescent could have an eating disorder, which may result from altered body image. Being sexually active with her boyfriend does not necessarily indicate an altered body image. Irregular menses do not necessarily indicate an altered body image. Arguments with parents do not necessarily indicate an altered body image.

Rationale 4: The adolescent could have an eating disorder, which may result from altered body image. Being sexually active with her boyfriend does not necessarily indicate an altered body image. Irregular menses do not necessarily indicate an altered body image. Arguments with parents do not necessarily indicate an altered body image.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8-2

Question 8

Type: MCSA

The nurse provides care for elders in an assisted living facility. What does the nurse assess as a primary contributing factor for medication complications in the elderly?

1. The elderly often abuse alcohol.

2. The elderly are frequently dehydrated.

3. The elderly are frequently constipated.

4. The elderly have decreased stomach acid.

Correct Answer: 2

Rationale 1: Fluid deficit is a critical factor in the older adult that can contribute to medication complications. Decreased stomach acid is not a critical factor with medication complications in the elderly. Frequent constipation is not a critical factor with medication complications in the elderly. Alcohol abuse could be a factor in medication complications with the elderly, but is not as critical as fluid volume deficit.

Rationale 2: Fluid deficit is a critical factor in the older adult that can contribute to medication complications. Decreased stomach acid is not a critical factor with medication complications in the elderly. Frequent constipation is not a critical factor with medication complications in the elderly. Alcohol abuse could be a factor in medication complications with the elderly, but is not as critical as fluid volume deficit.

Rationale 3: Fluid deficit is a critical factor in the older adult that can contribute to medication complications. Decreased stomach acid is not a critical factor with medication complications in the elderly. Frequent constipation is not a critical factor with medication complications in the elderly. Alcohol abuse could be a factor in medication complications with the elderly, but is not as critical as fluid volume deficit.

Rationale 4: Fluid deficit is a critical factor in the older adult that can contribute to medication complications. Decreased stomach acid is not a critical factor with medication complications in the elderly. Frequent constipation is not a critical factor with medication complications in the elderly. Alcohol abuse could be a factor in medication complications with the elderly, but is not as critical as fluid volume deficit.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8-5

Question 9

Type: MCSA

The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?

1. This is because your blood volume has increased.

2. Tell me how you have been taking your medication.

3. This is because your baby is receiving part of the medication.

4. Maybe the medication has expired; check the label.

Correct Answer: 1

Rationale 1: Increased blood volume results in hemodilution and increased excretion of the medication. The medication effectiveness is not reduced because of the baby. Asking the patient how she is taking the medication is a good idea, but in this case, increased blood volume is responsible for decreased drug effect. The medication has most likely not expired; most patients have it refilled monthly.

Rationale 2: Increased blood volume results in hemodilution and increased excretion of the medication. The medication effectiveness is not reduced because of the baby. Asking the patient how she is taking the medication is a good idea, but in this case, increased blood volume is responsible for decreased drug effect. The medication has most likely not expired; most patients have it refilled monthly.

Rationale 3: Increased blood volume results in hemodilution and increased excretion of the medication. The medication effectiveness is not reduced because of the baby. Asking the patient how she is taking the medication is a good idea, but in this case, increased blood volume is responsible for decreased drug effect. The medication has most likely not expired; most patients have it refilled monthly.

Rationale 4: Increased blood volume results in hemodilution and increased excretion of the medication. The medication effectiveness is not reduced because of the baby. Asking the patient how she is taking the medication is a good idea, but in this case, increased blood volume is responsible for decreased drug effect. The medication has most likely not expired; most patients have it refilled monthly.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-6

Question 10

Type: MCSA

The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his medication?

1. Tell him you will buy him a toy if he takes the medication.

2. Crush the tablet and mix it with a small amount of jam.

3. Crush the tablet and mix it with milk.

4. Tell him he will be punished if he does not take the medicine.

Correct Answer: 2

Rationale 1: Mixing the medication in jam will disguise the taste. The parent should not buy the childs compliance with a toy. Punishment will alienate the child and decrease compliance. Parents should avoid placing medication in milk as this may cause the toddler to avoid healthy foods.

Rationale 2: Mixing the medication in jam will disguise the taste. The parent should not buy the childs compliance with a toy. Punishment will alienate the child and decrease compliance. Parents should avoid placing medication in milk as this may cause the toddler to avoid healthy foods.

Rationale 3: Mixing the medication in jam will disguise the taste. The parent should not buy the childs compliance with a toy. Punishment will alienate the child and decrease compliance. Parents should avoid placing medication in milk as this may cause the toddler to avoid healthy foods.

Rationale 4: Mixing the medication in jam will disguise the taste. The parent should not buy the childs compliance with a toy. Punishment will alienate the child and decrease compliance. Parents should avoid placing medication in milk as this may cause the toddler to avoid healthy foods.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-6

Question 11

Type: MCSA

The adolescent is supposed to go to the school nurse at 12:00 to receive his medication for attention-deficit hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurses understanding of this situation?

1. The adolescent is embarrassed in front of his peers.

2. The adolescent does not understand the need for the medication.

3. The adolescent forgets that he is supposed to take the medication.

4. The adolescent has made a conscious decision not to take the medication.

Correct Answer: 1

Rationale 1: Adolescents relate strongly to peers and are easily embarrassed; the adolescent does not want to be made fun of. The adolescent is most likely not forgetting the medication. Most adolescents receiving attention-deficit hyperactivity disorder (ADHD) medication recognize that it helps them. Most adolescents know why they are receiving medication.

Rationale 2: Adolescents relate strongly to peers and are easily embarrassed; the adolescent does not want to be made fun of. The adolescent is most likely not forgetting the medication. Most adolescents receiving attention-deficit hyperactivity disorder (ADHD) medication recognize that it helps them. Most adolescents know why they are receiving medication.

Rationale 3: Adolescents relate strongly to peers and are easily embarrassed; the adolescent does not want to be made fun of. The adolescent is most likely not forgetting the medication. Most adolescents receiving attention-deficit hyperactivity disorder (ADHD) medication recognize that it helps them. Most adolescents know why they are receiving medication.

Rationale 4: Adolescents relate strongly to peers and are easily embarrassed; the adolescent does not want to be made fun of. The adolescent is most likely not forgetting the medication. Most adolescents receiving attention-deficit hyperactivity disorder (ADHD) medication recognize that it helps them. Most adolescents know why they are receiving medication.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-6

Question 12

Type: MCSA

The nurse is teaching a caregivers support group for caretakers of elderly patients. The focus is medication compliance. The nurse determines that learning has occurred when the caregivers make which response?

1. We should crush their medicine and put it in applesauce so they will swallow it.

2. We should use a medication management box so they wont forget to take it.

3. We should ask the doctor if all the medication is really necessary.

4. We should give them more education about the medicine so they will take it.

Correct Answer: 2

Rationale 1: Most elderly patients will be medication compliant if they have a way to remember to take the medication; a medication management box is an excellent idea. Many elderly can swallow pills just fine, and many medications cannot be crushed. The problem is not the education; it is that the elderly often forget what medication to take at what time. Asking the physician about medications is fine, but this will not help the elderly patient to remember when to take it.

Rationale 2: Most elderly patients will be medication compliant if they have a way to remember to take the medication; a medication management box is an excellent idea. Many elderly can swallow pills just fine, and many medications cannot be crushed. The problem is not the education; it is that the elderly often forget what medication to take at what time. Asking the physician about medications is fine, but this will not help the elderly patient to remember when to take it.

Rationale 3: Most elderly patients will be medication compliant if they have a way to remember to take the medication; a medication management box is an excellent idea. Many elderly can swallow pills just fine, and many medications cannot be crushed. The problem is not the education; it is that the elderly often forget what medication to take at what time. Asking the physician about medications is fine, but this will not help the elderly patient to remember when to take it.

Rationale 4: Most elderly patients will be medication compliant if they have a way to remember to take the medication; a medication management box is an excellent idea. Many elderly can swallow pills just fine, and many medications cannot be crushed. The problem is not the education; it is that the elderly often forget what medication to take at what time. Asking the physician about medications is fine, but this will not help the elderly patient to remember when to take it.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-5

Question 13

Type: MCSA

Which statement is the most accurate regarding medication use in pregnant women?

1. Inhaled drugs are absorbed more quickly.

2. Drug excretion rates are lowered.

3. Oral drugs absorption rate is lowered.

4. Drug use should be avoided during pregnancy.

Correct Answer: 1

Rationale 1: Increases in tidal volume and pulmonary vasodilation during pregnancy lead to quicker absorption rates. Gastric emptying is delayed, leading to prolonged oral drug absorption rates. Renal blood flow is increased, leading to higher excretion rates. Some circumstances call for drug administration during pregnancy. (p. 64)

Rationale 2: Increases in tidal volume and pulmonary vasodilation during pregnancy lead to quicker absorption rates. Gastric emptying is delayed, leading to prolonged oral drug absorption rates. Renal blood flow is increased, leading to higher excretion rates. Some circumstances call for drug administration during pregnancy. (p. 64)

Rationale 3: Increases in tidal volume and pulmonary vasodilation during pregnancy lead to quicker absorption rates. Gastric emptying is delayed, leading to prolonged oral drug absorption rates. Renal blood flow is increased, leading to higher excretion rates. Some circumstances call for drug administration during pregnancy. (p. 64)

Rationale 4: Increases in tidal volume and pulmonary vasodilation during pregnancy lead to quicker absorption rates. Gastric emptying is delayed, leading to prolonged oral drug absorption rates. Renal blood flow is increased, leading to higher excretion rates. Some circumstances call for drug administration during pregnancy. (p. 64)

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-1

Question 14

Type: MCSA

A drug that is known to cause birth defects is known as

1. category A.

2. category C.

3. cautionary.

4. teratogenic.

Correct Answer: 4

Rationale 1: Drugs that are known to cause birth defects are called teratogenic, or classified as category D or category X.

Rationale 2: Drugs that are known to cause birth defects are called teratogenic, or classified as category D or category X.

Rationale 3: Drugs that are known to cause birth defects are called teratogenic, or classified as category D or category X.

Rationale 4: Drugs that are known to cause birth defects are called teratogenic, or classified as category D or category X.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8-3

Question 15

Type: MCSA

Which stage of fetal development poses the greatest risk to the fetus related to medication administration?

1. Each stage is equal in risk.

2. Pre-implantation period

3. Third trimester

4. Embryonic

Correct Answer: 4

Rationale 1: The embryonic phase poses the greatest risk to fetal development.

Rationale 2: The embryonic phase poses the greatest risk to fetal development.

Rationale 3: The embryonic phase poses the greatest risk to fetal development.

Rationale 4: The embryonic phase poses the greatest risk to fetal development.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-2

Question 16

Type: MCSA

A drug for which research has shown an adverse effects in animals but not in pregnant women would be categorized as Category

1. A.

2. B.

3. D.

4. C.

Correct Answer: 2

Rationale 1: A drug that has adverse effects in animals but not in pregnant women is a Category B drug.

Rationale 2: A drug that has adverse effects in animals but not in pregnant women is a Category B drug.

Rationale 3: A drug that has adverse effects in animals but not in pregnant women is a Category B drug.

Rationale 4: A drug that has adverse effects in animals but not in pregnant women is a Category B drug.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8-3

Question 17

Type: MCSA

Which of the following kinds of drugs would be most likely to enter breast milk?

1. Ionized

2. Lipid-soluble

3. Water-soluble

4. Bound to plasma protein

Correct Answer: 2

Rationale 1: As with the placenta, drugs that are ionized, water-soluble, and bound to plasma protein are less likely to enter breast milk.

Rationale 2: As with the placenta, drugs that are ionized, water-soluble, and bound to plasma protein are less likely to enter breast milk.

Rationale 3: As with the placenta, drugs that are ionized, water-soluble, and bound to plasma protein are less likely to enter breast milk.

Rationale 4: As with the placenta, drugs that are ionized, water-soluble, and bound to plasma protein are less likely to enter breast milk.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-3

Question 18

Type: MCSA

Which method is the most appropriate for administering medications to school-age children?

1. Allowing the child to make decisions regarding the time the medications are taken

2. Providing a brief explanation

3. Administering drugs while holding the child down

4. Providing a lengthy explanation followed by quick drug administration

Correct Answer: 2

Rationale 1: School-age children should be provided a brief explanation followed by quick drug administration. Children should not be held down. Lengthy explanations and allowing for choices are more appropriate for adolescents.

Rationale 2: School-age children should be provided a brief explanation followed by quick drug administration. Children should not be held down. Lengthy explanations and allowing for choices are more appropriate for adolescents.

Rationale 3: School-age children should be provided a brief explanation followed by quick drug administration. Children should not be held down. Lengthy explanations and allowing for choices are more appropriate for adolescents.

Rationale 4: School-age children should be provided a brief explanation followed by quick drug administration. Children should not be held down. Lengthy explanations and allowing for choices are more appropriate for adolescents.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-7

Question 19

Type: MCSA

Which statement is accurate regarding pharmacotherapy in the older adult?

1. Increased body water can lead to a higher risk of drug toxicity.

2. Plasma levels are increased, leading to a heightened drug response.

3. Generally, drug doses should be increased due to prolonged drug metabolism.

4. Drug absorption is slower due to increased gastric pH.

Correct Answer: 4

Rationale 1: The elderly have an increase in gastric pH, which slows absorption. Plasma levels are lower, causing a diminished drug response. Body water is reduced, leading to a higher risk of drug toxicity. Generally, drug doses are reduced because of prolonged drug metabolism.

Rationale 2: The elderly have an increase in gastric pH, which slows absorption. Plasma levels are lower, causing a diminished drug response. Body water is reduced, leading to a higher risk of drug toxicity. Generally, drug doses are reduced because of prolonged drug metabolism.

Rationale 3: The elderly have an increase in gastric pH, which slows absorption. Plasma levels are lower, causing a diminished drug response. Body water is reduced, leading to a higher risk of drug toxicity. Generally, drug doses are reduced because of prolonged drug metabolism.

Rationale 4: The elderly have an increase in gastric pH, which slows absorption. Plasma levels are lower, causing a diminished drug response. Body water is reduced, leading to a higher risk of drug toxicity. Generally, drug doses are reduced because of prolonged drug metabolism.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-8

Question 20

Type: MCSA

A patient presents with hypotension and bradycardia. The patient indicates that one of her physicians recently prescribed three new medications to her current list of 10 medications per day. Based on this information, which statement would be the most accurate?

1. The patient is having an allergic reaction to one of the new medications.

2. The patient is experiencing adverse reactions as a result of polypharmacy.

3. The patient is not in compliance with her prescribed medications.

4. The patient is experiencing an adverse effect that will go away in time.

Correct Answer: 2

Rationale 1: Polypharmacy increases the risk of drug interactions and side effects. It is not appropriate to assume the side effects will go away. The information provided does not reveal anything about patient compliance. Bradycardia and hypotension do not necessarily indicate an allergic reaction.

Rationale 2: Polypharmacy increases the risk of drug interactions and side effects. It is not appropriate to assume the side effects will go away. The information provided does not reveal anything about patient compliance. Bradycardia and hypotension do not necessarily indicate an allergic reaction.

Rationale 3: Polypharmacy increases the risk of drug interactions and side effects. It is not appropriate to assume the side effects will go away. The information provided does not reveal anything about patient compliance. Bradycardia and hypotension do not necessarily indicate an allergic reaction.

Rationale 4: Polypharmacy increases the risk of drug interactions and side effects. It is not appropriate to assume the side effects will go away. The information provided does not reveal anything about patient compliance. Bradycardia and hypotension do not necessarily indicate an allergic reaction.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8-9

Question 21

Type: MCMA

When possible, drug therapy is postponed until after pregnancy and lactation. However, certain acute and chronic conditions must be managed during pregnancy, including

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. epilepsy.

2. serious cystic acne.

3. sexually transmitted infections.

4. gestational diabetes.

5. hypertension.

Correct Answer: 1,3,4,5

Rationale 1: Epilepsy is a preexisting disease. It would not be wise to discontinue therapy during pregnancy and lactation.

Rationale 2: Cystic acne may be treated with isotretinoin (Accutane). Isotretinoin is a Class X drug and can cause fetal brain damage. Other antibiotics such as tetracycline are Class D and should not be used in pregnancy.

Rationale 3: Sexually transmitted infections can harm the fetus.

Rationale 4: Gestational diabetes is a complication related to pregnancy that must be treated for the safety of both the mother and growing fetus.

Rationale 5: If hypertension is present prior to pregnancy, it would be unwise to discontinue therapy during pregnancy and lactation.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-1

Question 22

Type: MCMA

The nurse preparing a teaching plan for an adolescent postpartum mother includes which topics?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Most medications are secreted into breast milk.

2. The new mothers insulin will not be secreted into her breast milk.

3. Over-the-counter (OTC) drugs and herbal products are secreted into breast milk and have the potential to cause harm to the infant.

4. Topical medications must be avoided as these also are secreted into breast milk.

5. Most drugs are safe to take right after breastfeeding because they have not reached the blood stream yet.

Correct Answer: 1,2,3

Rationale 1: The majority of drugs are secreted into breast milk.

Rationale 2: Insulin molecules are too large to be secreted into breast milk.

Rationale 3: OTC drugs and herbal products can be secreted into breast milk and have the potential to harm the infant. All products should be approved by the provider prior to use.

Rationale 4: Topical medications are not secreted into breast milk and are safe to use during breastfeeding. Topical medications could be ingested by the infant if applied to the nipple or breast.

Rationale 5: Drugs should only be taken during breastfeeding if the benefits to the mother outweigh the risks to the infant.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-8

Question 23

Type: MCMA

The nurse is planning care for a pregnant patient prone to substance abuse. When the patient states, My baby isnt getting my drugs, I am, how does the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Most illicit drugs will cross the placenta and hurt the baby.

2. Even drugs that do not cross the placenta can hurt your baby by preventing nutrients from getting across the placenta.

3. Research shows taking drugs can cause your baby to be born too early.

4. You are correct. You are far enough along in your pregnancy that drugs will not harm your baby.

5. If you continue to take drugs, it will make you have a very irritable infant.

Correct Answer: 1,2,3

Rationale 1: Most illicit drugs cross the placenta and can cause premature birth, low birth weight, birth defects, and withdrawal symptoms.

Rationale 2: Certain drugs can cause constriction of placental blood vessels, resulting in decreased nutrient exchange.

Rationale 3: Most illicit drugs cross the placenta and can cause premature birth, low birth weight, birth defects, and withdrawal symptoms.

Rationale 4: The effect the drug has on the fetus will depend on the stage of fetal development. There is a greater potential for harm during the first trimester but nutrients to the fetus can be compromised by drug abuse during the latter stages of pregnancy.

Rationale 5: While withdrawal can cause irritability in infants born to drug addicts, the risk for irritability is not the reason for abstaining from drug use during pregnancy.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-8

Question 24

Type: MCMA

A pregnant patient suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the patient about which complications associated with drug use during pregnancy?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Preterm birth

2. Low birth weight

3. Birth defects

4. Allergies to narcotics

5. Increased labor

Correct Answer: 1,2,3

Rationale 1: Many illicit drugs can cause preterm birth.

Rationale 2: Many illicit drugs can cause low birth weight.

Rationale 3: Many illicit drugs can cause birth defects.

Rationale 4: No research suggests that drug use can cause allergies to narcotics.

Rationale 5: No research suggests that drug use can cause increased labor.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-8

Question 25

Type: MCMA

For which patient would the nurse expect the health care provider to continue prescribed medications during pregnancy?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The patient recently diagnosed with gonorrhea

2. The patient with a history of frequent asthma attacks

3. The patient with hypertension

4. The patient with frequent insomnia

5. The patient with a family history of stroke

Correct Answer: 1,2,3

Rationale 1: Sexually transmitted infections are treated during pregnancy.

Rationale 2: Asthma is treated during pregnancy.

Rationale 3: Hypertension is treated during pregnancy.

Rationale 4: Insomnia would not be treated during pregnancy.

Rationale 5: This patient would not be treated unless she has a history of stroke.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8-1

Question 26

Type: MCMA

The clinic nurse will immediately alert the health care provider when which category X drugs are identified on a recently diagnosed pregnant patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Tetracycline

2. ACE inhibitor antihypertensive medication

3. Methotrexate

4. Isotretinoin (Accutane)

5. Oral contraceptives

Correct Answer: 3,4,5

Rationale 1: Tetracycline is in category D, not category X. It should be avoided during pregnancy, and the nurse should alert the health care provider.

Rationale 2: ACE inhibitor antihypertensive drugs are in category C and are considered safe during pregnancy.

Rationale 3: Methotrexate is in category X and should be avoided during pregnancy.

Rationale 4: Isotretinoin is in category X and should be avoided during pregnancy.

Rationale 5: Oral contraceptives are in category X and should be avoided during pregnancy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8-4

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E

Copyright 2014 by Pearson Education, Inc.

Leave a Reply