Chapter 16 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 16 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient tells the nurse, “I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?” What is the best response by the nurse?

1. “Bipolar disorder is just another type of depression, except your depression occurs in cycles.”
2. “Bipolar disorder is a type of depression that includes attention deficit disorder symptoms.”
3. “Bipolar disorder just means that your mood alternates with the seasons, and it becomes worse in the winter.”
4. “Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania.”

Correct Answer: 4

Rationale 1: Bipolar disorder must include either mania or hypomania, not just depression.

Rationale 2: Bipolar disorder must include depression with either mania or hypomania, not attention-deficit hyperactivity disorder.

Rationale 3: A mood change that becomes worse in the winter is called seasonal affective disorder.

Rationale 4: Patients with bipolar disorder may shift from emotions of extreme depression to extreme rage and agitation. Mania may include grandiosity, decreased need for sleep, pressured speech, racing thoughts, buying sprees, and sexual indiscretions.

Global Rationale: Patients with bipolar disorder may shift from emotions of extreme depression to extreme rage and agitation. Mania may include grandiosity, decreased need for sleep, pressured speech, racing thoughts, buying sprees, and sexual indiscretions. Bipolar disorder must include either mania or hypomania, not just depression. Bipolar disorder must include depression with either mania or hypomania, not attention-deficit hyperactivity disorder. A mood change that becomes worse in the winter is called seasonal affective disorder.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

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: 16-1 Identify the two major categories of mood disorders and their symptoms.

MNL Learning Outcome: 3.1.2 Examine characteristics of and classes of drugs used to manage bipolar disorder.

Page Number: 210

 

Question 2

Type: MCSA

The mother of a 7-year-old child says to the nurse, “My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think?” What is the best response by the nurse?

1. “This sounds like your child is depressed; depression looks different in children and is very serious.”
2. “This sounds like bipolar disorder; you might want to have your child tested by a child psychiatrist.”
3. “This could be attention-deficit hyperactivity disorder (ADHD); you might want to have your child tested.”
4. “This sounds like typical 7-year-old behaviors to me; if they do not resolve, have your child tested.”

Correct Answer: 3

Rationale 1: Depression does look different in children, but these symptoms are not symptoms of depression.

Rationale 2: Being distractible, unable to complete assignments, and interrupting other children are not symptoms of bipolar disorder.

Rationale 3: Symptoms of attention-deficit hyperactivity disorder (ADHD) include difficulty in paying attention and focusing on tasks, hyperactivity, distractibility, impulsivity, and talking excessively.

Rationale 4: Being distractible, unable to complete assignments, and interrupting other children are not typical 7-year-old behaviors.

Global Rationale: Symptoms of attention-deficit hyperactivity disorder (ADHD) include difficulty in paying attention and focusing on tasks, hyperactivity, distractibility, impulsivity, and talking excessively. Being distractible, unable to complete assignments, and interrupting other children are not typical 7-year-old behaviors. Depression does look different in children, but these symptoms are clearly symptoms of attention-deficit hyperactivity disorder (ADHD). Being distractible, unable to complete assignments, and interrupting other children are symptoms of attention-deficit hyperactivity disorder (ADHD), not bipolar disorder.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

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: 16-2 Identify the symptoms of attention deficit/hyperactivity disorder.

MNL Learning Outcome: 3.1.3 Examine characteristics of and classes of drugs used to manage ADHD.

Page Number: 211

 

Question 3

Type: MCMA

The nurse is conducting a group education session for patients who have been diagnosed with depression. The nurse evaluates the education as effective when a patient makes which comments about the cause of depression?

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

Standard Text: Select all that apply.

1. “Depression has many causes; they could include environmental as well as brain-based disorders.”
2. “Depression includes impaired relationships and is also an inherited illness.”
3. “We really don’t know what causes depression; it has not been studied very much.”
4. “Depression results from unresolved conflicts in your childhood.”
5. “Depression results from parents who are cold and distant and don’t really care about their children.”

Correct Answer: 1,2

Rationale 1: Depression has many causes; it is a brain-based disorder that is exacerbated by environmental influences.

Rationale 2: Depression runs in families, supporting a genetic link, and will include impaired relationships.

Rationale 3: Depression has been studied extensively.

Rationale 4: Environmental influences are only one of the causes of depression; this answer does not include the biological basis for depression.

Rationale 5: Depression could result from cold and distant parents, but this answer does not include the biological basis for depression.

Global Rationale: Depression has many causes; it is a brain-based disorder that is exacerbated by environmental influences. Depression runs in families, supporting a genetic link, and will include impaired relationships. Environmental influences are only one of the causes of depression; this answer does not include the biological basis for depression. Depression could result from cold and distant parents, but this answer does not include the biological basis for depression. Depression has been studied extensively.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

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: Evaluation

Learning Outcome: 16-3 Explain the etiology of major depressive disorder.

MNL Learning Outcome: 3.1.1 Examine characteristics of and classes of drugs used to manage depression.

Page Number: 201

 

Question 4

Type: MCSA

The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?

1. The patient’s cardiac status
2. The patient’s liver function
3. The patient’s renal status
4. The patient’s neurological function

Correct Answer: 1

Rationale 1: Tricyclic antidepressants are cardiotoxic. An overdose could result in a fatal dysrhythmia. Cardiac status is the primary assessment.

Rationale 2: Liver function is not the priority assessment.

Rationale 3: Renal function is not the priority assessment.

Rationale 4: Neurologic function may be affected but is not the primary assessment.

Global Rationale: Tricyclic antidepressants are cardiotoxic. An overdose could result in a fatal dysrhythmia. Cardiac status is the primary assessment, not the patient’s renal status. Cardiac status is the primary assessment, not the patient’s liver function. Cardiac status is the primary assessment, not the patient’s neurological function.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

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: Relationships between knowledge and science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 16-5 For each of the drug classes listed in Drugs at a Glance, know representative drug examples and explain their mechanism of drug action, primary actions, and important adverse effects.

MNL Learning Outcome: 3.1.1 Examine characteristics of and classes of drugs used to manage depression.

Page Number: 189