NURS-6521 Advanced Pharmacology Week 1 – Quiz

NURS-6521 Advanced Pharmacology Week 1 – Quiz
Review Test Submission: Week 1 – Quiz

Course
NURS-6521N-27,Advanced Pharmacology

Test
Week 1 – Quiz

Started
3/4/xx 11:15 PM

Submitted
3/5/xx 12:16 AM

Due Date
3/5/xx 1:59 AM

Status
Completed

Attempt Score
39 out of 40 points

Time Elapsed
1 hour, 0 minute out of 1 hour and 40 minutes

Instructions
Please answer each question below and click Submit when you have completed the Quiz.

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Question 1

1 out of 1 points

A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be

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Response Feedback:
If the child is vomiting, drug administration via a liquid, lozenge, or tablet would not be appropriate. Aspiration or losing the medication through vomitus or coughing would be a concern. The nurse would administer the medication by the rectal route using a suppository.

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. NURS-6521 Advanced Pharmacology Week 1 – Quiz.

Question 3

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 4

1 out of 1 points

In response to a patient’s nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback? NURS-6521 Advanced Pharmacology Week 1 – Quiz

 

Response Feedback:
When the patient receives continuous IV fluids and is also receiving intermittent IV drug therapy, the drug is normally given through a secondary IV tubing. When a secondary IV tubing is used to administer an IV drug, the tubing is added to the main line tubing, usually at a Y port. Adding secondary tubing is called “piggybacking” because the tubing with the drug rides on top of the primary fluid tubing. Failure to adhere to a prescribed regimen, unstable electrolyte levels, and need for continuous monitoring are not rationales for the use of an IV piggyback.

Question 5

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 an antihypertensive 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 6

1 out of 1 points

A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of

 

Response Feedback:
The incidence of hypertension is significantly higher among African-Americans than other ethnic groups. As well, African Americans respond to some antihypertensive drugs differently than whites.

Question 7

1 out of 1 points

30 ml = _______________tbsp

Question 8

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 9

1 out of 1 points

Tylenol 325 mg/tablet, patient needs 650 mg; how many tables should patient take?

Question 10

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 11

1 out of 1 points

Which of the following affects drug distribution throughout the body?

 

Response Feedback:
Both protein binding and altered pH of extracellular fluids affect drug distribution. The presence of food in the gastrointestinal tract affects drug absorption, whereas an increase in hepatic enzymes affects drug metabolism. High blood levels are not known to affect drug pharmacokinetics.

Question 12

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 13

1 out of 1 points

A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to

 

Response Feedback:
The first-pass effect involves drugs that are given PO and absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites; they may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for this phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.

Question 14

1 out of 1 points

On the 1 a.m. rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy and cleaning her room. The nurse evaluates the patient’s response to the hypnotic as

 

Response Feedback:
An idiosyncratic response is an unusual or opposite effect of what is intended. A response of this nature is related to a person’s unique response to a drug rather than to the dose of a drug. An allergic reaction is an immune system response. 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. A teratogenic effect is a physical defect in the developing fetus caused by a drug or a vaccine that the mother took during pregnancy.

Question 15

1 out of 1 points

The culture and sensitivity testing of a patient’s wound exudate indicates that a specific antibiotic is necessary for treatment. The United States Pharmacopeia–National Formulary indicates that the drug in question is 96% protein bound. What are the implications of this fact?

 

Response Feedback:
A drug that is 96% protein bound has only 4% of ingested molecules free and active, a fact that is likely to necessitate a high dose of the drug. This does not result in rapid absorption and/or excretion and does not indicate a need for increased protein intake.

Question 16

1 out of 1 points

In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

 

Response Feedback:
A synergistic effect occurs when two or more “unlike” drugs (in terms of therapeutic effect or mechanism of action) are used together to produce a combined effect, and the outcome is a drug effect greater than either drug’s activity alone. As a result, the patient’s hypertension may be better treated than with a single drug. This does not necessarily reduce the risk of adverse reactions or increase compliance with the regimen.

Question 17

1 out of 1 points

5 ml = _______________tsp

Question 18

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 19

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 20

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 21

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 is

 

Response 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 22

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 NURS-6521 Advanced Pharmacology Week 1 – Quiz. The subcutaneous and intramuscular routes could be used but would not ensure rapid drug effects. Intrathecal administration is usually done by a physician or a specially trained health care provider.

Question 23

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. NURS-6521 Advanced Pharmacology Week 1 – Quiz.

Question 24

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 25

0 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 26

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 NURS-6521 Advanced Pharmacology Week 1 – Quiz.

Question 27

1 out of 1 points

A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?

 

Response Feedback:
The nurse will assess for the amount of meat and vegetables in the woman’s diet. A diet rich in meat or in vegetables may influence the urine pH—either acidic or basic. The renal excretion of drugs may be changed significantly because drugs are generally either weak organic acids or bases. Grapefruit juice and certain drugs may cause an interaction that leads to an increase in bioavailability of the drug, which increases the serum drug level. Diminished protein status results in lower amounts of plasma proteins that can substantially increase the concentration of free drug available. This increase of free drug can increase the drug’s effect and the risk of adverse effects. A significant decrease of dietary sodium can alter the reabsorption of some drugs in the renal tubule, resulting in higher circulating levels of the drug and potential drug toxicity.

Question 28

1 out of 1 points

A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to

 

Response Feedback:
The benefits of Adderall XR are its once-daily dosing, its longer duration of action, and its potential for sprinkle administration. For patients with difficulty swallowing, Adderall XR’s capsule may be opened and the beads sprinkled in applesauce. It is not advisable to suggest the use of an alternative drug. Patients should be told not to crush the beads after opening the capsule because this would alter drug absorption. Ingesting the capsule with 8 ounces of water will not solve the patient’s difficulty with swallowing.

Question 29

1 out of 1 points

A 90-year-old frail, elderly woman has arrived at the emergency department with a broken hip and in acute respiratory distress. Succinylcholine will be used because of the need for rapid endotracheal intubation, and then the woman will be sent to surgery. Due to the woman’s frail condition, she is at risk for skin breakdown. Which of the following nursing diagnoses would be most appropriate?

 

Response Feedback:
The nursing diagnosis that directly relates to possible skin breakdown is Impaired Physical Mobility related to drug-induced paralysis. Patients who are unable to speak, move, or breathe unassisted can quickly develop pressure sores (decubitus ulcers). It is the responsibility of the nurse to help keep the patient positioned correctly to avoid skin breakdown. The nurse will plan interventions to prevent skin breakdown based on how long the patient will be immobilized. Impaired Spontaneous Ventilation is related to respiratory paralysis. Fear is related to paralysis and helplessness, and Disturbed Sensory Perception is related to CNS depression secondary to drugs used during anesthesia.

Question 30

1 out of 1 points

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that

 

Response Feedback:
The nurse should caution the patient against crushing the tablet before ingesting it. Crushing allows an extremely high dose of the drug to be available all at once, instead of being released slowly over time. Severe adverse effects are possible when it is used in this manner. The other options are false statements.

Question 31

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. NURS-6521 Advanced Pharmacology Week 1 – Quiz A healthy lifestyle is of benefit to older adults, but does not mitigate the potential for drug interactions.

Question 32

1 out of 1 points

An 80-year-old patient has been taking lorazepam since his wife died a year ago. He has been staying with his son, but will now move to an assisted living facility. Before admission to the assisted living facility, the patient’s physician has determined that the drug is no longer needed. The nurse at the facility will plan to

 

Response Feedback:
It is important for the nurse to understand that lorazepam should be gradually withdrawn, because the patient has been using the drug for a year. If stopped abruptly the patient could experience withdrawal symptoms. The craving for benzodiazepines will decrease over time without the use of another drug. Urticaria and rash are adverse effects of the drug, not withdrawal effects.

Question 33

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? NURS-6521 Advanced Pharmacology Week 1 – Quiz.

 

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.

Question 34

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 NURS-6521 Advanced Pharmacology Week 1 – Quiz.

Question 35

1 out of 1 points

A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs?

 

Response Feedback:
It would be appropriate for the nurse to consider all the responses. However, the most important consideration would be possible drug–drug reactions, since the patient is already taking medications. The nurse may have to decide on a new administration schedule, and she must be aware of signs and symptoms of actions that might occur.

Question 36

1 out of 1 points

A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman’s subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by

 

Response Feedback:
Impaired lung function may preclude, or complicate, the use of isoflurane. Advanced age, endocrine status, and nutritional status are all variables that warrant careful assessment, but they are less likely to influence the decision to use isoflurane than is her respiratory status.

Question 37

1 out of 1 points

Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen’s nurse should prioritize teach about

 

Response Feedback:
The potential for adverse effects, and strategies to minimize these risks, should be a central component of patient teaching around drug therapy. It is less necessary for the patient to understand the prescriber’s rationale for the specific regimen or the age-related changes that influence such decisions. Older adults do not necessarily need assistance with their medications, provided cognitive deficits do not exist.

Question 38

1 out of 1 points

A nurse is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient’s drug regimen?

 

Response Feedback:
The use of alternative medications and herbal treatments is high, and increasing; because older adults tend to take more prescribed medications than other age groups, they are at higher risk for drug interactions if they take alternative medications. Questions about the drug route, expectations for treatment and the particular pharmacy are less directly related to the issue of safety.

Question 39

1 out of 1 points

A nurse is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The nurse will base the patient’s plan of care on the understanding that there is

 

Response Feedback:
The patient’s creatinine level is within the normal range for his age. Less creatinine overall exists in the older adult because creatinine production declines as muscle mass decreases. The normal creatinine level can be misleading and should not be interpreted as an indication of normal renal function or effectiveness of the drug.

Question 40

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 NURS-6521 Advanced Pharmacology Week 1 – Quiz.

Question 41

0 out of 0 points

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

NURS-6521 Advanced Pharmacology Week 1 – Quiz

 
 

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