Pharmacology Connections to Nursing Practice 3rd Edition By Adams - Test Bank Instant Download - Complete Test Bank With Answers Sample Questions Are Posted Below Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test Bank Chapter 5 Question 1 Type: MCSA A client develops angioedema and difficulty swallowing after receiving …
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Pharmacology Connections to Nursing Practice 3rd Edition By Adams – Test Bank
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Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test Bank
Chapter 5
Question 1
Type: MCSA
A client develops angioedema and difficulty swallowing after receiving an intravenous medication. The nurse recognizes this is characteristic of which effect?
Correct Answer: 2
Rationale 1: Angioedema involves facial edema, which can lead to difficulty swallowing and is considered a serious or life-threatening adverse effect, not a minor adverse effect.
Rationale 2: Angioedema involves facial edema, which can lead to difficulty swallowing and is considered a serious or life-threatening adverse effect.
Rationale 3: Side effects are predictable and less severe than angioedema and difficulty swallowing.
Rationale 4: Urticaria is manifested by hives.
Global Rationale: Angioedema involves facial edema, which can lead to difficulty swallowing and is considered a serious or life-threatening adverse effect. Side effects are predictable and less severe than angioedema and difficulty swallowing. Urticaria is manifested by hives.
Cognitive Level: Understanding
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1.Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-1 Differentiate between adverse effects and side effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 2
Type: MCSA
The nurse monitors a client on a newly prescribed antihypertensive drug. The nurse recognizes the symptom of hypotension would be indicative of which reaction?
Correct Answer: 3
Rationale 1: Hypotension is not indicative of an allergic response.
Rationale 2: The therapeutic effect of an antihypertensive drug is to lower blood pressure, but not cause hypotension.
Rationale 3: Hypotension with an antihypertensive drug would be considered an adverse effect of the drug.
Rationale 4: Hypotension is not an idiosyncratic reaction.
Global Rationale: While a decrease in blood pressure is expected with antihypertensive medication, hypotension would be considered an adverse effect of the drug. Hypotension is not indicative of an allergic response or an idiosyncratic reaction.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1.Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-1 Differentiate between adverse effects and side effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 3
Type: MCSA
The nurse explains to a student nurse that side effects differ from adverse events in which way?
Correct Answer: 3
Rationale 1: Adverse effects can produce permanent damage, but not all side effects are that serious.
Rationale 2: Adverse effects are more serious than side effects.
Rationale 3: Side effects are types of effects that are predictable and can occur even at therapeutic doses.
Rationale 4: Side effects can also be dose-dependent. Adverse effects can occur with any drug; they are not just related to drug dose.
Global Rationale: Side effects are types of effects that are predictable and can occur even at therapeutic doses. Adverse effects are more serious than side effects and can produce permanent damage. Not all side effects are serious. Side effects can also be dose dependent. Adverse effects can occur with any drug; they are not just related to drug dose.
Cognitive Level: Understanding
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1.Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-1 Differentiate between adverse effects and side effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 4
Type: MCMA
When teaching the client about a new medication, the nurse should include which information?
Note: Credit will be given only is all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3
Rationale 1: In order to help the client identify and prevent adverse effects, the client should be taught the therapeutic action, adverse effects, and when to notify the health care provider of adverse effects.
Rationale 2: In order to help the client identify and prevent adverse effects, the client should be taught the therapeutic action, adverse effects, and when to notify the health care provider of adverse effects.
Rationale 3: In order to help the client identify and prevent adverse effects, the client should be taught the therapeutic action, adverse effects, and when to notify the health care provider of adverse effects.
Rationale 4: It is not necessary to teach the client the chemical makeup of the drug.
Rationale 5: It is not necessary to teach the client the name of the drug manufacturer.
Global Rationale: In order to help the client identify and prevent adverse effects, the client should be taught the therapeutic action, adverse effects, and when to notify the health care provider of adverse effects. It is not necessary to teach the client the chemical makeup of the drug or the name of the manufacturer.
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 Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-2 Create a plan to minimize or prevent adverse drug events in patients.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 5
Type: MCSA
A client with a history of multiple allergies is prescribed a new anti-infective. At which time should the nurse plan to monitor the client for an anaphylactic reaction?
Correct Answer: 3
Rationale 1: Anaphylactic reactions can be unpredictable. They can occur immediately after a drug is taken or can be delayed. The nurse needs to be prepared for a reaction at any time.
Rationale 2: Anaphylactic reactions can be unpredictable. They can occur immediately after a drug is taken or can be delayed. The nurse needs to be prepared for a reaction at any time.
Rationale 3: Anaphylactic reactions can be unpredictable. They can occur immediately after a drug is taken or can be delayed. The nurse needs to be prepared for a reaction at any time.
Rationale 4: Anaphylactic reactions can be unpredictable. They can occur immediately after a drug is taken, or can be delayed. The nurse needs to be prepared for a reaction at any time.
Global Rationale: Anaphylactic reactions can be unpredictable. They can occur immediately after a drug is taken or can be delayed. The nurse needs to be prepared for a reaction at any time.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-4 Describe the incidence and characteristics of drug allergies.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
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Question 6
Type: MCSA
Which clinical manifestation would the nurse identify as an allergic reaction?
Correct Answer: 1
Rationale 1: Urticaria, or hives, is indicative of an allergic response to a medication.
Rationale 2: Photosensitivity is a predictable side effect of some medications.
Rationale 3: Abdominal cramping could be a side effect or adverse effect of medications.
Rationale 4: Diarrhea is a common side effect of many medications.
Global Rationale: Urticaria, or hives, is indicative of an allergic response to a medication. Photosensitivity is a predictable side effect of some medications. Abdominal cramping could be a side effect or adverse effect of medications. Diarrhea is a common side effect of many medications.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-4 Describe the incidence and characteristics of drug allergies.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
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Question 7
Type: MCSA
A client with a documented allergy to penicillin is prescribed cephalosporin. The nurse will monitor the client for allergic responses, since cephalosporin can cause which reaction?
Correct Answer: 3
Rationale 1: The degree of drug response will not be affected by the cross-allergy.
Rationale 2: The allergy is not false, or pseudo.
Rationale 3: Drugs with similar structure can elicit an allergic response in a receptive client, which is called cross-allergy.
Rationale 4: An allergic response is a hyper-responsive reaction.
Global Rationale: Drugs with similar structure can elicit an allergic response in a receptive client, which is called cross-allergy. The degree of drug response will not be affected by the cross-allergy. The allergy is not false, or pseudo. An allergic response is a hyper-responsive reaction.
Cognitive Level: Understanding
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-4 Describe the incidence and characteristics of drug allergies.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
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Question 8
Type: MCSA
The nurse administers zolpidem (Ambien) to a client at 11 p.m. for sleep. The client awakens at 3 a.m. and is wide awake and agitated. How will the nurse document this client’s reaction to the medication in the medical record?
Correct Answer: 4
Rationale 1: Allergic responses are usually manifested by rashes, urticaria, or anaphylactic reactions.
Rationale 2: Side effects for Ambien would include nausea, diarrhea, dizziness, daytime drowsiness, and abnormal thinking.
Rationale 3: Adverse effects for Ambien would include hallucinations and hypersensitivity reactions.
Rationale 4: The desired response of Ambien is sleep induction. An opposite or unexpected reaction would be an idiosyncratic reaction.
Global Rationale: The desired response of Ambien is sleep induction. An opposite or unexpected reaction would be an idiosyncratic reaction. Allergic responses are usually manifested by rashes, urticaria, or anaphylactic reactions. Side effects for Ambien would include nausea, diarrhea, dizziness, daytime drowsiness, and abnormal thinking. Adverse effects for Ambien would include hallucinations and hypersensitivity reactions.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-5 Explain how idiosyncratic reactions differ from other types of adverse effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 9
Type: MCSA
The nurse determines that an idiosyncratic reaction to a drug has occurred when the client experiences drug effects that have which characteristic?
Correct Answer: 2
Rationale 1: Side effects of drugs are predictable.
Rationale 2: Idiosyncratic drug reactions are those that are unexpected or unexplained.
Rationale 3: Some adverse effects can be irreversible; this is not a characteristic of idiosyncratic reactions.
Rationale 4: Some adverse effects can be life threatening, but they are not considered to be idiosyncratic.
Global Rationale: Idiosyncratic drug reactions are those that are unexpected or unexplained. Side effects of drugs are predictable. Some adverse effects can be irreversible; this is not a characteristic of idiosyncratic reactions. Some adverse effects can be life threatening, but they are not considered to be idiosyncratic.
Cognitive Level: Understanding
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-5 Explain how idiosyncratic reactions differ from other types of adverse effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 10
Type: MCSA
A client is prescribed a medication and is concerned it might have teratogenic effects. Which response by the nurse is the most appropriate?
Correct Answer: 1
Rationale 1: The pregnancy risk category of a drug gauges the risk of birth defects or teratogenic effects.
Rationale 2: Although most drugs have more detrimental effects in the first trimester, they can have teratogenic effects throughout the pregnancy.
Rationale 3: This statement does not answer the client’s question. The client could be asking about an over-the-counter drug as well.
Rationale 4: Although it is best to limit the amount of drugs taken during pregnancy, there are some drugs that are safe to take when pregnant and that do not have teratogenic effects.
Global Rationale: The pregnancy risk category of a drug gauges the risk of birth defects or teratogenic effects. Although most drugs have more detrimental effects in the first trimester, they can have teratogenic effects throughout the pregnancy. Telling the client that the health care provider ordered the medication and, therefore, it should be okay does not answer the client’s question. The client could be asking about an over-the-counter drug as well. Although it is best to limit the amount of drugs taken during pregnancy, there are some drugs that are safe to take when pregnant and that do not have teratogenic effects.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.A.2 Describe EBP to include the components of research evidence, clinical expertise and patient/family values.
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-6 Explain why certain drugs with carcinogenic or teratogenic potential are used in pharmacotherapy.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
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Question 11
Type: MCSA
A client is prescribed a chemotherapeutic drug for treatment of leukemia and asks the nurse why a drug that can also cause cancer is being used to treat cancer. Which response by the nurse is the most appropriate?
Correct Answer: 3
Rationale 1: The incidence of carcinogenic drugs differs among drugs and is not always predictable.
Rationale 2: This response does not answer the client’s question.
Rationale 3: The benefits of treatment sometimes do outweigh the risks; this provides an honest answer to the client.
Rationale 4: Although carcinogenic effects often do not show up for 20 or more years, this is not the best explanation.
Global Rationale: The benefits of treatment sometimes do outweigh the risks; this provides an honest answer to the client. The incidence of carcinogenic drugs differs among drugs and is not always predictable. Telling the client that receiving potent drugs warrants a warning does not answer the client’s question. Although carcinogenic effects often do not show up for 20 or more years, this is not the best explanation.
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.A.2 Describe EBP to include the components of research evidence, clinical expertise and patient/family values.
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-6 Explain why certain drugs with carcinogenic or teratogenic potential are used in pharmacotherapy.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
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Question 12
Type: MCSA
The nurse determines that the client is most at risk for renal toxicity while receiving an aminoglycoside anti-infective when which diagnostic lab result is abnormal?
Correct Answer: 1
Rationale 1: Abnormal kidney function tests would indicate kidney impairment.
Rationale 2: An elevated WBC is indicative of inflammation or infection.
Rationale 3: An elevated liver function test indicates liver impairment.
Rationale 4: An abnormal platelet count would indicate a bleeding problem.
Global Rationale: Abnormal kidney function tests would indicate kidney impairment. An elevated WBC is indicative of inflammation or infection. An elevated liver function test indicates liver impairment. An abnormal platelet count would indicate a bleeding problem.
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
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Question 13
Type: MCSA
A client on long-term therapy with itraconazole (Sporanox) for treatment of a nail fungus is admitted to the hospital with right upper quadrant pain, nausea, and abdominal pain. Which laboratory results found in the medical record would support the diagnosis of hepatotoxicity?
Correct Answer: 1
Rationale 1: Elevated liver function tests, which include the enzymes ALT and AST, are indicative of liver inflammation and/or impaired function of the liver.
Rationale 2: Elevated creatinine levels are indicative of impaired renal function.
Rationale 3: A decreased blood sugar indicates hypoglycemia, which has many causes, but is not related to hepatotoxicity.
Rationale 4: Impaired liver function would cause an increased or prolonged prothrombin time.
Global Rationale: Elevated liver function tests, which include the enzymes ALT and AST, are indicative of liver inflammation and/or impaired function of the liver. Elevated creatinine levels are indicative of impaired renal function. A decreased blood sugar indicates hypoglycemia, which has many causes, but is not related to hepatotoxicity. Impaired liver function would cause an increased or prolonged prothrombin time.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 14
Type: MCSA
The nurse plans to monitor a client for dermatologic toxicities after administering which medication?
Correct Answer: 2
Rationale 1: Salicylates are associated with neurotoxicity.
Rationale 2: Antiseizure drugs are associated with dermatologic toxicity.
Rationale 3: Antithyroid drugs are associated with bone marrow toxicity.
Rationale 4: Loop diuretics are associated with neurotoxicity.
Global Rationale: Antiseizure drugs are associated with dermatologic toxicity. Salicylates are associated with neurotoxicity. Antithyroid drugs are associated with bone marrow toxicity. Loop diuretics are associated with neurotoxicity.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 15
Type: MCSA
When checking on the potential interactions of two drugs being administered at the same time, the nurse recognizes which principle?
Correct Answer: 4
Rationale 1: Drug–food interactions can be just as serious as drug–drug interactions.
Rationale 2: Although most drugs do have some type of interaction, it is possible that a drug might not have any.
Rationale 3: Therapeutic drug interactions do not need to be avoided.
Rationale 4: The combination of some drugs can produce a synergistic or additive effect, which often are therapeutic in nature.
Global Rationale: The combination of some drugs can produce a synergistic or additive effect, which often are therapeutic in nature. Drug–food interactions can be just as serious as drug–drug interactions. Although most drugs do have some type of interaction, it is possible that a drug might not have any. Therapeutic drug interactions do not need to be avoided.
Cognitive Level: Understanding
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-8 Use examples to explain the importance of drug interactions to pharmacotherapy.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
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Question 16
Type: MCSA
A client is receiving an antiviral drug that is a substrate of the CYP3A4 enzyme system. When a drug that is an inhibitor of the 3A4 system is added to the client’s regimen, the nurse should assess the client for which result?
Correct Answer: 1
Rationale 1: The drug inhibitor will interact with the antiviral drug and inhibit metabolism of it, resulting in accumulation of the drug with possible toxic effects.
Rationale 2: A change in viral-related symptoms could occur, since the level of antiviral drug is increased.
Rationale 3: An increase in side effects of the antiviral drug could occur, since more of the drug will remain in the bloodstream.
Rationale 4: Since the serum level of the antiviral drug will be elevated, the viral load might decrease, not increase.
Global Rationale: The drug inhibitor will interact with the antiviral drug and inhibit metabolism of it, resulting in accumulation of the drug with possible toxic effects. A change in viral-related symptoms could occur, since the level of antiviral drug is increased. An increase in side effects of the antiviral drug could occur, since more of the drug will remain in the bloodstream. Since the serum level of the antiviral drug will be elevated, the viral load might decrease, not increase.
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 Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-9 Describe the mechanisms of drug interactions that alter absorption, distribution, metabolism, or excretion.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
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Question 17
Type: MCSA
A client is prescribed tetracycline for an infection. The nurse instructs the client to avoid which food to prevent a possible drug-to-food interaction?
Correct Answer: 2
Rationale 1: Citrus juices will not cause drug interactions with tetracycline.
Rationale 2: The calcium in dairy products can interfere with the absorption of tetracycline, and so should not be taken with the medication.
Rationale 3: Legumes will not cause drug interactions with tetracycline.
Rationale 4: Beef will not cause drug interactions with tetracycline.
Global Rationale: The calcium in dairy products can interfere with the absorption of tetracycline, and so should not be taken with the medication. Citrus juices will not cause drug interactions with tetracycline. Legumes will not cause drug interactions with tetracycline. Beef will not cause drug interactions with tetracycline.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 18
Type: MCSA
A client is scheduled to receive a diuretic and a beta blocker. The nurse determines the combination of these drugs will have which effect on the client’s blood pressure?
Correct Answer: 4
Rationale 1: The drugs have different actions, but they do not oppose each other.
Rationale 2: The two drugs together might not have a greater effect than the effects of each drug used separately.
Rationale 3: The two drugs will not antagonize or cancel the actions of each other.
Rationale 4: The two drugs together have an additive effect on blood pressure. The diuretic will reduce blood volume; the beta blocker will block vasoconstriction, causing a decrease in peripheral vascular resistance. These two different actions will both help to reduce blood pressure.
Global Rationale: The two drugs together have an additive effect on blood pressure. The diuretic will reduce blood volume; the beta blocker will block vasoconstriction, causing a decrease in peripheral vascular resistance. These two different actions will both help to reduce blood pressure. The drugs have different actions, but they do not oppose each other. The two drugs together might not have a greater effect than the effects of each drug used separately. The two drugs will not antagonize or cancel the actions of each other.
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-10 Differentiate among additive, synergistic, and antagonistic drug interactions.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 19
Type: MCSA
The nurse administers ciprofloxacin (Cipro), a fluoroquinoline, to a client. In order to prevent a food–drug interaction, the nurse should remove which item from the client’s lunch tray?
Correct Answer: 3
Rationale 1: Orange juice will not cause a food–drug interaction with Cipro.
Rationale 2: Tomatoes will not cause a food–drug interaction with Cipro.
Rationale 3: Cipro may increase the stimulatory effects of caffeine.
Rationale 4: Chocolate cake will not cause a food–drug interaction with Cipro.
Global Rationale: Cipro may increase the stimulatory effects of caffeine. Orange juice will not cause a food–drug interaction with Cipro. Tomatoes will not cause a food–drug interaction with Cipro. Chocolate cake will not cause a food–drug interaction with Cipro.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 20
Type: MCSA
The nurse recognizes that which food on a client’s tray could cause a drug–food interaction with warfarin (Coumadin)?
Correct Answer: 4
Rationale 1: A banana will not cause a food–drug interaction with warfarin (Coumadin).
Rationale 2: Toasted cheese will not cause a food–drug interaction with warfarin (Coumadin).
Rationale 3: Iced tea will not cause a food–drug interaction with warfarin (Coumadin).
Rationale 4: The vitamin K in the spinach can interfere with the action of warfarin (Coumadin) and prolong bleeding time.
Global Rationale: The vitamin K in the spinach can interfere with the action of warfarin (Coumadin) and prolong bleeding time. A banana will not cause a food–drug interaction with warfarin (Coumadin). Toasted cheese will not cause a food–drug interaction with warfarin (Coumadin). Iced tea will not cause a food–drug interaction with warfarin (Coumadin).
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 21
Type: MCSA
The nurse is conducting medication teaching for a client recently prescribed a calcium channel blocker. Which food will the nurse caution the client to avoid when taking this medication?
Correct Answer: 1
Rationale 1: Grapefruit can enhance the absorption of calcium channel blockers, leading to elevated drug levels.
Rationale 2: Coffee can be taken with calcium channel blockers without risk of drug–food interactions.
Rationale 3: Dairy products can be taken with calcium channel blockers without risk of drug–food interactions.
Rationale 4: Green, leafy vegetables can be taken with calcium channel blockers without risk of drug–food interactions.
Global Rationale: Grapefruit can enhance the absorption of calcium channel blockers, leading to elevated drug levels. Coffee can be taken with calcium channel blockers without risk of drug–food interactions. Dairy products can be taken with calcium channel blockers without risk of drug–food interactions. Green, leafy vegetables can be taken with calcium channel blockers without risk of drug–food interactions.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 22
Type: MCMA
A nurse is preparing care for a newly admitted client with diabetic mellitus. Which information would be critical for the nurse to assess?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Medical history may reveal conditions that contraindicate the use of certain drugs.
Rationale 2: Current lab results may reveal important information about the health of organs, such as the kidneys and liver, which would be important to metabolism and excretion of drugs.
Rationale 3: Allergies to one drug may cross over to another drug and would need to be avoided.
Rationale 4: Some dietary supplements can interact with drugs.
Rationale 5: While this is good information, it is not critical to this admission.
Global Rationale: Medical history may reveal conditions that contraindicate the use of certain drugs. Current lab results may reveal important information about the health of organs, such as the kidneys and liver, which would be important to metabolism and excretion of drugs. Allergies to one drug may cross over to another drug and would need to be avoided. Some dietary supplements can interact with drugs. While the number of previous hospitalizations is good information, it is not critical to this admission.
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 Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-2 Create a plan to minimize or prevent adverse drug events in patients.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 23
Type: MCMA
A nurse is caring for a client diagnosed with acute asthma who is taking several medications. The nurse would suspect a common adverse drug effect when the client exhibits which symptoms?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Headache is a common adverse effect of some medications.
Rationale 2: Nausea is a common adverse effect of some medications.
Rationale 3: Vomiting is a common adverse effect of some medications.
Rationale 4: Changes in blood pressure is a common adverse effect of some medications.
Rationale 5: Loss of hearing would be considered a serious adverse effect, not a common one.
Global Rationale: Headache, nausea, vomiting, and changes in blood pressure are common adverse effects of some medications. Loss of hearing would be considered a serious adverse effect, not a common one.
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 Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-2 Create a plan to minimize or prevent adverse drug events in patients.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 24
Type: MCMA
A nurse is caring for a client who may be experiencing an allergic response to medication. The nurse bases the assessment on which information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,5
Rationale 1: Symptoms of drug allergies may range from skin rash to difficulty breathing.
Rationale 2: The symptoms of drug allergies may appear the same as common allergic triggers.
Rationale 3: It is important to determine the source of the allergic response in an effort to avoid it in the future.
Rationale 4: Nausea and vomiting are not caused by an overactive immune system and are therefore not truly allergic responses.
Rationale 5: Previous exposure to the allergic drug is required for a hyperimmune response.
Global Rationale: Symptoms of drug allergies may range from skin rash to difficulty breathing. The symptoms of drug allergies may appear the same as common allergic triggers. It is important to determine the source of the allergic response in an effort to avoid it in the future. Previous exposure to the allergic drug is required for a hyperimmune response. Nausea and vomiting are not caused by an overactive immune system and are therefore not truly allergic responses.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-4 Describe the incidence and characteristics of drug allergies.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
Page Number:
Question 25
Type: MCMA
A nurse teaching a prenatal class is reinforcing precautions concerning the use of medications during pregnancy. The nurse determines the class understands when the students make which comments?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: The pregnant client should consider all drugs are dangerous during pregnancy, unless her health care provider tells her otherwise.
Rationale 2: The pregnant client should always consult her health care provider before taking any medication.
Rationale 3: The pregnant client should consider all drugs to be dangerous during pregnancy unless her health care provider tells her otherwise.
Rationale 4: The pregnant client should consider all drugs to be dangerous during pregnancy unless her health care provider tells her otherwise.
Rationale 5: The pregnant client should consider all drugs to be dangerous during pregnancy unless her health care provider tells her otherwise.
Global Rationale: The pregnant client should consider all drugs are dangerous during pregnancy, unless her health care provider tells her otherwise. The pregnant client should always consult her health care provider before taking any medication.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.A.2 Describe EBP to include the components of research evidence, clinical expertise and patient/family values.
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-6 Explain why certain drugs with carcinogenic or teratogenic potential are used in pharmacotherapy.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
Page Number:
Question 26
Type: MCMA
The nurse is caring for a client who is taking a drug known to cause nephrotoxicity. Which interventions are appropriate to prevent drug-induced nephrotoxicity?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Encouraging proper hydration will help to protect the kidneys by improving excretion of drugs.
Rationale 2: It is important to monitor lab tests for any indication that a nephrotoxic drug is having an adverse effect on the kidneys.
Rationale 3: It is important to recognize drugs that affect the kidneys, monitor lab values, and adjust doses if needed.
Rationale 4: Identifying present kidney impairment will allow the provider to adjust any nephrotoxic drug doses, which will minimize the strain on the kidney.
Rationale 5: Providing proper nutrition will not prevent drug-induced kidney problems.
Global Rationale: Providing proper nutrition will not prevent drug-induced kidney problems. Encouraging proper hydration will help to protect the kidneys by improving excretion of drugs. It is important to monitor lab tests for any indication that a nephrotoxic drug is having an adverse effect on the kidneys. It is important to recognize drugs that affect the kidneys, monitor lab values, and adjust doses if needed. Identifying present kidney impairment will allow the provider to adjust any nephrotoxic drug doses, which will minimize the strain on the kidney.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 27
Type: MCMA
A nurse caring for a client taking a drug that can cross the blood-brain barrier determines the client is experiencing possible neurotoxicity when which symptoms are observed?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Symptoms of neurotoxicity may include visual changes.
Rationale 2: Symptoms of neurotoxicity may include loss of balance.
Rationale 3: Symptoms of neurotoxicity may include drowsiness.
Rationale 4: Symptoms of neurotoxicity may include depression.
Rationale 5: Nausea and vomiting is a symptom of hepatotoxicity and nephrotoxicity.
Global Rationale: Symptoms of neurotoxicity may include visual changes, loss of balance, sedation, and depression. Nausea and vomiting is a symptom of hepatotoxicity and nephrotoxicity.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 28
Type: MCMA
A nurse is caring for a client recently prescribed an oral antibiotic who is exhibiting signs of dermatologic toxicity. Which assessment findings support dermatologic toxicity?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Rash is a common hypersensitivity response.
Rationale 2: Itching is a common hypersensitivity response.
Rationale 3: Hives are common in a hypersensitive response.
Rationale 4: Certain drugs can cause the skin to be sensitive to the sun, resulting in sunburn.
Rationale 5: Photosensitivity is light-sensitive reaction to medication and is not considered a dermatologic response.
Global Rationale: Rash, itching, and hives are all common hypersensitivity response. Certain drugs can cause the skin to be sensitive to the sun, resulting in sunburn. Photosensitivity is light-sensitive reaction to medication and is not considered a dermatologic response.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 29
Type: MCMA
A nurse is planning care for a client taking a medication with the potential to cause bone marrow toxicity. Which interventions exemplify the nurse’s role in preventing complications?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Bone marrow toxic drugs can affect the production of white blood cells.
Rationale 2: Bone marrow toxic drugs can affect the production of red blood cells.
Rationale 3: Bone marrow toxic drugs can affect the production of red blood cells.
Rationale 4: Bone marrow toxic drugs can affect the production of platelets.
Rationale 5: Bone marrow toxic drugs do not affect sleep.
Global Rationale: Bone marrow toxic drugs can affect the production of white blood cells, red blood cells, and platelets. The affect on the red blood cells can cause fatigue. Bone marrow toxic drugs do not affect sleep.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-7 Report the characteristic signs, symptoms, and treatment for each of the following organ-specific adverse events: nephrotoxicity, neurotoxicity, hepatotoxicity, dermatologic toxicity, bone marrow toxicity, cardiotoxicity, and skeletal muscle toxicity.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 30
Type: MCMA
The nurse is caring for a client who is prescribed laxatives. Which statements are most relevant to the absorption of medications?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: The less time drugs stay in the stomach or small intestine, the less the time of absorption.
Rationale 2: The longer the drug is exposed to the stomach lining and small intestine, the greater the time of absorption.
Rationale 3: Absorption is increased when the stomach is empty.
Rationale 4: Many drug–drug interactions that cause decreased absorption can be avoided by separating the drugs by 2 to 3 hours.
Rationale 5: Increasing fluid intake will not affect absorption.
Global Rationale: The less time drugs stay in the stomach or small intestine, the less the time of absorption. The longer the drug is exposed to the stomach lining and small intestine, the greater the time of absorption. Absorption is increased when the stomach is empty. Many drug–drug interactions that cause decreased absorption can be avoided by separating the drugs by 2 to 3 hours. Increasing fluid intake will not affect absorption.
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 Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-9 Describe the mechanisms of drug interactions that alter absorption, distribution, metabolism, or excretion.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 31
Type: MCMA
The nurse is caring for a client who has been admitted for uncontrolled hypertension. When the health care provider orders a second antihypertensive drug for the client, the client asks the nurse why the health care provider ordered another drug instead of increasing the first drug. The nurse’s response is based on which principles?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3
Rationale 1: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects.
Rationale 2: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects.
Rationale 3: The two drugs will affect different receptor site to achieve the same goal, resulting in a greater response but at lower doses.
Rationale 4: Adding a second drug that has an antagonistic effect will result in canceling out the therapeutic effects of the first drug.
Rationale 5: Adding a second drug within the same class or from another class will allow lower dosing, which will decrease the potential for adverse effects.
Global Rationale: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects. The two drugs will affect different receptor site to achieve the same goal, resulting in a greater response but at lower doses. Adding a second drug that has an antagonistic effect will result in canceling out the therapeutic effects of the first drug and also increase the potential for adverse effects.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-10 Differentiate among additive, synergistic, and antagonistic drug interactions.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 32
Type: MCMA
A nurse is reinforcing discharge instructions concerning food–drug interactions. Which statements by the client indicate correct understanding of the discharge instructions?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: The safest fluid to take with medications is water.
Rationale 2: Grapefruit juice can increase absorption of certain drugs and should be avoided.
Rationale 3: The pharmacist will indicate on the medication label if the medication should be taken with or without food.
Rationale 4: Herbal supplements and vitamins can cause adverse effects when taken with medication.
Rationale 5: Taking medication with caffeine or a hot drink can affect absorption and the effectiveness of medication.
Global Rationale: The safest fluid to take with medications is water. Grapefruit juice can increase absorption of certain drugs and should be avoided. The pharmacist will indicate on the medication label if the medication should be taken with or without food. Herbal supplements and vitamins can cause adverse effects when taken with medication. Taking medication with caffeine or a hot drink can affect absorption and the effectiveness of medication.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug
Page Number:
Question 33
Type: MCMA
A client reports an adverse effect to the Adverse Event Reporting System. The nurse recognizes if a potential safety concern is identified, the Food and Drug Administration (FDA) may take which actions?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: The FDA will conduct additional epidemiologic studies to determine the validity or extent of the concern.
Rationale 2: The FDA will require the pharmaceutical company to change the product’s label to reflect this concern.
Rationale 3: The FDA will recall a product that may have performance concerns.
Rationale 4: The FDA will restrict the product’s use in certain populations.
Rationale 5: The FDA will not just continue to log in concerns regarding the safety of the product. At this point, additional studies, additional product labeling, recall, or removal of the product will occur.
Global Rationale: The FDA will conduct additional epidemiologic studies to determine the validity or extent of the concern, require the pharmaceutical company to change the product’s label to reflect this concern, recall a product that may have performance issues, and restrict the product’s use in certain populations. The FDA will not just continue to log in concerns regarding the safety of the product. At this point, additional studies, additional product labeling, recall, or removal of the product will occur.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-3 Explain the advantages and disadvantages of the Adverse Event Reporting System.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 34
Type: MCMA
The nurse is planning care for a client newly diagnosed with emphysema who complains that the medication is causing a “shaky” feeling. What does the nurse recognize this to be?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3
Rationale 1: Many drugs used for emphysema cause nervousness, which may result in the client feeling unsteady.
Rationale 2: Many drugs used for emphysema cause annoying sides effects such as nervousness, which may result in the client feeling unsteady.
Rationale 3: Many drugs used for emphysema cause side effects such as nervousness, resulting in the client feeling unsteady. This side effect is often dose dependent.
Rationale 4: The nurse recognizes that unsteadiness is a common symptom. It does not have the characteristics of an allergic response, such as hives and swelling.
Rationale 5: The nurse recognizes that unsteadiness is a common symptom, not a serious adverse effect.
Global Rationale: Many drugs used for emphysema cause nervousness, which may result in the client feeling unsteady. Many drugs used for emphysema cause annoying sides effects such as nervousness, which may result in the client feeling unsteady. This side effect is often dose dependent. The nurse recognizes that unsteadiness is a common symptom. It does not have the characteristics of an allergic response, such as hives and swelling. The nurse recognizes that unsteadiness is a common symptom, not a serious adverse effect.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-1 Differentiate between adverse effects and side effects.
MNL Learning Outcome: 1.1.4 Examine adverse effects of medication administration and risk reduction measures taken by the nurse.
Page Number:
Question 35
Type: MCMA
A client is prescribed tetracycline for acne. Which foods should the nurse ask the client to avoid while taking this medication?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,3
Rationale 1: Milk products contain calcium, which will decrease absorption.
Rationale 2: Almonds are not a source of calcium.
Rationale 3: Milk products decrease absorption.
Rationale 4: Hamburgers do not contain calcium and will not have an effect on absorption.
Rationale 5: Grapefruit juice does not decrease absorption.
Global Rationale: Milk products contain calcium, which will decrease absorption. Almonds are not a source of calcium. Hamburgers do not contain calcium and will not have an effect on absorption. Grapefruit juice does not decrease absorption.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug
Page Number:
Question 36
Type: MCMA
A client returns to the clinic for follow up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which statement?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3,4
Rationale 1: Some medications must be taken on an empty stomach. It is important to know if the medication should be taken with food or on an empty stomach.
Rationale 2: Taking medications with water will decrease the chance of an interaction that can occur with other juices or fluids.
Rationale 3: Alcohol can cause adverse interactions with medications.
Rationale 4: Filling all prescriptions at the same pharmacy will assist the pharmacist in comparing current and new medications for interactions.
Rationale 5: It is best not to take herbal supplements and vitamins with prescribed medications to avoid interactions.
Global Rationale: Some medications must be taken on an empty stomach. It is important to know if the medication should be taken with food or on an empty stomach. Taking medications with water will decrease the chance of an interaction that can occur with other juices or fluids. Alcohol can cause adverse interactions with medications. Filling all prescriptions at the same pharmacy will assist the pharmacist in comparing current and new medications for interactions. It is best not to take herbal supplements and vitamins with prescribed medications to avoid interactions.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug
Page Number:
Question 37
Type: MCMA
A nurse is caring for a client who is exhibiting signs of an adverse reaction to warfarin (Coumadin). Which statements made by the client would lead the nurse to suspect that this is the case?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 2,3,4
Rationale 1: Calcium products do not affect the action of warfarin.
Rationale 2: St. Johns’s wort may increase the risk for bleeding when taken with warfarin.
Rationale 3: Garlic may increase the risk for bleeding when taken with warfarin.
Rationale 4: Ginkgo may increase the risk for bleeding when taken with warfarin.
Rationale 5: Kava can increase drowsiness and sedation when taken with CNS depressants. It does not interact with warfarin.
Global Rationale: St. Johns’s wort may increase the risk for bleeding when taken with warfarin. Garlic may increase the risk for bleeding when taken with warfarin. Ginkgo may increase the risk for bleeding when taken with warfarin. Calcium products do not affect the action of warfarin. Kava can increase drowsiness and sedation when taken with CNS depressants. It does not interact with warfarin.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug
Page Number:
Question 38
Type: MCSA
A client is admitted to the emergency department in a hypertensive crisis. The client’s spouse said the client ate food containing tyramine. The nurse immediately rules out which types of drugs as the cause of the client’s hypertensive crisis?
Correct Answer: 4
Rationale 1: Foods with tyramine are not restricted in Tetracycline.
Rationale 2: Foods with tyramine are not restricted with warfarin (Coumadin).
Rationale 3: Foods with tyramine are not restricted with calcium channel blockers.
Rationale 4: Foods with tyramine can cause hypertensive crisis when taken with MAOIs.
Global Rationale: Foods with tyramine can cause hypertensive crisis when taken with MAOIs. Foods with tyramine are not restricted in Tetracycline, warfarin (Coumadin), or calcium channel blockers.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-11 Identify examples of drug–food interactions that may impact pharmacotherapeutic outcomes.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug
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Question 39
Type: MCMA
A nurse in the emergency department is preparing to care for a client suspected of an opiate overdose. The nurse is preparing to give the client a medication called naloxone (Narcan). Which rationales support the use of this medication?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2
Rationale 1: Narcan is an antagonist that will reverse the effects of an opiate overdose.
Rationale 2: Narcan is an antagonist.
Rationale 3: Narcan will not have an additive effect.
Rationale 4: Narcan will not have a synergist effect.
Rationale 5: Narcan reverses life-threatening CNS depression.
Global Rationale: Narcan is an antagonist that will reverse the effects of an opiate overdose. Narcan will not have an additive effect or a synergistic effect. Narcan reverses life-threatening CNS depression.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 5-10 Differentiate among additive, synergistic, and antagonistic drug interactions.
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
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Question 40
Type: MCMA
The nurse would anticipate an alteration in drug excretion in clients with which conditions?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2
Rationale 1: Any condition which decreases or impairs glomerular filtration rate will decrease excretion of drugs from the body.
Rationale 2: Glomerular filtration rate is directly related to cardiac output. Any heart disease that decreases cardiac output will decrease excretion of drugs from the body.
Rationale 3: The quick transit of medication through the small intestines alters absorption, not metabolism.
Rationale 4: The lungs do not metabolize drugs.
Rationale 5: Alzheimer disease will not affect the metabolism of drugs.
Global Rationale: Any condition which decreases or impairs glomerular filtration rate will decrease excretion of drugs from the body. Glomerular filtration rate is directly related to cardiac output. Any heart disease that decreases cardiac output will decrease excretion of drugs from the body. The quick transit of medication through the small intestines alters absorption, not metabolism. The lungs do not metabolize drugs. Alzheimer disease will not affect the metabolism of drugs.
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 Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-9 Describe the mechanisms of drug interactions that alter absorption, distribution, metabolism, or excretion.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 41
Type: MCMA
The nurse would anticipate an alteration in drug absorption in clients with which conditions?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,3,4
Rationale 1: The drug cannot be absorbed if it is vomited.
Rationale 2: Diabetes will not alter absorption; if the kidneys are impaired, it may alter excretion.
Rationale 3: The quick transit of medication through the small intestines may alter absorption.
Rationale 4: Bronchoconstriction could alter inhaled medications.
Rationale 5: Alzheimer disease will not affect the absorption of drugs.
Global Rationale: The drug cannot be absorbed if it is vomited. The quick transit of medication through the small intestines may alter absorption. Bronchoconstriction could alter inhaled medications. Diabetes will not alter absorption; if the kidneys are impaired, it may alter excretion. Alzheimer disease will not affect the absorption of drugs.
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 Essential Competencies: III.1. Explain the interrelationships among theory, practice and research
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-9 Describe the mechanisms of drug interactions that alter absorption, distribution, metabolism, or excretion.
MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug.
Page Number:
Question 42
Type: MCMA
A nurse educator explaining drug allergies to students includes which statements in the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Correct Answer: 1,2,3
Rationale 1: Drug allergies can occur with very small amounts of drug.
Rationale 2: The symptoms of drug allergies are unrelated to the pharmacologic actions of the drug and are attributed to the response of the body’s defenses.
Rationale 3: Drug allergies require a previous exposure to the drug or a similar drug.
Rationale 4: The symptoms of a drug allergy are produced by a hyper-response of the body’s defenses.
Rationale 5: The severity of the allergic response is unrelated to the dose of the drug.
Global Rationale: Drug allergies can occur with very small amounts of drug. The symptoms of drug allergies are unrelated to the pharmacologic actions of the drug and are attributed to the response of the body’s defenses Drug allergies require a previous exposure to the drug or a similar drug. The symptoms of a drug allergy are produced by a hyper-response of the body’s defenses. The severity of the allergic response is unrelated to the dose of the drug.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-4 Describe the incidence and characteristics of drug allergies.
MNL Learning Outcome: 1.1.1 Apply basic concepts related to pharmacology.
Page Number:
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Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
