Test Bank Pharmacology A Patient-Centered Nursing Process
Approach, 10th Edition by Linda E. McCuistion Chapter 1-58
, Chapter 01: The Nursing Process and Patient-Centered Care
McCuistion: Pharmacology: A Patient-Centered Nursing Process
Approach, 10thEdition
MULTIPLE CHOICE
• The nursing process is a five-step decision-making approach that includes all of
the followingsteps, EXCEPT:
• Assessment
• Patient problem
• Planning
• Right Drug
ANS: D
The nursing process is a five-step decision-making approach that includes: 1)
assessment, 2) patient problem, 3) planning, 4) implementation, and 5)
evaluation. “Right drug” is one of the“Six Rights” of medication administration.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: PlanningMSC: NCLEX: Management of Care
• The nurse is using data collected to set goals or expected outcomes and
interventions thataddress the patient’s problems. Which step of the nursing
process is the nurse applying?
• Assessment
• Patient problem
• Planning N
• Evaluation
ANS: C
During the planning phase, the nurse uses the data collected to set goals or
expected outcomesand interventions which address the patient’s problems. The
data was collected during the “Assessment” and “Patient problem” steps. During
the “Evaluation” phase the nurse would determine whether the goals and
objectives set during the planning phase were met.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process:
Nursing Intervention
MSC: NCLEX: Management of Care
• A 5-year-old child with type 1 diabetes mellitus has had repeated
hospitalizations for episodesof hyperglycemia. The parents tell the nurse that
they can’t keep track of everything that has to be done to care for their child.
, The nurse reviews medications, diet, and symptom management with the parents
and draws up a daily checklist for the family to use. These activities are
completed in which step of the nursing process?
• Assessment
• Planning
• Implementation
• Evaluation
ANS: C
The implementation phase is the part of the nursing process in which the
nurse provides education, drug administration, patient care, and other
interventions necessary to assist thepatient in accomplishing established
medication goals.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process:
Nursing Intervention
MSC: NCLEX: Management of Care
• The nurse is preparing to administer a medication and reviews the patient’s
chart for drug allergies, serum creatinine, and blood urea nitrogen (BUN)
levels. The nurse’s actions are reflective of which phase of the nursing
process?
• Assessment
• Evaluation
• Implementation
• Planning
ANS: A
Assessment involves gathering information about the patient and the drug,
including anyprevious use of the drug.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care
• Which assessment is categorized as objective data?
• A list of herbal supplements regularly used
• Lab values associated with the drugs the patient is taking
• The ages and relationship to the patient of all household members
• Usual dietary patterns and fNood intake
ANS: B
Objective data are measured and detected by another person and would
include lab values.The other examples are subjective data.
,
, DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care
• The nurse reviews a patient’s database and learns that the patient lives alone, is
forgetful, anddoes not have an established routine. The patient will be sent
home with three new medications to be taken at different times of the day. The
nurse develops a daily medication chart and enlists a family member to put the
patient’s pills in a pill organizer. This is an example of which phase of the
nursing process?
• Assessment
• Evaluation
• Implementation
• Planning
ANS: C
The implementation phase involves education and patient care in order to assist
the patient toaccomplish the goals of treatment.
DIF: Cognitive Level:
Applying (Application)TOP:
Nursing Process: Nursing
Intervention
MSC: NCLEX: Management of Care
• A patient who is hospitalized for chronic obstructive pulmonary disease
(COPD) wants to go home. The nurse and the patient discuss the patient’s
situation and decide that the patient maygo home when able to perform self-care
without dyspnea and hypoxia. This is an example of which phase of the nursing
process?
• Assessment
• Evaluation
• Implementation
• Planning
ANS: D
Planning involves goal setting, which, for this patient, means being able to
perform self-careactivities without dyspnea and hypoxia.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: PlanningMSC: NCLEX: Management of Care
• A patient will be sent home with a metered-dose inhaler, and the nurse is
providing teaching.Which is a correctly written goal for this process?
, • The nurse will demonstrate the correct use of a metered-dose inhaler to the
patient.
• The nurse will teach the patient how to administer medication with a
metered-doseinhaler.
• The patient will know how to self-administer the
medication using themetered-dose inhaler.
• The patient will independently administer the medication using the
metered-doseinhaler at the end of the session.
N
ANS: D
Goals must be patient-centered and clearly state the outcome with a reasonable
deadline andshould identify components for evaluation.
DIF: Cognitive Level: Applying (Application) TOP: Nursing
Process: PlanningMSC: NCLEX: Management of Care
• The nurse is developing a plan of care for a patient who has chronic lung disease
and hypoxia.The patient has been admitted for increased oxygen needs above a
baseline of 2 L/min. The nurse develops a goal stating, “The patient will have
oxygen saturations of >95% on room air at the time of discharge from the
hospital.” What is wrong with this goal?
• It cannot be evaluated.
• It is not measurable.
• It is not patient-centered.
• It is not realistic.
ANS: D
This goal is not realistic because the patient is not usually on room air and
should not beexpected to attain that goal by discharge from this
hospitalization.
DIF: Cognitive Level: Applying (Application) TOP: Nursing
Process: PlanningMSC: NCLEX: Management of Care
• The nurse is developing a teaching plan for an elderly patient who will
begin taking an antihypertensive drug that causes dizziness and
orthostatic hypotension. Which patient problem documented by the nurse
is appropriate for this patient?
• Deficient knowledge related to drug side effects
• Ineffective health maintenance related to age
• Readiness for enhanced knowledge related to medication side effects
• Risk for injury related to side effects of the medication
ANS: D
, This patient has an increased risk for injury because of drug side effects, so
this is an appropriate patient problem to direct the type of care and follow-up
the patient will receive.
DIF: Cognitive Level:
Applying (Application)TOP:
Nursing Process: Nursing
Diagnosis MSC: NCLEX:
Management of Care
• An older patient must learn to administer a medication using a device that
requires manual dexterity. The patient becomes frustrated and expresses lack of
self-confidence in performingthis task. Which action will the nurse perform
next?
• Ask the patient to keep trying until the skill is learned.
• Provide written instructions with illustrations showing each step of the skill.
• Schedule multiple sessions and practice each step separately.
• Teach the procedure to family members who can administer the
medication for thepatient.
ANS: C
Nurses should be sensitive to patient’s level of frustration when teaching skills. In
this case,breaking the steps down into inNdividual parts will help with this patient’s
frustration level.
DIF: Cognitive Level: Applying (Application) TOP: Nursing
Process: PlanningMSC: NCLEX: Management of Care
• A school-age child will begin taking a medication to be administered at 5
mL three timesdaily. The child’s parent tells the nurse that, with a previous
use of the drug, the child repeatedly forgot to bring the medication home
from school, resulting in missed eveningdoses. What will the nurse
recommend?
• Asking the provider if the medication may be taken before
school, after school,and at bedtime
• Putting a note on the child’s locker to encourage the child to take
responsibility formedication administration
• Asking the provider if 7.5 mL may be taken in the morning and
7.5 mL may betaken in the evening so that the correct amount is
given daily
• Taking the noon dose to school every day and giving it to the
school nurse toadminister
ANS: C
For busy families with school-age children, it may be necessary to adjust the
medication schedule to one that fits their schedule. The nurse should ask the
provider if a revised scheduleis possible. In this case, the most effective revised
, schedule would involve not taking the medication while at school. Putting a note
on the locker is not likely to be effective. It is not correct to adjust the dose.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Nursing
Intervention/PlanningMSC: NCLEX:
Management of Care
• A high-school student regularly forgets to use a twice-daily inhaled
corticosteroid to prevent asthma flares and is repeatedly admitted to the
hospital. The child’s parent tells the nurse thatthe child has been told that
forgetting to take the medication causes frequent hospitalizations.The nurse
will:
• encourage the child to take responsibility for taking the medication.
• reinforce the need to take prescribed medications to avoid hospitalizations.
• suggest putting the inhaler with the child’s toothbrush to use before brushing
teeth.
• suggest that the child’s parents administer the medication to increase
compliance.
ANS: C
It is important to empower patients to take responsibility for managing
medications. Putting the medication with the toothbrush can help this child
remember to use it. Telling the child totake medications and reminding the child
that failure to do so results in hospitalization is not working. Asking the child’s
parents to administer the medication does not empower the adolescent to take
responsibility.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Planning/Nursing
InterventionMSC: NCLEX: Management
of Care
• An adolescent patient who has acne is given a regimen of topical medications
and an oral antibiotic that generally clears up lesions to fewer than 10 within 6
to 8 weeks. At a 2-month follow-up, the patient continueN s to have more than 25
lesions. The child’s parent affirms that the child is using the medications as
prescribed. Which evaluation statement is correct for thispatient?
• “Goal of fewer than 10 lesions in 6 to 8 weeks is not met.”
• “Goal that the medication will be effective is not met.”
• “Goal that the patient will take medications as prescribed is not met.”
• “Goal that the patient understands the medication regimen is not met.”
ANS: A
, All indications are that this patient is taking the medications and they are not
effective. Thefirst statement is correct because it identifies a measurable goal
and a specific time frame.
DIF: Cognitive Level: Applying (Application) TOP: Nursing
Process: EvaluationMSC: NCLEX: Management of Care
• During a home visit, the nurse learns that a patient has not been taking their
medications as prescribed. The patient reports having no insurance and tells the
nurse that the drug is too expensive. After learning that there is no substitute
medication, the nurse will perform whichaction next?
• Assist the patient to apply for a patient-assist program.
• Contact the pharmacy to request a reduction in the cost of the drug.
• Determine the patient’s annual income.
• Give the patient the number of a charitable organization that may be able to
help.
ANS: C
Patient-assist programs may be helpful, but many are dependent on the
patient’s income, sothe nurse should determine that first. It is unlikely that the
pharmacy would offer a cost reduction. The patient has demonstrated an
inability to navigate the system by simply not taking the medication, so only
providing a phone number to the patient is not likely to be effective.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment/Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
N
, Chapter 02: Drug Development and Ethical Considerations
McCuistion: Pharmacology: A Patient-Centered Nursing Process
Approach, 10thEdition
MULTIPLE CHOICE
• The nurse is obtaining consent from a subject newly recruited for a clinical drug
trial that willlast for 6 months. All subjects will be given gift certificates for
participating. One subject says, “Well, I guess if the drug doesn’t work, I’ll just
have to put up with the symptoms for 6 months.” What will the nurse tell the
subject?
• “Participation for the duration of the study is required.”
• “Participation may end at any time without penalty.”
• “Withdrawal from the study may end at any time, but the gift
certificate will not begiven.”
• “You can request placement in the treatment group.”
ANS: B
All participants have the right to autonomy, which is the right to self-
determination. Patients have the right to refuse to participate or to withdraw
from a study at any time without penalty.Patients generally are not allowed to
choose participation in either the treatment or the controlgroup.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process:
Nursing Intervention
MSC: NCLEX: Management of Client Care
• Nnical drug trial in which the side effects of two
The nurse is assisting with a cli
effective drugs are being compared. A patient who would benefit from either
drug has elected to withdraw from the study, and the nurse assists with the
paperwork to facilitate this. This is an example of
• autonomy.
• beneficence.
• justice.
• veracity.
ANS: A
All participants have the right to autonomy, which is the right to self-
determination. Patients have the right to refuse to participate or to withdraw
from a study at any time without penaltyeven if the health care provider
disagrees with that choice.
