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Adams 4-6
| Question | Answer |
|---|---|
| What drug reaction is characterized by widespread epidermal sloughing of 30% or more, and multisystem organ failure when the liver fails to properly break down a drug? a) Stevens-Johnson Syndrome b) Anaphylaxis shock c) Toxic Epidermal Necrolysis | c) Toxic Epidermal Necrolysis or TEN |
| What drug reaction is characterized by skin sloughing of 10% of the body and blisterlike lesions? a) Stevens-Johnson Syndrome b) Anaphylaxis shock c) Toxic Epidermal Necrolysis | a) Stevens-Johnson Syndrome or SJS |
| An acquired hyperresponse of body defenses to a foreign substance is termed a_____? | Allergic reaction |
| A severe type of allergic reaction that involves the massive, systemic release of histamine and other chemical mediators of inflammation that can lead do life threatening shock is termed____? | Anaphylaxis |
| A nurse walks in a room and verifies the medication, dose, route, and time for the medication administration and proceeds to give the med to the pt. What right has she violated? | The first right. The right client. The nurse failed to verify the patients identity. |
| A nurse walks in a room and verifies the patients name and medication dose, route, and time for the medication administration and proceeds to give the med to the pt. What right has she violated? | The second right. The right medication. The nurse failed to verify that she was administering the right medication. |
| A nurse walks in a room and verifies the medication,right patient, dose, and route for the medication administration and proceed to give the med to the pt. What right has she violated? | The fifth right. The right time of delivery.The nurse failed to verify the correct time of delivery. |
| A nurse walks in a room and verifies the patient, medication, dose, and time for the medication administration and proceed to give the med to the pt. What right has she violated? | The fourth right. The right route of administration. The nurse did not verify the correct route to use. |
| What are the 3 checks of drug administration that the nurse must perform in addition to the 5 rights? | 1. Check the drug with the MAR 2. Check the drug when preparing it 3. Check the drug before administering it to the client |
| True/False: Reliability is taking a medication in the manner prescribed by the practitioner, or in case of OTC drugs, following the instructions on the label. | False: The definition described is of compliance! |
| What side effects often prompt nncompliance? Check all that apply a) headaches b)constipation c) dizziness d) wheezing e)nausea f) diarrhea g) impotence | a,c,e,f,g(headache,dizziness,nausea,diarrhea,impotence) |
| What juice may not be safe for people taking certain medications such as Versed, Sandimmune, Mevacor, Zocor, Sporanox, Nizoral, Posicor? a)Apple Juice b)Grape juice c)Orange Juice d)Grapefruit Juice | d) Grapefruit Juice |
| When a stat order is written, how much time do you have to administer the order? a) 5 minutes b) 10 minutes c)30 minutes d)it depends on what type of medication ordered | a) 5 minutes |
| What does tid stand for? a) once a day b) twice a day c) three times a day d) before meals | c) three times a day |
| True or False: When a doctor orders a drug ASAP, they have 30 minutes to administer it. | True |
| How long do you have to carry out a routine order? | 2 hours |
| What are the 3 systems of measurement that are used in pharmacology? | Metric, Apothecary, and Household |
| 1 ml = how many drops? | 15 drops |
| 1 teaspoon = how many ml? | 5 ml |
| 1 glass = how many ml? | 240 ml |
| 1 kg = how many pounds? | 2.2 lbs |
| True or False: The 3 broad categories of routes of drug administration are enteral, topical, and parenteral. | True |
| True or False: The enteral route includes drugs given orally, through a nasogastric or gastrostomy tube, or transdermally. | False: Enteral routes do NOT include transdermal meds! |
| True or False: Crushing tablets or opening capsules and sprinkling the drug over food or mixing it with juice will make it more palatable and easier to swallow. | True! |
| True or False: Tablets that have a hard, waxy coating may be crushed to help with swallowing. | False: This coating is often enteric, and helps to protect the pill from the highly acidic stomach acids. |
| When multiple drugs are ordered, when in the sequence should the sublingual preparation be administered? a) first b) second c) last d) never, you do not take sublingual meds with any other meds | c) last |
| True or False: When instructing a patient to take a med via the buccal route, instruct them to manipulate the med around with their tongue to help introduce more digestive enzyme containing saliva to the med. | False: The client must be instructed not to manipulate the medication with the tongue; otherwise it could get displaced to the sublingual area, where it would be more rapidly absorbed, or to the back of the throat where it could be swallowed. |
| True or False: Topical medication tends to produce more side effects due to the wide range of skin allergies people have. | False: Local, topical delivery produces fewer side effects compared with oral or parenteral administration of the same drug. This is because topically applied drugs are absorbed very slowly, and amounts reaching the general circulation are minimal. |
| What 2 things should you do prior to administering a transdermal medication? a) wipe the intended site with iodine b) apply gloves c) relocate the previous patch to a new area d) remove any previous medication and patch and wipe site. | b+d (wear gloves, and remove previous patches and wipe old meds off) |
| True of False: Drops or sprays are often used for their local histamine effect; that is they allow the membrane to expand and slough so that they can be expelled. | False: Drops and sprays are often used for their local astringent effect; that is they SHRINK swollen mucous membranes or loosen secretions and facilitate drainage. |
| What technique should be used for administering parenteral drug administration? a) clean b) sterile c) aseptic technique | c) aseptic technique |
| An intradermal (ID) injection is administered into the_____. a) deepest layer of the skin b) dermis of the skin c) muscle | b) dermis of the skin |
| A subcutaneous injection is delivered to what layer of the skin? a) deepest layer of the skin b) dermis of the skin c) muscle | a) deepest layer of the skin |
| During an intradermal drug administration, the needle is inserted, bevel up at ___to___ degrees. a) 10 to 15 b) 40 to 50 c)90 to 95 | a) 10-15 |
| True or False: Be sure to aspirate the needle prior to injection when giving any subcutaneous injection. | False: No aspiration is needed when giving subcutaneous injections. |
| True or False: tuberculine syringes and insulin syringes may be used interchangeably as long as you document the type of needle used in the MAR. | False: They are NOT interchangeable, so the nurse should not substitute one for the other. |
| Put the following meds in order from slowest to fastest, according to their absorption rate into the body: tablet, IM injection, ID injection, IV bolus, liquid. | tablet, liquid, ID injection, IM injection, IV bolus. |
| At what angle are subcutaneous drug administrations given? | 45 degree angle |
| At what angle are intramuscular drug administrations given? | 90 degree angle |
| True or False: Large-volume infusions are arranged tandem with or piggybacked to the intermittent infusion. | False: Vise versa, Intermittent infusions are arranged tandem with or piggybacked to the primary large-volume infusion. |
| True or False: IV bolus administrations are concentrated doses delivered directly to the circulation via syringe to administer single-dose medication. | True |
| Why is the IV route the most dangerous of routes? a) The site is at most risk for infection b) the IV site causes the least allergic reactions c) once injected the medication cannot be retrieved d) patients run the risk of a transfusion reaction | c) once injected the medication cannot be retrieved |
| What is the primary role of a nurse in med administration? a) Ensure meds are administered and delivered in a safe manner b) Be certain that physician orders are accurate c) Inform the clent that ordered meds need to be taken only if the client agrees | a) Ensure meds are administered and delivered in a safe manner |
| Which of the following medications should not be administered through a nasogastric tube? Check all that apply: a) liquids b) enteric-coated tablets c) sustained-release tablets d) tablets e) IV medications | b) enteric-coated tablets c) sustained-release tablets d) IV medications |
| The study of drug movement through the body is termed? a) pharmacokinetics b) absorption c) pharmacodynamics | a) pharmacokinetics |
| True or False: The kidneys, large intestine, and other organs attempt to excrete the medications from the body. | True |
| By what 2 mechanisms do drugs primarily use to cross body membranes? | Diffusion/passive transport and active transport. |
| Choose one word from each pair of words, which will cause drugs to pass through plasma membranes more easily. (small size/large size), (nonionized/ionized), (fat soluble/water soluble). | Drug molecules that are small, nonionized, and lipid soluble will usually pass through plasma membranes by simple diffusion and more easily reach their target cells. |
| True or False: All drugs must be absorbed in order to produce an effect. | False: MOST drugs must be absorbed in order to produce an effect, with the exception of a few topical meds, intestinal meds anti-infectives, and some radiological contrast agents. |
| Are acids absorbed better in basic, neutral, or acidic environments? How about bases? | Acids are absorbed better in acids, and bases are absorbed better in bases. |
| True or False: High fat meals can slow stomach motility significcantly and delay the absorption of oral medications taken with the meal | True |
| What factor determines the transportation of drugs throughout the body? a) temperature of body tissues b) acid present c) digestive enzymes present d) blood flow to body tissues | d) blood flow to body tissues |
| True or False: Water soluble agents are not limited by the barriers that normally stop lipid soluble drugs; thus they are more completely distributed to body tissues. | False: Vise versa, LIPID-soluble agents are not limited by the barriers that normally stop water-soluble drugs. |
| The bone marrow, teeth, eyes, and adipose tissue have especially high affinity for certain medications. What does this mean? | It means that those aread ATTRACT certain medications. |
| Why are drug-protein complexes formed? | Because not all drug molecules in the plasma can reach their target cells, since many drugs bind reversibly to plasma proteins. |
| Only ____ drugs can reach their cells. a) bound b) unbound c) basic d) acidic | b) unbound |
| Why must aspirin not be taken if you are already taking Coumadin? | Drugs such as aspirin displace warfarin from the drug-protein complex, thus raising blood levels of free warfarin to unintended levels. Your risk of hemorrhage is much greater! |
| How does the addition of side chains, known as conjugates, effect drugs? | They makes the drug more water soluble and more easily excreted by the kidneys. |
| What is the function of a hepatic microsomal enzyme system? | The primary actions of the hepatic microsomal enzymes are to inactivate drugs and accelerate their excretion. |
| True or False: During metabolism, drugs are always broken down to become less active as they are digested. | False: Some agents, such as prodrugs, have no pharmacological activity unless they are first metabolized to their active form by the body. |
| The process of increasing metabolic activity is termed? a) metabolistic antagonist b) metabolistic agonist c) enzyme induction d) enzyme reduction | c) enzymen induction |
| What about the liver, caused pediatric and geriatric clients to be more sensitive to drug therapy than middle-age clients? | They have reduced hepatic enzyme activity, so drugs are broken down and excreted slower from the body. |
| How should the drug dosage of patients with liver damage be altered? a) dosage should be increased since they have a reduced ability to break down the meds b) dosage should be reduced because of the decreased metabolic activity. | b) dosage should be reduced because of the decreased metabolic activity. |
| What is the first pass effect and how does it affect drug absorption? | Before blood is sent to the general circulation, it is passes through the liver circulation, where is may be completely metabolized to an inactive form before it ever has a chance to reach the general circulation. |
| What is the primary site of excretion for drugs? | The kidneys! |
| What would a nurse give to a patient who over-dosed on aspirin, to speed the renal excretion of the aspirin? a) more aspirin b) orange juice c) potassium bicarbonate d) sodium bicarbonate | d) sodium bicarbonate: Sodium bicarbonate will make the urine more basic, which ionizes more aspirin, causing it to be excreted more readily. |
| How should doses be altereed for patients with impaired kidney function? | They should be reduced to avoid drug toxicity. |
| What is the term given to the plasma concentration between the minimal effective concentration and the toxic concentration of a drug in the blood? | Therapeutic range |
| Theoretically how many half-lives does it take to reach the therapeutic range? a) 1 b) 2 c) 3 d) 4 | c) 3 |
| How does a loading dose compare to a maintenance dose? | A loading does is much larger. It is often given only once or twice to "prime" the bloodstream with a level sufficient to quickly induce a therapeutic response. |
| Before plasma levels can drop back toward zero, intermittent______doses are given to keep the plasma drug concentration in the therapeutic range. a) maintenance b) loading c) sequential d) secondary | a) maintenance |
| The term used to describe how a medicine changes the body is______? a) pharmacodynamics b) pharmacomedicine c)pharmacokinetics | a) pharmacodynamics |
| In the frequency distribution curve of the Interpatient variability in drug response, what does the peak of the curve represent? | The largest number of clients responding to the drug. Refer to p.57-58 of Adams for further explanation. |
| What is the median effective dose? (ED 50)? | It is the dose in the middle of the frequency distribution curve that represents the dose required to produce a response in 50% of a group of clients. |
| True or False: The nurse can feel confident that the standard average dose has been proved to elicit a response in over 75% of the population. | False: Only 50%! |
| How do you determine the therapeutic index? | Divide the median lethal dose(LD 50) by the median effective dose(ED 50). |
| What does a higher therapeutic index indicate? | That the drug has a larger safety margin. In other words, a larger therapeutic range means there is a larger range of a safe dose that can be administered. The larger the range, the better. |
| True or False: During the 3rd phase of the graded dose-response, a plateau is reached in which increasing the drug produces no additional therapeutic response. | True |
| When comparing two drugs side by side, what 2 factors would you assess to best understand how the drug works on the body. a) their potency and efficacy b) their route and timing c) their half life and pH | a) their potency and efficacy |
| The magnitude of the maximum response a drug can elicit is termed its______. a) potency b) efficacy c) strength d) action | b) efficacy |
| A drug that require 50 mg to be effective is considered more ____ then a drug that requires 100 mg to be effective. a) efficive b) weak c) potent d) basic | c) potent- a lower dosage means it is more strong or potent |
| Although a drug receptor can be any type of macromolecule, the vast majority are ____. a) lipids b) fats c) carbohydrates d) proteins | d) proteins |
| True or false: All components except steroid medications, vitamins, and hormones, are able to bind intracellular components. | False: Steroid medications, vitamins, and hormones, are some example of agents that ARE able to bind intracellular components. |
| True or false: Some drugs act independently of cellular receptors and these are termed non-specific cellular responses. | True! Non-specific cellular responses are associated with other mechanisms,like changing the permeability of cellular membranes,depressing membrane excitability, or altering the activity of cellular pumps. They act independently of the cellular receptors. |
| A drug that mimics the type of response as the endogenous substance is called a____. | Agonist |
| The term______refers to a medication that produces a weaker, or less efficacious, response than an agonist. a) antagonist b) partial antagonist c) agonist d) partial agonist | d) partial agonist |
| An unpredictable and unexplained drug reaction is termed_____. a) adverse reactions b) idiosyncratic reactions c) enzyme-specific reactions d) unaltered reactions | b) idiosyncratic reactions |
| A drug that occupies a receptir site and prevents endogenous chemicals from acting is termed? a) antagonist b) partial agonist c) agonist d) protagonist | a) antagonist |
| In considering the pharmacotherapeutic perspective, which property is considered to be of most importance? a) potency b) efficacy c) toxicity d) interaction with other drugs | b) efficacy |
| Morphine has greater efficacy than (check all that apply) a) aspirin b) Acetominophen c) inderal d) ibuprofen d) atenolol | b) acetominophen and d) Ibuprofen |
Created by:
ericapasay
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