Chapter 41 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 41 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nursing instructor teaches the student nurses about intrinsic factor. The instructor evaluates that learning has occurred when the students make which response?

1. “Intrinsic factor is secreted by the chief cells of the stomach.”
2. “Intrinsic factor is necessary for absorption of vitamin B₆.”
3. “Intrinsic factor aids in the secretion of mucus to protect the stomach.”
4. “Intrinsic factor is necessary for absorption of vitamin B₁₂.”

Correct Answer: 4

Rationale 1: Chief cells secrete pepsinogen and rennin, not intrinsic factor.

Rationale 2: Intrinsic factor is necessary for the absorption of vitamin B₁₂, not B₆.

Rationale 3: Intrinsic factor does not aid in the secretion of mucus in the stomach.

Rationale 4: Parietal cells secrete intrinsic factor, which is essential for the absorption of vitamin B_12.

Global Rationale: Parietal cells secrete intrinsic factor, which is essential for the absorption of vitamin B_12. Chief cells secrete pepsinogen and rennin, not intrinsic factor. Intrinsic factor does not aid in the secretion of mucus in the stomach.

 

Cognitive Level: Analyzing

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: 41-1 Describe the major anatomic structures of the upper gastrointestinal tract.

MNL Learning Outcome: 7.1.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 681

 

Question 2

Type: MCMA

The physician has ordered bismuth (Pepto-Bismol) for the client with a peptic ulcer who is colonized with H. pylori. The client asks the nurse why he is receiving this drug. 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. “Bismuth (Pepto-Bismol) increases stomach acid to help kill bacteria.”
2. “Bismuth (Pepto-Bismol) helps prevent the side effects of antibiotics.”
3. “Bismuth (Pepto-Bismol) is effective for inhibiting bacterial growth.”
4. “Bismuth (Pepto-Bismol) keeps bacteria from sticking in your stomach.”
5. “Bismuth (Pepto-Bismol) helps relieve ulcer-related constipation.”

Correct Answer: 3,4

Rationale 1: Bismuth (Pepto-Bismol) does not increase stomach acid.

Rationale 2: Bismuth (Pepto-Bismol) does not prevent the side effects of antibiotics.

Rationale 3: Bismuth compounds (Pepto-Bismol) are added to the antibiotic regimen to inhibit bacterial growth.

Rationale 4: Bismuth compounds (Pepto-Bismol) prevent H. pylori from adhering to the gastric mucosa.

Rationale 5: Bismuth (Pepto-Bismol) is used to relieve diarrhea, not constipation.

Global Rationale: Bismuth compounds (Pepto-Bismol) are added to the antibiotic regimen to inhibit bacterial growth and to prevent H. pylori from adhering to the gastric mucosa. Bismuth (Pepto-Bismol) does not increase stomach acid or prevent the side effects of antibiotics. Bismuth (Pepto-Bismol) is used to relieve diarrhea, not constipation.

 

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: 41-6 Explain the pharmacologic strategies for eradicating Helicobacter pylori.

MNL Learning Outcome: 7.1.2 Compare the classes of medications used in pharmacologic management.

Page Number: 690

 

 

Question 3

Type: MCSA

The physician orders misoprostol (Cytotec) for the female client with peptic ulcer disease (PUD). What is a priority question for the nurse to ask the client prior to administration of this medication?

1. “Do you plan on becoming pregnant?”
2. “Are you sexually active?”
3. “Are you pregnant?”
4. “Are your menstrual cycles irregular?”

Correct Answer: 3

Rationale 1: Misoprostol (Cytotec) is safe as long as the client is not currently pregnant.

Rationale 2: Asking if a client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.

Rationale 3: Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes used to terminate pregnancies.

Rationale 4: There is no contraindication for misoprostol (Cytotec) in a client with irregular menstrual cycles.

Global Rationale: Misoprostol (Cytotec) is contraindicated during pregnancy; it is sometimes used to terminate pregnancies. Misoprostol (Cytotec) is safe as long as the client is not currently pregnant. Asking if a client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control. There is no contraindication for misoprostol (Cytotec) in a client with irregular menstrual cycles.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care.

AACN Essentials Competencies: IX.8 Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 41-7 Describe the nurse’s role in the pharmacologic management of patients with peptic ulcer disease.

MNL Learning Outcome: 7.1.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 692

 

Question 4

Type: MCSA

The client receives esomeprazole (Nexium). He asks the nurse why that medication is better than his cimetidine (Tagamet). What is the best response by the nurse?

1. “It is about the same but a lot cheaper than your cimetidine (Tagamet).”
2. “It decreases acid in your stomach better than cimetidine (Tagamet).”
3. “It is about the same but has fewer side effects than your cimetidine (Tagamet).”
4. “It is not as effective as cimetidine (Tagamet) but kills bacteria better.”

Correct Answer: 2

Rationale 1: Esomeprazole (Nexium) is not cheaper than cimetidine (Tagamet).

Rationale 2: Proton-pump inhibitors reduce acid secretion to a greater extent than H₂-receptor antagonists, and have a longer duration of action.

Rationale 3: Esomeprazole (Nexium) does not have fewer side effects than cimetidine (Tagamet).

Rationale 4: Esomeprazole (Nexium) is more effective than cimetidine (Tagamet) but will not kill bacteria.

Global Rationale: Proton-pump inhibitors reduce acid secretion to a greater extent than H₂-receptor antagonists and have a longer duration of action. Esomeprazole (Nexium) is not cheaper than or have fewer side effects than cimetidine (Tagamet). Esomeprazole (Nexium) is more effective than cimetidine (Tagamet) but will not kill bacteria.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care.

AACN Essentials Competencies: IX.8 Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe nursing care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 41-7 Describe the nurse’s role in the pharmacologic management of patients with peptic ulcer disease.

MNL Learning Outcome: 7.1.3 Apply the nursing process to pharmacotherapy, safe drug administration, and client education.

Page Number: 684