Chapter 10 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 10 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient confides in the nurse that she is drawn to complementary and alternative medicine because it promotes the “whole person.” The patient would like spirituality and prayer included in her plan of care. What is the best response by the nurse?

1. “We will include spirituality in your plan. Would you like to say a prayer?”
2. “I think your spiritual concerns are best left up to you and your minister.”
3. “What exactly do you mean by spirituality and prayer?”
4. “We usually do not pray with patients; is there something you are worried about?”

Correct Answer: 1

Rationale 1: Complementary and alternative medicine tends to include the “whole person” more than traditional medicine does. The nurse should offer to pray with the patient if the patient requests this.

Rationale 2: Refusing to acknowledge the patient’s spiritual concerns, and referring her to her minister, does not treat the “whole person.” Asking the patient to clarify what she means by spirituality and prayer could be appropriate but is not the best.

Rationale 3: Asking the patient to clarify what she means by spirituality and prayer could be appropriate but is not the best answer.

Rationale 4: Telling the patient that the nurse does not usually pray with patients will discourage her from discussing spirituality.

Global Rationale: Complementary and alternative medicine tends to include the “whole person” more than traditional medicine does. The nurse should offer to pray with the patient if the patient requests this. Refusing to acknowledge the patient’s spiritual concerns, and referring her to her minister, does not treat the “whole person.” Asking the patient to clarify what she means by spirituality and prayer could be appropriate but is not the best answer. Telling the patient that the nurse does not usually pray with patients will discourage her from discussing spirituality.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity.

AACN Essentials Competencies: IX.17 Develop a beginning understanding of complementary and alternative modalities and their role in health care.

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

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-2 Analyze reasons why complementary and alternative therapies have increased in popularity.

MNL Learning Outcome: 1.2.4 Explore the nurse’s role as it applies to client use of complementary and alternative supplements.

Page Number: 104

 

 

Question 2

Type: MCSA

The nurse plans to teach patients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse?

1. “Herbs, like prescription drugs, usually only contain one active ingredient.”
2. “The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts.”
3. “Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA).”
4. “Herbs are considered to be safer than prescription medications as they are natural.”

Correct Answer: 2

Rationale 1: Herbs may actually contain dozens of active chemicals, not just one.

Rationale 2: Unlike prescription drugs, the active ingredients in an herb may be present in just one part or many parts.

Rationale 3: Most herbs have not been standardized and are not regulated by the Food and Drug Administration (FDA).

Rationale 4: Herbs are not necessarily safer than prescription medications; they are medications.

Global Rationale: Unlike prescription drugs, the active ingredients in an herb may be present in just one part or many parts. Herbs may actually contain dozens of active chemicals, not just one. Most herbs have not been standardized and are not regulated by the Food and Drug Administration (FDA). Herbs are not necessarily safer than prescription medications; they are medications.

 

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.5 Describe factors that create a culture of safety (such as, open communication strategies and organizational error reporting systems).

AACN Essentials Competencies: IX.17 Develop a beginning understanding of complementary and alternative modalities and their role in health care.

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

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3 Identify the parts of an herb that may contain active ingredients and the types of formulations made from these parts.

MNL Learning Outcome: 1.2.4 Explore the nurse’s role as it applies to client use of complementary and alternative supplements.

Page Number: 106

 

 

Question 3

Type: MCMA

The patient tells the nurse that she plans to take St. John’s wort to treat her depression. 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. “That should be fine as long as you are not suicidal.”
2. “St. John’s wort is successfully used in Europe for minor depression.”
3. “It would be a good idea to try this before paying for a prescription medication.”
4. “It would be better to have a psychiatric assessment first.”
5. “Herbal preparations can interact with many other medications.”

Correct Answer: 4,5

Rationale 1: The suicidality of the patient should not be a determining factor with using St. John’s wort.

Rationale 2: Even though St. John’s wort is successfully used in Europe, this does not mean it is appropriate for this patient.

Rationale 3: The cost of the prescription medication should not be a determining factor.

Rationale 4: Anyone who is depressed should have a psychiatric assessment prior to starting on any type of medication. Often, there is a physiological cause for the depression that must also be treated.

Rationale 5: Herbal preparations do interact with many other medications and can have serious adverse side effects.

Global Rationale: Anyone who is depressed should have a psychiatric assessment prior to starting on any type of medication. Often, there is a physiological cause for the depression that must also be treated. Herbal preparations do interact with many other medications and can have serious adverse side effects. The suicidality of the patient should not be a determining factor with using St. John’s wort. Even though St. John’s wort is successfully used in Europe, this does not mean it is appropriate for this patient. The patient should have a psychiatric assessment prior to trying St. John’s wort; the cost of the prescription medication should not be a determining factor.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity.

AACN Essentials Competencies: IX.7 Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care.

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

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-5 Describe the pharmacologic actions and safety of herbal and dietary supplements.

MNL Learning Outcome: 1.2.4 Explore the nurse’s role as it applies to client use of complementary and alternative supplements.

Page Number: 108

 

Question 4

Type: MCSA

The patient tells the nurse that he has been taking herbal preparations to boost his immune system functioning. He does not know the names of the preparations. What is the best assessment question for the nurse to ask?

1. “Would you please tell your doctor about the herbs during the next visit?”
2. “Would you please ask your wife to discuss this with me during her next visit?”
3. “Would you please have your wife bring the bottles to the hospital?”
4. “Would you please ask your wife to call the hospital pharmacist with the names?”

Correct Answer: 3

Rationale 1: It is preferable for the nurse to do the assessment rather than to refer to the physician. Discussing the herbs with the nurse is the second best answer, but having objective data, the bottles, will provide the best information.

Rationale 2: Discussing the herbs with the nurse is the second best answer, but having objective data, the bottles, will provide the best information.

Rationale 3: The best way for the nurse to assess the kinds of herbal preparations the patient is taking is to actually look at the bottles.

Rationale 4: It is preferable for the nurse to do the assessment rather than to refer to the pharmacist.

Global Rationale: The best way for the nurse to assess the kinds of herbal preparations the patient is taking is to actually look at the bottles. It is preferable for the nurse to do the assessment rather than to refer to the pharmacist. It is preferable for the nurse to do the assessment rather than to refer to the physician. Discussing the herbs with the nurse is the second best answer, but having objective data, the bottles, will provide the best information.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity.

AACN Essentials Competencies: IX.17 Develop a beginning understanding of complementary and alternative modalities and their role in health care.

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

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 10-6 Identify common specialty supplements taken by patients.

MNL Learning Outcome: 1.2.4 Explore the nurse’s role as it applies to client use of complementary and alternative supplements.

Page Number: 109