Pharmacology For Nurses A Pathophysiologic Approach 5th Edition Adams Test Bank 1

PHARMACOLOGY FOR NURSES A PATHOPHYSIOLOGIC
APPROACH 5TH EDITION ADAMS TEST BANK
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Adams, Pharmacology for Nurses: A Pathophysiologic Approach, 5/E

Chapter 9
Question 1
Type: MCMA
The nurse is doing a holistic assessment on a patient prior to the initiation of antihypertensive medication. What
will the best assessment include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Blood pressure
2. The biologic cause of the hypertension
3. Mood
4. Level of education
5. Belief in a higher power
Correct Answer: 1,3,4,5
Rationale 1: Holistic health care incorporates the whole patient to include the biological (blood pressure)
dimension.
Rationale 2: The biologic cause of the hypertension focuses on a specific disease, its cause, and treatment; this is
a medical model, not a holistic model.
Rationale 3: Holistic health care incorporates the whole patient to include the psychological (mood) dimension.
Rationale 4: Holistic health care incorporates the whole patient to include the sociocultural (level of education)
dimension.
Rationale 5: Holistic health care incorporates the whole patient to include the spiritual (belief in a higher power)
dimension.
Global Rationale: Holistic health care incorporates the whole patient to include the biological (blood pressure),
psychological (mood), sociocultural (level of education), and spiritual (belief in a higher power) dimensions. The
biologic cause of the hypertension focuses on a specific disease, its cause, and treatment; this is a medical model,
not a holistic model.
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: Relationship-Centered Care: Respect the patient’s dignity, uniqueness, integrity and self-
determination, and his or her own power and self-healing process.
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-1 Describe fundamental concepts underlying a holistic approach to patient care and their
importance to pharmacotherapy.
MNL Learning Outcome: 1.2.3 Compare pharmacologic implications across the lifespan and various
community settings.
Page Number: 95
Question 2
Type: MCSA
The adolescent Hispanic male has been diagnosed with attention-deficit hyperactivity disorder (ADHD), and is
taking methylphenidate (Ritalin). Even though the drug helps with focus and grades, the adolescent will not go to
the school office at noon for his medication. Which statement best describes the result of the nurse's evaluation?
1. The adolescent has developed alternative coping mechanisms to increase his focus during classes.
2. The adolescent is fearful that this drug may be a "gateway drug" and he will abuse other substances.
3. The adolescent really does not need an additional dose of methylphenidate (Ritalin) at school.
4. The adolescent is embarrassed about having to take medicine at school; it is a social stigma.
Correct Answer: 4
Rationale 1: Attention-deficit hyperactivity disorder is a brain-based disorder, and the primary treatment is
medication; alternative coping mechanisms will not usually help to increase focus during classes.
Rationale 2: Appropriate treatment of attention-deficit hyperactivity disorder will result in less addiction to
mood-altering substances, not more addiction.
Rationale 3: Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart,
so the patient must receive a dose during school hours.
Rationale 4: Some patients believe that having to take drugs in school will cause them to be viewed as weak,
unhealthy, or dependent. Patients can also perceive this as a social stigma.
Global Rationale: Some patients believe that having to take drugs in school will cause them to be viewed as
weak, unhealthy, or dependent. Patients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a
short-acting drug and doses must be administered about 4 hours apart, so the patient must receive a dose during
school hours. Attention-deficit hyperactivity disorder is a brain-based disorder, and the primary treatment is
medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate
treatment of attention-deficit hyperactivity disorder will result in less addiction to mood-altering substances, not
more addiction.
Cognitive Level: Analyzing

QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care:
patient/family/community preferences; values coordination and integration of care; information, communication,
and education; physical comfort and emotional support; involvement of family and friends; transitions and
continuity.
AACN Essentials Competencies: IX.18 Develop an awareness of patients as well as healthcare professionals’
spiritual beliefs and values and how those beliefs and values impact health care.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 9-2 Identify psychosocial factors that can affect pharmacotherapeutics.
community settings.
Page Number: 96
Question 3
Type: MCSA
The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and
will not allow her to receive any analgesia during the experience. What is the best action by the nurse?
1. Inform the husband that it is his wife's choice whether or not to receive analgesia.
2. Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital.
3. Allow the request but inform the husband that the physician will make the final decision about analgesia.
4. Allow this request and be available in the event the request changes.
Correct Answer: 4
Rationale 1: With some cultures, the husband makes the choices, not the wife.
Rationale 2: When cultural differences are allowed and supported, patients are not as likely to become involved
in litigation.
Rationale 3: With some cultures, the husband makes the choices, not the physician.
Rationale 4: Nurses must allow and support cultural differences. The husband's decisions must be respected as
long as patient safety is not involved, and it is not involved in this situation.
Global Rationale: Nurses must allow and support cultural differences. The husband's decisions must be respected
as long as patient safety is not involved, and it is not involved in this situation. With some cultures, the husband
makes the choices, not the wife or the physician. When cultural differences are allowed and supported, patients
are not as likely to become involved in litigation.

QSEN Competencies: I.A.2 Describe how diverse cultural, ethnic, and social backgrounds function as sources of
patient, family, and community values.
AACN Essentials Competencies: II.8 Promote achievement of safe and quality outcomes of care for diverse
populations.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 9-3 Explain how culture and ethnicity can affect pharmacotherapeutic outcomes.
community settings.
Page Number: 97
Question 4
Type: MCSA
A patient is diagnosed with cancer. The physician has recommended chemotherapy, which would likely save the
patient's life. The patient tells the nurse, "This is punishment from God for sins I have committed; some women at
my church say so." What will the best plan of the nurse include?
1. With the patient's permission, plan to involve a hospital minister to discuss the patient's perspective about
cancer.
2. With the patient's permission, plan to bring the case before the hospital's board of ethics.
3. With the patient's permission, plan to contact the patient's minister to discuss the patient's perspective about
cancer.
4. With the patient's permission, plan to meet with family members to discuss the patient's perspective about
cancer.
Correct Answer: 3
Rationale 1: Involving a hospital minister may be an option, but it is best to work through the patient's minister
initially.
Rationale 2: Bringing the case before the hospital's board of ethics is premature at this point.
Rationale 3: When patients have strong religious beliefs, these can affect the outcome of the illness. The nurse
should involve the patient's religious leader when possible.
Rationale 4: Meeting with family might help; however, they may have the same perspective as the patient.
Global Rationale: When patients have strong religious beliefs, these can affect the outcome of the illness. The
nurse should involve the patient's religious leader when possible. Meeting with family might help; however, they
may have the same perspective as the patient. Bringing the case before the hospital's board of ethics is premature
at this point. Involving a hospital minister may be an option, but it is best to work through the patient's minister
initially.

populations.
Nursing/Integrated Concepts: Nursing Process: Planning
community settings.
Page Number: 96
Question 5
Type: MCSA
The African American patient has panic attacks, is suicidal, and is on an inpatient psychiatric unit. The
psychiatrist orders sertraline (Zoloft) and clonazepam (Klonopin). The patient refuses the drugs; he requests to
have herbs and African objects in his room to "remove the curse." What is the priority action by the nurse?
1. Allow the request without seeking further information from the patient.
2. Allow the request as long as the herbs and objects do not pose a safety risk for the patient or other patients.
3. Allow the request after the patient signs a release of responsibility to avoid litigation.
4. Allow the request after all members of the treatment team agree to it.
Correct Answer: 2
Rationale 1: To allow an ethnic request without seeking further information about safety could jeopardize patient
safety.
Rationale 2: Nurses must grant ethnic requests as long as the request does not pose a safety risk to the patient or
others.
Rationale 3: There is no need for the patient to sign a release of responsibility to avoid litigation; if items pose a
safety risk, they cannot be allowed on the unit.
Rationale 4: The treatment team does not need to agree to this request; the nurse can approve it as long as the
items do not pose a safety risk.
Global Rationale: Nurses must grant ethnic requests as long as the request does not pose a safety risk to the
patient or others. To allow an ethnic request without seeking further information about safety could jeopardize
patient safety. There is no need for the patient to sign a release of responsibility to avoid litigation; if items pose a
safety risk, they cannot be allowed on the unit. The treatment team does not need to agree to this request; the
nurse can approve it as long as the items do not pose a safety risk.

populations.
community settings.
Page Number: 97
Question 6
Type: MCSA
The public health nurse notices that several patients in the hypertension clinic have poorly controlled
hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will
best enable the nurse to assess these patients?
1. "Does your religion allow the use of high blood pressure medication?"
2. "Do you think your high blood pressure is a problem?"
3. "Can you afford the high blood pressure medication?"
4. "Does your culture use herbs to treat high blood pressure?"
Correct Answer: 3
Rationale 1: Religious beliefs could result in the patient not taking the medication, but the cost of the medication
is more likely the problem.
Rationale 2: To ask a patient if they think hypertension is a problem should not be necessary; the nurse could
eliminate this by appropriate medication education when the medication is prescribed for the patient.
Rationale 3: Once treatment is rendered, the cost of prescription drugs may be far too high for patients on limited
incomes.
Rationale 4: The use of herbs may be important in the patient's culture, but the cost of the medication is more
likely the problem.
Global Rationale: Once treatment is rendered, the cost of prescription drugs may be far too high for patients on
limited incomes. The use of herbs may be important in the patient's culture, but the cost of the medication is more
likely the problem. To ask a patient if they think hypertension is a problem should not be necessary; the nurse
could eliminate this by appropriate medication education when the medication is prescribed for the patient.
Religious beliefs could result in the patient not taking the medication, but the cost of the medication is more likely
the problem.

populations.
community settings.
Page Number: 97
Question 7
Type: MCSA
The nurse is providing education about warfarin (Coumadin) to a patient of Asian ancestry. The nurse determines
that learning has occurred when the patient makes which statement?
1. "I may need to have more frequent blood tests."
2. "I may need to have less frequent blood tests."
3. "I may need more medication than someone from a different ethnic group."
4. "I may need less medication than someone from a different ethnic group."
Correct Answer: 4
Rationale 1: There is no need for patients of Asian ancestry to have more frequent blood tests than other patients..
Rationale 2: There is no need for patients of Asian ancestry to have less frequent blood tests.
Rationale 3: A patient of Asian ancestry may be a poor metabolizer of warfarin (Coumadin), so they will not
require a higher dose.
Rationale 4: A patient of Asian ancestry may be a poor metabolizer of warfarin (Coumadin), so they will often
require lower dosages.
Global Rationale: A patient of Asian ancestry may be a poor metabolizer of warfarin (Coumadin), so they will
often require lower dosages. There is no need for patients of Asian ancestry to have more or less frequent blood
tests than other patients.

continuity.
Learning Outcome: 9-5 Convey how genetic polymorphisms can influence pharmacotherapy.
community settings.
Page Number: 100
Question 8
Type: MCMA
The nurse is conducting a holistic assessment of a patient with alcoholism. What are the important questions to
ask?
1. "How is drinking alcohol viewed by your culture?"
2. "Have you ever attended Alcoholics Anonymous meetings?"
3. "Did you see your parents drinking alcohol when you were growing up?"
4. "Have you been in alcohol rehabilitation before now?"
5. "What blood relatives of yours are addicted to alcohol?"
Correct Answer: 1,3,5
Rationale 1: Cultural questions are valid questions to ask during a holistic assessment.
Rationale 2: Participation in Alcoholics Anonymous refers to treatment and does not have relevance to a holistic
assessment.
Rationale 3: Environmental questions are valid questions to ask during a holistic assessment.
Rationale 4: Participation in a rehabilitation program refers to treatment and does not have relevance to a holistic
assessment.
Rationale 5: Biological questions are valid questions to ask during a holistic assessment.
Global Rationale: Biological, environmental, and cultural questions are valid questions to ask during a holistic
assessment. Participation in a rehabilitation program refers to treatment and does not have relevance to a holistic
assessment. Participation in Alcoholics Anonymous refers to treatment and does not have relevance to a holistic
assessment.

community settings.
Page Number: 95
Question 9
Type: MCSA
The patient, who is an American Indian, has been admitted to the hospital for chemotherapy. At any given time,
five family members are in the patient's room, which is private. The nurse tells the patient that according to
hospital policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal
about the nurse's action?
1. The nurse should have assessed the patient's preferences about how many family members she wanted to be
present.
2. The nurse should have called the physician and obtained an order for additional family members to be present.
3. This was the correct action; the nurse was following protocol by informing the patient about hospital policy.
4. The nurse should have allowed the patient to have as many family members as she wanted to be present.
Correct Answer: 1
Rationale 1: The nurse should have assessed the patient's preference about how many visitors she wanted in her
room before so strictly interpreting the hospital rules.
Rationale 2: This situation could be resolved by the nurse; there is no need for a physician's order at this point.
Rationale 3: Many hospital rules, such as how many visitors are allowed, are flexible and do not have to be
strictly interpreted; this patient is in a private room.
Rationale 4: The nurse must be realistic with regard to the number of family visitors the patient wants present;
five family members is acceptable; twenty would be too many.
Global Rationale: The nurse should have assessed the patient's preference about how many visitors she wanted
in her room before so strictly interpreting the hospital rules. Many hospital rules, such as how many visitors are
allowed, are flexible and do not have to be strictly interpreted; this patient is in a private room. The nurse must be
realistic with regard to the number of family visitors the patient wants present; five family members is acceptable;
twenty would be too many. This situation could be resolved by the nurse; there is no need for a physician's order
at this point.
populations.
community settings.
Page Number: 97
Question 10
Type: MCSA
The physician has prescribed a chemotherapeutic drug for the patient with cancer. This drug commonly causes
loss of hair. The patient asks the nurse, "Will all of my hair fall out?" What is the most therapeutic response by the
nurse?
1. "We are not really sure; applying an ice bag to your head may help."
2. "Don't worry, we can recommend an excellent wig company if need be."
3. "Yes, that is one of the expected side effects of this medication."
4. "It might. Have you discussed this with your physician?"
Correct Answer: 3
Rationale 1: Ice bags can minimize hair loss with some patients, but the nurse is not honestly answering the
patient's question.
Rationale 2: Telling a patient not to worry is one of the most non-therapeutic responses a nurse can make.
Rationale 3: The nurse must always be forthright in explaining drug actions and potential side effects;
minimizing potential adverse effects can result in a distrust of the nurse.
Rationale 4: In this case, the nurse, not the physician, is responsible for answering the patient's questions.
Global Rationale: The nurse must always be forthright in explaining drug actions and potential side effects;
minimizing potential adverse effects can result in a distrust of the nurse. Ice bags can minimize hair loss with
some patients, but the nurse is not honestly answering the patient's question. Telling a patient not to worry is one
of the most non-therapeutic responses a nurse can make. In this case, the nurse, not the physician, is responsible
for answering the patient's questions.
continuity.
community settings.
Page Number: 96
Question 11
Type: MCSA
The patient is admitted to the hospital following an abortion, and she is septic. The physician orders antibiotics
that the patient refuses stating, "I don't deserve them." The nurse providing care has anti-abortion beliefs. What is
the best response by the nurse?
1. "I think you need to do what is best for you."
2. "You have a serious infection and really need the drug."
3. "It seems you think you should be punished because you had an abortion"
4. "I'll call your physician and let him know about your decision."
Correct Answer: 2
Rationale 1: Telling the patient she needs to do what is best is inappropriate; the nurse knows she needs the drug.
Rationale 2: Telling the patient she needs the drug is providing the best care possible; this must be done even
though the nurse's beliefs are different from the patient's beliefs.
Rationale 3: Telling the patient what she thinks is not appropriate.
Rationale 4: Calling the physician is inappropriate; the nurse knows the patient needs the drug.
Global Rationale: Telling the patient she needs the drug is providing the best care possible; this must be done
even though the nurse's beliefs are different from the patient's beliefs. Telling the patient she needs to do what is
best is inappropriate; the nurse knows she needs the drug. Calling the physician is inappropriate; the nurse knows
the patient needs the drug. Telling the patient what she thinks is not appropriate.

populations.
community settings.
Page Number: 97
Question 12
Type: MCSA
The African American patient had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse caring
for the patient is Caucasian. The nurse assesses the patient's diet to be very high in fat. What is the best plan by
the nurse to improve the patient's diet and reduce the risk for additional medications?
1. With the patient's permission, plan to ask an African American nurse to speak to him about a low-fat diet.
2. With the patient's permission, plan to discuss his diet with whomever prepares meals for his family.
3. Plan to give the patient information specific to African Americans about low-fat diets.
4. Plan to ask the physician for a consult by dietary services so a dietician can teach the patient about low-fat
diets.
Correct Answer: 2
Rationale 1: Asking the patient about having an African American nurse speak to him is racist and implies that a
Caucasian nurse cannot understand the dietary needs of an African American patient.
Rationale 2: Every culture has culture-specific diets; the nurse must include the person in the family who does the
meal preparation if a different diet is to be successful.
Rationale 3: Providing information is a good idea, but the nurse must also teach the patient.
Rationale 4: At this point, a consult by dietary services is premature.

Global Rationale: Every culture has culture-specific diets; the nurse must include the person in the family who
does the meal preparation if a different diet is to be successful. Asking the patient about having an African
American nurse speak to him is racist and implies that a Caucasian nurse cannot understand the dietary needs of
an African American patient. At this point, a consult by dietary services is premature. Providing information is a
good idea, but the nurse must also teach the patient.

populations.
community settings.
Page Number: 97
Question 13
Type: MCSA
The patient is receiving a beta-blocker medication. The nurse has done medication education and provided the
patient with printed information to take home. During the next appointment, the nurse notes that the patient is not
taking the medication properly. What is a therapeutic assessment question to ask this patient?
1. "Do I have to inform your physician about your noncompliance?"
2. "Why didn't you take your medicine as we talked about?"
3. "Are you able to read and comprehend the printed information?"
4. "Don't you understand how important it is to take the medicine?"
Correct Answer: 3
Rationale 1: It is inappropriate to involve the physician before the nurse assesses the reason for noncompliance,
and this question is threatening.
Rationale 2: Asking "why" questions put the patient on the defensive, and the nurse might not receive the most
accurate answer.
Rationale 3: Many English-speaking patients do not have functional literacy, a basic ability to read, understand,
and act on health information. The nurse should ask the patient about the ability to read and understand printed
information.
Rationale 4: Being confrontational with a "don't you understand" question is as demeaning as asking a "why"
question.
Global Rationale: Many English-speaking patients do not have functional literacy, a basic ability to read,
understand, and act on health information. The nurse should ask the patient about the ability to read and
understand printed information. Asking "why" questions put the patient on the defensive, and the nurse might not
receive the most accurate answer. Being confrontational with a "don't you understand" question is as demeaning
as asking a "why" question. It is inappropriate to involve the physician before the nurse assesses the reason for
noncompliance, and this question is threatening.

populations.
community settings.
Page Number: 97
Question 14
Type: MCSA
All of the patients listed have cancer and are receiving chemotherapy. Which patient does the nurse evaluate as
having the highest probability for a remission?
1. The patient with a support group of cancer survivors
2. The patient who is also seeing a psychiatrist for treatment of depression
3. The wealthy patient who can afford the best medical care available
4. The patient who is a former physician
Correct Answer: 1
Rationale 1: Positive attitudes and high expectations toward therapeutic outcomes in the patient may influence
the success of pharmacotherapy. The support group of cancer survivors would provide the best support and the
highest probability for a positive outcome.
Rationale 2: Treatment for depression might help the outcome, but this patient would not have as high a
probability for remission as the patient with another resource.
Rationale 3: A wealthy patient can afford the best medical care, but this patient may not have good psychosocial
support.
Rationale 4: A former physician may have a sound knowledge base about cancer, but this patient might not have
good psychosocial support.
Global Rationale: Positive attitudes and high expectations toward therapeutic outcomes in the patient may
influence the success of pharmacotherapy. The support group of cancer survivors would provide the best support
and the highest probability for a positive outcome. A wealthy patient can afford the best medical care, but this
patient may not have good psychosocial support. Treatment for depression might help the outcome, but this
patient would not have as high a probability for remission as the patient with another resource. A former
physician may have a sound knowledge base about cancer, but this patient might not have good psychosocial
support.

continuity.
community settings.
Page Number: 96
Question 15
Type: MCMA
A nurse is teaching a community group about holistic medicine. Which information should the nurse include
about Western medicine?
1. Western medicine focuses on the cause of disease.
2. Western medicine is not compatible with holistic medicine.
3. The patient is at the center of concern in Western medicine.

4. Disease is often viewed as a malfunction in a specific body system.
5. Western medicine may focus on disease treatment.
Rationale 1: Western medicine often focuses on determining which disease is present and what caused it.
Rationale 2: Western medicine is compatible with holistic medicine, but this requires that those providing care
remain mindful of the individuality of the patient.
Rationale 3: Disease and treatment are typically at the center of Western medicine.
Rationale 4: In Western medicine disease is often viewed as a specific malfunction of a body part.
Rationale 5: Western medicine often focuses on the treatment of a disease, not the care of the patient with the
disease.
Global Rationale: Western medicine often focuses on determining which disease is present and what caused it.
In Western medicine disease is often viewed as a specific malfunction of a body part. Western medicine often
focuses on the treatment of a disease, not the care of the patient with the disease. Western medicine is compatible
with holistic medicine, but this requires that those providing care remain mindful of the individuality of the
patient. Disease and treatment are typically at the center of Western medicine.

community settings.
Page Number: 95
Question 16
Type: MCSA
Which of the following best indicates an ethnic characteristic that can affect pharmacotherapy?
1. Genetic differences
2. Diet
3. Health beliefs
4. Alternative therapies
Correct Answer: 1
Rationale 1: Ethnicity relates to biology and genetics.
Rationale 2: Diet is a cultural characteristic.
Rationale 3: Health belief is a cultural characteristic.
Rationale 4: Alternative therapies are cultural characteristics.
Global Rationale: Ethnicity relates to biology and genetics. Diet, alternative therapies, and health beliefs are
cultural characteristics.

community settings.
Page Number: 100
Question 17
Type: MCMA
The nurse manager would determine that a nurse understands culturally sensitive care if which statements are
made?
1. "Since all of our patients have the same illnesses, I sometimes get bored."
2. "I have been helping my patient understand how to choose foods from our diet menu."
3. "I am concerned because my patient needs sterile dressing changes but has no running water at home."
4. "My patient and I worked out a way to get her medications delivered to her at home."
5. "I invited a group from my church to come and sing hymns for our patients."
Rationale 1: A nurse who believes that patients who have the same illness are alike is not seeing their
psychosocial needs.
Rationale 2: Helping the patient cope and navigate through the hospital “culture” is a culturally sensitive action.
Rationale 3: Cultural sensitivity takes environment into consideration.
Rationale 4: Helping the patient cope and navigate through potential blockers to medication adherence is a
culturally sensitive action.
Rationale 5: Imposing one’s own religious beliefs on others is not culturally sensitive.
Global Rationale: Helping the patient cope and navigate through the hospital “culture” is a culturally sensitive
action. Cultural sensitivity takes environment into consideration. Helping the patient cope and navigate through
potential blockers to medication adherence is a culturally sensitive action. A nurse who believes that patients who
have the same illness are alike is not seeing their psychosocial needs. Imposing one’s own religious beliefs on
others is not culturally sensitive.

community settings.
Page Number: 95
Question 18
Type: MCSA
Which statement regarding human DNA sequences is accurate?
1. Only 2% of human DNA is different among the different ethnicities.
2. Due to enzyme polymorphism, Hispanics are less likely to metabolize codeine to morphine.
3. Even though human genetic differences are small, significant differences can be seen with drug metabolism.
4. Asian Americans are the ethnic group known to be slow acetylators.
Correct Answer: 3
Rationale 1: Human DNA differences of only 0.2% can produce significant differences in the way drugs are
handled within the body.
Rationale 2: Asian Americans are less likely to metabolize codeine to morphine.
Rationale 3: Human DNA differences of only 0.2% can produce significant differences in the way drugs are
handled within the body.
Rationale 4: Caucasians are known to be slow acetylators.
Global Rationale: Human DNA differences of only 0.2% can produce significant differences in the way drugs
are handled within the body. Asian Americans are less likely to metabolize codeine to morphine, and Caucasians
are known to be slow acetylators.
Cognitive Level: Remembering

community settings.
Page Number: 99
Question 19
Type: MCSA
Which statement is accurate regarding gender and pharmacology?
1. Women tend to seek medical care earlier than men do.
2. Heart disease has traditionally been thought of as a woman’s disease.
3. Since the 1980s, the FDA has mandated that research studies include both male and female subjects.
4. Studies indicate that men and women suffer from Alzheimer’s disease in equal numbers.
Correct Answer: 1
Rationale 1: Women are quicker to seek medical care than are men.
Rationale 2: Cardiac disease has traditionally been thought of as a men’s issue.
Rationale 3: In 1993, the FDA mandated that research studies include both male and female subjects.
Rationale 4: Studies indicate that more women than men suffer from Alzheimer’s disease.
Global Rationale: Women are quicker to seek medical care than are men. Studies indicate that more women than
men suffer from Alzheimer’s disease. In 1993, the FDA mandated that research studies include both male and
female subjects. Cardiac disease has traditionally been thought of as a men’s issue.
Cognitive Level: Remembering

populations.
Learning Outcome: 9-6 Relate the implications of gender to the actions of certain drugs.
community settings.
Page Number: 100
Question 20
Type: MCMA
The nurse is assessing several patients. For which patient does assessment reveal a psychosocial history that may
affect the patient's outcome?
1. Older adult who recently suffered a stroke, has an unsteady gait, and lives in a two-story home
2. Middle-aged patient with Down syndrome living in a group home
3. Recently divorced mother of three children with breast cancer
4. Sixteen-year-old requesting birth control without parental consent
5. Seven-year-old with asthma in a foster care home

Rationale 1: This patient may not be able to return to a home that requires climbing stairs.
Rationale 2: A patient with Down syndrome needs additional care to ensure that treatment outcome is successful.
Rationale 3: This patient may be the family's sole provider and may have financial concerns.
Rationale 4: Many teens seek contraception without their parents' consent. This should not have a negative
impact on outcome.
Rationale 5: Residing in foster care should not have a negative impact on outcome.
Global Rationale: A patient who had a stroke may not be able to return to a home that requires climbing stairs. A
patient with Down syndrome needs additional care to ensure that treatment outcome is successful. The patient
with breast cancer may be the family's sole provider and may have financial concerns. Many teens seek
contraception without their parents' consent. This should not have a negative impact on outcome. Residing in
foster care should not have a negative impact on outcome.

populations.
Learning Outcome: 9-4 Explain how community and environmental factors can affect health care outcomes.
community settings.
Page Number: 98
Question 21
Type: MCMA
The nurse in charge of a clinical study welcomes the participants in an open forum. One patient is surprised that
there are men and women from several ethnic groups. The nurse tells the group that in the past, ethnic variables
were largely unknown or ignored for what reasons?
1. Clinical trials failed to include ethnically diverse subjects.
2. Clinical trials comprised mostly Caucasian males.

3. Little attention was focused on identifying the different effects drugs had on various ethnic groups.
4. Research proved there were no differences among ethnic groups.
5. The large majority of clinical trials included Caucasian females.
Rationale 1: There was a lack of ethnic diversity in early clinical trials.
Rationale 2: Until recently, clinical trials comprised mostly Caucasian males.
Rationale 3: Little attention was focused on identifying the differences in pharmacologic effects in diverse ethnic
groups.
Rationale 4: There was insufficient research to show differences because little attention was focused on these
differences.
Rationale 5: The large majority of clinical trials excluded females.
Global Rationale: There was a lack of ethnic diversity in early clinical trials. Little attention was focused on
identifying the differences in pharmacologic effects in diverse ethnic groups. Until recently, clinical trials
comprised mostly Caucasian males.
Cognitive Level: Understanding

populations.
community settings.
Page Number: 96
Question 22
Type: MCMA
The nurse in the emergency department is caring for several patients from diverse cultures. Which statement
shows the nurse's ability to provide culturally competent care?
1. "I understand your religion prohibits blood transfusions. Would you consider nonblood alternatives?"
2. "I just want to make sure you and your spouse understand the risks as you consider the options."
3. "I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to
alleviate your fear?"
4. "I really don't understand why you won't consider an abortion. Your admission papers say you are an atheist."
5. "I'm not quite sure why the health care provider is giving you these prescriptions. You didn't get them filled the
last time you were here."
Rationale 1: This statement shows the nurse is respectful of religious beliefs and open to offering alternative
treatment.
Rationale 2: This statement shows the nurse is accepting of patients' beliefs.
Rationale 3: This statement may encourage the patient to open up to the nurse about fears.
Rationale 4: This is a judgmental and insensitive comment. A culturally competent nurse is sensitive to the
patient's spiritual beliefs or lack thereof.
Rationale 5: This statement does not consider social factors that may contribute to nonadherence.
Global Rationale: The nurse providing culturally competent care is respectful of and sensitive to religious beliefs
and open to alternate treatment. The nurse encourages patient to open up about fears. There are social factors that
may contribute to nonadherence to therapy.

continuity.
community settings.
Page Number: 96
Question 23
Type: MCMA
A home health nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural
variables?
1. Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are
possible
2. Assessing the patient's response to acupuncture for pain
3. Discussing the patient's beliefs regarding treatment
4. Notifying the health care provider of the patient's intentions to consult with a medicine man for spiritual
guidance
5. Removing the patient's collection of herbs to decrease the risk of an adverse effect when taken with Western
medicine
Rationale 1: It is important to assess the cultural use of herbs and spices and determine if there may be any
interactions with prescribed medications.
Rationale 2: The nurse can assess the patient's response to acupuncture and interpret the effects on prescribed
treatment with respect for the patient's culture.
Rationale 3: Cultures view health and wellness in different ways. An understanding of the patient's cultural
beliefs allows the nurse to provide better support and guidance.
Rationale 4: As long as the medicine man does not "prescribe" any herbs, the nurse does not have to discuss this
with the provider.
Rationale 5: The nurse need not remove the herbs but rather should discuss possible adverse effects when the
herbs are mixed with prescribed medications.
Global Rationale: It is important to assess the cultural use of herbs and spices and determine if there may be any
interactions with prescribed medications. The nurse need not remove the herbs but rather should discuss possible
adverse effects when the herbs are mixed with prescribed medications. The nurse can assess the patient's response
to acupuncture and interpret the effects on prescribed treatment with respect for the patient's culture. Cultures
view health and wellness in different ways. An understanding of the patient's cultural beliefs allows the nurse to
provide better support and guidance. As long as the medicine man does not "prescribe" any herbs, the nurse does
not have to discuss this with the provider.
continuity.
community settings.
Page Number: 96
Question 24
Type: MCMA
A patient asks the nurse why a medication prescribed by the provider "didn't do anything at all." Which statement
by the nurse accurately describes how genetics influence drug action?
1. "Genetic differences can result in significant differences in how each patient's body handles the same
medication."
2. "Genetic differences can cause mutations in enzymes, changing the way they function. This can alter how the
body metabolizes and excretes drugs."
3. "Because of genetic differences, medication may accumulate to toxic levels in one patient while in another
patient may be inactivated before it can have a therapeutic effect."
4. "Genetic differences can be expressed as an alteration in the structure of an enzyme, which can cause a
defective receptor and an allergic response to drugs."
5. "Genetic differences in patients who are biracial result in an allergic response to medications."
Rationale 1: 99.8% of human DNA sequences are identical. The remaining 0.2% can account for significant
differences in people's ability to handle medications.
Rationale 2: The structure of an enzyme is closely related to its function. A mutation can cause a change in the
structure of the enzyme, resulting in a change in its function.
Rationale 3: When enzymes are functionally changed by genetics, metabolism and excretion can be altered,
resulting in the drug either accumulating or being inactivated.
Rationale 4: Small changes in the structure of a protein may result in a defective receptor that will not accept the
drug and the drug not having any therapeutic effect. This is not an allergic response.
Rationale 5: Genetic differences can result in mutations of enzymes or proteins, which may result in changes in
function. Being of a certain race may predispose a patient to mutations and, therefore, uncommon responses to
medication, but this does not mean the patient will have an allergic response to medications.
Global Rationale: 99.8% of human DNA sequences are identical. The remaining 0.2% can account for
significant differences in people's ability to handle medications. The structure of an enzyme is closely related to
its function. A mutation can cause a change in the structure of the enzyme, resulting in a change in its function.
When enzymes are functionally changed by genetics, metabolism and excretion can be altered, resulting in the
drug either accumulating or being inactivated. Small changes in the structure of a protein may result in a defective
receptor that will not accept the drug and the drug not having any therapeutic effect. This is not an allergic
response. Genetic differences can result in mutations of enzymes or proteins, which may result in changes in
function. Being of a certain race may predispose a patient to mutations and, therefore, uncommon responses to
medication, but this does not mean the patient will have an allergic response to medications.

continuity.
community settings.
Page Number: 99
Question 25
Type: MCMA
A nurse administering medications to a variety of patients on a medical-surgical floor recognizes that which
patients may need additional education about medication adherence?
1. Fifty-year-old recently remarried male taking antihypertensive medication

2. Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive
3. Thirty-eight-year-old male recently started on an antidepressant
4. Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth
5. Seventy-eight-year-old female being treated for shingles
Rationale 1: Antihypertensive medications can cause impotence. This patient will need additional education
about this possible side effect.
Rationale 2: Estrogen can cause an increased risk for thrombolytic events, especially in patients who have a
positive family history.
Rationale 3: Taking an antidepressant may result in the man feeling weak, unhealthy, or dependent.
Rationale 4: Some acne medications cause increased hair growth in a male pattern, such as on the face. While
controlling acne is a goal, the patient may not want the extra hair growth.
Rationale 5: There is no indication that treatment for shingles requires education in excess of that which is
generally provided.
Global Rationale: Antihypertensive medications can cause impotence. This patient will need additional
education about this possible side effect. Estrogen can cause an increased risk for thrombolytic events, especially
in patients who have a positive family history. Taking an antidepressant may result in the man feeling weak,
unhealthy, or dependent. Some acne medications cause increased hair growth in a male pattern, such as on the
face. While controlling acne is a goal, the patient may not want the extra hair growth. There is no indication that
treatment for shingles requires education in excess of that which is generally provided.

populations.
Learning Outcome: 9-6 Relate the implications of gender to the actions of certain drugs.
community settings.
Page Number: 100
Question 26
Type: MCMA
A patient who is strictly vegetarian due to religious beliefs has been prescribed a medication contained in a gelatin
capsule. Which nursing actions are indicated?
1. Do not tell the patient the capsule contains gelatin.
2. Collaborate with the prescriber to find an alternative medication.
3. Check to see if the capsule can be opened for administration.
4. Work to convince the patient that this application does not violate vegetarian beliefs.
5. Tell the patient that the gelatin is an inactive ingredient in the medication.
Correct Answer: 2,3
Rationale 1: Withholding information regarding the medication is not ethical.
Rationale 2: An alternative dosage form that does not require use of a gelatin capsule may be available.
Rationale 3: Many capsules can be opened and the contents placed in fluid or on soft food for administration.
Rationale 4: If the patient is strictly vegetarian the use of a gelatin capsule is a violation of belief. The nurse
should not try to influence the patient otherwise.
Rationale 5: Whether the gelatin is an active ingredient or an inactive ingredient is not relevant.
Global Rationale: An alternative dosage form that does not require use of a gelatin capsule may be available.
Many capsules can be opened and the contents placed in fluid or on soft food for administration. Withholding
information regarding the medication is not ethical. If the patient is strictly vegetarian the use of a gelatin capsule
is a violation of belief. The nurse should not try to influence the patient otherwise. Whether the gelatin is an active
ingredient or an inactive ingredient is not relevant.

continuity.
community settings.
Page Number: 96
Question 27
Type: MCMA
Which patient statements would the nurse evaluate as negatively affecting access to health care?
1. An older adult says, “If I tell my doctor that I fall frequently, I might have to go to a nursing home.”
2. A young adult says, “A benefit of my new job is that it pays for my health, dental, and vision insurance.”
3. A patient being discharged says, “Can you call my prescriptions in to the pharmacy?”
4. The patient’s new insurance plan requires a $10 copay for office visits.
5. A patient asks to be discharged before noon as he has a 3-hour drive home.
Rationale 1: The older adult may not reveal a fall history out of concern for loss of independence and a change in
living conditions.
Rationale 2: Having a job that pays insurance helps ensure access.
Rationale 3: Being able to call prescriptions in to the pharmacy helps ensure access.
Rationale 4: Even a low cost copay may be difficult for some patients to afford.
Rationale 5: Living long distances from health care sources decreases access.
Global Rationale: The older adult may not reveal a fall history out of concern for loss of independence and a
change in living conditions. Even a low cost copay may be difficult for some patients to afford. Living long
distances from health care sources decreases access. Having a job that pays insurance helps ensure access. Being
able to call prescriptions in to the pharmacy helps ensure access.

populations.
community settings.
Page Number: 98
Question 28
Type: MCMA
A nurse has been asked to present health promotion information at a community clinic whose clients are primary
non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include
information about which disorders?
1. Stroke
2. Coronary artery disease
3. Diabetes
4. Illicit drug use
5. Prenatal care
Rationale 1: The rate of premature death due to stroke is higher among non-Hispanic Blacks than among non-
Hispanic Whites.
Rationale 2: The rate of premature death due to coronary artery disease is higher among non-Hispanic Blacks
than among non-Hispanic Whites.
Rationale 3: Diabetes is highest among non-Hispanic Blacks and Hispanics.
Rationale 4: Rates for drug-induced death (from both legal and illegal drugs) is highest among American Indians,
Alaskan Natives, and non-Hispanic Whites.
Rationale 5: The infant mortality rate for non-Hispanic Black women is more than double that for non-Hispanic
White women.
Global Rationale: The rate of premature death due to stroke and coronary artery disease is higher among non-
Hispanic Blacks than among non-Hispanic Whites. Diabetes is highest among non-Hispanic Blacks and
Hispanics. The infant mortality rate for non-Hispanic Black women is more than double that for non-Hispanic
White women. Rates for drug-induced death (from both legal and illegal drugs) is highest among American
Indians, Alaskan Natives, and non-Hispanic Whites.

populations.
community settings.
Page Number: 98
Question 29
Type: MCMA
A patient’s genetic testing indicates presence of a genetic polymorphism of the CYP 450 enzyme. The nurse
expects this difference to be one of which classifications?
1. Extensive
2. Poor
3. Normal
4. Ultrarapid
5. Inefficient
Rationale 1: “Extensive” is one of the classifications used to describe this change in drug metabolism.
Rationale 2: “Poor” is one of the classifications used to describe this change in drug metabolism
Rationale 3: Since this patient has a change, the metabolism would not be classified as “normal.”
Rationale 4: “Ultrarapid” is one of the classifications used to describe this change in drug metabolism.
Rationale 5: “Inefficient” is not used to describe this change.
Global Rationale: “Extensive,” “poor,” and “ultrarapid” are all classifications used to describe this change in
drug metabolism. Since this patient has a change, the metabolism would not be classified as “normal.”
“Inefficient” is not used to describe this change.

continuity.
community settings.
Page Number: 99
Question 30
Type: MCMA
A patient’s genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this
discovery?
1. Teaching the patient to avoid caffeine-containing drugs.
2. Planning additional time and interventions to help the patient stop smoking.
3. Use of an alternative to the drug warfarin.

4. Increased surveillance for the development of lung cancer.
5. Frequent monitoring of blood pressure.
Correct Answer: 2,4
Rationale 1: CYP2A6 is not associated with caffeine.
Rationale 2: CYP2A6 reduction may make smoking cessation more difficult.
Rationale 3:.CYP2C9 is associated with reduced metabolism of warfarin.
Rationale 4: CYP2A6 reduction may increase risk of lung cancer.
Rationale 5: CYP2A6 is not associated with blood pressure level.
Global Rationale: CYP2A6 reduction may make smoking cessation more difficult and increases risk of lung
cancer. It is not associated with caffeine or blood pressure level. CYP2C9 is associated with reduced metabolism
of warfarin.

continuity.
community settings.
Page Number: 100

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PHARMACOLOGY FOR NURSES A PATHOPHYSIOLOGIC

APPROACH 5TH EDITION ADAMS TEST BANK

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Test bank: https://testbankpack.com/p/test-bank-for-pharmacology-

Solution Manual: https://testbankpack.com/p/solution-manual-for-

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

Standard Text: Select all that apply.

2. The biologic cause of the hypertension

Correct Answer: 1,3,4,5

Cognitive Level: Applying

Cognitive Level: Analyzing

Cognitive Level: Analyzing

Cognitive Level: Applying

Cognitive Level: Analyzing

2. "Do you think your high blood pressure is a problem?"

3. "Can you afford the high blood pressure medication?"

4. "Does your culture use herbs to treat high blood pressure?"

Cognitive Level: Analyzing

1. "I may need to have more frequent blood tests."

2. "I may need to have less frequent blood tests."

Cognitive Level: Applying

Standard Text: Select all that apply.

1. "How is drinking alcohol viewed by your culture?"

2. "Have you ever attended Alcoholics Anonymous meetings?"

4. "Have you been in alcohol rehabilitation before now?"

5. "What blood relatives of yours are addicted to alcohol?"

Correct Answer: 1,3,5

Cognitive Level: Applying

2. "Don't worry, we can recommend an excellent wig company if need be."

3. "Yes, that is one of the expected side effects of this medication."

4. "It might. Have you discussed this with your physician?"

1. "I think you need to do what is best for you."

2. "You have a serious infection and really need the drug."

Rationale 3: Telling the patient what she thinks is not appropriate.

Cognitive Level: Analyzing

Rationale 4: At this point, a consult by dietary services is premature.

Cognitive Level: Analyzing

1. "Do I have to inform your physician about your noncompliance?"

2. "Why didn't you take your medicine as we talked about?"

3. "Are you able to read and comprehend the printed information?"

4. "Don't you understand how important it is to take the medicine?"

Cognitive Level: Analyzing

1. The patient with a support group of cancer survivors

2. The patient who is also seeing a psychiatrist for treatment of depression

4. The patient who is a former physician

Cognitive Level: Analyzing

Standard Text: Select all that apply.

1. Western medicine focuses on the cause of disease.

2. Western medicine is not compatible with holistic medicine.

3. The patient is at the center of concern in Western medicine.

5. Western medicine may focus on disease treatment.

Correct Answer: 1,4,5

Cognitive Level: Applying

Rationale 1: Ethnicity relates to biology and genetics.

Rationale 2: Diet is a cultural characteristic.

Rationale 3: Health belief is a cultural characteristic.

Rationale 4: Alternative therapies are cultural characteristics.