Pharmacology for Nursing Care, 7th Edition by Richard A. Lehne - Test Bank

Pharmacology for Nursing Care, 7th Edition by Richard A. Lehne – Test Bank

 

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Lehne: Pharmacology for Nursing Care, 7^th Edition

 

Chapter 5: Pharmacodynamics

 

Test Bank

 

1. A nurse is trying to ensure a nursing student’s understanding regarding drug interactions with receptor binding. Which statement made by the nursing student indicates a need for further teaching?

a.	Drugs can bind to receptors and cause activation.
b.	Drugs can bind to receptors and block receptor activation by other agents.
c.	Drugs can bind receptor components and enhance receptor activation.
d.	Drugs bind to receptors and thereby alter a cell’s function.

 

 

ANS:   D

Drugs bind to receptors but do NOT alter a cell’s function.

Drugs do bind to receptors and cause activation.

Drugs can bind to receptors and block receptor activation by other agents.

Drugs can also bind receptor components and enhance receptor activation.

 

DIF:    Cognitive Level: Comprehension      REF:    pp. 50-51

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. Two nurses are discussing theories of drug-receptor interaction. One of the nurses states that which of the following statements is(are) true regarding the affinity of a drug and its receptor? (Select all that apply.)

a.	Affinity and intrinsic activity are dependent properties.
b.	Affinity refers to the strength of the attraction between a drug and its receptor.
c.	Drugs with high affinity are strongly attracted to their receptors.
d.	Drugs with low affinity are strongly attracted to their receptors.
e.	The affinity of a drug for its receptors is reflected in its potency.

 

 

ANS:   B, C, E

Affinity does refer to the strength of the attraction between a drug and its receptor, drugs with high affinity are strongly attracted to their receptors, and the affinity of a drug for its receptors is reflected in its potency.

Affinity and intrinsic activity are independent properties.

Drugs with low affinity are weakly attracted to their receptors.

 

DIF:    Cognitive Level: Comprehension      REF:    pp. 51-52

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. Education on pharmacology is taking place on the nursing unit. The discussion involves the receptor sensitivity of a medication. The presenter asks the nurses to provide an example of desensitization. Which of the following responses would be an example of desensitization?

a.	The synthesis of more receptors
b.	Continuous exposure to antagonists
c.	Continual exposure to an agonist
d.	Antacids used to reduce gastric acid

 

 

ANS:   C

Continual exposure to an agonist would cause the cell to become less responsive or desensitized.

The synthesis of more receptors would create a hypersensitivity reaction.

Continuous exposure to antagonists would also contribute to hypersensitivity.

Antacids used to reduce gastric acid are an example of receptorless drugs.

 

DIF:    Cognitive Level: Application             REF:    p. 53

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient has been receiving an antibiotic with a narrow therapeutic index for 10 days. Upon assessment, the nurse suspects that the patient may be experiencing toxicity. The nurse’s priority action would be to

a.	call the prescriber and have the antibiotic changed.
b.	suspect an allergic reaction and administer a prn antihistamine.
c.	ask the prescriber to order a plasma drug level.
d.	set up oxygen and obtain an order for an antagonist.

 

 

ANS:   C

A drug with a narrow therapeutic index indicates that a drug is relatively unsafe and should be monitored closely. The nurse should have a blood level drawn to confirm suspicions of toxicity.

The nurse would not have the antibiotic changed, because there is no cause at this time.

The patient is unlikely to be experiencing an allergic reaction, because the antibiotic has been in the system for 10 days.

There is no indication that the patient is anaphylactic, therefore oxygen and an antagonist are not indicated.

 

DIF:    Cognitive Level: Application             REF:    p. 55

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. A prescriber has just ordered a medication for a patient and has ordered a larger dose than is normally indicated. The patient questions the nurse and asks why the dose is so large. The nurse would be correct to explain that

a.	the initial dose is sometimes higher to reach a therapeutic level more quickly.
b.	an average effective dose is important to evaluate the response.
c.	an initial dose will mean a half dose of subsequent medication.
d.	all patients receive a high initial dose.

 

 

ANS:   A

The initial dose is sometimes given in a higher amount, a loading dose, to reach a therapeutic level in the blood more quickly, thus making the drug more effective.

An average effective dose is not used to evaluate the response to the medication.

The initial dose does not indicate that the subsequent doses will be one half of the initial dose.

All patients do not receive a high initial dose of a medication.

 

DIF:    Cognitive Level: Application             REF:    pp. 54-55

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

6. The nurse is providing nursing education regarding receptorless drugs. Which example of a receptorless drug given by the learner would indicate a need for further teaching?

a.	Antiseptics
b.	Saline laxatives
c.	Chelating agents
d.	Eye drops

 

 

ANS:   D

Eye drops do bind with receptors for a desired effect; they therefore are not receptorless, and the learner needs further instruction.

Antiseptics, saline laxatives, and chelating agents all are receptorless drugs.

 

DIF:    Cognitive Level: Application             REF:    p. 53

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies