Chapter 25 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 25 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

The nurse practitioner conducts education for home-health nurses who care for geriatric patients. Many of the patients abuse laxatives, so the nurse practitioner focuses the education on problems that can be caused by chronic laxative use. The nurse practitioner evaluates that learning has occurred when the nurses 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. “The kidneys and GI tract keep electrolytes in narrow balance, where they must be.”
2. “Electrolytes carry electricity in the body and must stay in balance.”
3. “The electrolytes can be replaced by eating the right foods.”
4. “The most important electrolytes are sodium, potassium, and magnesium.”
5. “Laxatives can lower the level of potassium, necessary for proper heart function.”

Correct Answer: 1,2,3,5

Rationale 1: Levels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and GI tract.

Rationale 2: Small, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity.

Rationale 3: As electrolytes are lost due to normal excretory functions, they must be replaced by adequate intake, otherwise electrolyte imbalances will result.

Rationale 4: The most important electrolytes are sodium, potassium, and calcium, not magnesium.

Rationale 5: Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible consequence of hypokalemia.

Global Rationale: Small, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible consequence of hypokalemia. Levels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and GI tract. As electrolytes are lost due to normal excretory functions, they must be replaced by adequate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium.

 

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: 25-4 Explain the importance of electrolyte balance in the body.

MNL Learning Outcome: 11.1.3 Compare various electrolytes used to maintain fluid balance and the nurse’s role in therapy.

Page Number: 362

 

Question 2

Type: MCSA

The patient is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse’s priority action?

1. Increase the rate of the infusion and continue to assess the patient for symptoms of acidosis.
2. Decrease the rate of the infusion and continue to assess the patient for symptoms of alkalosis.
3. Continue the infusion; the patient is still in acidosis.
4. Stop the infusion and notify the physician; the patient is in alkalosis.

Correct Answer: 4

Rationale 1: The patient is not in acidosis, and the infusion should not be increased.

Rationale 2: Slowing the infusion is not sufficient.

Rationale 3: patient is not in acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid.

Rationale 4: The patient receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The patient’s symptoms indicate alkalosis so infusion must be stopped and the physician notified.

Global Rationale: The patient receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The patient’s symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis.

 

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: Implementation

Learning Outcome: 25-6 Discuss common causes of alkalosis and acidosis and the medications used to treat these conditions.

MNL Learning Outcome: 11.1.4 Correlate the characteristics of acid-base disorders, pharmacotherapy, and nursing management.

Page Number: 370

 

Question 3

Type: MCMA

The nurse cares for a patient in the emergency department who was just severely burned. The wife of the patient asks the nurse, “Why does he need those intravenous infusions (IVs)?” What are the best responses by the nurse that indicates the primary reasons for intravenous infusions (IVs) with a burned patient?

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

Standard Text: Select all that apply.

1. “So we have an open line for resuscitation in case his heart stops.”
2. “So he can receive his antibiotics.”
3. “So we can keep his blood pressure stable.”
4. “So we can be sure he keeps enough blood volume.”
5. “So we can rapidly administer his pain medications.”

Correct Answer: 3,4

Rationale 1: Cardiac resuscitation is not a primary reason for intravenous (IV) fluid replacement.

Rationale 2: Antibiotic therapy is not a primary reason for intravenous (IV) fluid replacement.

Rationale 3: Net loss of fluids from the body can result in dehydration and shock. Intravenous (IV) fluid therapy is used to maintain blood pressure.

Rationale 4: Net loss of fluids from the body can result in dehydration and shock. Intravenous (IV) fluid therapy is used to maintain blood volume.

Rationale 5: Administration of analgesics is not a primary reason for intravenous (IV) fluid replacement.

Global Rationale: Net loss of fluids from the body can result in dehydration and shock. Intravenous (IV) fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (IV) fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (IV) fluid replacement. Administration of analgesics is not a primary reason for intravenous (IV) fluid replacement.

 

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: Implementation

Learning Outcome: 25-1 Describe conditions for which intravenous fluid therapy may be indicated.

MNL Learning Outcome: 11.1.1 Examine etiology, pathophysiology, and clinical manifestations of fluid imbalance.

Page Number: 360

 

Question 4

Type: MCSA

The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema. The nurse hangs a bag of a hypotonic solution. What will the priority assessment by the nurse include?

1. Headache, irritability, and decreasing level of consciousness
2. Nausea, projectile vomiting, and pinpoint pupils
3. Confusion, hallucinations, and agitation
4. Hypertension, headache, and nausea

Correct Answer: 1

Rationale 1: A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. Headache, irritability, and decreasing level of consciousness are signs of cerebral edema.

Rationale 2: Projectile vomiting and pinpoint pupils are not classical signs of cerebral edema.

Rationale 3: Confusion, hallucinations, and agitation are not classical signs of cerebral edema.

Rationale 4: Hypertension and nausea are not classical signs of cerebral edema.

Global Rationale: A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. Headache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. Hypertension and nausea are not classical signs of cerebral edema. Projectile vomiting and pinpoint pupils are not classical signs of cerebral edema.

 

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: 25-2 Explain how changes in the osmolality or tonicity of a fluid can cause water to move between fluid compartments.

MNL Learning Outcome: 11.1.2 Compare various intravenous fluids used to regulate fluid balance and the nurse’s role in therapy.

Page Number: 359