Chapter 34 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 34 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include?

1. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if he develops chickenpox.
2. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
3. The child should be brought to the clinic immediately to receive a vaccination for chickenpox.
4. The child should be kept away from other children to avoid further exposure to varicella.

Correct Answer: 2

Rationale 1: Immune globulin is not given after the disease develops.

Rationale 2: Immune globulin must be given before the disease develops.

Rationale 3: The child is immunosuppressed; administering a vaccination for chickenpox could result in developing the disease.

Rationale 4: Keeping the child away from others will not help; the child has already been exposed.

Global Rationale: Immune globulin must be given before the disease develops. Immune globulin is not given after the disease develops. The child is immunosuppressed; administering a vaccination for chickenpox could result in developing the disease. Keeping the child away from others will not help; the child has already been exposed.

 

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: 34-4 Distinguish between active immunity and passive immunity.

MNL Learning Outcome: 5.1.1 Examine specific and nonspecific body defenses and functions of the inflammatory response.

Page Number: 522

 

Question 2

Type: MCSA

A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization. What does the best action by the nurse include?

1. Administer only a pertussis-tetanus immunization.
2. Withhold this immunization and contact the physician.
3. Tell the mother to give the child acetaminophen (Tylenol) if another rash develops.
4. Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.

Correct Answer: 2

Rationale 1: There is no such immunization as pertussis-tetanus.

Rationale 2: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such as anaphylaxis, so the nurse should withhold the immunization and contact the physician.

Rationale 3: The nurse should not tell the mother to administer acetaminophen (Tylenol); this will not prevent anaphylaxis.

Rationale 4: The nurse cannot administer diphenhydramine (Benadryl) without a physician’s order.

Global Rationale: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such as anaphylaxis, so the nurse should withhold the immunization and contact the physician. There is no such immunization as pertussis-tetanus. The nurse should not tell the mother to administer acetaminophen (Tylenol); this will not prevent anaphylaxis. The nurse cannot administer diphenhydramine (Benadryl) without a physician’s order.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

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: Implementation

Learning Outcome: 34-10 Use the nursing process to care for patients receiving pharmacotherapy for immune conditions.

MNL Learning Outcome: 5.2.3 Compare medications used in pharmacotherapy and nurse’s role in administration: Immunizing agents.

Page Number: 522

 

Question 3

Type: MCMA

The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that learning has occurred when the women 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 immunizations are more effective if they are given closer together.”
2. “Our babies might have a mild fever and be fussy for a few days.”
3. “If our babies develop a fever, we must call the doctor immediately.”
4. “We can give acetaminophen (Tylenol) if our babies have a mild fever.”
5. “If our babies develop a mild fever, it means an allergic reaction.”

Correct Answer: 2,4

Rationale 1: The recommended immunization schedule should be followed. There is no benefit to giving the immunizations closer together.

Rationale 2: A mild fever is a typical reaction to immunizations.

Rationale 3: The physician does not need to be called unless the fever is high.

Rationale 4: Acetaminophen (Tylenol) is indicted for relief of mild symptoms.

Rationale 5: A mild fever does not indicate an allergic reaction to the immunization.

Global Rationale: A mild fever is a typical reaction to immunizations. Acetaminophen (Tylenol) is indicted for relief of mild symptoms. The recommended immunization schedule should be followed. There is no benefit to giving the immunizations closer together. The physician does not need to be called unless the fever is high. A mild fever does not indicate an allergic reaction to the immunization.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

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: 34-10 Use the nursing process to care for patients receiving pharmacotherapy for immune conditions.

MNL Learning Outcome: 5.2.3 Compare medications used in pharmacotherapy and nurse’s role in administration: Immunizing agents.

Page Number: 522

 

Question 4

Type: MCSA

The client receives interferon alfa-2b (Intron-A). The client tells the nurse that he gets very sleepy and thirsty every time he takes the medication. What is the best assessment question for the nurse to ask?

1. “Are you consuming at least eight glasses of water daily?”
2. “Are you including beverages with alcohol in your diet?”
3. “Have you had any flu symptoms lately?”
4. “How much time have you spent out in the sun?”

Correct Answer: 2

Rationale 1: There is no indication to drink eight glasses of water daily when taking immunostimulants.

Rationale 2: Combining immunostimulants with ethanol can result in excessive drowsiness and dehydration.

Rationale 3: While flu-like symptoms are common with immunostimulants, this question does not address the client complaint as well as another option.

Rationale 4: There is no indication that sun exposure would result in these symptoms in a client taking an immunostimulant.

Global Rationale: Combining immunostimulants with ethanol can result in excessive drowsiness and dehydration. There is no indication to drink eight glasses of water daily when taking immunostimulants. While flu-like symptoms are common with immunostimulants, this question does not address the client complaint as well as another option. There is no indication that sun exposure would result in these symptoms in a client taking an immunostimulant.

 

Cognitive Level: Applying

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: Assessment

Learning Outcome: 34-9 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: 5.2.1 Compare medications used in pharmacotherapy and nurse’s role in administration: Immunostimulants.

Page Number: 527