Chapter 27 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 27 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient has hypertension and asks the nurse how this can lead to heart failure. What is the best response by the nurse?

1. “Hypertension causes resistance in your blood vessels, or afterload; your heart works harder, and weakens.”
2. “Hypertension limits the ability of your heart to stretch before emptying, or afterload; your heart works harder, and weakens.”
3. “Hypertension causes resistance in your aorta, or afterload; your heart works harder and weakens.”
4. “Hypertension limits the amount of blood entering your left ventricle, or afterload; your heart works harder, and weakens.”

Correct Answer: 1

Rationale 1: The most common cause of increased afterload is an increase in peripheral resistance due to hypertension.

Rationale 2: The ability of the heart to stretch before emptying is known as preload, not afterload.

Rationale 3: Afterload refers to peripheral resistance, not to resistance in the aorta.

Rationale 4: Afterload refers to peripheral resistance, not to the amount of blood entering the left ventricle.

Global Rationale: The most common cause of increased afterload is an increase in peripheral resistance due to hypertension. Afterload refers to peripheral resistance, not to the amount of blood entering the left ventricle. The ability of the heart to stretch before emptying is known as preload, not afterload. Afterload refers to peripheral resistance, not to resistance in the aorta.

 

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: Implementation

Learning Outcome: 27-2 Relate how the symptoms associated with heart failure may be caused by weakened heart muscle and diminished cardiac output.

MNL Learning Outcome: 4.3.1 Examine etiology, pathophysiology, clinical manifestations, and mechanisms to maintain perfusion.

Page Number: 396

Question 2

Type: MCMA

The patient comes to the emergency department complaining of coughing and difficulty breathing. The patient’s diagnosis is heart failure. He asks the nurse how difficulty breathing could be a heart problem. What is the best response by the nurse?

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

Standard Text: Select all that apply.

1. “The right side of your heart has weakened and blood has entered your lungs.”
2. “The right side of your heart has enlarged and cannot effectively pump blood.”
3. “What you have is called congestive heart failure.”
4. “The left side of your heart is weak and pumps blood too quickly.”
5. “The left side of your heart has weakened and blood has entered your lungs.”

Correct Answer: 3,5

Rationale 1: Right-sided heart failure results in peripheral edema, not pulmonary congestion.

Rationale 2: Right-sided heart failure results in peripheral edema, not pulmonary congestion.

Rationale 3: Left heart failure is sometimes called congestive heart failure.

Rationale 4: Heart failure results from the inability of the left ventricle to pump blood, not pumping blood too quickly.

Rationale 5: When the left ventricle cannot compensate for increased preload, blood backs up into the lungs resulting in cough and shortness of breath.

Global Rationale: When the left ventricle cannot compensate for increased preload, blood backs up into the lungs resulting in cough and shortness of breath. Left heart failure is sometimes called congestive heart failure. Left-sided, not right-sided, heart failure is associated with pulmonary congestion. Right-sided heart failure results in peripheral edema, not pulmonary congestion. Heart failure results from the inability of the left ventricle to pump blood, not pumping blood too quickly.

 

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: Implementation

Learning Outcome: 27-2 Relate how the symptoms associated with heart failure may be caused by weakened heart muscle and diminished cardiac output.

MNL Learning Outcome: 4.3.1 Examine etiology, pathophysiology, clinical manifestations, and mechanisms to maintain perfusion.

Page Number: 397

 

Question 3

Type: MCMA

The nurse teaches the patient about digoxin (Lanoxin) toxicity and 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. “I should limit my fluids while taking this medication.”
2. “It is okay to keep taking my ginseng.”
3. “If I have nausea, it means I must stop the medication.”
4. “I can drink orange juice every morning.”
5. “I must check my pulse and not take the medication if it is less than 60.”

Correct Answer: 4,5

Rationale 1: Dehydration can increase the risk for digoxin (Lanoxin) toxicity; the patient must not limit fluids.

Rationale 2: Ginseng may increase the risk of digoxin (Lanoxin) toxicity.

Rationale 3: Nausea, by itself, may be a side effect, but it is not necessarily indicative of digoxin (Lanoxin) toxicity.

Rationale 4: Orange juice is a source of potassium, which will minimize the risk for digoxin (Lanoxin) toxicity.

Rationale 5: Sixty beats per minute is the generally accepted limit for withholding digoxin (Lanoxin).

Global Rationale: Orange juice is a source of potassium, which will minimize the risk for digoxin (Lanoxin) toxicity. Sixty beats per minute is the generally accepted limit for withholding digoxin (Lanoxin). Nausea, by itself, may be a side effect, but it is not necessarily indicative of digoxin (Lanoxin) toxicity. Ginseng may increase the risk of digoxin (Lanoxin) toxicity. Dehydration can increase the risk for digoxin (Lanoxin) toxicity; the patient must not limit fluids.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

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: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 27-5 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 4.3.3 Compare the classes of medication used in pharmacologic management.

Page Number: 403

 

Question 4

Type: MCSA

The nurse teaches the patient about lisinopril (Prinivil) and evaluates that additional teaching is required when the patient makes which statement?

1. “I will monitor my blood pressure until my next appointment.”
2. “I will avoid using salt substitutes for seasoning.”
3. “It takes a while for this medication to take effect.”
4. “I don’t need to worry about having blood tests done.”

Correct Answer: 4

Rationale 1: Blood pressure should be monitored to assess effectiveness of the medication.

Rationale 2: Potassium should be limited to avoid hyperkalemia.

Rationale 3: It takes a while for lisinopril (Prinivil) to become effective.

Rationale 4: The use of ACE inhibitors can lead to electrolyte disturbances so levels should be monitored.

Global Rationale: The use of ACE inhibitors can lead to electrolyte disturbances so levels should be monitored. Potassium should be limited to avoid hyperkalemia. Blood pressure should be monitored to assess effectiveness of the medication. It takes a while for lisinopril (Prinivil) to become effective.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.A.4 Delineate general categories of errors and hazards in care.

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: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 27-5 For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.

MNL Learning Outcome: 4.3.3 Compare the classes of medication used in pharmacologic management.

Page Number: 401