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45 Cards in this Set
- Front
- Back
- 3rd side (hint)
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A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain relief, the nurse administers the medication so that it is most rapidly absorbed from the gastrointestinal (GI) tract. Which of the following has the fastest absorbtion |
liquid suspension |
Liquid medications do not need to go through the dissolution phase and may be immediately absorbed. Tablets and capsules must be dissolved. Enteric-coated tablets are designed to be absorbed at a slower rate |
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A client asks why he has to take a medication on an empty stomach. The nurse explains that generally food does which of the following to drug dissolution and absorbtion? |
decreases |
Food in the stomach describes the contact with the digestive lining of the stomach, decreasing the absorptive surface |
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A client asks why the oral dose of his pain medication is higher than the intravenous dose. The nurse explains that the oral dose, some of the drug is absorbed from the GI tract and is metabolized by the liver to an inactive drug form. This reduces the amount of active drug and is called the |
hepatic first pass |
Oral medication are partly metabolized in the liver such that less active drug is available |
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When providing medication, if the nurse wanted to select the route that ensures greatest biovailability, the route is |
intravenously |
The intravenous (IV) route is immediately available for distribution and action. The other routes require metabolism in order to become active |
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A client's serum protien and albumin levels are below normal values. For a drug that is highly protein bound, there would be |
more free drug in circulation |
With less protein available , less drug is attached to protein. Drugs that are not protein-bound are active or free |
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A client is taking a drug that is moderately high protein-bound. Several days later, the client takes a second drug htat is 90% protein-bound. What happens to the first drug that is highly protein-bound? |
The first drug is released from the protein and becomes more pharmacologically active |
90% protein binding is considered very highly bound. When taken by the client, it would displace the moderately highly protein-bound medication and make the first drug free in the circulation and active |
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A nurse is determining if a medication is ordered to be given at the appropriate intervals. This is done by assessing the half life of the medication. The serum half-ife (t1/2) of a drug is |
the time required after absorbtion for half of the drug to be eliminated |
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A client is to receive a drug that has a half-life of 36 hours. The drug would probably be administered on a dose scheduled of |
once a day |
36 hours is considered a long half life. It allows for a dosing patter that is once per day because it takes 36 hours for half of the drug to be eliminated, maintaining therapeutic drug levels |
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A client is suffering from end-stage renal disease. Because of this condition, the nurse monitors drug levels to access for |
accumulation |
Although some mediations are excreted via the skin and feces, the primary route for the drug elimination is the renal system. If kidney function is impaired, drugs may reach toxic levels |
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Isoproterenol (Isuprel) is an example of a medication that enhances the beta receptors in the body. Drugs that enhance the beta receptors in the body. Drugs that enhane a response is known as |
agonists |
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A nursing role is to teach clients to watch for adverse medication reactions. Adverse effects are |
undesired effects |
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Undesired effects are frequently associated with a client stopping a medication before completion of the full course. Physiologic effects, are related to the desired effect, that can be predicted or associate with the use of the drug are called |
side effects |
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A nurse is learning how to draw peak and trough levels of a medication. The nurse is aware that the trough level is the |
lowest plasma concentration of a drug |
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For the client receiving frequent daily drug dosing of a drug that has a long duration of action, the effect may be |
a drug accumulatio and possibe drug toxicity |
medications with a long half-ife and frequent dosing may build up in the system or accumulate and lead to toxic effects |
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Drug tolerance to a frequently repeated administration of a certain drug is known as |
tachyphylaxis |
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Because of hereditary influence, drug action may vary from a predicted drug response. This is known as |
pharmacogenetics |
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A medication has a low therapeutic index. Which of the following nursing interventions is indicated when administering this medication |
Monitor blood levels of the medication |
A medication with a low therapeutic index has a narrow margin of safety. Because of this, nurses must monitor blood levels to ensure that drug dose is a therepeutic dose, not a toxic dose |
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A nurse is administering a high dose of a medication in order to rapidly achieve a minimum effective concentration. This dose is known as the |
loading dose |
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Which of the following is the sequence of steps in the nursing process |
assessment, planning, implementaton, evaluation |
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Effectivenesss of health teaching and drug therapy is associated with which of the following phases of the nursing process |
evaluation |
the nurse would assess the effectiveness of a medication during the evaluation phase |
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In your assessment, a client tells you that he or she has had a reaction to a medication. Your next nursing intervention is to: |
ask the client the type of reaction experienced |
It is important for the nurse to know what type of reaction occured in order to plan action |
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A nurse is teaching a client about a medication that is scheduled to be administered qid. The client states that she does not use a watch or clock and lives without a daily routine. Which of the following would be most helpful for a client |
instruct the client to take the medication with meals and at bedtime each day |
For a client who is not timed oriented and needs to take the medication 4 times a day, this the only feasible way |
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The nurse practices the "10 rights" of drug administration to ensure which of the following |
safe drug administration |
the 10 rights ensure that the nurse has considered all of the details of safe medication administration |
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"Give Tylenol 650 mg q3-4h as needed for headache" is an example of which of the following categories of drug orders |
PRN |
PRN means as needed |
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During administration of eye drops, the nurse should teach the client to prevent systemic absorption of the drug by doing which of the following |
gently press on the lacrimal duct |
by applying pressure on the inner canthus of the eye, the medication is likely to be systemically absorbed |
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A nurse is preparing to administer an IM injection to an 8 month old infants is the |
vactus lateralis |
The gluteal muscles should not be used until the child is walking well for 1 year. The vastus lateralis is a large muscle that is accessible in infants |
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A nurse administers an injection using the z-track method. The nurse instructs the patient that the z-track technique is designed to accomplish which of the following |
prevent medication from leaking into subcutaneous tissue |
The z-track method displaces the tissue during medication injection and replaces the tissue whe withdrawn. This prevents leaking |
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A nurse is applying nitroglycerin ointment to a client. When applying medication topically, the nurse should |
avoid contact of the medicine with the nurse's skin |
because this medication is typically absorbed, contact with the nurse's skin may cause the nurse to feel the effects of the medication |
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A nurse prepares to administer an ear medication to a 2 year old child. The nurse correctly |
pulls the ear downward and backward |
This is the correct method for a child younger than 3 years, the ear is pulled up and back |
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A nurse is ordered to administer a medication via the sublingual route. The nurse correctly places the medication |
under the tongue |
sublingual means under the tongue |
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A client has been receiving pain medication secondary to surgery. Two weeks postoperatively, the client reports that "the medication doesn't seem to work as well as it did" The nurse should first access for |
tolerance to the medication |
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A client with chronic angina is ordered to recieve nitroglycerin via a patch. Which of the following is true about the application of this transdermal medication |
the old patch should be remove before applying the new patch |
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A nurse is administering an intradermal PPD to test for client exposure to the tuberculosis bacterium. Which of the following demonstrates the correct method to administer this injection |
Use a 10 degree angle to insert a 25 guage needle |
This is for an intradermal injection |
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A nurse is preparing to adminster a subcutaneous injection of morphine sulfate (MSO4) to a client. The client's height, weight, and muscle mass are within normal limits. Which of the following describes the appropriate needle size and angle for this injection |
25 guage needle, 45 degree angle |
angle and size for a subcuateous injection |
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A nurse conversing with a client is aware that the majority of the message is nonverbal in clients from which of the following cultures |
Vietnamese |
people of Vietnamese culture are attuned to nonverbal messages to a greater extent than people of other cultures |
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When conversing with a client of tradition German heritage, the preferred distance between speakers is |
more than 2 feet |
People of German descent traditionally have a large personal body space, which necessitates maintaining a respectful distance |
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In general clients from which of the following cultures expect to be seen reguardless of how late they arrive for an appointment |
Mexican Americans |
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A pregnant Islamic women goes to a clinic for routine prenatal care. The client is very apprehenisive about a male nurse practitioner would be most helpful to the client in tis situation |
"I will examine you with gloves on and a female nurse in the room" |
Islamic tenets discourage me touching women, even in a professional capacity. The gloves and witness should increase her comfort level. In addition, most of the prenatal exam can occur with the woman fully dressed
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You are teaching a client about his medications. In his care plan, the assessment indicates that he is a visual learner. Which teaching strategy is indicated for this client |
pamphlets or videos about the medication |
A visual learner would respond best to teaching strategies that can be seen |
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A nurse is adminstering a medication to a client. The nurse tellse the client the indications for the prescribed medication. Which client right is the nurse observing |
informed consent |
In order to observe the clients rights for informed consent, clients must be taught all aspects of the drug therapy |
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Clients from which ethnicity/culture generally do not have the expected response to angiotensin converting enzymes (ACE) inhibitors nor to beta blockers |
African Americans |
African Americans do not responds as well to beta blockers as white counterparts. This is due to the rennin levels and dictates that diuretics or ACE inhibitors are more effective |
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A nurse is administering medications in a tuberculosis clinic. Clients from which of the following cultures experience a higher incidence of side effects from drugs used to treat tuberculosis |
Hispanics |
Those of the Hispanic culture respond to antitubercular medications with an increased incidence of side of effects |
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A nurse is evaluating a dark-skinned client for jaundice secondary to liver dysfunction. The best place for the nurse to assess is |
the sclera of the eye |
The sclera allows for appraisal of jaundice in clients with darker skin tones. Frequently, in those with darker skin, it is difficult to discern jaundice |
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When adminstering medications to a hospitalized patient who is awake and carrying on a conversation with visitors, what would be the most accurate way for the nurse to check this patients identity |
ask the patient "Can you tell me your name and birth date" |
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An elderly patient is given a prescription for celecoxib (Celebrex) for pain and stiffness of osterarthritis of the hips and back. The nurse should first perform which of the following |
Complete and thorough medication assessment to see what other medications the patient is taking |
Assessment is the first step of the nursing process and should be completed first to assess current medications. The elderly are usually many medications and the potential for drug interactions is high |
