Chapter 09: Collaboration in Community Settings

Chapter 09: Collaboration in Community Settings

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During a home visit, the nurse learns that a patient has not been taking the prescribed medications. The patient reports having no insurance and tells the nurse that the drug is too expensive. After learning that there is no substitute medication, the nurse will perform which action next?

a.	Assist the patient to apply for a patient-assist program.
b.	Contact the pharmacy to request a reduction in the cost of the drug.
c.	Determine the patient’s annual income.
d.	Give the patient the number of a charitable organization that may be able to help.

 

 

ANS:  C

Patient-assist programs may be helpful, but many are dependent on the patient’s income so the nurse should determine that first. It is unlikely that the pharmacy would offer a cost reduction. The patient has demonstrated an inability to navigate the system by simply not taking the medication, so only providing a phone number to the patient is not likely to be effective.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 99

TOP:   NURSING PROCESS: Assessment/Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient calls the clinic and tells the nurse that a newly prescribed medication isn’t working. What is the nurse’s next action?

a.	Notify the provider and discuss increasing the dose.
b.	Question the patient about compliance with the regimen.
c.	Review the drug information with the patient.
d.	Suggest the patient discuss changing medications with the provider.

 

 

ANS:  C

It is important for patients to understand the therapeutic effects and expected time frame for effects to occur. The nurse should review this with the patient first to make sure the patient’s expectations are consistent with the drug’s effects. The dose should not be increased or the drug changed until it is determined that the drug is not working as it should. Questioning the patient about compliance first assumes that the patient is doing something wrong. The nurse may question the patient about compliance after reviewing the drug information.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 99

TOP:   NURSING PROCESS: Assessment/Nursing Intervention

MSC:  NCLEX: Health Promotion and Maintenance

 

3. The parent of a school-age child tells the nurse that the child often misses the midday dose of a medication because the child forgets to take it to school. What will the nurse suggest?

a.	Asking the pharmacist to divide the prescription into two labeled packages
b.	Discussing a different medication with the child’s provider
c.	Putting the bottle of pills in the child’s lunchbox
d.	Requesting permission for the child to come home from school during the day

 

 

ANS:  A

Patients and families should be assisted to have medications available at home, work, or school if it is necessary to take the medications in those locations. Asking the pharmacist to label some of the drug for school will allow a supply to be kept at school. It should not be necessary to take a different medication. Children should not have medications in their lunchboxes. It should not be necessary for the child to come home to take a medication.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 99

TOP:   NURSING PROCESS: Planning/Nursing Intervention

MSC:  NCLEX: Health Promotion and Maintenance

 

4. The community health nurse is teaching a group of elderly residents in an assisted care facility about medication use. The nurse will remind the residents that over-the-counter (OTC) medications

a.	are not as effective as prescription medications.
b.	are not recommended for older adults.
c.	are safer than prescription medications.
d.	should be reviewed with a provider before taking.

 

 

ANS:  D

OTC medications should be reviewed as part of a medication history at every encounter with the provider to prevent food and drug interactions. OTC medications may be just as effective as prescription medications, may be used by older adults, and often have serious side effects.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 99

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Health Promotion and Maintenance