1. A new graduate nurse, who is preparing to administer medications, knows that what
is required for a drug to move through the body?
2.
3. a) Selectivity and effectiveness
4. b) The ability to cross membranes
5. c) Development of an electric charge
6. d) A transporter protein - ANS-B
7. To move through the body, drugs must cross membranes. They cross membranes to
enter the bloodstream, to exit the bloodstream and reach the site of action, and to
undergo metabolism and excretion. Selectivity and effectiveness are not related to
drug movement. Development of an electric charge (ionization) reduces a drug's
ability to be absorbed. Transporter proteins are not required for drugs to move
through the body.
8. A new medication becomes available for treatment of a debilitating neurologic
disease. What would the nurse expect about the safety of the drug?
9.
10. a) The drug is safe for administration to children.
11. b) The drug has been tested in pregnant women.
12. c) All possible adverse effects have been identified by animal testing.
13. d) The drug has passed the FDA approval process. - ANS-D
14. A new medication must meet the FDA's stringent requirements before it comes to
market. Most drugs have not been tested in women (including pregnant women) or
children. Animal testing cannot identify all possible adverse effects.
15. A nurse administers naloxone (Narcan) to a postoperative patient experiencing
respiratory sedation. What undesirable effect would the nurse anticipate after giving
this medication?
16.
17. a) Drowsiness
18. b) Tics and tremors
19. c) Increased pain
20. d) Nausea and vomiting - ANS-C
21. Naloxone reverses the effects of narcotics. Although the patient's respiratory status
will improve after administration of naloxone, the pain will be more acute.
22. A nurse instructs a patient to discontinue the scheduled use of high-dose aspirin
before undergoing which procedures? (Select all that apply.)
23.
24. a) Routine dental cleaning
25. b) Removal of a skin mole
26. c) Cataract surgery
27. d) Cholecystectomy
,28. e) Hysterectomy - ANS-D, E
29. Aspirin promotes bleeding by causing irreversible suppression of platelet
aggregation. High-dose aspirin should be discontinued 1 week before elective
surgery (cholecystectomy, hysterectomy). There is no need to stop aspirin before
procedures with a low risk of bleeding, such as dental cleaning or dermatologic or
cataract surgery.
30. A nurse instructs the parent of a child with influenza that which medication or
medications may be used safely to reduce fever? (Select all that apply.)
31.
32. a) Ibuprofen (Advil)
33. b) Naproxen (Aleve)
34. c) Aspirin (Bayer)
35. d) Acetaminophen (Tylenol)
36. e) Indomethacin (Indocin) - ANS-D
37.
38. The use of NSAIDs, which include ibuprofen (Advil), naproxen (Aleve), indomethacin
(Indocin), and especially aspirin (Bayer), by children with influenza or chickenpox
may precipitate Reye's syndrome. This is a potentially fatal multisystem organ
disease. Acetaminophen (Tylenol) may be used safely to reduce fever in children
with influenza.
39. A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4)
and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient
is likely suffering from what?
40.
41. A. Thyrotoxicosis
42. B. Hypothyroidism
43. C. Hyperthyroidism
44. D. Graves' disease - ANS-B. Hypothyroidism
45.
46. The anterior pituitary increases production of TSH when thyroid hormone levels of T3
and T4, are reduced, reflecting primary hypothyroidism. Patients may experience
fatigue caused by a lowered basal metabolic rate. Thyrotoxicosis, hyperthyroidism,
and Graves' disease are medical conditions indicative of excessive thyroid activity.
47. A nurse is preparing to give an oral dose of drug X to treat a patient's high blood
pressure. After giving the drug, the nurse finds that it reduces the blood pressure
without serious harmful effects, but it also causes the patient to have nausea and a
headache. Based on this information, which property of an ideal drug is this drug
lacking?
48. a Effectiveness
49. b Safety
50. c Selectivity
51. d Ease of administration - ANS-C
52. The drug is effective in lowering the blood pressure and safe in that it does not cause
harmful effects. However, as do most drugs, it causes other effects besides the one
response desired; therefore, it lacks selectivity. The oral form provides ease of
administration.
, 53. A nurse prepares to administer acetaminophen (Tylenol) to a patient with an oral
temperature of 101.7°F. Which preparation would the nurse expect to have the most
rapid onset of action?
54.
55. a) Tylenol elixir
56. b) Tylenol tablets
57. c) Tylenol capsules
58. d) Tylenol gel caps - ANS-A
59. A liquid does not have to dissolve first to allow absorption; therefore, the onset of
action occurs more quickly than with capsules, tablets, or gel caps.
60. A nurse provides discharge instructions for a patient who is taking acetaminophen
(Tylenol) after surgery. The nurse should instruct the patient to avoid which product
while taking acetaminophen?
61.
62. a) Alcoholic drinks
63. b) Leafy green foods
64. c) Bananas
65. d) Dairy products - ANS-A
66. Through several mechanisms, regular alcohol consumption while taking
acetaminophen (Tylenol) increases the risk of liver injury when dosages are
excessive. Therapeutic doses of acetaminophen (Tylenol) may be safe for patients
who drink alcohol; however, the U.S. Food and Drug Administration (FDA) requires
that acetaminophen (Tylenol) labels state an alcohol warning for patients who
consume three or more drinks a day to consult their prescriber to determine whether
acetaminophen (Tylenol) can be taken safely. It is not necessary to avoid leafy green
foods, bananas, or dairy products when taking acetaminophen.
67. A nurse should recognize that a patient who takes an angiotensin-converting enzyme
(ACE) inhibitor while also taking high-dose aspirin is at risk of developing what
complication?
68.
69. a) Congestive heart failure
70. b) Liver toxicity
71. c) Renal failure
72. d) Hemorrhage - ANS-C
73. High-dose aspirin therapy should be avoided in patients taking ACE inhibitors. In
susceptible patients, these medications can impair renal function when they are
combined with aspirin. Liver toxicity, congestive heart failure, and hemorrhage are not
effects of ACE inhibitor and aspirin interactions.
74. A nurse teaches a patient who takes daily low-dose aspirin for protection against
myocardial infarction and stroke to avoid also taking which medication?
75.
76. a) Ibuprofen (Motrin)
77. b) Zolpidem (Ambien)
78. c) Loratadine (Claritin)
79. d) Diphenhydramine (Benadryl) - ANS-A
80. Ibuprofen (Motrin) can block the antiplatelet effects of aspirin; therefore, patients who
take low-dose aspirin to protect against myocardial infarction and thrombosis should
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