CHAPTER 04 - THE NURSING PROCESS IN DRUG THERAPY AND PATIENT SAFETY

1. A 70-year-old patient has just received a drug that can cause sedation. What would be the priority
nursing diagnosis for this patient?
A) Noncompliance: Cost of the drug
B) Deficient knowledge: Unfamiliar with drug therapy
C) Risk for injury: Related to adverse effects of the drug
D) Ineffective health maintenance: Need for medication

2. What is the responsibility of the nurse related to the patient’s drug therapy? (Select all that apply.)
A) Teaching the patient how to cope with therapy to ensure the best outcome
B) Providing therapy as well as medications
C) Evaluating the effectiveness of therapy
D) Altering the drug regimen to optimize outcome
E) Recommending appropriate over-the-counter medications to treat adverse effects of prescription
drug therapy

3. The nurse is gathering assessment data from a medication history of a 38-year-old man with four
children. What assessment information would be most important in providing care for this patient?
A) The medication history of the patient’s mother and/or father
B) The name of the patient’s pharmacy
C) Insurance, financial support, and stability for the patient and his family
D) The last time the patient was hospitalized

4. During what phase of the nursing process would the nurse be required to consider the efficacy of
nursing interventions related to drug therapy?
A) Assessment
B) Nursing diagnosis
C) Interventions
D) Evaluation

5. When the nurse reads in the drug handbook the section related to recommended dosage, it is
important to remember that this suggested dosage is based on what?
A) A 40-year-old man
B) An average-sized adult
C) A 150-pound adult male
D) A healthy young adult

6. A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric
dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse
use to calculate the correct dose?
A) Surface area
B) Height
C) Birth date
D) Adult dosage

7. You are evaluating the discharge teaching you have done with your patient concerning drug
therapy. What statement from the patient would indicate that teaching had been effective?
A) I have to take three pills each day and I can take them at the time that fits my schedule.
B) I should take the white pill in the morning because the doctor wants me to take it.
C) I will add the names and dosages of these new drugs to my medication list in my wallet.
D) I have prescriptions at different pharmacies. I shop around for the best price for each drug

8. The nurse would expect to see an adjusted dosage in what patients? (Select all that apply.)
A) Young adult women
B) Middle-aged men
C) Infants
D) Neonates
E) Older adults

9. When taking a medication history on a patient why should the nurse ask about the use of
complementary or alternative therapies?
A) Patients starting on new drugs are usually not compliant with medical regimens.
B) Many drug-alternative therapy interactions can cause serious problems.
C) Natural products may be more effective and the prescribed drug may not be needed.
D) The cost of the drug and the alternative therapy may be too expensive for the patient to hand

10. The nurse is reviewing the patient’s medication orders and finds an order stating amoxicillin 250
mg every 8 hours. What would the nurse question regarding this order?
A) Dose
B) Route
C) Frequency of administration
D) Allowance for generic substitution

11. The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would
the nurse consider a priority to assess to develop the most effective plan of care related to
medication administration?
A) Description of the patient’s living environment
B) Required lifestyle changes
C) Family members in the community
D) Compliance with therapy to reduce risk of skin breakdown

12. Student nurses are learning to weigh patients and do vital signs. How does a correct weight impact
administering medication?
A) Proper dosage calculation
B) Assessing changes in fluid balance
C) Assessing changes in nutritional status
D) Caloric needs

13. Teaching the patient/caregiver about her or his medications is an important step in reducing the
risk of medication errors. What is an important teaching point about medications? (Select all that
apply.)
A) Speak up and ask questions.
B) Store medications in a warm humid place.
C) Adjust your medication according to how you feel
D) Keep a list of your prescribed medications.
E) Take all medications together in the morning

14. A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10
mL of guaifenesin (Robitussin) PO q4h. This over-the-counter pharmaceutical comes in bottles with
plastic measuring caps. How much should the nurse teach the patient to take at home?
A) 1/2 tsp
B) 1 tsp
C) 2 tsp
D) 1 tbsp

15. It is important for the nurse to evaluate the efficacy of what parameter when evaluating the drug
therapy of a patient?
A) Appropriateness of drug dosages
B) Compliance
C) Caregivers’ knowledge level
D) Nursing interventions

16. The nurse is conducting an admission assessment on a patient. When collecting data related to
medications the nurse asks, What medications are you currently taking? After collecting this
information, what other questions should the nurse ask? (Select all that apply.)
A) Do you take any medications?
B) What over-the-counter (OTC) medications do you take?
C) Do you take an herbs, vitamins, or supplements?
D) Do you take medications safely when you take them?
E) Why do you take this medication?

17. A 27-year-old man is admitted to the emergency department (ED) after a serious motorcycle
accident. The patient has a head injury, abrasions covering the left side of his body, a broken left
femur, and internal injuries that are not fully assessed at this time. He is transferred from the ED to
the intensive care unit (ICU). The nurse who is going to care for this patient in the ICU knows that a
priority responsibility in regard to drug therapy is what?
A) Support vital functions
B) Continue curative treatment
C) Institute life-saving treatment
D) Monitor patient’s response

18. When assessing a patient before starting a drug regimen, why would the nurse consider it
important to assess baseline kidney function?
A) To anticipate adverse effects of drugs
B) To determine patient’s baseline electrolyte levels
C) To determine patient’s ability to excrete the drug
D) To determine patient’s ability to metabolize the drug

19. A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the
knowledge that the aging process impacts drug therapy in what important way?
A) Blood volume decreases
B) Subcutaneous tissue increases
C) Total body water increases
D) Muscle mass increase

20. The nurse is caring for a patient who takes several drugs. What patient would the nurse monitor
most closely because of an increased risk for adverse effects of medications?
A) The school-aged child
B) The obese middle-aged man
C) The adolescent
D) The newborn infant

21. Which statement best describes drug efficacy/toxicity in pediatric patients?

A) Drug requirements for infants have been extensively studied.
B) Drug dosage is altered by age and weight in children.
C) Children always need smaller doses of medication than adults.
D) Infants and children are not at risk for drug toxicity if the dosage is correct

22. A 7-year-old boy fell off a wood pile while playing. He has been admitted to the intensive care unit
with multiple broken bones and internal bleeding. What should the nurse know about drug therapy
in this type of patient?
A) Adverse effects may be decreased.
B) Therapeutic effects may be increased.
C) Pharmacodynamics may be altered.
D) Pharmacokinetics remain the same
23. After admitting a patient to the unit, the nurse is organizing times to administer ordered
medications. What important consideration will guide the nurse’s timing of each medication?
A) Comfort
B) Ethnicity of patient
C) Gender
D) Age

24. The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell
the students about what could affect therapeutic dosing in an older adult?
A) Changes in the gastrointestinal (GI) system can reduce drug absorption.
B) In older adults, drugs enter into circulation more quickly.
C) In older adults, drugs are distributed to a smaller portion of the tissues.
D) In older adults, drugs have an increased action

25. In today’s health care environment there is often more contact between the patient and the nurse
than between the patient and the physician. How does this increased patient contact impact drug
therapy?
A) Choosing the best medication to treat the patient’s condition
B) Assessing the patient’s preferred communication strategies
C) Assessing the therapeutic success of the drug therapy
D) Reducing dosage quickly when adverse effects arise

26. The nurse admits a patient to the unit and learns the patient has recently been diagnosed with
chronic renal failure but has not informed the primary care provider of this diagnosis. What is the
nurse’s first priority?
A) Administer medications ordered immediately.
B) Maintain the patient’s confidentiality.
C) Call the admitting physician immediately.
D) Provide teaching about chronic renal failure

27. It is often necessary to obtain baseline data prior to initiating many forms of drug therapy. These
baseline data include what? (Select all that apply.)
A) Education level
B) Allergies
C) Drug use
D) Number of members in family
E) Father’s occupation

28. A 32-year-old woman is admitted to the unit with a diagnosis of hypovolemia. The nurse is
developing a care plan for this patient. What is an appropriate nursing diagnosis to help prevent
medication errors?
A) Dysfunctional gastrointestinal motility
B) Ineffective self-health maintenance
C) Risk for injury
D) Deficient fluid volume

29. The nurse applies the nursing process in medication therapy to ensure what?
A) That medications are given at the right time
B) That care is efficient and effective
C) That the right dose of the drug is given to the patient
D) That the right drug is given to the right patient at the right time
30. A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being
treated at home, but became worse when he quit taking his antibiotic prematurely. What is an
appropriate nursing diagnosis for this patient?
A) Deficient knowledge: monitoring temperature
B) Noncompliance
C) Risk for injury related to hypoxia
D) Non-adherence: overuse

31. The nurse is reviewing the patient’s admission medication orders. What order would the nurse to
question?
A) Digoxin .5 mg orally now give one dose only
B) Lasix 20 mg. IV every 4 hours times 3
C) Gentamicin 80 mg IV to infuse over 1 hour every 12 hours
D) Acetaminophen 650 mg PO every 4 hours as needed for pain

32. The nursing instructor observes several nursing students administer medications to their assigned
patients. The instructor would stop what student from administering the medication until the error
was corrected?
A) The student checks the label on the medication against the administration record three times.
B) The student enters the patient’s room and asks the patient Are you Mr. Jones?
C) The student checks the drug’s brand name and generic name before taking it to the patient.
D) The student documents the medication upon exiting the patient’s room

33. The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything
orally. The nurse reviews the medication administration record and finds the patient has an
important medication due but it is supposed to be given orally. What is the nurse’s best action?
A) Give the medication with a small sip of water.
B) Give the medication via a different route.
C) Hold the medication and put a note on the front of the chart for the surgeon.
D) Call the ordering health care provider and clarify administration

34. The nurse admits an older adult patient to the emergency room with reports of shortness of breath
on exertion and a productive cough. The nurse reviews the patient’s current medications and the
patient says, I take one pink pill every morning. The nurse asks the name of the drug and the
patient says she doesn’t know. The patient cannot supply the name of the drug or the purpose in
taking it either. This happens with four other medications the patient says she takes. What is an
appropriate nursing diagnosis for this patient?
A) Acute confusion
B) Risk-prone health behavior
C) Ineffective health maintenance
D) Noncompliance

35. What action does the nurse take during the intervention state of the nursing process related to drug
therapy? (Select all that apply.)
A) Administer the medication.
B) Determine medication effectiveness.
C) Document the medication.
D) Analyze the data collected.
E) Collect a nursing history