Chapter 17 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 17 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The patient has been admitted to the hospital for the treatment of schizophrenia. The patient’s mother says to the nurse, “This is all so confusing. How did he get this? Did I do something?” Which nursing responses are indicated?

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

Standard Text: Select all that apply.

1. “Schizophrenia is a biological brain disorder.”
2. “Schizophrenia is linked to drinking alcohol during pregnancy.”
3. “Research indicates that a very stressful environment causes schizophrenia.”
4. “Research indicates that schizophrenia is a genetic disorder.”
5. “Schizophrenia is due to too much dopamine in certain parts of the brain.”

Correct Answer: 1,4,5

Rationale 1: Theories explaining the cause of schizophrenia include imbalances in neurotransmitters in specific areas of the brain.

Rationale 2: There isn’t any evidence to support that schizophrenia is linked to alcohol consumption during pregnancy.

Rationale 3: A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.

Rationale 4: Theories explaining the cause of schizophrenia include a genetic component.

Rationale 5: Theories explaining the cause of schizophrenia include overactive dopaminergic pathways in the basal nuclei.

Global Rationale: Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There isn’t any evidence to support that schizophrenia is linked to alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.

 

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: 17-1 Explain theories for the etiology of schizophrenia.

MNL Learning Outcome: 3.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 225

 

Question 2

Type: MCSA

The patient with schizophrenia is sitting quietly in a chair. The patient does not respond much to what is happening and has a lack of interest in the environment. How does the nurse interpret this assessment?

1. The patient is most likely very depressed.
2. The patient is most likely hearing voices.
3. The patient is experiencing positive symptoms.
4. The patient is experiencing negative symptoms.

Correct Answer: 4

Rationale 1: There isn’t any evidence to support that the patient is very depressed.

Rationale 2: There isn’t any evidence to support that the patient is hearing voices.

Rationale 3: Positive symptoms include hallucinations, delusions, and a disorganized thought or speech pattern.

Rationale 4: Negative symptoms are those that subtract from normal behavior. These symptoms include a lack of interest, motivation, responsiveness, or pleasure in daily activities.

Global Rationale: Negative symptoms are those that subtract from normal behavior. These symptoms include a lack of interest, motivation, responsiveness, or pleasure in daily activities. Positive symptoms include hallucinations, delusions, and a disorganized thought or speech pattern. There isn’t any evidence to support that the patient is hearing voices. There isn’t any evidence to support that the patient is very depressed.

 

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: 17-2 Compare and contrast the positive and negative symptoms of schizophrenia.

MNL Learning Outcome: 3.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 224

 

Question 3

Type: MCSA

The physician has prescribed haloperidol (Haldol) for the patient with schizophrenia. What is the priority patient outcome?

1. The patient will consume adequate fluids and a high-fiber diet.
2. The patient will be compliant with taking the medication as prescribed.
3. The patient will report a decrease in auditory hallucinations.
4. The patient will report symptoms of restlessness.

Correct Answer: 2

Rationale 1: Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome.

Rationale 2: Medication compliance is a priority for patients with schizophrenia. Relapse of symptoms will occur without the medications.

Rationale 3: A decrease in auditory hallucinations is an expected effect of haloperidol (Haldol), but this is not the priority outcome.

Rationale 4: The symptom of restlessness is known as akathisia. This would be important to report but is not the priority outcome.

Global Rationale: Medication compliance is a priority for patients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report but is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of haloperidol (Haldol), but this is not the priority outcome.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

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: Planning

Learning Outcome: 17-9 Use the nursing process to care for patient receiving pharmacotherapy for psychoses.

MNL Learning Outcome: 3.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 230

 

Question 4

Type: MCSA

The nurse is managing the care of a group of patients with schizophrenia. The patients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

1. Acute dystonia
2. Complaint of a severe headache
3. Hypertension
4. Urinary retention

Correct Answer: 4

Rationale 1: Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect.

Rationale 2: Headaches are not anticholinergic side effects.

Rationale 3: Hypotension, not hypertension, is a cardiac side effect, not an anticholinergic side effect.

Rationale 4: Urinary retention is an anticholinergic side effect of conventional antipsychotics. This must be reported immediately to the physician.

Global Rationale: Urinary retention is an anticholinergic side effect of conventional antipsychotics. This must be reported immediately to the physician. Hypotension, not hypertension, is a cardiac side effect, not an anticholinergic side effect. Headaches are not anticholinergic side effects. Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

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: Planning

Learning Outcome: 17-9 Use the nursing process to care for patient receiving pharmacotherapy for psychoses.

MNL Learning Outcome: 3.2.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 233