Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A nurse is preparing a drug for administration to a patient. The drug does not have
an indicated use for the patient’s medical diagnosis. What should the nurse do?
a. Administer the drug as ordered.
b. Question the prescriber concerning the ordered drug.
c. Ask a coworker his or her thoughts about the ordered drug for the patient.
d. Ask the patient why the drug has been prescribed for him or her.
Ans: B
Feedback:
If the nurse is not sure about giving a drug, the order should be questioned. The nurse
should never give a medication that is not clear. Mistakes do happen and the drug
ordered, if not approved for the condition that the patient has, could be an error on
someone’s part. The person who wrote the order should be questioned, not a co
worker, who probably does not know why an off-label drug is being used. It would be
unprofessional and inappropriate to ask the patient about the drug.
2. According to Center for Disease Control and Prevention (CDC) recommendations,
what is the role of the nurse in preparing for the possibility of bioterrorism?
a. Post updated information on signs and symptoms of infections caused by
biological agents
b. Provide guidelines for treating patients exposed to, or potentially exposed
to, biological agents
c. Remain current on recognition and treatment of infections caused by
biological weapons
, d. Advocate for increased funding for research involving bioterrorism and
patient treatment
Ans: C
Feedback:
Nurses need to remain current about recognition of and treatment for those exposed to
biological weapons because nurses are often called upon to answer questions, reassure
the public, offer educational programs, and serve on emergency preparedness
committees. The CDC posts updated information on signs and symptoms of infections
caused by biological agents that nurses would read. The CDC also provides guidelines
for how to treat patients exposed to biological agents and the nurse must remain
current on this information. Although nurses could advocate for funding, this is not
usually the role of the nurse.
3. How can the nurse find the most up-to-date information about emergency
preparedness related to bioterrorism agents?
a. Read textbooks devoted to the topic.
b. Ask coworkers to explain current events.
c. Read journal articles about bioterrorism agents.
d. Visit the Centers for Disease Control and Prevention (CDC) Web site.
Ans: D
Feedback:
The most current information will be found on the CDC Web site because new
information can be posted immediately whereas textbooks and journal articles take
time to print. Coworkers may or may not remain current on emergency preparedness
and should not be the primary source of information.
4. The nurse is assessing a diabetic patient who has presented at the clinic reporting
several hypoglycemic episodes during the past 3 weeks. The nurse questions the
patient about the use of herbal or alternative therapies, suspecting what herbal
remedy could cause the hypoglycemic episodes?
a. St. John’s wort
b. Kava
c. Fish oil
d. Ginseng
Ans: D
Feedback:
Ginseng is known to decrease blood sugar levels. If the patient used this in
combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood
sugar could drop below therapeutic levels. St. John’s wort interacts with many drugs,
but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has
been associated with decreased coronary artery disease.
,5. A 22-year-old patient calls the clinic and tells the nurse that she has been depressed
and is thinking about taking St. John’s wort but wants to know if it is safe first. The
nurse begins by questioning what other medications the patient takes and would be
concerned about a drug-alternative drug interaction if the patient is also taking
what type of medication?
a. Antihistamines
b. Analgesics
c. Antibiotics
d. Oral contraceptives
Ans: D
Feedback:
St. John’s wort can interact with oral contraceptives that alter drug metabolism, which
can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and
antihistamines can be taken in combination with St. John’s wort without known
adverse effects.
6. A patient tells the clinic nurse that he or she has been taking over-the-counter
(OTC) Pepcid to relieve acid indigestion for several years. This is the first time the
patient has ever reported this issue to a health care provider. As part of the teaching
plan for this patient, the nurse explains what risk associated with not sharing OTC
drug use with the provider?
a. The OTC drug could be more expensive than seeking health care advice.
b. The drug could mask symptoms of a serious problem that is undiagnosed.
c. Use of the drug could cause a rebound effect of Pepcid.
d. The drug could interact with several cold medicines.
Ans: D
Feedback:
OTC drugs allow patients to self-diagnose and treat routine signs and symptoms
without seeing a health care provider. This self-prescribed treatment, however, could
mask a more serious underlying medical problem and result in a poor outcome for the
patient. The issues of drug rebound and drug interaction need to be considered, but the
safety issue related to self-diagnosis and self-prescription presents the greatest risk to
the patient. Patients should always be encouraged to discuss the use of OTC products
with their health care provider.
7. What patient populations would the nurse expect is most likely to be prescribed a
drug for an off-label use?
a. Adolescent and middle-aged adult patients
b. Patients with diabetes or heart disease
c. Obstetric and neonatal patients
d. Pediatric and geriatric patients
, Ans: D
Feedback:
Drugs being used for an off-label purpose are commonly prescribed for pediatric and
geriatric populations due to the lack of drug trial information and minimal premarket
testing. Often a trial-anderror method is used in treating both the pediatric and
geriatric populations when only adult information is known. The geriatric population
responds to medication more like children because of their decreased ability to
metabolize medications. Adolescents, especially later adolescents, use medications
similarly to young adults as do middle-aged adults. Patients with different diagnoses
are often involved in drug testing including those with diabetes and heart disease.
Drugs are discouraged for use in obstetric patients.
8. A patient calls the clinic and asks to speak to a nurse. The patient questions the
nurse about the use of a drug that was advertised on TV. The patient tells the nurse
he or she is sure that the drug will make him or her feel the same way as described
in the commercial. What response is most appropriate for the nurse to make?
a. I’m glad that you want to be involved in treatment decisions but you are not
qualified to decide what medications are best for your condition.
b. It’s important to remember that drug advertisements emphasize the positive
effects of drug therapy and not the adverse effects or contraindications.
c. You need to remember that the drugs being advertised are much more
expensive than other drugs that have the same effect.
d. I’ve seen those advertisements and I would want to take that medication too
if I had the condition it was designed to treat.
Ans: B
Feedback:
It would be important for the nurse to remind the patient that advertisements always
emphasize the positive effects of drug therapy. The patient should not be discouraged
from contributing to the plan of care by being told she is not adequately qualified to
make decisions because no one is more qualified to make decisions about her own
body. Although the drug may be more expensive, this is not a reason to choose or
avoid a medication that could be more effective. Agreeing with the patient is not
meeting the nurse’s obligation to teach and inform.
9. The clinic nurse is talking with a patient about information concerning a drug her
or she bought online. What is the nurse’s responsibility to the patient concerning
this information?
a. Encourage the patient to seek information about drugs from a pharmacist.
b. Explain that information obtained from the Internet is not always accurate.
c. Offer the patient a drug reference guide to read and learn more about the
drug.
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