Chapter 40 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 40 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The client receives albuterol (Proventil) via inhaler. He asks the nurse why he can’t just take a pill. What is the best response by the nurse?

1. “When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting in quicker effects.”
2. “Because pills cannot help your illness; you must have inhaled medications for relief of symptoms.”
3. “Because pills would produce too many side effects; you will have very few side effects with inhaled medications.”
4. “Because this medication cannot be absorbed from your GI tract; the acid in your stomach would destroy it.”

Correct Answer: 1

Rationale 1: The respiratory system offers a rapid and efficient mechanism for delivering drugs. The enormous surface area of the bronchioles and alveoli, and the rich blood supply to these areas, results in an almost instantaneous onset of action for inhaled substances.

Rationale 2: Albuterol (Proventil) can be given orally (PO) but has a faster onset of action if inhaled.

Rationale 3: Inhaled medications also produce side effects.

Rationale 4: Oral medications are effective with some symptoms of respiratory disorders, but inhaled medications work faster.

Global Rationale: The respiratory system offers a rapid and efficient mechanism for delivering drugs. The enormous surface area of the bronchioles and alveoli, and the rich blood supply to these areas, results in an almost instantaneous onset of action for inhaled substances. Albuterol (Proventil) can be given orally (PO) but has a faster onset of action if inhaled. Inhaled medications also produce side effects. Oral medications are effective with some symptoms of respiratory disorders, but inhaled medications work faster.

 

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 element 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: Implementation

Learning Outcome: 40-3 Compare the advantages and disadvantages of using the inhalation route of administration for pulmonary drugs.

MNL Learning Outcome: 10.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 662

 

Question 2

Type: MCSA

The nurse teaches a medication class on bronchodilators for clients with asthma. The nurse evaluates that learning has occurred when the clients make which statement?

1. “The medication widens the airways because it decreases the production of mucus that narrows them.”
2. “The medication widens the airways because it decreases the production of histamine that narrows them.”
3. “The medication widens the airways because it acts on the parasympathetic nervous system.”
4. “The medication widens the airways because it stimulates the fight-or-flight response of the nervous system.”

Correct Answer: 4

Rationale 1: Bronchodilators do not decrease the production of mucus.

Rationale 2: Bronchodilators do not decrease the production of histamine.

Rationale 3: Bronchodilators act on the sympathetic nervous system, not the parasympathetic nervous system.

Rationale 4: During the fight-or-flight response, beta₂-adrenergic receptors of the sympathetic nervous system are stimulated, the bronchiolar smooth muscle relaxes, and bronchodilation occurs.

Global Rationale: During the fight-or-flight response, beta₂-adrenergic receptors of the sympathetic nervous system are stimulated, the bronchiolar smooth muscle relaxes, and bronchodilation occurs. Bronchodilators do not decrease the production of mucus or histamine. Bronchodilators act on the sympathetic nervous system, not the parasympathetic nervous system.

 

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: Evaluation

Learning Outcome: 40-2 Explain how the autonomic nervous system regulates airflow in the lower respiratory tract, and how this process can be modified with drugs.

MNL Learning Outcome: 10.2.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 661

 

Question 3

Type: MCSA

The client asks the nurse why she must continue taking her asthma medication even though she has not had an asthma attack in several months. What is the best response by the nurse?

1. “The medication needs to be taken indefinitely according to your doctor, so you should discuss this with him.”
2. “The medication is still needed to decrease inflammation in your airways and help prevent an attack.”
3. “The medication needs to be taken or your lungs will be severely damaged, and we will not be able to stop an acute attack.”
4. “The medication needs to be taken for at least a year; then, if you have not had an acute attack, you can stop it.”

Correct Answer: 2

Rationale 1: The nurse is able to answer the client’s question; it does not need to be referred to the physician.

Rationale 2: Effective treatment of asthma includes long-term treatment to prevent attacks and decrease inflammation, as well as short-term treatment when an attack occurs.

Rationale 3: Telling a client that his or her lungs will be severely damaged is non-therapeutic; the inability to prevent an acute attack in this client is not true.

Rationale 4: Long-term treatment of asthma continues indefinitely, not for just 1 year.

Global Rationale: Effective treatment of asthma includes long-term treatment to prevent attacks and decrease inflammation, as well as short-term treatment when an attack occurs. The nurse is able to answer the client’s question; it does not need to be referred to the physician. Telling a client that his or her lungs will be severely damaged is non-therapeutic; the inability to prevent an acute attack in this client is not true. Long-term treatment of asthma continues indefinitely, not for just 1 year.

 

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: 40-5 Compare and contrast the pharmacotherapy of acute and chronic asthma.

MNL Learning Outcome: 10.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 669

 

Question 4

Type: MCSA

The nurse plans to teach an adolescent about inhalation therapy as part of the treatment plan for the client’s asthma. What does the best plan by the nurse include?

1. Inhalation therapy is effective because it provides around-the-clock therapy, as opposed to oral medications.
2. Inhalation therapy is the preferred treatment for adolescents because it is easier for them to manage.
3. Inhalation therapy is effective because it provides systemic relief of symptoms as well as local relief.
4. Inhalation therapy is effective because it goes to the direct site of action in the respiratory tract.

Correct Answer: 4

Rationale 1: Inhalation therapy does not provide around-the-clock therapy.

Rationale 2: Inhalation therapy is used for adolescents because it is effective, not because it is easier for them to manage.

Rationale 3: Inhalation therapy does not provide systemic relief of symptoms.

Rationale 4: The major advantage of aerosol therapy is that it delivers the drugs to their direct site of action.

Global Rationale: The major advantage of aerosol therapy is that it delivers the drugs to their direct site of action. Inhalation therapy does not provide around-the-clock therapy. Inhalation therapy does not provide systemic relief of symptoms. Inhalation therapy is used for adolescents because it is effective, not because it is easier for them to manage. Inhalation therapy does not provide around-the-clock therapy. Inhalation therapy is used for adolescents because it is effective, not because it is easier for them to manage. Inhalation therapy does not provide systemic relief of symptoms.

 

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 element 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: Planning

Learning Outcome: 40-3 Compare the advantages and disadvantages of using the inhalation route of administration for pulmonary drugs.

MNL Learning Outcome: 10.2.2 Compare the classes of medications used in pharmacologic management.

Page Number: 662