Chapter 07: Adverse Drug Reactions and Medication Errors

Chapter 07: Adverse Drug Reactions and Medication Errors

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due, what will the nurse do?

a.	Administer the drug and tell the patient to report further nausea.
b.	Hold the drug and notify the provider of the patient’s symptoms.
c.	Report the symptoms of nausea to the MEDWATCH program.
d.	Request an order for an antiemetic to counter this drug’s effects.

 

 

ANS:  A

Not all adverse drug reactions (ADRs) can be detected during clinical trials, and nurses should be alert to any effects that may result from drug administration. Because nausea is not a serious effect and because it is not yet known whether the drug is the cause of this patient’s nausea, the nurse should administer the medication and observe the patient for recurrence of the symptom. It is not necessary to hold the drug, because nausea is not a serious side effect. The MEDWATCH program should be notified when there is a greater suspicion that the drug may have caused the nausea if the nausea occurs with subsequent doses. Until there is greater suspicion that the drug actually caused this patient’s nausea, giving an antiemetic is not indicated.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 65-66

TOP:   Nursing Process: Evaluation

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

 

2. A patient is being discharged after surgery. During the admission history, the nurse learned that the patient normally consumes two or three glasses of wine each day. The prescriber has ordered hydrocodone with acetaminophen [Lortab] for pain. What will the nurse do?

a.	Request an order for acetaminophen without hydrocodone for pain.
b.	Suggest that the patient use ibuprofen for pain.
c.	Tell the patient not to drink wine while taking Lortab.
d.	Tell the patient to limit wine intake to one or two glasses per day.

 

 

ANS:  C

Combining a hepatotoxic drug with certain other drugs may increase the risk of hepatotoxicity. When even therapeutic doses of acetaminophen are taken with alcohol, the acetaminophen can cause liver damage. Patients should be cautioned not to drink alcohol; even two drinks with acetaminophen can produce this effect. Hydrocodone does not contribute to hepatotoxicity. Ibuprofen is not indicated for postoperative pain unless the pain is mild. Limiting wine to one or two glasses per day still increases the risk of hepatotoxicity.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 63-64

TOP:   Nursing Process: Diagnosis

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

 

3. A nurse is reviewing a medication administration record before administering medications. Which order will the nurse implement?

a.	Furosemide [Lasix] 20 mg QD PO
b.	Furosemide [Lasix] 20 mg qd PO
c.	Furosemide [Lasix] 20 mg daily
d.	Furosemide [Lasix] 20 mg PO daily

 

 

ANS:  D

The correct answer is a complete order; it contains the medication, dose, route, and time. “qd” is no longer an accepted abbreviation; it should be written out as “daily” or “every day.” The order of “20 mg daily” does not specify the route to be used.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 70

TOP:   Nursing Process: Planning

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

 

4. A patient is given a drug for the first time and develops shortness of breath. The patient’s heart rate is 76 beats per minute, the respiratory rate is 20 breaths per minute, and the blood pressure is 120/70 mm Hg. The nurse checks a drug administration manual to make sure the correct dose was given and learns that some patients taking the drug experience shortness of breath. The nurse will contact the provider to report what?

a.	An allergic reaction
b.	An idiosyncratic effect
c.	An iatrogenic response
d.	A side effect

 

 

ANS:  D

A side effect is a secondary drug effect produced at therapeutic doses. This patient received the correct dose of the drug and developed shortness of breath, which, in this case, is a drug side effect. To experience an allergic reaction, a patient must have prior exposure to a drug and sensitization of the immune response. An idiosyncratic effect results from a genetic predisposition to an uncommon drug response. An iatrogenic response occurs when a drug causes symptoms of a disease.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 62-63

TOP:   Nursing Process: Implementation

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

 

5. A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, what will the nurse do first?

a.	Ask whether the patient has taken this antibiotic for other infections
b.	Question the patient about allergies to other medications
c.	Request an order for a lower dose of the antibiotic
d.	Request an order for an antihistamine

 

 

ANS:  A

The nurse needs to assess whether the patient is truly allergic to this drug. Allergic reactions require previous exposure to the drug, so the nurse should ask whether the patient has taken this antibiotic before. If a patient is allergic to a drug, lowering the dose will not decrease the risk of allergic reaction. Antihistamines sometimes are given when patients must take a drug to which they are allergic.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 62-63

TOP:   Nursing Process: Assessment