Chapter 05 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 05 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A patient looks up the drug he is taking in a drug guide. The patient asks the nurse why the physician prescribed a medication that has a lethal dose measure. What is the best response by the nurse?

1. “It just refers to what is done in research; it is not used by doctors prescribing drugs.”
2. “It is a value determined during research, which helps to determine the safe dose to give.”
3. “All that means is that the drug could be lethal, but I will watch you for side effects.”
4. “Don’t worry about that, I’ll have your doctor explain it to you.”

Correct Answer: 2

Rationale 1: The lethal dose measure is used by doctors prescribing drugs.

Rationale 2: The difference between a median effective dose and a median lethal dose is a measure of a drug’s safety margin, which helps determine the safest dose to give.

Rationale 3: Telling a patient that the drug could be lethal, but he will be observed for side effects, will frighten him and most likely result in refusal of the medication.

Rationale 4: Telling a patient not to worry is non-therapeutic; this is a condescending response.

Global Rationale: The difference between a median effective dose and a median lethal dose is a measure of a drug’s safety margin, which helps determine the safest dose to give. The lethal dose measure is used by doctors prescribing drugs. Telling a patient not to worry is non-therapeutic; this is a condescending response. Telling a patient that the drug could be lethal, but he will be observed for side effects, will frighten him and most likely result in refusal of the medication.

 

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: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-4 Compare and contrast median lethal dose (LD₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.

Page Number: 52

Question 2

Type: MCSA

Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student’s understanding of therapeutic index?

1. The student is able to determine if the physician prescribed the best drug for the patient.
2. The student is able to determine if the patients are receiving safe doses of the medications.
3. The student is able to identify interactions among the drugs each patient is receiving.
4. The student is able to identify the patients who will need to have serum blood levels monitored.

Correct Answer: 4

Rationale 1: The therapeutic index will not help to determine if the physician prescribed the best drug for the patient.

Rationale 2: The therapeutic index will give some information about safe doses, but this is not the most complete response.

Rationale 3: The therapeutic index will not help to identify interactions among the drugs the patients receive.

Rationale 4: Drugs with a narrow therapeutic index have a low safety margin and the concentration of the drug should be monitored by regular serum tests.

Global Rationale: Drugs with a narrow therapeutic index have a low safety margin and the concentration of the drug should be monitored by regular serum tests. The therapeutic index will give some information about safe doses, but this is not the most complete response. The therapeutic index will not help to determine if the physician prescribed the best drug for the patient. The therapeutic index will not help to identify interactions among the drugs the patients receive.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.

Page Number: 52

 

Question 3

Type: MCSA

The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses?

1. About 50% of patients will experience severe side effects from the drug.
2. Some patients will respond differently depending on their ethnic background.
3. About 50% of patients will not experience any effect from the drug.
4. Some patients will require more or less than the average dose of the drug.

Correct Answer: 4

Rationale 1: The mean effective dose does not predict how many patients will experience severe side effects from the drug.

Rationale 2: The mean effective dose is not related to ethnicity.

Rationale 3: The mean effective dose does not predict that 50% of patients will not experience any effect of the drug.

Rationale 4: The mean effective dose predicts how 50% of the population will respond to the average dose of the drug. Some patients will require more or less of the drug.

Global Rationale: The mean effective dose predicts how 50% of the population will respond to the average dose of the drug. Some patients will require more or less of the drug. The mean effective dose is not related to ethnicity. The mean effective dose does not predict how many patients will experience severe side effects from the drug. The mean effective dose does not predict that 50% of patients will not experience any effect of the drug.

 

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: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5-3 Explain the importance of the median effective dose (ED₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.

Page Number: 51

 

Question 4

Type: MCSA

The patient receives antibiotics for a serious infection. The patient asks the nurse, “Why don’t you just give me more of that drug to cure this infection faster?” What is the best response by the nurse?

1. “I will check with the doctor to see if it is time to increase the medication.”
2. “You are at a maximum dose; taking more will cause interactions with other medications.”
3. “You must stay on this drug for 2 more weeks before it can be increased.”
4. “You are at a maximum dose; taking more will not help.”

Correct Answer: 4

Rationale 1: Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage.

Rationale 2: An increase in dosage may cause interactions with other medications, but this is not the best answer.

Rationale 3: Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect.

Rationale 4: When the plateau of a drug has been reached, administering more of the drug will not produce additional benefit. Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect. Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage. An increase in dosage may cause interactions with other medications, but this is not the best answer.

Global Rationale: When the plateau of a drug has been reached, administering more of the drug will not produce additional benefit. Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect. Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage. An increase in dosage may cause interactions with other medications, but this is not the best answer.

 

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: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.

Page Number: 53