Lilley Pharmacology and the Nursing Process 7th Edition 2022 latest update

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Lilley Pharmacology and the Nursing Process 7th Edition 2022 latest update Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Objective: Ch 01: The Nursing Process and Drug Therapy 1. Quest... ion Name: 0001 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis? A. Anxiety B. Anxiety related to new drug therapy C. Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as “I’m upset about having to test my blood sugars.” * D. Anxiety related to new drug therapy, as evidenced by statements such as “I’m upset about having to test my blood sugars.” Correct Answer: D Explanation/Rationale: ANS: D Formulation of nursing diagnoses is usually a three-step process. “Anxiety” is missing the “related to” and “as evidenced by” portions of defining characteristics. “Anxiety related to new drug therapy” is missing the “as evidenced by” portion of defining characteristics. The statement beginning “Anxiety related to anxious feelings” is incorrect because the “related to” section is simply a restatement of the problem “anxiety,” not a separate factor related to the response. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 9 TOP: NURSING PROCESS: Nursing Diagnosis MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 2. Question Name: 0002 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? * A. “Right time” problem B. “Right dose” problem C. “Right route” problem D. “Right medication” problem Correct Answer: A Explanation/Rationale: ANS: A “Right time” is correct because the medication was given more than 30 minutes after the scheduled dose was due. “Dose” is incorrect because the dose is not related to the time the medication administration is scheduled. “Route” is incorrect because the route is not affected. “Medication” is incorrect because the medication ordered will not change. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 13 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 3. Question Name: 0003 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse has been monitoring the patient’s progress on a new drug regimen since the first dose and documenting the patient’s therapeutic response to the medication. Which phase of the nursing process do these actions illustrate? A. Nursing diagnosis B. Planning C. Implementation * D. Evaluation Correct Answer: D Explanation/Rationale: ANS: D Monitoring the patient’s progress, including the patient’s response to the medication, is part of the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by this example. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 15 TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 4. Question Name: 0004 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? A. The patient will follow instructions. B. The patient will not experience complications. C. The patient will adhere to the new insulin treatment regimen. * D. The patient will demonstrate correct blood glucose testing technique. Correct Answer: D Explanation/Rationale: ANS: D “Demonstrating correct blood glucose testing technique” is a specific and measurable outcome criterion. “Following instructions” and “not experiencing complications” are not specific criteria. “Adhering to new regimen” would be difficult to measure. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 11 TOP: NURSING PROCESS: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 5. Question Name: 0005 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension? * A. Providing education on keeping a journal of blood pressure readings B. Setting goals and outcome criteria with the patient’s input C. Recording a drug history regarding over-the-counter medications used at home D. Formulating nursing diagnoses regarding deficient knowledge related to the new treatment regimen Correct Answer: A Explanation/Rationale: ANS: A Education is an intervention that occurs during the implementation phase. Setting goals and outcomes reflects the planning phase. Recording a drug history reflects the assessment phase. Formulating nursing diagnoses reflects analysis of data as part of planning. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 11 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 6. Question Name: 0006 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order. What is the nurse’s best action? A. Give the medication intravenously because the patient might vomit. B. Give the medication orally because the tablets are available in 4-mg doses. * C. Contact the prescriber to clarify the route of the medication ordered. D. Hold the medication until the prescriber returns to make rounds. The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may be Correct Answer: C Explanation/Rationale: ANS: C A complete medication order includes the route of administration. If a medication order does not include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral routes are not interchangeable. Holding the medication until the prescriber returns would mean that the patient would not receive a needed medication. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 14 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:19:30 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 7. Question Name: 0007 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? A. The patient’s ability to swallow B. The patient’s height * C. The patient’s last meal D. The patient’s allergies Correct Answer: C Explanation/Rationale: ANS: C DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 7 affected by the timing of the last meal. The patient’s ability to swallow, height, and allergies are not factors to consider regarding the timing of the drug’s administration. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 13 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 8. Question Name: 0008 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data? A. Blood pressure 158/96 mm Hg B. Weight 255 pounds * C. The patient reports that he uses the herbal product ginkgo. D. The patient’s laboratory work includes a complete blood count and urinalysis. Correct Answer: C Explanation/Rationale: ANS: C Subjective data include information shared through the spoken word by any reliable source, such as the patient. Objective data may be defined as any information gathered through the senses or that which is seen, heard, felt, or smelled. A patient’s blood pressure, weight, and laboratory tests are all examples of objective data. TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 9. Question Name: 0009 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When giving medications, the nurse will follow the rights of medication administration, which include what rights? (Select all that apply.) * A. Right drug * B. Right route * C. Right dose D. Right diagnosis * E. Right time * F. Right patient * G. Right documentation Correct Answer: ABCEFG Explanation/Rationale: ANS: A, B, C, E, F, G The Six Rights of medication administration must always include the right drug, right dose, right time, right route, right patient, and right documentation. The right diagnosis is incorrect. DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 11 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:20:18 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D E F G Last: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Objective: Ch 02: Pharmacologic Principles 1. Question Name: 0001 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Thus, because they have the same absorption rates, they are * A. bioequivalent. B. synergistic. C. prodrugs. D. in a steady state. Correct Answer: A Explanation/Rationale: ANS: A Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug’s steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 22 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 2. Question Name: 0002 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When given an intravenous medication, the patient says to the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best answer? A. “The medication will cause fewer adverse effects when given intravenously.” B. “The intravenous medication will have delayed absorption into the body’s tissues.” * C. “The action of the medication will begin sooner when given intravenously.” D. “There is a lower chance of allergic reactions when drugs are given intravenously.” Correct Answer: C Explanation/Rationale: ANS: C An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 23 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 3. Question Name: 0003 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? * A. Parenteral drugs bypass the first-pass effect. B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. C. Absorption of parenteral drugs is faster when the stomach is empty. D. Parenteral drugs exert their effects while circulating in the bloodstream. Correct Answer: A Explanation/Rationale: ANS: A Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to parenteral drugs. 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: Understanding (Comprehension) REF: p. 23 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 4. Question Name: 0004 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction? A. An adverse effect B. An allergic reaction C. An idiosyncratic reaction * D. A pharmacologic reaction Correct Answer: D Explanation/Rationale: ANS: D A pharmacologic reaction is an extension of a drug’s normal effects in the body. In this case, the antihypertensive drug lowered the patient’s blood pressure levels too much. The other options do not describe a pharmacologic reaction. 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: Understanding (Comprehension) REF: p. 34 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 5. Question Name: 0005 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that a drug’s half-life is the time it takes for A. the drug to cause half of its therapeutic response. B. one half of the original amount of a drug to reach the target cells. * C. one half of the original amount of a drug to be removed from the body. D. one half of the original amount of a drug to be absorbed into the circulation. Correct Answer: C Explanation/Rationale: 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. The other options are incorrect definitions of half-life. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 29 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 R 6. Question Name: 0006 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time A. it takes for a drug to elicit a therapeutic response. B. needed to remove a drug from circulation. C. it takes for a drug to achieve its maximum therapeutic response. * D. period when a drug’s concentration is sufficient to cause a therapeutic response. Correct Answer: D Explanation/Rationale: ANS: D Duration of action is the time during which drug concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug’s onset of action is the time it takes for the drug to elicit a therapeutic response. A drug’s peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 29 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 esponse Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 7. Question Name: 0007 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. This process occurs when the drug A. alters cell membrane permeability. B. enhances its effectiveness within the cell walls of the target tissue. C. is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. * D. binds to an enzyme molecule and inhibits or enhances the enzyme’s action with the normal target cell. Correct Answer: D Explanation/Rationale: ANS: D With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells. As a result, the target cells are protected from the action of the enzymes. This results in a drug effect. The actions described in the other options do not occur with selective enzyme interactions. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 30 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 8. Question Name: 0008 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient’s albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound? A. Renal excretion will be faster. B. The drug will be metabolized quickly. C. The duration of action of the medication will be shorter. * D. The duration of action of the medication will be longer. Correct Answer: D Explanation/Rationale: ANS: D Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 26 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 9. Question Name: 0009 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? * A. Under the tongue B. On top of the tongue C. At the back of the throat D. In the space between the cheek and the gum Correct Answer: A Explanation/Rationale: ANS: A Drugs administered via the sublingual route are placed under the tongue. Drugs administered via the buccal route are placed in the space between the cheek and the gum; oral drugs are swallowed. The other options are incorrect. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 23 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 10. Question Name: 0010 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is administering medications to the patient who is in liver failure resulting from endstage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase? A. Absorption D. Supplemental therapy B. Distribution * C. Metabolism D. Excretion Correct Answer: C Explanation/Rationale: ANS: C The liver is the organ that is most responsible for drug metabolism. Decreased liver function most strongly affects the metabolism of a drug. Liver function does not affect the absorption and distribution of a drug. Excretion is affected only because decreased liver function may not transform drugs into water-soluble substances for elimination via the kidneys, but that is not the best answer for this question. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 27 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 11. Question Name: 0011 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? * A. Palliative therapy B. Maintenance therapy C. Empiric therapy D. Teratogenic reaction Correct Answer: A Explanation/Rationale: ANS: A The goal of palliative therapy is to make the patient as comfortable as possible. It is typically used in the end stages of illnesses when all attempts at curative therapy have failed. Maintenance therapy is used for the treatment of chronic illnesses such as hypertension. Empiric therapy is based on clinical probabilities and involves drug administration when a certain pathologic condition has an uncertain but high likelihood of occurrence based on the patient’s initial presenting symptoms. Supplemental (or replacement therapy) supplies the body with a substance needed to maintain normal function. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 31 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 12. Question Name: 0012 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse administered a sleeping pill to an elderly patient at bedtime. Two hours later, the patient was irritable, restless, and unable to sleep. The nurse describes the patient’s response as which type of reaction? A. Allergic reaction B. Mutagenic effect * C. Idiosyncratic reaction Correct Answer: C Explanation/Rationale: ANS: C An idiosyncratic reaction is not the result of a known pharmacologic property of a drug or of a patient allergy but instead occurs unexpectedly in a particular patient. Such a reaction is a genetically determined abnormal response to normal dosages of a drug. An allergic reaction (also known as a hypersensitivity reaction) involves the patient’s immune system. Mutagenic effects are permanent changes in the genetic composition of living organisms and consist of alterations in chromosome structure, the number of chromosomes, or the genetic code of the deoxyribonucleic acid (DNA) molecule. Teratogenic effects of drugs or other chemicals result in structural defects in the fetus. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 34 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 13. Question Name: 0013 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest? A. A capsule B. A tablet C. An enteric-coated tablet * D. A powder Correct Answer: D Explanation/Rationale: ANS: D Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 21 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 14. Question Name: 0014 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse will be injecting a drug into the fatty tissue of the patient’s abdomen. Which route does this describe? A. Intradermal * B. Subcutaneous C. Intramuscular D. Transdermal Correct Answer: B Explanation/Rationale: ANS: B Injections into the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections. Injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as intradermal injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch. DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 23 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:24:47 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 15. Question Name: 0015 Type: MC Objective: Ch 02: Pharmacologic Principles Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Which drugs would be affected by the first-pass effect? (Select all that apply.) A. Morphine given by IV push injection B. Sublingual nitroglycerin tablets * C. Diphenhydramine (Benadryl) elixir * D. Levothyroxine (Synthroid) tablets E. Transdermal nicotine patches * F. Esomeprazole (Nexium) capsules G. Penicillin given by IV piggyback infusion Correct Answer: CDF Explanation/Rationale: ANS: C, D, F Correct Answer: C Orally administered drugs (elixirs, tablets, capsules) undergo the first-pass effect because they are metabolized in the liver after being absorbed into the portal circulation from the small intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal patches also enter the bloodstream without going directly to the liver, thus avoiding the first-pass effect. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 23 TOP: NURSING PROCESS: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 14:24:47 Date Modified: 01/31/13 14:25:58 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D E F G Last: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Objective: Ch 03: Lifespan Considerations 1. Question Name: 0001 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason? A. Decreased fetal surface area B. Increased placental surface area * C. Enhanced blood flow to the fetus D. Increased amount of protein-bound drug in maternal circulation Correct Answer: D Explanation/Rationale: ANS: C Drug transfer to the fetus is more likely during the last trimester as a result of enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta’s surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not proteinbound drug, in the mother’s circulation. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 38 TOP: NURSING PROCESS: General MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:17:53 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 2. Question Name: 0002 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration (FDA) pregnancy safety category? A. Category X B. Category B C. Category C * D. Category D Explanation/Rationale: ANS: D Pregnancy category D fits the description given. Category B indicates no risk to animal fetus; information for humans is not available. Category C indicates adverse effects reported in animal fetus; information for humans is not available. Category X consists of drugs that should not be used in pregnant women because of reports of fetal abnormalities and positive evidence of fetal risk in humans. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 39 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:17:59 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 3. Question Name: 0003 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations? A. West nomogram B. Clark rule C. Height-to-weight ratio * D. Mg/kg formula Correct Answer: D Explanation/Rationale: ANS: D The mg/kg formula, based on body weight, is the most common method of calculating doses for pediatric patients. The other options are available methods but are not the most commonly used. Height-to-weight ratio is not used. DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 41 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:18:05 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 4. Question Name: 0004 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? A. The patient is experiencing multiple illnesses. B. The patient uses one medication for an illness several times per day. C. The patient uses over-the-counter drugs for an illness. * D. The patient uses multiple medications simultaneously. Correct Answer: D Explanation/Rationale: ANS: D Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. The other options are incorrect. Polypharmacy addresses the medications taken, not just the illnesses. Polypharmacy means the patient is taking several different medications, not just one. Polypharmacy can include prescription drugs, over-the-counter medications, and herbal products. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 42 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:18:10 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 5. Question Name: 0005 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug? A. Laxatives B. Anticoagulants * C. Sedatives D. Antidepressants Correct Answer: C Explanation/Rationale: ANS: C Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and antidepressants may cause adverse effects in the elderly, but not the ones specified in the question. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 45 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:18:16 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 6. Question Name: 0006 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed For accurate medication administration to pediatric patients, the nurse must take into account which criteria? * A. Organ maturity B. Renal output C. Body temperature D. Height Correct Answer: A Explanation/Rationale: ANS: A To administer medications to pediatric patients accurately, one must take into account the body surface area (including weight and height), age, and organ maturity. The other options are incorrect; renal output and body temperature are not considerations, and height alone is not sufficient. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 41 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:18:23 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 7. Question Name: 0007 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse recognizes that it is not uncommon for an elderly patient to experience a reduction in the stomach’s ability to produce hydrochloric acid. This change may result in which effect? A. Delayed gastric emptying B. Increased gastric acidity C. Decreased intestinal absorption of medications * D. Altered absorption of weakly acidic drugs Correct Answer: D Explanation/Rationale: ANS: D Reduction in the stomach’s ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of weakly acidic drugs. The other options are not results of reduced hydrochloric acid production. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 44 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:19:52 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 R 8. Question Name: 0008 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is administering drugs to neonates and will consider which factor that may contribute the most to drug toxicity? A. The lungs are immature. B. The kidneys are small. * C. The liver is not fully developed. D. Excretion of the drug occurs quickly. Correct Answer: C Explanation/Rationale: ANS: C A neonate’s liver is not fully developed and cannot detoxify many drugs. The other options are incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renal excretion is slow, not fast, because of organ immaturity, but this is not the factor that contributes the most to drug toxicity. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 39 TOP: NURSING PROCESS: Planning MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:20:07 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 esponse Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 9. Question Name: 0009 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems? A. Constipation and anorexia * B. Fatigue, leg cramps, and dehydration C. Daytime sedation and lethargy D. Edema, nausea, and blurred vision Correct Answer: B Explanation/Rationale: ANS: B Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe complications that occur when these drugs are given to the elderly. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 45 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 01/31/13 15:35:10 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 10. Question Name: 0010 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy? A. Drug therapy will be based on the patient’s weight. B. Drug therapy will be based on the patient’s age. C. The patient will receive the maximum dose that is expected to reduce the blood pressure. * D. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed. Correct Answer: D Explanation/Rationale: ANS: D As a general rule, dosing for elderly patients should follow the admonition, “Start low, and go slow,” which means to start with the lowest possible dose (often less than an average adult dose) and increase the dose slowly, if needed, based on patient response. The other responses are incorrect. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 42 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:20:17 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 11. Question Name: 0011 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is trying to give a liquid medication to a 2 -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child? * A. Give the medication with spoonfuls of ice cream. B. Add the medication to the child’s bottle. C. Tell the child you have candy for him. D. Add the medication to a cup of milk. Correct Answer: A Explanation/Rationale: ANS: A Ice cream or another nonessential food disguises the taste of the medication. The other options are incorrect. If the child does not drink the entire contents of the bottle, medication is wasted and the full dose is not administered. Using the word candy with drugs may lead to the child thinking that drugs are actually candy. If the medication is mixed with a cup of milk, the child may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse milk in the future. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 48 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:20:23 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 12. Question Name: 0012 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed The nurse is preparing to give an injection to a 4-year-old child. Which intervention is ageappropriate for this child? A. Give the injection without any advanced preparation. * D. First-pass elimination is reduced because of the immaturity of the liver. B. Give the injection, and then explain the reason for the procedure afterwards. * C. Offer a brief, concrete explanation of the procedure at the patient’s level and with the parent or caregiver present. D. Prepare the child in advance with details about the procedure without the parent or caregiver present. Correct Answer: C Explanation/Rationale: ANS: C For a 4-year-old child, offering a brief, concrete explanation about a procedure just beforehand, with the parent or caregiver present, is appropriate. The other options are incorrect for any age group. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 41 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Psychosocial Integrity Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:20:29 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D Last: 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 13. Question Name: 0013 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.) * A. The levels of microsomal enzymes are decreased. * B. Perfusion to the kidneys may be decreased and may result in reduced renal function. C. First-pass elimination is increased because of higher portal circulation. * E. The number of intact nephrons is decreased. E. Total body water content is much less than in adults. * F. Gastric emptying is slowed because of slow or irregular peristalsis. G. Gastric emptying is more rapid because of increased peristaltic activity. Correct Answer: A+B+D+F Explanation/Rationale: ANS: A, B, D, F In children, first-pass elimination by the liver is reduced because of the immaturity of the liver, and microsomal enzymes are decreased. In addition, gastric emptying is reduced because of slow or irregular peristalsis. Perfusion to the kidneys may be decreased, resulting in reduced renal function. The other options are incorrect. In addition, remember that total body water content is greater in children than in adults. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 39 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:21:50 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Biserial: 0.00 Response Frequencies (%) A B C D E F G Last: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Cumulative: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 14. Question Name: 0014 Type: MC Objective: Ch 03: Lifespan Considerations Item Bank: Lilley Pharmacology and the Nursing Process 7th Ed Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.) * A. The levels of microsomal enzymes are decreased. * B. Fat content is increased because of decreased lean body mass. C. Fat content is decreased because of increased lean body mass. D. The number of intact nephrons is increased. * F. Gastric pH is less acidic. Correct Answer: A+B+E+F Explanation/Rationale: ANS: A, B, E, F In the elderly, levels of microsomal enzymes are decreased because the aging liver is less able to produce them; fat content is increased because of decreased lean body mass; the number of intact nephrons is decreased as the result of aging; and gastric pH is less acidic because of a gradual reduction of the production of hydrochloric acid. The other options are incorrect statements. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 43 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Health Promotion and Maintenance Reference/Notes: Keywords: Points: 1.00 Penalty: 0.00 Score Mode: Active Date Created: 01/31/13 15:35:10 Date Modified: 02/05/13 17:22:35 Date Used: Difficulty: Easy Discrimination: Low Item Analysis: Last Item Analysis: Cumulative No. of Students Responded: 0 No. of Students Responded: 0 Correct Responses (%): Correct Responses (%): Total Group: 0.00 Total Group: 0.00 Upper 27% of Group: 0.00 Upper 27% of Group: 0.00 Lower 27% of Group: 0.00 Lower 27% of Group: 0.00 Point Biserial: 0.00 Point Bis [Show More]

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