Chapter 22 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 22 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The nurse is managing care for a group of patients with substance use disorder. The patients have completed group education about the disease of addiction. The nurse determines that learning has occurred when the patients make 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. “Heroin addicts often die from heroin withdrawal.”
2. “Substance abuse depends on complex variables.”
3. “Most addicts became addicted from pain medication in a hospital.”
4. “Addiction includes a compulsion to use a mood-altering substance.”
5. “There is most likely a genetic component to addiction.”

Correct Answer: 2,4,5

Rationale 1: While extremely unpleasant, withdrawal from opioids is typically not life threatening.

Rationale 2: Substance abuse depends on multiple, complex, interacting variables.

Rationale 3: Prescription drugs rarely cause addiction when used according to accepted medical protocols.

Rationale 4: Addiction is an overwhelming compulsion that drives someone to repetitive drug-taking behavior, despite serious health and social consequences.

Rationale 5: Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents.

Global Rationale: Addiction is an overwhelming compulsion that drives someone to repetitive drug-taking behavior, despite serious health and social consequences. Substance abuse depends on multiple, complex, interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents. Prescription drugs rarely cause addiction when used according to accepted medical protocols. While extremely unpleasant, withdrawal from opioids is not life threatening.

 

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: 22-1 Explain underlying causes of substance abuse.

MNL Learning Outcome:

Page Number: 313

 

Question 2

Type: MCSA

The adolescent patient is in a drug rehabilitation program. The mother of this patient says to the nurse, “The doctor said my son has a physical addiction to alcohol. What does this mean?” What is the best response by the nurse?

1. “His brain remembers the euphoria he had with alcohol, and he has a craving to return to it.”
2. “He will have an intense craving for alcohol; this is best managed in group therapy.”
3. “His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped.”
4. “He will have feelings of depression when stopping alcohol; we need to monitor him for suicide.”

Correct Answer: 3

Rationale 1: Alcohol does produce euphoria, but a craving for the substance is not a medical issue.

Rationale 2: Psychological dependence, or craving, does not involve physical withdrawal symptoms.

Rationale 3: Over time, the body’s cells become accustomed to the presence of the unnatural substance. Specific, physical withdrawal symptoms will occur; the patient needs to be medically withdrawn from the substance.

Rationale 4: Depression may accompany physical withdrawal, but physical signs are what require medical management.

Global Rationale: Over time, the body’s cells become accustomed to the presence of the unnatural substance. Specific, physical withdrawal symptoms will occur; the patient needs to be medically withdrawn from the substance. Psychological dependence, or craving, does not involve physical withdrawal symptoms. Alcohol does produce euphoria, but a craving for the substance is not a medical issue. Depression may accompany physical withdrawal, but physical signs are what require medical management.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-2 Compare and contrast psychological and physical dependence.

MNL Learning Outcome:

Page Number: 314

 

 

Question 3

Type: MCSA

The patient has an extensive history of alcoholism. He is having coronary bypass surgery. While administering anesthesia, the certified nurse anesthetist notes that the patient requires higher-than-usual amounts of the drug. The nurse correctly evaluates this response as what phenomenon?

1. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this patient.
2. The patient has developed a paradoxical reaction to the anesthesia and will require a different drug.
3. The patient has developed a resistance to the anesthesia, so it will not work very well.
4. The patient has developed cross-tolerance to the anesthesia and will require higher amounts.

Correct Answer: 4

Rationale 1: There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose.

Rationale 2: Paradoxical refers to the opposite response; in this case, the patient would have become very excitable; there is no evidence of this.

Rationale 3: Resistance refers to the immune system and infections and should not be used interchangeably with tolerance.

Rationale 4: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This patient has a tolerance to alcohol, so he will require additional anesthesia for surgery since both drugs are CNS depressants.

Global Rationale: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This patient has a tolerance to alcohol, so he will require additional anesthesia for surgery since both drugs are CNS depressants. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose. Resistance refers to the immune system and infections and should not be used interchangeably with tolerance. Paradoxical refers to the opposite response; in this case, the patient would have become very excitable, and there is no evidence of this.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

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: Relationship between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-4 Discuss how the nurse can recognize drug tolerance in patients.

MNL Learning Outcome:

Page Number: 313

 

Question 4

Type: MCSA

The patient comes to the emergency department and tells the nurse, “I am going to get clean. I haven’t had any drugs or any alcohol for 2 days.” The nurse plans care based on the knowledge that withdrawal from which substance can be life threatening?

1. Heroin
2. Alcohol
3. Cocaine
4. Marijuana

Correct Answer: 2

Rationale 1: Withdrawal from heroin is very unpleasant, but it is not life threatening.

Rationale 2: Alcohol withdrawal syndrome is severe and may be life threatening.

Rationale 3: Withdrawal from cocaine is uncomfortable, but it is not life threatening.

Rationale 4: There is virtually no withdrawal from marijuana.

Global Rationale: Alcohol withdrawal syndrome is severe and may be life threatening. Withdrawal from heroin is very unpleasant, but it is not life threatening. Withdrawal from cocaine is uncomfortable, but it is not life threatening. There is virtually no withdrawal from marijuana.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-3 Compare withdrawal syndromes for the various substance abuse classes.

MNL Learning Outcome:

Page Number: 316–317