Chapter 42 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 42 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nursing instructor is teaching student nurses about lower gastrointestinal (GI) functioning and the large intestine. The nursing instructor evaluates that learning has occurred when the students make which statement?

1. “The large intestine contains host flora that manufacture vitamin E.”
2. “The large intestine absorbs most of the nutrients from food.”
3. “The large intestine absorbs water and eliminates stool.”
4. “Food travels through the large intestine for 3 to 6 hours.”

Correct Answer: 3

Rationale 1: The large intestine contains host flora that manufacture B-complex vitamins and vitamin K, not vitamin E.

Rationale 2: The small intestine, not the large intestine, absorbs most of the nutrients from food.

Rationale 3: Major functions of the large intestine include absorption of water and elimination of stool.

Rationale 4: Food travels through the large intestine for 12 to 24 hours, not for 3 to 6 hours.

Global Rationale: Major functions of the large intestine include absorption of water and elimination of stool. The large intestine contains host flora that manufacture B-complex vitamins and vitamin K, not vitamin E. The small intestine, not the large intestine, absorbs most of the nutrients from food. Food travels through the large intestine for 12 to 24 hours, not for 3 to 6 hours.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 42-1 Identify major anatomic structures of the lower gastrointestinal tract.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 697

 

Question 2

Type: MCSA

An elderly client has constipation. He asks the nurse the reason for this. What is the best response by the nurse?

1. “You could have a serious illness and should check with your doctor.”
2. “You probably drink too much alcohol and end up constipated.”
3. “You probably don’t eat enough fiber, so the stool stays in your intestine too long.”
4. “Your large intestine is old and does not work as well as it used to.”

Correct Answer: 3

Rationale 1: The client could have a serious illness, but constipation in the elderly is more likely related to dietary habits.

Rationale 2: Alcohol can be a contributing factor to constipation, but the nurse should first assess alcohol intake and not just assume excessive alcohol intake.

Rationale 3: If the waste material remains in the intestine too long due to lack of fiber, too much water is reabsorbed leading to small, hard stools.

Rationale 4: Telling an elderly client that his intestine is old is very non-therapeutic.

Global Rationale: If the waste material remains in the intestine too long due to lack of fiber, too much water is reabsorbed leading to small, hard stools. The client could have a serious illness, but constipation in the elderly is more likely related to dietary habits. Alcohol can be a contributing factor to constipation, but the nurse should first assess alcohol intake and not just assume excessive alcohol intake. Telling an elderly client that his intestine is old is very non-therapeutic.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 42-2 Explain the pathophysiology and pharmacotherapy of constipation.

MNL Learning Outcome: 7.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 698

 

Question 3

Type: MCSA

The nurse designs a teaching plan for the client with chronic pancreatitis who receives pancrelipase (Pancreaze). What will the best plan by the nurse include as it relates to the rationale for the client to receive this drug?

1. “These enzymes replace what your ineffective pancreas cannot make.”
2. “These enzymes will help promote healing of your pancreas.”
3. “These enzymes promote digestion of starches and fats.”
4. “These enzymes will help digest all of the food you eat.”

Correct Answer: 1

Rationale 1: Chronic pancreatitis eventually leads to pancreatic insufficiency that may necessitate replacement of pancreatic enzymes.

Rationale 2: Pancreatic enzymes do not help heal the pancreas.

Rationale 3: Pancreatic enzymes will help digest food, but this is not the reason the client is receiving them.

Rationale 4: Pancreatic enzymes will help digest food, but this is not the reason the client is receiving them.

Global Rationale: Chronic pancreatitis eventually leads to pancreatic insufficiency that may necessitate replacement of pancreatic enzymes. Pancreatic enzymes do not help heal the pancreas. Pancreatic enzymes will help digest food, but this is not the reason the client is receiving them.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-8 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 713

 

Question 4

Type: MCMA

The nurse is planning care for the client who experiences frequent constipation. What will the best plan by 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. Increase protein in the diet.
2. Drink a glass of water every hour.
3. Increase dairy products in the diet.
4. Increase dietary fiber in the diet.
5. Increase daily physical exercise.

Correct Answer: 4,5

Rationale 1: Increasing protein in the diet will not help prevent constipation.

Rationale 2: Drinking a glass of water every hour is too much fluid and can result in hyponatremia.

Rationale 3: Dairy products in the diet will lead to, not prevent, constipation.

Rationale 4: Increasing fiber in the diet will help prevent constipation.

Rationale 5: Increasing exercise will help prevent constipation.

Global Rationale: Increasing exercise and fiber in the diet will help prevent constipation. Increasing protein in the diet will not help prevent constipation. Drinking a glass of water every hour is too much fluid and can result in hyponatremia. Dairy products in the diet will lead to, not prevent, constipation.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 42-9 Use the nursing process to care for patients receiving pharmacotherapy for bowel disorders, nausea, vomiting and other gastrointestinal conditions.

MNL Learning Outcome: 7.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 698