Pharmacology- Part 1- NCLEX Review Questions

Pharmacology- Part 1- NCLEX Review Questions Leave the first rating Students also studied Terms in this set (54) Science MedicineNursing Save EDAPT: NCLEX Readiness: Pharmac...60 terms BRAV3RPreview Ch 1 NCLEX ques 42 terms lynie_lynPreview Cardiovascula and Renal Systems - ...20 terms sommertimesithelps Preview Pharma 20 terms ang In which step of the nursing process does the nurse determine the outcome of medication administration?

• Implementation
• Evaluation
• Assessment
• Planning

(B) Evaluation It is systematic, ongoing, and a dynamic phase of the nursing process as related to drug therapy. It includes monitoring the fulfillment of outcomes and monitoring the patient's therapeutic response to the drug and its adverse effects and toxic effects. The planning phase prioritizes the nursing diagnoses and specifies outcomes. Assessment allows you to organize the information and place it into meaningful categories. Implementation consists of initiating and completion of specific nursing actions as defined by nursing diagnoses.(B) Enlist the help of a home care nurse for pharmacotherapy. After establishing the nursing diagnosis, the nurse plans care by determining the nursing goals and outcome criteria. As a means of working toward blood pressure control, the nurse chooses to set up nursing assistance for the patient in the home. The home care nurse can help the patient adhere to the therapeutic regimen by making a medication schedule and dispensing medication into a pill box, among other strategies. The nurse assesses the patient before establishing the nursing diagnosis and evaluates care after implementing the plan. Collaboration on a new medication regimen is not indicated. Examining the results of nursing help with the medications is part of the evaluation process to determine if the plan was effective.Collaboration on a new medication regimen is not indicated. The nurse assesses the patient before establishing the nursing diagnosis and evaluates care after implementing the plan.The nurse plans care for a male patient who is 80 years old. The nursing diagnosis is noncompliance with the medication regimen related to living alone, as evidenced by uncontrolled blood pressure. What should the nurse do next?

• Collaborate with the provider on a new medication regimen.
• Enlist the help of a home care nurse for pharmacotherapy.
• Assess the impact of home self-management of medications.
• Examine the results of nursing help with the medications.

What things should the nurse check when reviewing a prescription with a patient? (Select all that apply.)

• The signature of the prescriber
• The age of the patient
• The patient's home address
• The patient's emergency contact
• The route of administration

(A) and (E) After assessment of the patient and the drug has been completed, the specific prescription or medication order from any prescriber must be checked for the following seven elements: (1) patient's name, (2) date the drug order was written, (3) name of drug(s), (4) drug dosage amount, (5) drug dosage frequency, (6) route of administration, and (7) prescriber's signature.What information should the nurse chart when documenting medication administration? (Select all that apply.)

• The dosage of medication administered
• The time of administration
• The patient's age
• Information about an "incident report" in the patient's

chart

• The route of administration

(A), (B), and (E) Documentation of administration is one of the nine rights of patient medication administration and should include patient response, teaching related to the medication, if the medication is not given, refusal of medication, and reason for refusal. Medication errors should be noted in an incident report but should not be documented as an incident report in the patient's chart. Information about "incident report" is never placed in the patient's chart but is sent to risk management. The patient's age is already a part of the patient's record and is not needed in the documentation of administration.Which statement is an example of objective data? (Select all that apply.)

• The patient has had a fever for 5 days.
• The patient says that she feels like someone is touching

her arm.

• The patient has clear urine.

D)The patient states that she has a headache.

• The patient says that she has felt tired for almost a

week.(A) and (C) Objective data may be defined as any information gathered through the senses or that is seen, heard, felt, or smelled. Objective data may also be obtained from a nursing physical assessment; nursing history; past and present medical history; results of laboratory tests, diagnostic studies, or procedures; measurement of vital signs, weight, and height; and medication profile. Subjective data include information shared through spoken word by any reliable source, such as the patient, spouse, family member, significant other, or caregiver.An 86-year-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities?

• The patient and patient's daughter will state the proper

way to take the drug.

• The nurse will provide teaching about the drug's

adverse effects.

• The patient will state all the symptoms of digitalis

toxicity.

• The patient will call the prescriber if adverse effects

occur.(A)The patient and patient's daughter will state the proper way to take the drug.

A patient has a new prescription for a blood pressure medicine that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation?

• Activity intolerance
• Risk for injury
• Disturbed body image
• Self-care deficit

(B) Risk for injury

A patient's chart includes an order that reads as follows:

"Atenolol 25mg once daily at 0900" Which action by the nurse is correct?

• The nurse gives the drug via the transdermal route
• The nurse gives the drug orally.
• The nurse gives the drug via IV
• The nurse contacts the prescriber to clarify the dosage

route

• The nurse contacts the prescriber to clarify the dosage route

The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient?

• "Do you depend on sleeping pills to get to sleep?"
• "Do you have a family history of heart disease?"
• "When you have pain, what do you do to relieve it?"
• "What childhood diseases did you have?"
• "When you have pain, what do you do to relieve it?"

A 77-year old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the appropriate response by the nurse?

• Many people are allergic to penicillin
• This allergy is not a major concern because the drug is

given so often

• What type of reaction did you have when you took

penicillin?

• Drug allergies don't usually occur in older individuals

due to built-up resistance to allergic reactions.

• What type of reaction did you have when you took penicillin?

The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus.Which of these reflect the correct order of the nursing process?

• Assessment, planning, nursing diagnosis,

implementation, evaluation

• Evaluation, assessment, nursing diagnosis, planning,

implementation,

• Nursing diagnosis, assessment, planning,

implementation, evaluation

• Assessment, nursing diagnosis, planning,

implementation, evaluation

• Assessment, nursing diagnosis, planning, implementation, evaluation

The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders?

• Metformin (Glucophage) 1000mg PO 2 x day
• Sitagliptin (Januvia) 50mg daily
• Simivastatin (Zocor) 20mg PO every evening
• Irbesartan (Avapro) 300mg PO once a day
• Docusate (Colace) as needed for constipation

(B) and (E) no route given The nurse is reviewing data collected from a medication history. Which of these data are considered objective data?

• White blood cell count 22,000mm^3
• BP 150/94 mmHg
• Patient rates pain as an "8" on a 10-point pain scale
• Patient's wife reports the patient has been very sleepy

during the day

• Patient's weight is 68kg

(A), (B) and (E) When medications were administered during night shift,a patient refused to take his 0200 dose of antibiotic, claiming he had just taken it. What is the best action by the nurse to maintain patient safety?Whenever a patient questions a particular medication or mentions something about the medication that is not in accordance with what the nurse thinks, the nurse must always be careful—stop, recheck the prescriber's order against the medication administration record or profile, and check the dispensing system or medication record/profile to determine whether a dose was given and signed off by another nurse. Never ignore a patient's concerns! Never assume that the patient is unaware of his or her medication; always double-check to be safe. If all records and orders have been checked, and the nurse is certain that the drug has not been given, then the nurse proceeds with medication administration. A simple explanation could then be given to the patient. If the patient continues to refuse the medication, document this in the nurses' notes and report it to the charge nurse or nurse supervisor and to the prescriber.During a busy shift, the nurse notes that the chart of a newly admitted patient has a few orders for various medications and diagnostic tests that were taken by telephone by another nurse. The nurse is on the way to the patient's room to do an assessment when the unit security tells the nurse that one of the orders reads as

follows: "Lasix, 20mg, stat." What is the priority action by

the nurse? How does the nurse go about giving the drug? Explain the best action to take in this situation.Because this is a newly admitted patient, it would be best to perform an assessment before giving any medications. However, because the order is stat, meaning to give immediately, the assessment has to be brief and focused. Assess the patient's vital signs (blood pressure, pulse, respirations, temperature) and level of consciousness. Check for signs of fluid retention (pedal edema), ask about urine output and function, and listen to breath and heart sounds. Do not forget to assess for drug allergies and other drug reactions. However, the stat order is missing something—a route. Never assume that a medication is to be given by mouth. Even though this patient was just admitted and may or may not have an intravenous line, the best action is to clarify the route by which this drug should be given. The order was taken by telephone by another nurse, so you can ask the nurse whether a route was specified when the nurse spoke to the prescriber. If not, the prescriber must be contacted right away for clarification. To streamline things, the order can be checked by another nurse or, in some facilities, the pharmacist, while you are performing the assessment. Lastly, even though the medication is stat, be sure to check the patient's identification with two patient identifiers per the health care institution protocol.