Chapter 06 Challenges to Effective Drug Therapy

1. A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient’s medical diagnosis. What should the nurse do?

1. A)  Administer the drug as ordered.
2. B)  Question the prescriber concerning the ordered drug.
3. C)  Ask a coworker his or her thoughts about the ordered drug for the patient.
4. D)  Ask the patient why the drug has been prescribed for him or her.

Ans: B

Feedback:

If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone’s part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.

2. According to Center for Disease Control and Prevention (CDC) recommendations, what is the role of the nurse in preparing for the possibility of bioterrorism?

1. A)  Post updated information on signs and symptoms of infections caused by biological agents
2. B)  Provide guidelines for treating patients exposed to, or potentially exposed to, biological agents
3. C)  Remain current on recognition and treatment of infections caused by biological weapons
4. D)  Advocate for increased funding for research involving bioterrorism and patient treatment

Ans: C

Feedback:

Nurses need to remain current about recognition of and treatment for those exposed to biological weapons because nurses are often called upon to answer questions, reassure the public, offer educational programs, and serve on emergency preparedness committees. The CDC posts updated information on signs and symptoms of infections caused by biological agents that nurses would read. The CDC also provides guidelines for how to treat patients exposed to biological agents and the nurse must remain current on this information. Although nurses could advocate for funding, this is not usually

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the role of the nurse.

3. How can the nurse find the most up-to-date information about emergency preparedness related to bioterrorism agents?

1. A)  Read textbooks devoted to the topic.
2. B)  Ask coworkers to explain current events.
3. C)  Read journal articles about bioterrorism agents.
4. D)  Visit the Centers for Disease Control and Prevention (CDC) Web site.

Ans: D

Feedback:

The most current information will be found on the CDC Web site because new information can be posted immediately whereas textbooks and journal articles take time to print. Coworkers may or may not remain current on emergency preparedness and should not be the primary source of information.

4. The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?

1. A)  St. John’s wort
2. B)  Kava
3. C)  Fish oil
4. D)  Ginseng

Ans: D

Feedback:

Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John’s wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.

5. A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John’s wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?

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1. A)  Antihistamines
2. B)  Analgesics
3. C)  Antibiotics
4. D)  Oral contraceptives

Ans: D

Feedback:

St. John’s wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John’s wort without known adverse effects.