Pharmacology For Nurses A Pathophysiologic Approach 5th Edition by Michael Patrick Adams – Test Bank

Complete Test Bank With Answers

 

 

Sample Questions Posted Below

 

Adams, Pharmacology for Nurses: A Pathophysiologic Approach, 5/E
Chapter 5

Question 1

Type: MCSA

A patient looks up the drug he is taking in a drug guide. The patient asks the nurse why the physician prescribed a medication that has a lethal dose measure. What is the best response by the nurse?

1. “It just refers to what is done in research; it is not used by doctors prescribing drugs.”

2. “It is a value determined during research, which helps to determine the safe dose to give.”

3. “All that means is that the drug could be lethal, but I will watch you for side effects.”

4. “Don’t worry about that, I’ll have your doctor explain it to you.”

Correct Answer: 2

Rationale 1: The lethal dose measure is used by doctors prescribing drugs. 

Rationale 2: The difference between a median effective dose and a median lethal dose is a measure of a drug’s safety margin, which helps determine the safest dose to give. 

Rationale 3: Telling a patient that the drug could be lethal, but he will be observed for side effects, will frighten him and most likely result in refusal of the medication.

Rationale 4: Telling a patient not to worry is non-therapeutic; this is a condescending response. 

Global Rationale: The difference between a median effective dose and a median lethal dose is a measure of a drug’s safety margin, which helps determine the safest dose to give. The lethal dose measure is used by doctors prescribing drugs. Telling a patient not to worry is non-therapeutic; this is a condescending response. Telling a patient that the drug could be lethal, but he will be observed for side effects, will frighten him and most likely result in refusal of the medication.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-4 Compare and contrast median lethal dose (LD₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 2

Type: MCSA

Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student’s understanding of therapeutic index?

1. The student is able to determine if the physician prescribed the best drug for the patient.

2. The student is able to determine if the patients are receiving safe doses of the medications.

3. The student is able to identify interactions among the drugs each patient is receiving.

4. The student is able to identify the patients who will need to have serum blood levels monitored.

Correct Answer: 4

Rationale 1: The therapeutic index will not help to determine if the physician prescribed the best drug for the patient. 

Rationale 2: The therapeutic index will give some information about safe doses, but this is not the most complete response. 

Rationale 3: The therapeutic index will not help to identify interactions among the drugs the patients receive.

Rationale 4: Drugs with a narrow therapeutic index have a low safety margin and the concentration of the drug should be monitored by regular serum tests. 

Global Rationale: Drugs with a narrow therapeutic index have a low safety margin and the concentration of the drug should be monitored by regular serum tests. The therapeutic index will give some information about safe doses, but this is not the most complete response. The therapeutic index will not help to determine if the physician prescribed the best drug for the patient. The therapeutic index will not help to identify interactions among the drugs the patients receive.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 3

Type: MCSA

The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses?

1. About 50% of patients will experience severe side effects from the drug.

2. Some patients will respond differently depending on their ethnic background.

3. About 50% of patients will not experience any effect from the drug.

4. Some patients will require more or less than the average dose of the drug.

Correct Answer: 4

Rationale 1: The mean effective dose does not predict how many patients will experience severe side effects from the drug. 

Rationale 2: The mean effective dose is not related to ethnicity. 

Rationale 3: The mean effective dose does not predict that 50% of patients will not experience any effect of the drug.

Rationale 4: The mean effective dose predicts how 50% of the population will respond to the average dose of the drug. Some patients will require more or less of the drug. 

Global Rationale: The mean effective dose predicts how 50% of the population will respond to the average dose of the drug. Some patients will require more or less of the drug. The mean effective dose is not related to ethnicity. The mean effective dose does not predict how many patients will experience severe side effects from the drug. The mean effective dose does not predict that 50% of patients will not experience any effect of the drug.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5-3 Explain the importance of the median effective dose (ED₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 51

Question 4

Type: MCSA

The patient receives antibiotics for a serious infection. The patient asks the nurse, “Why don’t you just give me more of that drug to cure this infection faster?” What is the best response by the nurse?

1. “I will check with the doctor to see if it is time to increase the medication.”

2. “You are at a maximum dose; taking more will cause interactions with other medications.”

3. “You must stay on this drug for 2 more weeks before it can be increased.”

4. “You are at a maximum dose; taking more will not help.”

Correct Answer: 4

Rationale 1: Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage. 

Rationale 2: An increase in dosage may cause interactions with other medications, but this is not the best answer.

Rationale 3: Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect. 

Rationale 4: When the plateau of a drug has been reached, administering more of the drug will not produce additional benefit. Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect. Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage. An increase in dosage may cause interactions with other medications, but this is not the best answer.

Global Rationale: When the plateau of a drug has been reached, administering more of the drug will not produce additional benefit. Once the plateau of a drug has been reached, there is no time frame for an increase in dosage because an increase in dosage will not produce a greater effect. Telling the patient the nurse will check with the physician is inappropriate because the plateau of the drug has been reached; the physician will not change the dosage. An increase in dosage may cause interactions with other medications, but this is not the best answer.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 5

Type: MCSA

The nurse administers narcotics to surgical patients. Which statement represents the nurse’s best understanding as it relates to the potency of different narcotics?

1. Codeine is less potent than morphine; it will not produce an allergic reaction.

2. Morphine is more potent than codeine; a lesser dose will be required.

3. Morphine is more potent than codeine; it will produce more adverse effects.

4. Codeine is less potent than morphine; it will not relieve pain as well.

Correct Answer: 2

Rationale 1: The potency of a drug is not related to its ability to cause an allergic reaction.

Rationale 2: A drug that is more potent will produce a therapeutic effect at a lower dose. 

Rationale 3: Potency does not mean the drug will produce more adverse effects. 

Rationale 4: Less potent narcotics can be very effective with pain relief. 

Global Rationale: A drug that is more potent will produce a therapeutic effect at a lower dose. Potency does not mean the drug will produce more adverse effects. Less potent narcotics can be very effective with pain relief. The potency of a drug is not related to its ability to cause an allergic reaction.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-7 Compare and contrast the terms potency and efficacy.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 6

Type: MCSA

The nurse is conducting medication education about the difference between potency and efficacy to a group of patients. The nurse correctly determines that learning has occurred when the patients makes which response?

1. “The best drug for us is the one with the highest potency.”

2. “The best drug for us is the one with the greatest efficacy.”

3. “Drugs with the greatest efficacy will produce the least side effects.”

4. “Low-potency drugs have efficacy and do not produce side effects.”

Correct Answer: 2

Rationale 1: Potency refers to the dose of the drug; high-potency drugs do not necessarily provide the best response in the patient. 

Rationale 2: Efficacy means the magnitude of maximal response that can be produced from a particular drug. 

Rationale 3: Efficacious drugs do produce side effects.

Rationale 4: Low-potency drugs do produce side effects.

Global Rationale: Efficacy means the magnitude of maximal response that can be produced from a particular drug. Potency refers to the dose of the drug; high-potency drugs do not necessarily provide the best response in the patient. Efficacious drugs and low-potency drugs do produce side effects.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-7 Compare and contrast the terms potency and efficacy.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 7

Type: MCMA

The patient has had hypertension for many years. The physician orders an antihypertensive drug that has just come on the market. The nurse teaches the patient that this drug works more effectively than his prior drug and has fewer side effects. The patient asks how this can be. What is the best response by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Newer drugs are altered to affect your cells’ receptors in a different way.”

2. “Receptors tend to ‘burn-out,’ so newer drugs are required.”

3. “Research into receptors helps ‘fine-tune’ drugs to be more effective.”

4. “Changing the response of the drug to protein receptor-complexes produces fewer side effects.”

5. “It is a process of trial and error with receptors until the new drug proves effective.”

Correct Answer: 1,3

Rationale 1: Receptor research results in the development of new medications that activate very specific receptors to produce a greater therapeutic response as well as fewer side effects. 

Rationale 2: Receptors do not “burn-out.” 

Rationale 3: Research into receptors has resulted in the “fine-tuning” of medications that are more effective with fewer side effects. 

Rationale 4: There is no such thing as a protein receptor-complex.

Rationale 5: Research is not a process of trial and error with receptors. 

Global Rationale: Receptor research results in the development of new medications that activate very specific receptors to produce a greater therapeutic response as well as fewer side effects. Research into receptors has resulted in the “fine-tuning” of medications that are more effective with fewer side effects. Research is not a process of trial and error with receptors. Receptors do not “burn-out.” There is no such thing as a protein receptor-complex.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-9 Explain the relationship between receptors and drug action.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 55

Question 8

Type: Hot Spot

Indicate the spot of the median effective dose on the frequency distribution curve.

1. A

2. B

3. C

4. D

Answer: 3

Rationale: The dose in the middle of the frequency distribution curve represents the drug’s median effective dose. 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5-3 Explain the importance of the median effective dose (ED₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 51

Question 9

Type: MCSA

The patient and his wife receive the same medication for hypertension. The patient’s wife asks the nurse why she is receiving a higher amount of the medication. What is the best response by the nurse?

1. “Females have a higher metabolism, so you need more medication.”

2. “Everyone is unique and responds differently to medications.”

3. “Your hormones are different from your husband’s, so you need more medication.”

4. “You have a greater percentage of body fat, so more medication is needed.”

Correct Answer: 2

Rationale 1: Females do not necessarily have higher metabolic rates than men.

Rationale 2: Many variables will influence how patients will respond to medications; each patient must be individually evaluated for response to medications. 

Rationale 3: Hormone status is only one of the variables involved in the patient’s response to medications and may not pertain to this drug. 

Rationale 4: The percentage of body fat is only one of the variables involved in the patient’s response to medications and may not pertain to this medication. 

Global Rationale: Many variables will influence how patients will respond to medications; each patient must be individually evaluated for response to medications. The percentage of body fat, hormones, and the patient’s rate of metabolism are only a few of the variables involved in the patient’s response to medications. These factors may or may not pertain to the medication in question. Females do not necessarily have higher metabolic rates than men.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: 111.5 Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes. 

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-2 Discuss how frequency distribution curves may be used to explain how patients respond differently to medications. 

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 51

Question 10

Type: MCSA

The student nurse has been reading about the Human Genome Project and asks the nursing instructor how this will impact future pharmacological therapies. What is the best response by the instructor?

1. “We will be able to alter genes so we will not need drugs.”

2. “We will be able to standardize drug doses to make prescribing easier.”

3. “It will help prevent disease through gene manipulation but will not impact drugs.”

4. “It will help to individualize drug therapy for people in a more effective way.”

Correct Answer: 4

Rationale 1: Altering genes to prevent illness is a possibility, but we will always need medications. 

Rationale 2: Individuals will still respond differently to medications; not all drugs will have standardized doses. 

Rationale 3: Medications will be very much impacted by this research.

Rationale 4: The goal of pharmacogenetics is to help individualize drug therapy for people in a more effective way. 

Global Rationale: The goal of pharmacogenetics is to help individualize drug therapy for people in a more effective way. Altering genes to prevent illness is a possibility, but we will always need medications. Individuals will still respond differently to medications; not all drugs will have standardized doses. Medications will be very much impacted by this research.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-10 Explain possible future developments in the field of pharmacogenetics. 

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 56

Question 11

Type: MCSA

The home health nurse notes that the elderly patient doubled up on his pain medication, even though the prescribed dose was at a therapeutic level. The patient says, “If one pill is good, two pills are better.” Which statement best describes the result of the patient’s action?

1. The patient develops tolerance and does not experience any difference.

2. The patient experiences more pain relief from the additional dose.

3. The patient develops tolerance and will need increased doses of the drug.

4. The patient is more likely to exhibit side effects from the additional dose.

Correct Answer: 4

Rationale 1: Tolerance may occur but is not the primary issue here.

Rationale 2: Once the plateau of a drug has been reached, increased doses will not provide added therapeutic benefit, such as more pain relief. 

Rationale 3: Tolerance may occur but is not the primary issue here.

Rationale 4: Once the plateau of a drug has been reached, increasing the dose may produce adverse effects. 

Global Rationale: Once the plateau of a drug has been reached, increasing the dose may produce adverse effects. Once the plateau of a drug has been reached, increased doses will not provide added therapeutic benefit, such as more pain relief. Tolerance may occur but is not the primary issue here.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 12

Type: MCSA

The patient was receiving haloperidol (Haldol), a dopamine antagonist. The psychiatrist changed the order to aripiprazole (Abilify), a partial dopamine antagonist. Which statement best describes the effect of the change of medication on the patient?

1. The patient is more compliant in taking his medication.

2. The patient experiences greater efficacy.

3. The patient experiences a greater reduction in symptoms.

4. The patient experiences fewer side effects.

Correct Answer: 4

Rationale 1: The patient will not necessarily be more compliant in taking the medicine. 

Rationale 2: The patient will not necessarily experience greater efficacy. 

Rationale 3: Experiencing a greater reduction in symptoms is the same as greater efficacy.

Rationale 4: Partial blocking of dopamine results in fewer side effects than complete blocking of dopamine. 

Global Rationale: Partial blocking of dopamine results in fewer side effects than complete blocking of dopamine. The patient will not necessarily experience greater efficacy or be more compliant in taking the medicine. Experiencing a greater reduction in symptoms is the same as greater efficacy.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-8 Distinguish among an agonist, a partial agonist, and an antagonist.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 55

Question 13

Type: MCMA

The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor? 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “It could be that all of the receptors for the drug are occupied.”

2. “It may mean that the drug has brought 100% relief to the patient.”

3. “It means that the patient has developed resistance and needs another drug.”

4. “It probably means that the drug is losing efficacy.”

5. “It means that the patient needs a higher dose of the drug.”

Correct Answer: 1,2

Rationale 1: Drug plateaus occur with medications because all the receptors for the drug are occupied.

Rationale 2: Drug plateaus occur with medications when the drug has brought 100% relief to the patient. 

Rationale 3: Drug plateaus are not associated with resistance. 

Rationale 4: A drug plateau is not related to efficacy of the drug. 

Rationale 5: When a drug has reached its plateau, giving additional amounts will not result in an increased therapeutic effect.

Global Rationale: Drug plateaus occur with medications because all the receptors for the drug are occupied; the drug has brought 100% relief to the patient. A drug plateau is not related to efficacy of the drug. When a drug has reached its plateau, giving additional amounts will not result in an increased therapeutic effect. Drug plateaus are not associated with resistance.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 14

Type: MCSA

When administering a standard or median effective dose to a patient, the nurse explains that this amount of drug will have which effect?

1. It will produce an effect without the presence of adverse effects.

2. It will be metabolized within 24 hours.

3. It will be effective in half of the population.

4. It will be effective in the majority of patients.

Correct Answer: 3

Rationale 1: The median effective dose may result in toxicity in some patients. 

Rationale 2: Rate of metabolism is not a specific factor in determining median effective dose.

Rationale 3: The median effective dose is the amount of a drug that produces an effect in 50% of a group of patients.

Rationale 4: Median does not refer to a value in excess of 50%. 

Global Rationale: The median effective dose is the amount of a drug that produces an effect in 50% of a group of patients. The median effective dose may result in toxicity in some patients. Rate of metabolism is not a specific factor in determining median effective dose. Median does not refer to a value in excess of 50%.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-3 Explain the importance of the median effective dose (ED₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 51

Question 15

Type: MCSA

Drug X has a median lethal dose of 30 mg and a median effective dose of 10. Drug Y has a therapeutic index of 4, while drug Z has a therapeutic index of 3. Which statement is accurate based on this information?

1. Drugs X and Y are safer than drug Z.

2. The therapeutic index of drug X is 20.

3. Drug Y is the safest of the three.

4. Drug Z is the safest of the three.

Correct Answer: 3

Rationale 1: Drugs X and Z have the same therapeutic index and are more dangerous than drug Y.

Rationale 2: The therapeutic index of drug X is 30/10 or 3. 

Rationale 3: Since drug Y has the highest therapeutic index, it is the safest drug.

Rationale 4: Drugs X and Z have the same therapeutic index and are more dangerous than drug Y. 

Global Rationale: Since drug Y has the highest therapeutic index, it is the safest drug. Drugs X and Z have the same therapeutic index and are more dangerous than drug Y. The therapeutic index of drug X is 30/10 or 3.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 16

Type: MCSA

When reading about a drug, the nurse learns it has a median toxic dose of 50 mg. The patient has been receiving 60 mg of the drug. What analysis does the nurse make? 

1. It is likely the drug will not produce the desired effect.

2. The efficacy and potency of this drug have not been well defined.

3. The patient will be at greater risk of adverse effects.

4. This amount of drug would have been lethal to half the population.

Correct Answer: 3

Rationale 1: This information is insufficient to predict if the drug will produce the desired effect.

Rationale 2: The median toxicity dose is not a measure of efficacy and potency. 

Rationale 3: Since the dose exceeds the median toxicity for this drug, the patient is at greater risk of developing adverse effects. 

Rationale 4: Median toxicity dose has to do with development of toxicity, not lethality. 

Global Rationale: Since the dose exceeds the median toxicity for this drug, the patient is at greater risk of developing adverse effects. This information is insufficient to predict if the drug will produce the desired effect. The median toxicity dose is not a measure of efficacy and potency. Median toxicity dose has to do with development of toxicity, not lethality.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-4 Compare and contrast median lethal dose (LD₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 17

Type: MCSA

Graded dose-response curves are most useful for determining

1. response intensity within an individual.

2. response intensity within a large group of people with different characteristics.

3. response intensity within a large group of people with similar characteristics.

4. response intensity within a small group of people with similar characteristics.

Correct Answer: 1

Rationale 1: Graded dose-response curves are used to determine response intensity within an individual. 

Rationale 2: Frequency distribution curves are used to visualize patient differences in response to medication in a population.

Rationale 3:  Frequency distribution curves are used to visualize patient differences in response to medication in a population.

Rationale 4:  Frequency distribution curves are used to visualize patient differences in response to medication in a population.

Global Rationale: Graded dose-response curves are used to determine response intensity within an individual. Frequency distribution curves are used to visualize patient differences in response to medication in a population.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment 

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 18

Type: MCSA

At a dose of 10 mg, drug X lowers total cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 65 mg/dL is achieved at 40 mg. At a dose of 5 mg, drug Y lowers cholesterol by 50 mg/dL, while a maximum drop in cholesterol of 55 mg/dL is achieved at 10 mg. What can be concluded about the efficacy and potency of these two drugs?

1. Drug X is more potent, and drug Y has a higher efficacy.

2. Drug X is more potent and has higher efficacy.

3. Drug Y is more potent and has higher efficacy.

4. Drug Y is more potent, and drug X has a higher efficacy.

Correct Answer: 4

Rationale 1: Drug X is not more potent. Drug Y does not have higher efficacy.

Rationale 2: Drug X is not more potent.

Rationale 3:  Drug Y does not have higher efficacy.

Rationale 4: Drug Y causes a greater drop in cholesterol at lower doses (higher potency), whereas drug X causes the highest drop in total cholesterol (efficacy).

Global Rationale: Drug Y causes a greater drop in cholesterol at lower doses (higher potency), whereas drug X causes the highest drop in total cholesterol (efficacy).

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-7 Compare and contrast the terms potency and efficacy.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 19

Type: MCSA

 A drug has been prescribed to decrease the effects of an endogenous chemical. The nurse would place this drug in which category?

1. An agonist

2. A partial agonist

3. An antagonist

4. An agonist-antagonist

Correct Answer: 3

Rationale 1: An agonist drug produces the same type of response as the endogenous substance.

Rationale 2: A partial agonist produces a weaker, or less efficacious, response than an agonist.

Rationale 3: An antagonist occupies receptor sites, preventing them from being activated by the medication. This prevents the endogenous chemical from acting.

Rationale 4: An agonist-antagonist produces a weaker, or less efficacious, response than an agonist. 

Global Rationale: An antagonist occupies receptor sites, preventing them from being activated by the medication. This prevents the endogenous chemical from acting. An agonist drug produces the same type of response as the endogenous substance. A partial agonist produces a weaker, or less efficacious, response than an agonist. An agonist-antagonist produces a weaker, or less efficacious, response than an agonist.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-8 Distinguish among an agonist, a partial agonist, and an antagonist.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 55

Question 20

Type: MCSA

Pharmacogenetics is a relatively new area within pharmacology. Which statement best describes the potential of this new area?

1. To customize drugs and prevent idiosyncratic responses

2. To reduce the overall number of drugs and their associated adverse effects

3. To reduce medication errors and provide optimal drug choices

4. To provide cost-effective pharmacotherapy and higher drug efficacy

Correct Answer: 1

Rationale 1: Pharmacogenetics explores the role of heredity in drug response. It might be useful to customize drugs based on genetic makeup and reduce idiosyncratic responses. 

Rationale 2: Reducing the number of drugs might occur but is not the best descriptive statement. 

Rationale 3: Pharmacogenetics will not reduce medication errors.

Rationale 4: Currently, increased cost is a deterrent. 

Global Rationale: Pharmacogenetics explores the role of heredity in drug response. It might be useful to customize drugs based on genetic makeup and reduce idiosyncratic responses. Pharmacogenetics will not reduce medication errors. Currently, increased cost is a deterrent. Reducing the number of drugs might occur but is not the best descriptive statement.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-10 Explain possible future developments in the field of pharmacogenetics. 

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 56

Question 21

Type: FIB

From a transcription error, a patient received an overdose of a prescribed medication. If the therapeutic index of the medication is 10 and the median effective dose is 2, the nurse would calculate as the median lethal dose for the medication as _____.

Standard Text: Record your answer rounding to the nearest whole number.

Correct Answer: 20 

Rationale: 10 = x/2; solving for x, the median lethal dose would be 20. 

Global Rationale: 10 = x/2; solving for x, the median lethal dose would be 20.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 22

Type: MCMA

The nurse is participating in the clinical trial of a new medication for the treatment of hypertension. To assess the effectiveness of the medication, which interventions would the nurse perform to help determine whether the average dose is effective for the patient? 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Monitoring blood pressure

2. Monitoring heart rate

3. Interpreting laboratory values

4. Monitoring diet

5. Monitoring sleep habits

Correct Answer: 1,2,3

Rationale 1: By monitoring the patient’s vital signs, the nurse helps to determine whether the average dose is effective for the patient.

Rationale 2: By monitoring the patient’s vital signs, the nurse helps to determine whether the average dose is effective for the patient.

Rationale 3: By interpreting any associated laboratory data, the nurse helps to determine whether the average dose is effective for the patient.

Rationale 4: Monitoring the patient’s diet will not help determine if the average dose of a medication is effective for the patient.

Rationale 5: Monitoring the patient’s sleep habits will not help determine if the average dose of a medication is effective for the patient.

Global Rationale: By monitoring the patient’s vital signs and associated laboratory data, the nurse helps to determine whether the average dose is effective for the patient. Monitoring the patient’s diet and sleeping habits will not help determine if the average dose of a medication is effective for the patient.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.B.1 Participate effectively in appropriate data collection and other research activities.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-1 Explain the applications of pharmacodynamics to nursing process.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 51

Question 23

Type: MCMA

The nurse explains to a student nurse that the median lethal dose of drugs is often determined in laboratory preclinical trials because 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. it would be unethical to determine these values in human subjects.

2. the safety of the medication must be determined prior to clinical trials.

3. it is difficult to obtain sufficient participants for clinical trials.

4. clinical trials determine only the effective dose of a drug.

5. it is too costly to conduct the studies during clinical trials.

Correct Answer: 1,2

Rationale 1: Laboratory animals are used in clinical trials to determine the LD₅₀, or the dose that kills 50% of the subjects. It would be unethical to kill human subjects.

Rationale 2: Before a drug is released for trials in human subjects, its safety must be determined.

Rationale 3: It can be challenging to obtain sufficient subjects at times, but this is not the reason for doing lethal studies during preclinical trials.

Rationale 4: Clinical trials determine not only the effectiveness of a drug, but also its adverse and toxic effects.

Rationale 5: The cost of the trials is the reason they are conducted with animal subjects.

Global Rationale: Laboratory animals are used in clinical trials to determine the LD₅₀, or the dose that kills 50% of the subjects. It would be unethical to kill human subjects. Before a drug is released for trials in human subjects, its safety must be determined. It can be challenging to obtain sufficient subjects at times, but this is not the reason for doing lethal studies during preclinical trials. Clinical trials determine not only the effectiveness of a drug, but also its adverse and toxic effects. The cost of the trials is the reason they are conducted with animal subjects.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-4 Compare and contrast median lethal dose (LD₅₀) to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 24

Type: FIB

The nurse is preparing to administer a medication to a patient on a medical-surgical unit. The median lethal dose of the drug is 40 mg, and the median effective dose is 10 mg. The nurse calculates the therapeutic index to be _____. 

Standard Text: Record your answer rounding to the nearest whole number.

Correct Answer: 4

Rationale: The therapeutic index is calculated by dividing the median lethal dose (LD₅₀) by the median effective dose (ED₅₀).

Global Rationale: The therapeutic index is calculated by dividing the median lethal dose (LD₅₀) by the median effective dose (ED₅₀).

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 25

Type: MCMA

A patient with hypertension is taking a potent antihypertensive without results. The patient is concerned when the health care provider orders a new drug. The nurse explains, 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “The drug you took is very potent, and a higher dose is needed.”

2. “The new drug has greater efficacy, so it will help reduce your blood pressure.”

3. “The prescriber must have made an error in the orders.”

4. “Efficacy in treating your hypertension is more important than potency.”

5. “You are correct. I think the prescriber meant to order both drugs.”

Correct Answer: 2,4

Rationale 1: A higher dose of a potent drug may cause more serious adverse effects without greater efficacy.

Rationale 2: Efficacy is more important than potency in providing blood pressure control.

Rationale 3: This is not an appropriate response by the nurse.

Rationale 4: Efficacy is more important than potency in pharmacologic treatment.

Rationale 5: This is not an appropriate response, and the nurse cannot assume the order was supposed to be for two drugs.

Global Rationale: Efficacy is more important than potency in providing blood pressure control. Efficacy is more important than potency in pharmacologic treatment. A higher dose of a potent drug may cause more serious adverse effects without greater efficacy. Statements regarding the prescriber are not appropriate.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-7 Compare and contrast the terms potency and efficacy.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 26

Type: MCMA

The nurse is reviewing the medication administration record for a group of patients and recognizes that which agents have nonspecific cellular responses? 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Ethyl alcohol

2. General anesthetics

3. Osmotic diuretics

4. Calcium channel blockers

5. Alpha-adrenergic antihypertensives

Correct Answer: 1,2,3

Rationale 1: Ethyl alcohol is an example of an agent that acts by nonspecific mechanisms, independently of cellular receptors.

Rationale 2: General anesthetics are an example of agents that act by nonspecific mechanisms, independently of cellular receptors.

Rationale 3: Osmotic diuretics are an example of agents that act by nonspecific mechanisms, independently of cellular receptors.

Rationale 4: Calcium channel blockers have a specific mechanism of action.

Rationale 5: Alpha-adrenergic antihypertensives have a specific mechanism of action.

Global Rationale: Ethyl alcohol is an example of an agent that acts by nonspecific mechanisms, independently of cellular receptors. General anesthetics are an example of agents that act by nonspecific mechanisms, independently of cellular receptors. Osmotic diuretics are an example of agents that act by nonspecific mechanisms, independently of cellular receptors. Calcium channel blockers have a specific mechanism of action. Alpha-adrenergic antihypertensives have a specific mechanism of action.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-8 Distinguish among an agonist, a partial agonist, and an antagonist.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 55

Question 27

Type: Hot Spot

Mark the location of the beginning of the plateau phase on this dose-response relationship curve.

1. A

2. B

3. C

4. D

Answer: 4

Rationale: The plateau phase occurs when increasing the drug dose produces no additional therapeutic response. It is represented on this curve as the horizontal line at the top right of the curve. 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5-6 Explain the significance of the graded dose-response relationship to nursing practice.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 53

Question 28

Type: FIB

Literature review reveals that a new drug has a median lethal dose of 10 and a median effective dose of 5. The nurse determines that an error in which _____ times the correct dose is given could be lethal.

Standard Text: Record your answer rounding to the nearest whole number.

Correct Answer: 2 

Rationale: x = 10/5; solving for x, the therapeutic index would be 2. This means it would only take an error in magnitude of approximately 2 times the average dose to be lethal.

Global Rationale: x = 10/5; solving for x, the therapeutic index would be 2. This means it would only take an error in magnitude of approximately 2 times the average dose to be lethal.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality.

AACN Essentials Competencies: 11.7 Promote factors that create a culture of safety and caring.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5-5 Discuss how a drug’s therapeutic index is related to its margin of safety.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 52

Question 29

Type: MCMA

During assessment, the patient mentions that he recently “sent off to a company for pharmacogenomic testing.” What nursing responses are indicated?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Have you changed your medications any?”

2. “Have you talked with your physician about the results?”

3. “Why did you do that?”

4. “Was that test expensive?”

5. “Who told you about the testing?”

Correct Answer: 1,2

Rationale 1: The most important question is if the patient has changed therapy secondary to test results.

Rationale 2: It is important for the patient to discuss the results of the tests and any indicated changes with the health care provider.

Rationale 3: Asking a “why” question is confrontational and is likely to result in the patient not sharing more information.

Rationale 4: The nurse may be curious as to the expense of the test, but the cost is not pertinent to this discussion.

Rationale 5: Asking who suggested the test is confrontational and is likely to result in the patient not sharing more information. 

Global Rationale: The most important question is if the patient has changed therapy secondary to test results. It is important for the patient to discuss the results of the tests and any indicated changes with the health care provider. Asking a “why” question or asking who suggested the test is confrontational and is likely to result in the patient not sharing more information. The nurse may be curious as to the expense of the test, but the cost is not pertinent to this discussion.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.2 Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-10 Explain possible future developments in the field of pharmacogenetics. 

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 56

Question 30

Type: MCMA

The nurse reads that a newly discovered drug is a functional antagonist for some commonly administered medications. The nurse interprets this information as indicating the new drug could have which actions? 

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Blocks alpha receptors

2. Enhances drug excretion

3. Blocks beta receptors

4. Speeds drug metabolism 

5. Inhibits protein synthesis 

Correct Answer: 2,4

Rationale 1: Functional antagonists do not block alpha receptors.

Rationale 2: Functional antagonists change pharmacokinetic factors such as excretion.

Rationale 3: Functional antagonists do not block beta receptors.

Rationale 4: Functional antagonists change pharmacokinetic factors such as metabolism.

Rationale 5: Drugs that bind with DNA may inhibit protein synthesis. 

Global Rationale: Functional antagonists change pharmacokinetic factors such as excretion and metabolism. They do not block alpha or beta receptors. Drugs that bind with DNA may inhibit protein synthesis.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-9 Explain the relationship between receptors and drug action.

MNL Learning Outcome: 1.1.3 Relate processes of pharmacokinetics and pharmacodynamics to the therapeutic effect(s) of a drug. 

Page Number: 55