NURS 6521 QUIZ 1 with Response feedback

NURS 6521 QUIZ 1  Question 1 1 out of 1 points In which of the following patients would a nurse expect to experience alterations in drug metabolism? Response Feedback: The liver is the most important site for dru ...

NURS 6521 QUIZ 1  Question 1 1 out of 1 points In which of the following patients would a nurse expect to experience alterations in drug metabolism? Response Feedback: The liver is the most important site for drug metabolism. If the liver is not functioning effectively, as with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. Drug dosage will have to be altered to ensure normal levels in the body. The patient with kidney stones and the patient in acute renal failure would most likely have alterations in drug excretion. If there are no complications with the cervical cancer patient, there should be no alterations in drug therapy.  Question 2 1 out of 1 points The nurse's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? Response Feedback: True allergic reactions include formation of rash or hives, itching, redness, swelling, difficulty breathing, and anaphylactic shock. Nausea and vomiting, however, are adverse effects of drug therapy. Similarly, an unsafe drop in blood pressure and gastric bleeding from aspirin use are adverse drug effects, not allergic reactions.  Question 3 0 out of 1 points A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication? Response Feedback: The ventrogluteal site is the preferred site for intramuscular injection. IM injections necessitate the use of a larger gauge needle than is required for subcutaneous injections.  Question 4 1 out of 1 points A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice?Response Feedback: Metabolism of many varied drugs such as calcium channel blockers (used to treat hypertension), statins (used to lower blood lipid levels), and antihistamines (used to prevent allergic reactions) is affected by grapefruit juice.  Question 5 1 out of 1 points A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Response Feedback: Efficacy indicates how well a drug produces its desired effect. Different drugs have different strengths of attraction or affinity for receptor sites. A drug's ability to stimulate its receptor is called its intrinsic activity, and the amount of a drug that must be given to produce a particular response is called the potency of a drug.  Question 6 1 out of 1 points A home health nurse notes that there have been changes to a patient's oral drug regimen. The nurse will closely monitor the new drug regimen to Response Feedback: Changes in the drug regimen may cause changes in drug absorption and thereby decrease the anticipated drug effect. This decrease is due to the prevention of binding and loss of absorption and overall drug effectiveness. A change in the drug regimen would not help a nurse to track the route of metabolism or determine the speed of chelation. If any adverse effect were to occur as a result of a drug regimen change, it would not necessarily be immunotoxicity; it could also be nephrotoxicity, ototoxicity, or cardiotoxicity.  Question 7 1 out of 1 points 5 ml = _______________tsp  Question 8 1 out of 1 points A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient's care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?Response Feedback: Because absorption takes place mostly in the small intestine, there could be possible alterations with this process. Distribution takes place in the blood vessels; metabolism in the liver; and elimination via the kidneys. Because these systems are not affected by her surgery, these phases of pharmacokinetics would not be altered.  Question 9 1 out of 1 points A patient has a blood serum drug level of 50 units/mL. The drug's half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range? Response Feedback: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range.  Question 10 1 out of 1 points A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient's compromised renal function will likely Response Feedback: Impaired renal function will increase the half-life of drugs that are metabolized by the kidneys. This does not necessarily render such medications ineffective and it does not decrease the first-pass effect. IV administration will not compensate for the patient's impaired renal function.  Question 11 1 out of 1 points A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to Response Feedback: Antihypertensive drugs work to decrease blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure decreases. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and a feeling of weakness. After several years on anantihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue. Most antihypertensives are metabolized and excreted and do not accumulate in the body. The patient has not given the nurse any information that would indicate that she has not been compliant with her drug regimen due to the move.  Question 12 1 out of 1 points A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Response Feedback: The nurse should post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record; this will allow continuous access of the dietary staff and the other members of the health care team to the information and serve to limit errors. The prescriber would always ask the patient about her allergies before prescribing a new medication. The patient is not having an allergic reaction, so treating her for an allergic reaction is unnecessary. If the allergies are documented in the appropriate area of the patient's record, the dietary staff will be aware that the patient should not be served eggs.  Question 13 1 out of 1 points In order to promote therapeutic drug effects, the nurse should always encourage patients to Response Feedback: Taking a drug at the appropriate time will help the patient maintain therapeutic drug levels. Not all medications should be taken with food, which can alter the absorption of some drugs. A patient should never increase or decrease a medication dosage without checking with the prescriber. Alternative therapy should only be used if the patient has discussed the therapy with the prescriber and they are in agreement.  Question 14 1 out of 1 points Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin isResponse Feedback: An antagonistic drug interaction results in a therapeutic effect that is less than the effect of either drug alone because the second drug either diminishes or cancels the effects of the first drug. An additive effect occurs when two or more “like” drugs are combined and the result is the sum of the drugs' effects. A synergistic effect occurs when two or more “unlike” drugs are used together to produce a combined effect and the outcome is a drug effect greater than either drug's activity alone. Potentiation is an interaction in which the effect of only one of the two drugs is increased.  Question 15 1 out of 1 points An older adult patient with a history of Alzheimer's disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patient's cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient? Response Feedback: A tablet that is designed for immediate release into the gastric environment is normally safe to crush and administer to the patient. Enteric coated and sustained release tablets may not be crushed because doing so compromising the delayed release into the GI tract that is intended with these medications. Sublingual medications should be placed under the tongue to dissolve rather than swallowed.  Question 16 1 out of 1 points A patient is treated with an antibiotic for an infection in his leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of Response Feedback: Pharmacodynamics is the biologic, chemical, and physiologic actions of a particular drug within the body and the study of how those actions occur, including adverse effects. It is how the drug affects the body. The pharmacodynamics of a drug is responsible for its therapeutic effects and sometimes its adverse effects. Pharmacotherapeutics refers to the desired, therapeutic effect of the drug. Pharmacokinetics is the changes that occur to the drug while it is inside the body. Pharmacogenetics is the study of how genetic variables affect the pharmacodynamics of a drug in a specific patient.  Question 17 1 out of 1 pointsA patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the Response Feedback: Baseline body weight and height, heart rate, and blood pressure are all important considerations during the assessment of a patient. However, if a patient has to be given drugs intravenously, it is important to inspect the skin for rashes, moles, or sores, so those areas can be avoided as an insertion or injection site.  Question 18 1 out of 1 points For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications? Response Feedback: The use of an NG tube for medication administration requires a functioning GI tract. An NG tube would not be used if a patient is vomiting frequently or has had recent bowel surgery. Similarly, an NG tube would not be used in the case of a competent adult who wishes to discontinue his or her medications.  Question 19 1 out of 1 points An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? Response Feedback: Absorption of drugs is dependent primarily on the route of administration. IV, IM, and sublingual administration results in faster absorption than drugs that are given orally.  Question 20 1 out of 1 points An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication? Response Feedback: Intravenous infusion is the preferred method for use in emergency situations when rapid drug effects are desired. Absorption is considered to be instantaneous, as the drug is placed directly into the bloodstream. The subcutaneous and intramuscular routes could be used but would not ensure rapid drug effects. Intrathecaladministration is usually done by a physician or a specially trained health care provider.  Question 21 1 out of 1 points Which of the following statements best defines how a chemical becomes termed a drug? Response Feedback: Even though all the responses are correct, a chemical must undergo a series of tests to determine its therapeutic value and efficacy without severe toxicity or damaging properties before it is termed a drug. Test results are reported to the FDA, which may or may not give approval.  Question 22 1 out of 1 points A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety? Response Feedback: If patients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the patient. However, a substitution may not be allowed, and the cost of a drug does not improve patient safety. Most patients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with patients.  Question 23 1 out of 1 points A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate? Response Feedback: Receptors are not static; they can change or modify their response to a stimulus. Such change occurs when a receptor is continuously stimulated to act or continually inhibited from action. Continual stimulation from an agonist usually makes the receptor desensitized to the drug and thus less active. Therefore, the nurse should anticipate a decrease in effectiveness of the drug.  Question 24 1 out of 1 points During a clinic visit, a patient complains of having frequent muscle cramps in herlegs. The nurse's assessment reveals that the patient has been taking over-thecounter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Response Feedback: Long-term intake of laxatives, antidepressants, and antibiotics has been found to deprive a person of most essential nutrients, such as vitamins. Prolonged use of laxatives is not known to turn urine acidic, cause urinary tract infections, counter the effect of other drugs, or inhibit the biotransformation of drugs.  Question 25 1 out of 1 points The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity? Response Feedback: Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid–base balance, and electrolyte imbalances can occur with nephrotoxicity. Ringing noise in the ears (tinnitus) is an indication of possible ototoxicity. Visual disturbances can suggest neurotoxicity, and yellowing of the skin (jaundice) is a sign of hepatotoxicity.  Question 26 1 out of 1 points A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 p.m. The nurse finds the patient drowsy and confused at 10 a.m. the next day. The nurse is aware that this behavior is most likely due to Response Feedback: Decreased hepatic function may extend the half-life of a drug and increase the patient's response to the drug. Increased renal function would rid the body of the drug faster than normal and would not cause prolonged effects. A toxic effect would be a more serious effect such as inability to awaken the patient. An allergic reaction does not usually manifest itself as a confused and drowsy state.  Question 27 1 out of 1 points A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to Response Feedback: Beta-adrenergic antagonists should be used cautiously in patients with diabetes mellitus because beta blockade can mask the signs of hypoglycemia, especially palpitations, tachycardia, and tremors.Taking his pulse, weekly weighing, and avoiding smoke-filled rooms are good health practices and should be done when taking these drugs, but they are not specifically necessary for a diabetic patient taking a beta-adrenergic antagonist.  Question 28 1 out of 1 points A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that Response Feedback: If ataxia and confusion occur, especially in older adults or in a debilitated patient, dose adjustments should be made if the effects persist. If the drug is stopped immediately, withdrawal symptoms may occur. Intravenous administration or continuing the same dosage and medication would not help relieve ataxia or confusion in the patient.  Question 29 1 out of 1 points A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Response Feedback: Polypharmacy is defined as taking several drugs at the same time. The other options are false statements.  Question 30 1 out of 1 points A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Response Feedback: For postmenopausal osteoporosis, the recommended intranasal dose of calcitonin is 200 international units, in alternating nostrils each day. This practice decreases nasal irritation. Intranasal administration is preferred over IM, SC, or IV routes.  Question 31 1 out of 1 points A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered andthe results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? Response Feedback: Damage to the kidneys is called nephrotoxicity. Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid-base balance, and electrolyte imbalances can all occur with kidney damage.  Question 32 1 out of 1 points A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for Response Feedback: Decreased levels of plasma albumin can lead to fewer binding sites for protein-binding drug molecules. Decreased binding sites results in higher concentrations of unbound forms of a drug, which increases the risk of adverse effects and toxicity and can increase therapeutic effects. Plasma albumin does not alter absorption of a drug but is responsible for binding, transporting, and distributing drugs throughout the body. Even though higher concentrations of a free drug increase the amount of the drug available for metabolism, normal age-related decreases in liver function offset any increase in the pharmacokinetic process.  Question 33 1 out of 1 points A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication? Response Feedback: Digoxin is used to maintain clinical stability and improve symptoms, quality of life, and exercise tolerance in patients with all phases of CHF; it does not decrease mortality from CHF or cure the disease. Digoxin increases urine production but its therapeutic effect is not primarily gained from diuresis or blood pressure reduction.  Question 34 1 out of 1 points A nurse who is working with an older adult patient who takes eight medications a day wants to promote medication adherence. Which of the following nursing interventions would best promote medication adherence?Response Feedback: Placing pills in a daily or weekly pillbox will help remind the patient to take the pills as scheduled and should serve as a visual aid to help make him more aware of having to take medication. Patients should always take medications as prescribed to ensure therapeutic effects, and prescriptions should be refilled prior to the last dose to ensure continuity of drug therapy. Elderly patients should ask for bottles with easy open caps due to possible arthritic changes that might interfere with the patient opening a bottle.  Question 35 1 out of 1 points Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Response Feedback: Ranolazine should be used only in combination with other antianginal therapy (either nitrates, beta blockers (metoprolol or atenolol), or amlodipine, a calcium channel blocker. It does not achieve its effects by lowering the heart rate or the blood pressure. Ranolazine has the potential to prevent MI.  Question 36 1 out of 1 points A nurse who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the nurse should encourage them to Response Feedback: The introduction of new drugs into an individual's drug regimen without the advice of a health professional can increase the risk of drug interactions. This measure is more important that taking all drugs with food or taking drugs individually since these actions do not remove the risk of adverse drug interactions. A healthy lifestyle is of benefit to older adults, but does not mitigate the potential for drug interactions.  Question 37 1 out of 1 points Medication reconciliation of an 82-year-old man who has recently moved to a longterm care facility reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this aspect of the resident's drug regimen? Response In a systematic review of medications as risk factors for fall, it wasFeedback: found that one of the main group of drugs associated with this risk were benzodiazepines. Benzodiazepines are not associated with cold intolerance, anorexia, or aggression.  Question 38 1 out of 1 points An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Response Feedback: Angiotensin II receptor blockers such as losartan are associated with a risk of dizziness and a consequent risk for falls. This risk is more pronounced among older adults. Losartan is not associated with constipation, xerostomia, or depression.  Question 39 1 out of 1 points Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? Response Feedback: Older adults may have a more pronounced venous dilation from nitroglycerin than younger adults and may experience more hypotension from the drug. Xerostomia does not inhibit the absorption of nitroglycerin spray and it is unnecessary to adjust the timing of nitroglycerin doses based on age.  Question 40 1 out of 1 points An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease? Response Feedback: In male patients, antiandrogens are used to treat prostate cancer. They are not included in treatment of lymphomas, skin cancer, or lung cancer.