Chapter 19 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 19 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The nursing instructor teaches the nursing students about the advantages of local anesthetics, such as lidocaine (Xylocaine). What will the best plan of the nursing instructor include?

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

Standard Text: Select all that apply.

1. Amides have fewer side effects than esters.
2. Amides block potassium entry into the cell.
3. Amides are similar in structure to cocaine.
4. Amides tend to last longer than esters.
5. Amides block calcium entry into the cell.

Correct Answer: 1,4

Rationale 1: Amides have largely replaced esters because they produce fewer side effects.

Rationale 2: Amides block sodium, not potassium, entry into the cell.

Rationale 3: Cocaine is a natural ester, not an amide.

Rationale 4: Amides have largely replaced esters because they generally have a longer duration of action.

Rationale 5: Amides block sodium, not calcium, entry into the cell.

Global Rationale: Amides have largely replaced esters because they produce fewer side effects and generally have a longer duration of action. Amides block sodium, not potassium, entry into the cell. Cocaine is a natural ester, not an amide. Amides block sodium, not calcium, entry into the cell.

 

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.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: Planning

Learning Outcome: 19-2 Describe differences between the two major chemical classes of local anesthetics.

MNL Learning Outcome:

Page Number: 265

 

Question 2

Type: MCSA

The patient has entered Stage 3 of general anesthesia, known as surgical anesthesia. What will the best assessment of the nurse reveal?

1. Heart rate and breathing become irregular.
2. General sensation is lost, but the patient remains conscious.
3. The medulla region of the brain is paralyzed.
4. Relaxation, stable respiration, and slow eye movements

Correct Answer: 4

Rationale 1: Heart rate and breathing become irregular in Stage 2, not Stage 3.

Rationale 2: Loss of general sensation while still conscious occurs in Stage 1, not Stage 3.

Rationale 3: The medulla region of the brain is paralyzed in Stage 4, not Stage 3.

Rationale 4: In surgical anesthesia, skeletal muscles become relaxed, cardiovascular and breathing activities stabilize, and eye movements are slow.

Global Rationale: In surgical anesthesia, skeletal muscles become relaxed, cardiovascular and breathing activities stabilize, and eye movements are slow. Heart rate and breathing become irregular in Stage 2, not Stage 3. The medulla region of the brain is paralyzed in Stage 4, not Stage 3. Loss of general sensation while still conscious occurs in Stage 1, not Stage 3.

 

Cognitive Level: Analyzing

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.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: Assessment

Learning Outcome: 19-6 Identify the four stages of general anesthesia.

MNL Learning Outcome:

Page Number: 270

 

Question 3

Type: MCMA

The nurse teaches the patient about the correct use of a topical anesthetic for a skin condition. The nurse determines that learning has occurred when the patient makes which statements?

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

Standard Text: Select all that apply.

1. “This lotion should only be used on small areas of skin.”
2. “I must wear gloves when I apply the lotion.”
3. “This lotion works well on cuts too.”
4. “I must wash my hands before touching my eyes.”
5. “It’s all right to use a lotion after the expiration date.”

Correct Answer: 1,4

Rationale 1: Injury could result if topical anesthetics are applied to large areas of skin.

Rationale 2: The nurse, not the patient, must wear gloves when applying topical anesthetics.

Rationale 3: Topical anesthetics should be applied to intact skin only, not on cuts.

Rationale 4: Topical anesthetics must be kept away from the eyes unless they are ophthalmic preparations.

Rationale 5: Drugs, including lotions, should not be used past the expiration date.

Global Rationale: Topical anesthetics must be kept away from the eyes unless they are ophthalmic preparations, and injury could result if topical anesthetics are applied to large areas of skin. Topical anesthetics should be applied to intact skin only, not on cuts. Drugs, including lotions, should not be used past the expiration date. The nurse, not the patient, must wear gloves when applying topical anesthetics.

 

Cognitive Level: Analyzing

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: 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: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 19-1 Compare and contrast the five major clinical techniques for administering local anesthetics.

MNL Learning Outcome:

Page Number: 269

 

Question 4

Type: MCSA

What does the nurse recognize as the most dangerous adverse effect of volatile liquid inhalation anesthesia?

1. Hypertension
2. Ventricular tachycardia
3. Malignant hyperthermia
4. Increased intracranial pressure

Correct Answer: 3

Rationale 1: Hypotension is more likely to occur than hypertension.

Rationale 2: Ventricular tachycardia is serious but can be treated.

Rationale 3: Malignant hyperthermia is rare, but it is fatal if not treated immediately.

Rationale 4: Increased intracranial pressure is not a common adverse effect but can be treated.

Global Rationale: Malignant hyperthermia is rare, but it is fatal if not treated immediately. Ventricular tachycardia is serious but can be treated. Increased intracranial pressure is not a common adverse effect but can be treated. Hypotension is more likely to occur than hypertension.

 

Cognitive Level: Analyzing

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.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: Assessment

Learning Outcome: 19-4 Identify the actions of general anesthetics on the central nervous system.

MNL Learning Outcome:

Page Number: 272