Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 4 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ Formulation of nursing diagnoses is usually a three-step process. The only complete answer is “Anxiety related to new drug therapy, as evidenced by statements such as ‘I’m upset about having to give myself shots.’” The answer “Anxiety” is missing the “related to” and “as evidenced by” portions. The answer “Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The “related to” section in “Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as ‘I’m upset about having to give myself shots’” is simply a restatement of the problem “anxiety,” not a separate factor related to the response. DIF: Cognitive Level: Analysis OTHER 1. Place the phases of the nursing process in the correct order, starting with the first phase. a. Planning b. Evaluation c. Assessment d. Implementation e. Diagnosing ANS: C, E, A, D, B DIF: Cognitive Level: Analysis Chapter 02: Pharmacological Principles Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition MULTIPLE CHOICE 1. A patient is receiving two different drugs, which, at their current dose forms and dosages, are both absorbed into the circulation in identical amounts. Which term best denotes that the drugs have the same absorption rates? a. Equivalent b. Synergistic c. Compatible d. Bioequivalent ANS: D Two drugs absorbed into the circulation at the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. “Equivalent” is incorrect because the term “bioavailability” is used to express the extent of drug absorption. “Synergistic” is incorrect because this term refers to two drugs given together whose resulting effect is greater than the sum of the effects of each drug given alone. “Compatible” is incorrect because this term is a general term used to indicate that two substances do not have a chemical reaction when mixed (or given, in the case of drugs) together. DIF: Cognitive Level: Comprehension

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 5 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ 2. A patient is receiving medication via intravenous injection. Which information should the nurse provide for patient education? a. The medication will cause fewer adverse effects when given intravenously. b. The medication will be absorbed slowly into the tissues over time. c. The medication’s action will begin faster when given intravenously. d. Most of the drug is inactivated by the liver before it reaches the target area. ANS: C Intravenous injections are the fastest route of absorption. The intravenous route does not affect the number of adverse effects, the intravenous route is not a slow route of absorption, and the intravenous route does not cause inactivation of the drug by the liver before it reaches the target area. DIF: Cognitive Level: Comprehension 3. Which is true regarding parenteral drugs? a. They bypass the first-pass effect. b. They decrease blood flow to the stomach. c. They are altered by the presence of food in the stomach. d. They exert their effects while circulating in the bloodstream. ANS: A Drugs given by the parenteral route bypass the first-pass effect, but they still must be absorbed into cells and tissues before they can exert their effects. Enteral drugs (drugs taken orally), not parenteral drugs, decrease blood flow to the stomach and are altered by the presence of food in the stomach. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream. DIF: Cognitive Level: Analysis 4. A drug’s half-life is best defined as a. The time it takes for the drug to elicit half its therapeutic response. b. The time it takes one-half of the original amount of a drug to reach the target cells. c. The time it takes one-half of the original amount of a drug to be removed from the body. d. The time it takes one-half of the original amount of a drug to be absorbed into the circulation. ANS: C A drug’s half-life is the time it takes for one-half of the original amount of a drug to be removed from the body. It is a measure of the rate at which drugs are removed from the body. Answers A, B, and D are not correct definitions of a drug’s half-life. DIF: Cognitive Level: Comprehension 5. The term “duration of action” is best defined as a. The time it takes for the drug to elicit a therapeutic response. b. The time it takes a drug to reach its maximum therapeutic response. c. The length of time it takes to remove a drug from circulation. d. The time during which drug concentration is sufficient to elicit a therapeutic response.

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 7 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ A pharmacological reaction is an extension of the drug’s normal effects in the body. In this case, the insulin lowered the patient’s blood glucose levels too much. An adverse effect is a predictable, well- known adverse drug reaction that results in minor or no changes in patient management. An allergic reaction (also known as a hypersensitivity reaction ) involves the patient’s immune system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of a drug. DIF: Cognitive Level: Comprehension 9. A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where should the nurse tell the patient to place the tablet? a. Under the tongue b. In the space between the cheek and gum c. At the back of the throat, for easy swallowing d. On a non-hairy area on the chest ANS: A Drugs taken by the sublingual route are placed under the tongue. Placing the tablet in the space between the cheek and gum is done for the buccal route; placing the tablet at the back of the throat (for easy swallowing) is done in the oral route; and placing the tablet on a non-hairy area on the chest is done in the topical or transdermal route. DIF: Cognitive Level: Comprehension 10. The nurse is administering medications to a patient who is in liver failure due to end-stage cirrhosis. The nurse is aware that patients with liver failure are most likely to have problems with which pharmacokinetic phase? a. Absorption b. Distribution c. Metabolism d. Excretion ANS: C The liver is the organ that is most responsible for drug metabolism. Decreased liver function will most affect a drug’s metabolism. The absorption of a drug is not affected by liver function, and distribution is not affected by liver function. Excretion is affected only because decreased liver function may not transform drugs into water-soluble substances for elimination via the kidneys, but this is not the best answer to this question. DIF: Cognitive Level: Application Chapter 03: Legal and Ethical Considerations Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition MULTIPLE CHOICE 1. In the development of a new drug by a pharmaceutical company, the researcher must ensure that the participants in experimental drug studies do not have unrealistic expectations of the new drug’s usefulness. What will the researcher include in the design of the study to prevent bias that may occur?

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 8 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ a. A placebo b. Health Canada approval c. Informed consent d. Efficacy information ANS: A To prevent bias that may occur as a result of unrealistic expectations of an investigational new drug, a placebo will be incorporated into the study. Health Canada approval, if given, does not be obtained until after phase III of the study. Informed consent is required in all drug studies. Efficacy information is not determined until the study is under way. DIF: Cognitive Level: Comprehension 2. A member of an investigational drug study team is working with healthy volunteers whose participation will help determine the optimal dosage range and pharmacokinetics of the drug. In what type of study is the team member participating? a. Phase I b. Phase II c. Phase III d. Phase IV ANS: A Phase I studies involve small numbers of healthy volunteers to determine the optimal dosage range and the pharmacokinetics of the drug. Phases II, III, and IV involve progressively larger numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. DIF: Cognitive Level: Application 3. A patient has a prescription for a drug classified as Schedule F. What important information should the nurse give this patient about obtaining refills for this medication? a. No prescription refills are permitted. b. Refills may be obtained via telephone order. c. Refills are indicated by the prescriber. d. The patient may have no more than six refills in a 12-month period. ANS: C Schedule F contains a list of drugs that can be sold and refilled only on prescription; prescriptions can be refilled as often as indicated by the prescriber. DIF: Cognitive Level: Analysis 4. A patient has been chosen to be a recipient of an investigational drug for heart failure and has given informed consent. Which is indicated by the patient’s informed consent? a. The patient has been informed of the possible benefits of the new therapy. b. The patient will be informed of the details of the study as the research continues. c. The patient will not be assured of receiving the actual drug during the experiment. d. The patient has received an explanation of the study’s purpose, procedures, and the benefits and risks involved. ANS: D

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 10 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ ANS: A Part G, Part II drugs are those with high potential for misuse that have an accepted medical use (e.g., barbiturates). DIF: Cognitive Level: Comprehension 8. Miss Knox, a 26-year-old, has returned to the surgical unit post appendectomy. The physician has prescribed intravenous (IV) morphine for pain. According to the Controlled Drugs and Substances ACT (CDSA), morphine is classified under which schedule? a. Schedule I b. Schedule IV c. Schedule V d. Schedule III ANS: A The CDSA is based on eight schedules that list controlled drugs and substances based on potential for misuse or harm or how easy they are to manufacture into illicit substances. A summary of Schedule I contains the most dangerous drugs, including opiates (opium, heroin, morphine, cocaine), fentanyls, and methamphetamine. DIF: Cognitive Level: Comprehension MULTIPLE RESPONSE 1. Which are elements of ethical principles in nursing and health care according to the Canadian Nurses Association (CNA) Code of Ethics? ( Select all that apply. ) a. Promoting justice b. Maintaining anonymity c. Demonstrating responsibility d. Preserving dignity e. Promoting health and well-being ANS: A, D, E Elements of ethical principles in nursing and health care according to the CNA Code of Ethics include providing safe, compassionate, competent, and ethical nursing care; maintaining privacy and confidentiality; promoting justice, being accountable, preserving dignity, and promoting and respecting informed decision making; and promoting health and well-being. DIF: Cognitive Level: Critical Thinking 2. The personal Information Protection and Electronic Documents Act (PIPEDA) is a federal law governing the collection, use and disclosure of personal health details. Protected health information includes? ( Select all that apply. ) a. Patients’ health conditions b. Payment information c. Prescription numbers d. Dietary restrictions e. Medications

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 11 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ ANS: A, B, C, E The personal Information Protection and Electronic Documents Act (PIPEDA) requires all health care providers, health insurance and life insurance companies, public health authorities, employers, and schools to maintain patient privacy regarding protected health information. Protected health information includes any individually identifying information such as patients’ health conditions, account numbers, prescription numbers, medications, and payment information. A postal code on its own covers a wide geographical area. DIF: Cognitive Level: Comprehension Chapter 04: Patient-Focused Considerations Sealock: Lilley’s Pharmacology for Canadian Health Care Practice, 4th Edition MULTIPLE CHOICE 1. During the last trimester of pregnancy, drug transfer to the fetus is more likely to occur. Which is a reason for this possibility? a. Fetal size b. Decreased surface area c. Enhanced placental blood flow d. Increased amount of bound drug in maternal circulation ANS: C Drug transfer to the fetus is more likely during the last trimester, as a result of enhanced placental blood flow, increased fetal surface area, and an increased amount of free drug in the mother’s circulation. Increased, not decreased, fetal surface area affects drug transfer to the fetus. The placenta’s surface area does not increase during this time. Drug transfer is increased due to an increased amount of free drug, not protein-bound drug, in the mother’s circulation. “Fetal size” is incorrect because the first trimester of pregnancy is the period of greatest danger of drug-induced developmental defects. During this period, the fetus undergoes rapid cell proliferation. Gestational age is more important than fetal size. DIF: Cognitive Level: Comprehension 2. Which type of dosage calculation is used most commonly when calculating drug dosages for children? a. Fried’s rule b. Clark’s rule c. Young’s rule d. The mg/kg formula ANS: D The body weight method, using the mg/kg formula, is the most common and reliable method for calculating doses for young patients. Fried’s rule, Clark’s rule, and Young’s rule are not methods used for calculating drug dosages for young patients. DIF: Cognitive Level: Knowledge 3. While assessing an 82-year-old woman, the nurse determines that the patient is experiencing polypharmacy. What is this experience most likely to indicate?

Lilley's Pharmacology for Canadian Health Care Practice 4th Edition by Kara Sealock, Cydnee Seneviratne Test Bank 13 Download All Chapters Here: https://www.stuvia.com/doc/3815984/ d. Altered absorption of select drugs ANS: D This aging-related change results in a decrease in gastric acidity and may alter the absorption of some drugs. Delayed gastric emptying, increased gastric acidity, and decreased intestinal absorption of medications are not results of reduced hydrochloric acid production. DIF: Cognitive Level: Application 7. Which is the reason drug toxicity is more likely to occur in the neonate? a. The lungs are immature. b. The kidneys are smaller. c. The liver is not fully developed. d. Renal excretion of the drug is faster. ANS: C A neonate’s liver is not fully developed and cannot detoxify many drugs; thus, drug toxicity is more likely to occur in the neonate. The lungs and kidneys do not play major roles in drug metabolism. Renal excretion of the drug is slower, not faster, due to organ immaturity. DIF: Cognitive Level: Comprehension 8. An 83-year-old female patient has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be taught to watch for which complications? a. Dizziness and constipation b. Fatigue and dehydration c. Daytime sedation and lethargy d. Edema and blurred vision ANS: B Electrolyte imbalance, fatigue, and dehydration are common complications of thiazide diuretics in older adult patients. Dizziness and constipation, daytime sedation and lethargy, and edema and blurred vision are not complications that occur when these drugs are given to older adults. DIF: Cognitive Level: Comprehension 9. Which complication is common with an older adult patient who is taking digoxin? a. Hallucinations b. Edema c. Dry mouth d. Constipation ANS: A Common complications for older adults taking digoxin include visual disorders, nausea, diarrhea, dysrhythmias, hallucinations, decreased appetite, and weight loss. Nonsteroidal anti-inflammatory drugs may cause edema, anticholinergics and antihistamines may cause dry mouth, and opioids may cause constipation. DIF: Cognitive Level: Comprehension