Chapter 45 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 45 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The client has been diagnosed with type 1 diabetes mellitus. He asks the nurse what this means. What is the best response by the nurse?

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

Standard Text: Select all that apply.

1. “The exocrine function of your pancreas is to secrete insulin, and it is not working.”
2. “Without insulin you will develop ketoacidosis (DKA).”
3. “The endocrine function of your pancreas is to secrete insulin, but it isn’t working.”
4. “Your alpha cells should be able to secrete insulin, but cannot.”
5. “It means your pancreas cannot secrete insulin.”

Correct Answer: 2,3,5

Rationale 1: The endocrine, not the exocrine, function of the pancreas is to secrete insulin.

Rationale 2: A consequence of diabetes mellitus type 1 is that, without insulin, severe metabolic disturbances, such as diabetic ketoacidosis (DKA) will result.

Rationale 3: The endocrine function of the pancreas is to secrete insulin.

Rationale 4: Insulin is secreted by the beta, not the alpha, cells of the pancreas.

Rationale 5: One function of the pancreas is to secrete insulin.

Global Rationale: A consequence of diabetes mellitus type 1 is that, without insulin, severe metabolic disturbances, such as diabetic ketoacidosis (DKA) will result. The endocrine function of the pancreas is to secrete insulin. One function of the pancreas is to secrete insulin. The endocrine, not the exocrine, function of the pancreas is to secrete insulin. Insulin is secreted by the beta, not the alpha, cells of the pancreas.

 

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: 45-1 Explain how blood glucose levels are maintained within narrow limits by insulin and glucagon.

MNL Learning Outcome: 9.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 769

 

Question 2

Type: MCSA

The physician orders insulin lispro (Humalog), 10 units for the client. When will the nurse administer this medication?

1. Thirty minutes before meals
2. Five minutes before a meal
3. When the meal trays arrive on the floor
4. Fifteen minutes after meals

Correct Answer: 2

Rationale 1: The onset of action for insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating, not 30 minutes before meals, to prevent hypoglycemia.

Rationale 2: The onset of action for insulin lispro (Humalog) is 10 to 15 minutes so it must be given 5 to 10 minutes before the client eats.

Rationale 3: The onset of action for insulin lispro (Humalog) is 10 to 15 minutes so it must be given just before the client eats, not when meal trays arrive on the floor, to prevent hypoglycemia.

Rationale 4: The onset of action for insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating, not 15 minutes after meals, to prevent hypoglycemia.

Global Rationale: The onset of action for insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating, not 30 minutes before meals, not when meal trays arrive on the floor, and not 15 minutes after meals, to prevent hypoglycemia.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

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

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: Implementation

Learning Outcome: 45-3 Compare and contrast types of insulin.

MNL Learning Outcome: 9.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 771

 

Question 3

Type: MCSA

The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician?

1. Lantus insulin 20U BID
2. Administering regular insulin 30 minutes prior to meals
3. 5 units of Humalog/10 units NPH daily
4. Metformin (Glucophage) 1000 mg per day in divided doses

Correct Answer: 1

Rationale 1: Lantus insulin is usually prescribed in once-a-day dosing so an order for BID dosing should be validated with the physician.

Rationale 2: Regular insulin is administered 30 minutes before meals.

Rationale 3: Humalog and NPH insulin can be mixed.

Rationale 4: Metformin (Glucophage) is often prescribed in divided doses of 1000 mg per day.

Global Rationale: Lantus insulin is usually prescribed in once-a-day dosing so an order for BID dosing should be validated with the physician. Regular insulin is administered 30 minutes before meals. Humalog and NPH insulin can be mixed. Metformin (Glucophage) is often prescribed in divided doses of 1000 mg per day.

 

Cognitive Level: Analyzing

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: 45-8 Use the nursing process to care for patients receiving pharmacotherapy for diabetes mellitus.

MNL Learning Outcome: 9.2.3 Apply the nursing process to the administration of insulin and oral hypoglycemic agents.

Page Number: 771

 

Question 4

Type: MCSA

A client with diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority?

1. Call a code.
2. Treat the client for hypoglycemia.
3. Call the physician STAT.
4. Assess the client’s vital signs.

Correct Answer: 2

Rationale 1: Assessment for ABCs should precede calling a code; there is no information that the client is not breathing.

Rationale 2: When a client with diabetes mellitus type 1 is found unresponsive, the nurse should focus on and treat for hypoglycemia, as this is more likely than hyperglycemia.

Rationale 3: This is an emergency situation where the nurse must act before calling the physician.

Rationale 4: Vital signs should be taken after the client is treated for hypoglycemia.

Global Rationale: When a client with diabetes mellitus type 1 is found unresponsive, the nurse should focus on and treat for hypoglycemia, as this is more likely than hyperglycemia. Assessment for ABCs should precede calling a code; there is no information that the client is not breathing. This is an emergency situation where the nurse must act before calling the physician. Vital signs should be taken after the client is treated for hypoglycemia.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

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

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: Implementation

Learning Outcome: 45-4 Describe the signs and symptoms of insulin overdose and underdose.

MNL Learning Outcome: 9.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 774