Chapter 24 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 24 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 diagnosed with chronic renal failure and is receiving hydrochlorothiazide (HCTZ). The nurse has taught the patient about the importance of kidney function and evaluates 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. “Kidneys help my heart by balancing potassium.”
2. “Kidneys balance the fluid and electrolytes in my body.”
3. “Kidneys keep blood pressure from getting too low.”
4. “Kidneys help decrease infections by excreting bacteria.”
5. “Kidneys help regulate the oxygen levels in my blood.”

Correct Answer: 1,2,3

Rationale 1: The kidneys are the primary organs for regulating potassium balance.

Rationale 2: The kidneys are the primary organs for regulating fluid and electrolyte balance.

Rationale 3: They secrete renin, which helps to regulate blood pressure.

Rationale 4: The kidneys do not have any impact on bacterial infections.

Rationale 5: The kidneys do not affect serum oxygen levels.

Global Rationale: The kidneys are the primary organs for regulating fluid and electrolyte balance. The kidneys are the primary organs for regulating potassium balance. They secrete renin, which helps to regulate blood pressure. The kidneys do not affect serum oxygen levels. The kidneys do not have any impact on bacterial infections.

 

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: 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: 24-1 Explain the primary functions of the kidneys.

MNL Learning Outcome: 13.4.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 343

 

Question 2

Type: MCSA

The nurse is managing care for a group of patients on a renal failure unit. What does the nurse recognize as the most important patient safety precaution with regard to medication administration?

1. Know that patients will require less-than-average doses of medications.
2. Know which drugs will increase fluid retention.
3. Ensure that each patient’s intake and output is measured precisely.
4. Be aware of what drugs are nephrotoxic.

Correct Answer: 1

Rationale 1: Administering the “average” dose of medication to a patient in severe renal failure can have mortal consequences. The consequences of recognizing that renal patients will require less-than-average doses of medications cannot be overemphasized.

Rationale 2: Knowing which drugs will increase fluid retention is important but not as important as recognizing another precaution.

Rationale 3: Ensuring that each patient’s intake and output is measured precisely is important but not as important as another precaution.

Rationale 4: Recognizing which drugs are nephrotoxic is important but not as important as another precaution.

Global Rationale: Administering the “average” dose of medication to a patient in severe renal failure can have mortal consequences. The consequences of recognizing that renal patients will require less-than-average doses of medications cannot be overemphasized. Recognizing which drugs are nephrotoxic is important but not as important as knowing that patients will need less-than-average doses. Ensuring that each patient’s intake and output is measured precisely is important but not as important as knowing that patients will need less-than-average doses. Knowing which drugs will increase fluid retention is important but not as important as knowing that patients will need less-than-average doses.

 

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.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

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

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 24-3 Describe the adjustments in pharmacotherapy that must be considered in patients with renal failure.

MNL Learning Outcome: 13.4.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 345

 

Question 3

Type: MCSA

The patient has a routine urinalysis done, and the results show protein in the urine. What does the nurse correctly conclude about this result?

1. The patient is in acute renal failure and needs to be hospitalized.
2. The patient probably has kidney damage; protein should not be present in the urine.
3. There could be a mistake with the results; the patient should have another test done.
4. The results probably mean nothing if the amount of protein is very small.

Correct Answer: 2

Rationale 1: There is no evidence that this patient is in acute renal failure.

Rationale 2: When filtrate passes through Bowman’s capsule, its composition is similar to plasma. Plasma proteins are too large to pass through the filter, and if they appear in the filtrate or urine, this indicates kidney pathology.

Rationale 3: There is no evidence to support a mistake with the results of the urinalysis.

Rationale 4: Any amount of protein in the kidney is considered abnormal. There is no evidence that this patient is in acute renal failure.

Global Rationale: When filtrate passes through Bowman’s capsule, its composition is similar to plasma. Plasma proteins are too large to pass through the filter, and if they appear in the filtrate or urine, this indicates kidney pathology. There is no evidence to support a mistake with the results of the urinalysis. Any amount of protein in the kidney is considered abnormal. There is no evidence that this patient is in acute renal failure.

 

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: 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: 24-2 Explain the processes that change the composition of filtrate as it travels through the nephron.

MNL Learning Outcome: 13.4.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 343

 

Question 4

Type: MCMA

Several patients have been seen in the acute-care clinic. The nurse will plan to administer diuretic therapy to which patients?

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

Standard Text: Select all that apply.

1. The patient experiencing visual and auditory hallucinations
2. The patient with confusion and ataxia
3. The patient with a blood pressure of 200/98 mmHg
4. The patient with generalized edema and decreased urine output
5. The patient with pinpoint pupils and extreme paranoia

Correct Answer: 3,4

Rationale 1: Visual and auditory hallucinations could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here.

Rationale 2: Confusion and ataxia could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here.

Rationale 3: Diuretics are indicated for the treatment of renal failure, hypertension, and for the removal of edema fluid.

Rationale 4: Diuretics are indicated for the treatment of renal failure, hypertension, and for the removal of edema fluid.

Rationale 5: Pinpoint pupils and extreme paranoia could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here.

Global Rationale: Diuretics are indicated for the treatment of renal failure, hypertension, and for the removal of edema fluid. Confusion and ataxia could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here. Visual and auditory hallucinations could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here. Pinpoint pupils and extreme paranoia could be the result of non-renal pathology; there is no evidence of fluid overload or hypertension here.

 

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: 24-4 Identify indications for diuretics.

MNL Learning Outcome: 13.4.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 345