Chapter 02: Application of Pharmacology in Nursing Practice

Chapter 02: Application of Pharmacology in Nursing Practice

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer “2 puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she doesn’t feel that the medication is always effective. Which action is outside the nurse’s scope of practice?

a.	Asking the patient to demonstrate use of the inhaler
b.	Assessing the patient’s exposure to tobacco smoke
c.	Auscultating lung sounds and obtaining vital signs
d.	Suggesting that the patient use one puff to reduce side effects

 

 

ANS:  D

It is not within the nurse’s scope of practice to change the dose of a medication without an order from a prescriber. Asking the patient to demonstrate inhaler use helps the nurse to evaluate the patient’s ability to administer the medication properly and is part of the nurse’s evaluation. Assessing tobacco smoke exposure helps the nurse determine whether nondrug therapies, such a smoke avoidance, can be used as an adjunct to drug therapy. Performing a physical assessment helps the nurse evaluate the patient’s response to the medication.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 9-10

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A postoperative patient is being discharged home with acetaminophen/hydrocodone [Lortab] for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct?

a.	“It is not safe to take over-the-counter drugs with prescription medications.”
b.	“Taking the two medications together poses a risk of drug toxicity.”
c.	“There are no known drug interactions, so this will be safe.”
d.	“Tylenol and Lortab are different drugs, so there is no risk of overdose.”

 

 

ANS:  B

Tylenol is the trade name and acetaminophen is the generic name for the same medication. It is important to teach patients to be aware of the different names for the same drug to minimize the risk of overdose. Over-the-counter (OTC) medications and prescription medications may be taken together unless significant harmful drug interactions are possible. Even though no drug interactions are at play in this case, both drugs contain acetaminophen, which could lead to toxicity.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 8

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

3. The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process?

a.	Asking the prescriber for an order to monitor serum drug levels
b.	Monitoring the patient for drug interactions after giving the medication
c.	Questioning the patient about over-the-counter medications
d.	Taking the patient’s blood pressure throughout the course of treatment

 

 

ANS:  C

The assessment part of the nursing process involves gathering information before beginning treatment, and this includes asking about other medications the patient may be taking. Monitoring serum drug levels, watching for drug interactions, and checking vital signs after giving the medication are all part of the evaluation phase.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 6

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A postoperative patient reports pain, which the patient rates as an 8 on a scale from 1 to 10 (10 being the most extreme pain). The prescriber has ordered acetaminophen [Tylenol] 650 mg PO every 6 hours PRN pain. What will the nurse do?

a.	Ask the patient what medications have helped with pain in the past.
b.	Contact the provider to request a different analgesic medication.
c.	Give the pain medication and reposition the patient to promote comfort.
d.	Request an order to administer the medication every 4 hours.

 

 

ANS:  B

The nursing diagnosis for this patient is severe pain. Acetaminophen is given for mild to moderate pain, so the nurse should ask the prescriber to order a stronger analgesic medication. Asking the patient to tell the nurse what has helped in the past is part of an initial assessment and should be done preoperatively and not when the patient is having severe pain. Because the patient is having severe pain, acetaminophen combined with nondrug therapies will not be sufficient. Increasing the frequency of the dose of a medication for mild pain will not be effective.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 9

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

5. A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse teaching this patient about home management should begin by doing what?

a.	Asking the patient to demonstrate how to measure and administer insulin
b.	Discussing methods of storing insulin and discarding syringes
c.	Giving information about how diet and exercise affect insulin requirements
d.	Teaching the patient about the long-term consequences of poor diabetes control

 

 

ANS:  A

Because insulin must be given correctly to control symptoms and because an overdose can be fatal, it is most important for the patient to know how to administer it. Asking for a demonstration of technique is the best way to determine whether the patient has understood the teaching. When a patient is receiving a lot of new information, the information presented first is the most likely to be remembered. The other teaching points are important as well, but they are not as critical and can be taught later.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 9

TOP:   Nursing Process: Planning