Test Bank for Maternal Child Nursing Care 6th Edition Perry NURSINGTB.COM Chapter 01: 21st Century Maternity Nursing Perry: Maternal Child Nursing Care, 6th Edition MULTIPLE CHOICE 1. When providing care for a pregnant woman, the nurse should be aware that one of the most frequently reported maternal medical risk factors is: a. diabetes mellitus. b. mitral valve prolapse (MVP). c. chronic hypertension. d. anemia. ANS: A The most frequently reported maternal medical risk factors are diabetes and hypertension associated with pregnancy. Both of these conditions are associated with maternal obesity. There are no studies that indicate MVP is among the most frequently reported maternal risk factors. Hypertension associated with pregnancy, not chronic hypertension, is one of the most frequently reported maternal medical risk factors. Although anemia is a concern in pregnancy, it is not one of the most frequently reported maternal medical risk factors in pregnancy. PTS: 1 DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 2. To ensure optimal outcomes for the patient, the contemporary maternity nurse must incorporate both teamwork and communication with clinicians into her care delivery. The SBAR technique of communication is an easy-to-remember mechanism for communication. Which of the following correctly defines this acronym? a. Situation, baseline assessment, response b. Situation, background, assessment, recommendation c. Subjective background, assessment, recommendation d. Situation, background, anticipated recommendation ANS: B The situation, background, assessment, recommendation (SBAR) technique provides a specific framework for communication among health care providers. Failure to communicate is one of the major reasons for errors in health care. The SBAR technique has the potential to serve as a means to reduce errors. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment, Planning MSC: Client Needs: Safe and Effective Care Environment 3. The role of the professional nurse caring for childbearing families has evolved to emphasize: a. providing care to patients directly at the bedside. b. primarily hospital care of maternity patients. c. practice using an evidence-based approach. d. planning patient care to cover longer hospital stays. ANS: C NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM Professional nurses are part of the team of health care providers who collaboratively care for patients throughout the childbearing cycle. Providing care to patients directly at the bedside is one of the nurse’s tasks; however, it does not encompass the concept of the evolved professional nurse. Throughout the prenatal period, nurses care for women in clinics and physician’s offices and teach classes to help families prepare for childbirth. Nurses also care for childbearing families in birthing centers and in the home. Nurses have been critically important in developing strategies to improve the well-being of women and their infants and have led the efforts to implement clinical practice guidelines using an evidence-based approach. Maternity patients have experienced a decreased, rather than an increased, length of stay over the past two decades. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 4. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the woman to a social worker. c. Advise the woman to see an obstetrician, not a midwife. d. Explain to the woman the importance of keeping her prenatal care appointments. ANS: D Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but a nutrition assessment is not the most important action a nurse should take in this situation. The patient may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high risk problems, her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a patient is to receive. PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 5. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to: a. use maternity jargon in order for the patient to become familiar with these terms. b. speak quickly and efficiently to expedite the visit. c. provide the patient with handouts. d. assess whether the patient understands the discussion. ANS: D Nurses contribute to health literacy by using simple, common words; avoiding jargon; and evaluating whether the patient understands the discussion. Speaking slowly and clearly and focusing on what is important increase understanding. Most patient education materials are written at too high a level for the average adult and may not be useful for a patient with limited English proficiency. NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 6. When managing health care for pregnant women at a prenatal clinic, the nurse should recognize that the most significant barrier to access to care is the pregnant woman’s: a. age. b. minority status. c. educational level. d. inability to pay. ANS: D The most significant barrier to health care access is the inability to pay for services; this is compounded by the fact that many physicians refuse to care for women who cannot pay. Although adolescent pregnant patients statistically receive less prenatal care, age is not the most significant barrier. Significant disparities in morbidity and mortality rates exist for minority women; however, minority status is not the most significant barrier to access of care. Disparities in educational level are associated with morbidity and mortality rates; however, educational level is not the most significant barrier to access of care. PTS: 1 DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 7. When the nurse is unsure about how to perform a patient care procedure, the best action would be to: a. ask another nurse. b. discuss the procedure with the patient’s physician. c. look up the procedure in a nursing textbook. d. consult the agency’s procedure manual and follow the guidelines for the procedure. ANS: D It is always best to follow the agency’s policies and procedures manual when seeking information on correct patient procedures. These policies should reflect the current standards of care and state guidelines. Each nurse is responsible for her own practice. Relying on another nurse may not always be safe practice. Each nurse is obligated to follow the standards of care for safe patient care delivery. Physicians are responsible for their own patient care activity. Nurses may follow safe orders from physicians, but they are also responsible for the activities that they as nurses are to carry out. Information provided in a nursing textbook is basic information for general knowledge. Furthermore, the information in a textbook may not reflect the current standard of care or individual state or hospital policies. PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity 8. From the nurse’s perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further? a. Implementing programs to ensure women’s early participation in ongoing prenatal care. b. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days. NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM c. Expanding the number of neonatal intensive care units (NICUs). d. Mandating that all pregnant women receive care from an obstetrician. ANS: A Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of infant mortality. An increased length of stay has been shown to foster improved self-care and parental education. However, it does not prevent the incidence of leading causes of infant mortality rates, such as low birth weight. Early prevention and diagnosis reduce the rate of infant mortality. NICUs offer care to high risk infants after they are born. Expanding the number of NICUs would offer better access for high risk care, but this factor is not the primary focus for further reduction of infant mortality rates. A mandate that all pregnant women receive obstetric care would be nearly impossible to enforce. Furthermore, certified nurse-midwives (CNMs) have demonstrated reliable, safe care for pregnant women. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 9. Alternative and complementary therapies: a. replace conventional Western modalities of treatment. b. are used by only a small number of American adults. c. recognize the value of patients’ input into their health care. d. focus primarily on the disease an individual is experiencing. ANS: C Many popular alternative healing modalities offer human-centered care based on philosophies that recognize the value of the patient’s input and honor the individual’s beliefs, values, and desires. Alternative and complementary therapies are part of an integrative approach to health care. An increasing number of American adults are seeking alternative and complementary health care options. Alternative healing modalities offer a holistic approach to health, focusing on the whole person, not just the disease. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 10. A 38-year-old Hispanic woman delivered a 9-pound, 6-ounce girl vaginally after being in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds would the woman potentially have a legitimate legal case for negligence? a. She is Hispanic. b. She delivered a girl. c. The standards of care were not met. d. She refused fetal monitoring. ANS: C Not meeting the standards of care is a legitimate factor for a case of negligence. The patient’s race is not a factor for a case of negligence. The infant’s gender is not a factor for a case of negligence. Although fetal monitoring is the standard of care, the patient has the right to refuse treatment. This refusal is not a case for negligence; however, informed consent should be properly obtained, and the patient should sign an against medical advice form for refusal of any treatment that is within the standard of care. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM MSC: Client Needs: Health Promotion and Maintenance 11. A newly graduated nurse is attempting to understand the reason for increasing health care spending in the United States. Her research finds that these costs are much higher compared with other developed countries as a result of: a. a higher rate of obesity among pregnant women. b. limited access to technology. c. increased usage of health care services along with lower prices. d. homogeneity of the population. ANS: A Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.5% of the gross domestic product is spent on health care. Higher spending in the United States compared with 12 other industrialized countries is related to higher prices and readily accessible technology along with greater obesity rates among women. More than one third of women in the United States are obese. Of the U.S. population, 16% is uninsured and has limited access to health care. Maternal morbidity and mortality are directly related to racial disparities. PTS: 1 DIF: Cognitive Level: Analysis OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 12. The term used to describe legal and professional responsibility for practice for maternity nurses is: a. collegiality. b. ethics. c. evaluation. d. accountability. ANS: D Accountability refers to legal and professional responsibility for practice. Collegiality refers to a working relationship with one’s colleagues. Ethics refers to a code to guide practice. Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes. PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 13. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for patients. The most concerning pitfall for nurses using this technology is: a. violation of patient privacy and confidentiality. b. institutions and colleagues may be cast in an unfavorable light. c. unintended negative consequences for using social media. d. lack of institutional policy governing online contact. ANS: A NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM The most significant pitfall for nurses using this technology is the violation of patient privacy and confidentiality. Furthermore, institutions and colleagues can be cast in unfavorable lights with negative consequences for those posting information. Nursing students have been expelled from school and nurses have been fired or reprimanded by their Board of Nursing for injudicious posts. The American Nurses Association has published six principles for social networking and nurses. All institutions should have policies guiding the use of social media, and nurses should be familiar with these guidelines. PTS: 1 DIF: Cognitive Level: Analysis OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 14. An important development that affects maternity nursing is integrative health care, which: a. seeks to provide the same health care for all racial and ethnic groups. b. blends complementary and alternative therapies with conventional Western treatment. c. focuses on the disease or condition rather than the background of the patient. d. has been mandated by Congress. ANS: B Integrative health care tries to mix the old with the new at the discretion of the patient and health care providers. Integrative health care is a blending of new and traditional practices. Integrative health care focuses on the whole person, not just the disease or condition. U.S. law supports complementary and alternative therapies but does not mandate them. PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 15. The nurse caring for a pregnant patient should be aware that the U.S. birth rate shows which trend? a. Births to unmarried women are more likely to have less favorable outcomes. b. Birth rates for women 40 to 44 years old are beginning to decline. c. Cigarette smoking among pregnant women continues to increase. d. The rates of maternal death owing to racial disparity are elevated in the United States. ANS: A Low-birth-weight infants and preterm birth are more likely because of the large number of teenagers in the unmarried group. Birth rates for women in their early 40s continue to increase. Fewer pregnant women smoke. In the United States, there is significant racial disparity in the rates of maternal death. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 16. Maternity nursing care that is based on knowledge gained through research and clinical trials is: a. derived from the Nursing Intervention Classification. b. known as evidence-based practice. c. at odds with the Cochrane School of traditional nursing. NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM d. an outgrowth of telemedicine. ANS: B Evidence-based practice is based on knowledge gained from research and clinical trials. The Nursing Intervention Classification is a method of standardizing language and categorizing care. Dr. Cochrane systematically reviewed research trials and is part of the evidence-based practice movement. Telemedicine uses communication technologies to support health care. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 17. The level of practice a reasonably prudent nurse provides is called: a. the standard of care. b. risk management. c. a sentinel event. d. failure to rescue. ANS: A Guidelines for standards of care are published by various professional nursing organizations. Risk management identifies risks and establishes preventive practices, but it does not define the standard of care. Sentinel events are unexpected negative occurrences. They do not establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does not define the standard of care. PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Diagnosis MSC: Client Needs: Safe and Effective Care Environment 18. While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse realizes that the patient has undergone female genital mutilation (FGM). The nurse’s best response to this patient is: a. “this is a very abnormal practice and rarely seen in the United States.” b. “do you know who performed this so that it can be reported to the authorities?” c. “we will be able to restore your circumcision fully after delivery.” d. “the extent of your circumcision will affect the potential for complications.” ANS: D “The extent of your circumcision will affect the potential for complications” is the most appropriate response. The patient may experience pain, bleeding, scarring, or infection and may require surgery before childbirth. With the growing number of immigrants from countries where FGM is practiced, nurses will increasingly encounter women who have undergone the procedure. Although this practice is not prevalent in the United States, it is very common in many African and Middle Eastern countries for religious reasons. Responding with, “This is a very abnormal practice and rarely seen in the United States” is culturally insensitive. The infibulation may have occurred during infancy or childhood. The patient will have little to no recollection of the event. She would have considered this to be a normal milestone during her growth and development. The International Council of Nurses has spoken out against this procedure as harmful to a woman’s health. PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM 19. To ensure patient safety, the practicing nurse must have knowledge of the current Joint Commission’s “Do Not Use” list of abbreviations. Which of the following is acceptable for use? a. q.o.d. or Q.O.D. b. MSO4 or MgSO4 c. International Unit d. Lack of a leading zero ANS: C The abbreviations “i.u.” and “I.U.” are no longer acceptable because they could be misread as “I.V.” or the number “10.” The abbreviation “q.o.d. or Q.O.D.” should be written out as “every other day.” The period after the “Q” could be mistaken for an “I”; the “o” could also be mistaken for an “i.” With MSO4 or MgSO4, it is too easy to confuse one medication for another. These medications are used for very different purposes and could put a patient at risk for an adverse outcome. They should be written as morphine sulfate and magnesium sulfate. The decimal point should never be missed before a number to avoid confusion (i.e., 0.4 rather than .4). PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 20. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and providing care across the perinatal continuum. Therefore, it is important for the nurse to be aware that significant progress has been made in: a. the reduction of fetal deaths and use of prenatal care. b. low birth weight and preterm birth. c. elimination of health disparities based on race. d. infant mortality and the prevention of birth defects. ANS: A Trends in maternal child health indicate that progress has been made in relation to reduced infant and fetal deaths and increased prenatal care. Notable gaps remain in the rates of low birth weight and preterm births. According to the March of Dimes, persistent disparities still exist between African-Americans and non-Hispanic Caucasians. Many of these negative outcomes are preventable through access to prenatal care and the use of preventive health practices. This demonstrates the need for comprehensive community-based care for all mothers, infants, and families. PTS: 1 DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Which interventions would help alleviate the problems associated with access to health care for maternity patients? (Select all that apply.) a. Provide transportation to prenatal visits. b. Provide child care so that a pregnant woman may keep prenatal visits. c. Mandate that physicians make house calls. NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM d. Provide low-cost or no-cost health care insurance. e. Provide job training. ANS: A, B, D Lack of transportation to visits, lack of child care, and lack of affordable health insurance are prohibitive factors associated with lack of prenatal care. House calls are not a cost-effective approach to health care. Although job training may result in employment and income, the likelihood of significant changes during the time frame of the pregnancy is remote. PTS: 1 DIF: Cognitive Level: Implementation OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance MATCHING Medical errors are a leading cause of death in the United States. The National Quality Forum has recommended numerous safe practices that nursing can promote to reduce errors. Match each safe practice with the correct statement. a. Ask the patient to “teach back.” b. Comply with CDC guidelines. c. Ensure that information is documented in a timely manner. d. Promote interventions that will reduce patient risk. e. Reduce exposure to radiation. 1. Hand hygiene 2. Informed consent 3. Culture measurement, feedback, and intervention 4. Pediatric imaging 5. Patient care information 1. ANS: B PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines. 2. ANS: A PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines. 3. ANS: D PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines. 4. ANS: E PTS: 1 DIF: Cognitive Level: Application NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANKNURSINGTB.COM OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines. 5. ANS: C PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines. NURSINGTB.COM MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BAN
Test Bank Focus on Nursing Pharmacology 8th Edition Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) Table of Contents Chapter 01 - Introduction to Drugs Chapter 02 - Drugs and the Body Chapter 03 - Toxic Effects of Drugs Chapter 04 - The Nursing Process in Drug Therapy and Patient Safety Chapter 05 - Dosage Calculations Chapter 06 - Challenges to Effective Drug Therapy Chapter 07 - Introduction to Cell Physiology Chapter 08 - Antiinfective Agents Chapter 09 - Antibiotics Chapter 10 - Antiviral Agents Chapter 11 - Antifungal Agents Chapter 12 - Antiprotozoal Agents Chapter 13 - Anthelmintic Agents Chapter 14 - Antineoplastic Agents Chapter 15 - Introduction to the Immune Response and Inflammation Chapter 16 - Antiinflammatory, Antiarthritis, and Related Agents Chapter 17 - Immune Modulators Chapter 18 - Vaccines and Sera Chapter 19 - Introduction to Nerves and the Nervous System Chapter 20 - Anxiolytic and Hypnotic Agents Chapter 21 - Antidepressant Agents Chapter 22 - Psychotherapeutic Agents Chapter 23 - Antiseizure Agents Chapter 24 - Antiparkinsonism Agents Chapter 25 - Muscle Relaxants Chapter 26 - Narcotics, Narcotic Antagonists, and Antimigraine Agents Chapter 27 - General and Local Anesthetic Agents Chapter 28 - Neuromuscular Junction Blocking Agents Chapter 29 - Introduction to the Autonomic Nervous System Chapter 30 - Adrenergic Agonists Chapter 31 - Adrenergic Antagonists Chapter 32 - Cholinergic Agonists Chapter 33 - Anticholinergic Agents Chapter 34 - Introduction to the Endocrine System Chapter 35 - Hypothalamic and Pituitary Agents Chapter 36 - Adrenocortical Agents Chapter 37 - Thyroid and Parathyroid Agents Chapter 38 - Agents to Control Blood Glucose Levels Chapter 39 - Introduction to the Reproductive System Chapter 40 - Drugs Affecting the Female Reproductive System Chapter 41 - Drugs Affecting the Male Reproductive System Chapter 42 - Introduction to the Cardiovascular System Chapter 43 - Drugs Affecting Blood Pressure Chapter 44 - Agents for Treating Heart Failure Chapter 45 - Antiarrhythmic Agents Chapter 46 - Antianginal Agents Chapter 47 - Lipid-Lowering Agents Chapter 48 - Drugs Affecting Blood Coagulation Chapter 49 - Drugs Used to Treat Anemias Chapter 50 - Introduction to the Renal System Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) 2 Chapter 51 - Diuretic Agents Chapter 52 - Drugs Affecting the Urinary Tract and the Bladder Chapter 53 - Introduction to the Respiratory System Chapter 54 - Drugs Acting on the Upper Respiratory Tract Chapter 55 - Drugs Acting on the Lower Respiratory Tract Chapter 56 - Introduction to the Gastrointestinal System Chapter 57 - Drugs Affecting Gastrointestinal Secretions Chapter 58 - Drugs Affecting Gastrointestinal Motility Chapter 59 - Antiemetic Agents
|Chapter 01: Using Evidence in Practice Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition MULTIPLE CHOICE |
- Evidence-based practice is a problem-solving approach to making decisions about patient care that is grounded in:
ANS: B The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data; infection control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence. DIF: Cognitive Level: Comprehension REF: Text reference: p. 2 OBJ: Discuss the benefits of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)
|a.||the latest information found in textbooks.|
|b.||systematically conducted research studies.|
|c.||tradition in clinical practice.|
|d.||quality improvement and risk-management data.|
- When evidence-based practice is used, patient care will be:
ANS: C Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate. DIF: Cognitive Level: Application REF: Text reference: p. 2 OBJ: Discuss the benefits of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)
|a.||standardized for all.|
|b.||unhampered by patient culture.|
|c.||variable according to the situation.|
|d.||safe from the hazards of critical thinking.|
ANS: C C = Comparison of interest. What standard of care or current intervention do you usually use now in practice? P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem. I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice? O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention? DIF: Cognitive Level: Knowledge REF: Text reference: p. 3 OBJ: Develop a PICO question. TOP: PICO KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
- When a PICOT question is developed, the letter that corresponds with the usual standard of care is:
- A well-developed PICOT question helps the nurse:
ANS: A The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care. DIF: Cognitive Level: Analysis REF: Text reference: p. 3 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
|a.||search for evidence.|
|b.||include all five elements of the sequence.|
|c.||find as many articles as possible in a literature search.|
|d.||accept standard clinical routines.|
- The nurse is not sure that the procedure the patient requires is the best possible for the situation. Utilizing which of the following resources would be the quickest way to review research on the topic?
ANS: D The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care. DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
|d.||The Cochrane Database|
- The nurse is getting ready to develop a plan of care for a patient who has a specific need. The best source for developing this plan of care would probably be:
ANS: C The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised evidence). DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
|a.||The Cochrane Database.|
- The nurse has done a literature search and found 25 possible articles on the topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
ANS: A An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-based article—clinical or research. DIF: Cognitive Level: Application REF: Text reference: p. 7 OBJ: Discuss elements to review when critiquing the scientific literature. TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
|b.||the literature reviews.|
|c.||the “Methods” sections.|
|d.||the narrative sections.|
- The nurse wants to determine the effects of cardiac rehabilitation program attendance on the level of postmyocardial depression for individuals who have had a myocardial infarction. The type of study that would best capture this information would be a:
ANS: B Qualitative studies examine individuals’ experiences with health problems and the contexts in which these experiences occur. A qualitative study is best in this case of an individual nurse who wants to examine the effectiveness of a local program. Randomized controlled trials involve close monitoring of control groups and treatment groups to test an intervention against the usual standard of care. Case control studies typically compare one group of subjects with a certain condition against another group without the condition, to look for associations between the condition and predictor variables. Descriptive studies focus mainly on describing the concepts under study. DIF: Cognitive Level: Synthesis REF: Text reference: p. 6 OBJ: Discuss ways to apply evidence in nursing practice. TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)
|a.||randomized controlled trial.|
|c.||case control study.|
- Six months after an early mobility protocol was implemented, the incidence of deep vein thrombosis in patients was decreased. This is an example of what stage in the EBP process?
ANS: C After implementing a practice change, your next step is to evaluate the effect. You do this by analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation tells you whether your practice change improved conditions, created no change, or worsened conditions. DIF: Cognitive Level: Application REF: Text reference: p. 9 OBJ: Discuss ways to apply evidence in nursing practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe and Effective Care Environment (safety and infection control) MULTIPLE RESPONSE
|a.||Asking a clinical question|
|b.||Applying the evidence|
|c.||Evaluating the practice decision|
|d.||Communicating your results|
- To use evidence-based practice appropriately, you need to collect the most relevant and best evidence and to critically appraise the evidence you gather. This process also includes: (Select all that apply.)
ANS: A, B, C, D
|a.||asking a clinical question.|
|b.||applying the evidence.|
|c.||evaluating the practice decision.|
|d.||communicating your results.|
Test Bank for Psychiatric Mental Health Nursing, 8th Edition Wanda Mohr
Chapter 01- Introduction to Psychiatric-Mental Health Nursing
- A nurse is giving a presentation about preventing mental illness to college freshmen. A student asks, “What does it mean to be mentally healthy?” Which of the following potential responses by the nurse is best?
A) “Mental health is difficult to define and depends on cultural norms.” B) “Mental health is marked by productivity, fulfilling relationships, and adaptability.” C) “Mental health is characterized by the absence of mental illness.” D) “Mental health is the performance of behavior that is accepted as normal.”
- A 48-year-old independent, successful woman is recovering from a modified radical mastectomy. She states she was grateful that during the first few weeks after surgery her mother stayed with her and did “everything” for her. Which element of mental health does this reflect?
A) Reality orientation B) Mastery of the environment C) Self-governance D) Tolerance of the unknown
- Why is the document Mental Health: A Report of the Surgeon General (1999) most significant?
A) Because it states clearly that there are effective treatments for mental illness B) Because it allocates research money to psychiatric facilities C) Because it sets new guidelines for use of restraints D) Because it establishes reimbursement guidelines for third-party payers
- While a nurse is performing an admission assessment for a mental health client, the client states that all of his problems have been caused by his parents. The nurse knows that psychological factors that can influence mental health include which of the following?
A) Neuroanatomy B) Emotional developmental level C) Values and beliefs D) Religion
- What is the primary purpose of the five-axis system used in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision(DSM-IV-TR)?
A) To separate the various mental disorders into five related categories B) To give a comprehensive picture of client functioning C) To improve prognostic ability D) To provide a decision-making algorithm for pharmacologic treatment
- One limitation of the DSM relates to diagnostic labels given to children. The most problematic issue caused by applying adult categories to children is which of the following?
A) It prevents the proper treatment of childhood disorders. B) The criteria for diagnosis of a disorder are flexible for an adult, but not for children. C) Categories are based on manifestations of adult disorders, not research in children. D) The DSM
was written before childhood psychological conditions were recognized.
- Which of the following represents a problem complicating the treatment of people with mental illness?
A) Insurers' reimbursement decisions B) Increased responsibility for care by state mental hospitals C) Overuse of the well-coordinated mental health care system D) Lack of effective treatments
- Julie, a 47-year-old woman, missed 1 week of work when she was hospitalized with bipolar disorder. She was placed on medication and was able to return to work. When asked about her absence, Julie informed coworkers that she was suffering from influenza. What is the most likely reason Julie lied about her illness?
A) This is a sign that the medication is not effectively treating her illness. B) Fear of rejection, isolation, and discrimination based on her mental health diagnosis
C) Due to workplace policies that encourage the firing of those with mental illnesses D) To avoid eliciting sympathy among her coworkers
- A 22-year-old man with a history of a recent suicide attempt is being treated for depression. Prior to becoming depressed, the client attended a prestigious art school and enjoyed many social and leisure activities. Of the following long-term goals for this client, which is consistent with an overarching recovery goal for all clients with mental disorders?
A) The client will not injure himself. B) The client's symptoms will be reduced. C) The client will show interest in social and leisure activities. D) The client will resume pre-illness functioning.
- Which of the following approaches to care best reflects cultural competence?
A) Always assign nurses of a specific ethnic background to clients with the same ethnic background. B) Learn the behaviors and values associated with people of specific ethnic backgrounds. C) Assess the culturally mediated beliefs of each client. D) Believe that people are more alike than they are different. Chapter 02- Neuroscience-Biology and Behavior
- The basic units of structure and function in the nervous system are called which of the following?
A) Glial cells B) Neurons C) Axons D) Dendrites
- The structure and function of a neuron form the basis for the overall function of the nervous system. What are the components of a neuron?
A) A glial cell, nucleus, organelles, dendrites, and axons B) A glial cell, nucleus, dendrites, and synapses C) A cell body, nucleus, organelles, dendrites, and axons D) A cell body, nucleus, axon, and synapses
- A patient has researched the role of neurotransmitters in her mental illness. What is the role of neurotransmitters?
A) Excite the receptor cell located inside the synaptic cleft. B) Inhibit the receptor cell found inside of glial cells. C) Communicate information within the receptor cell. D) Communicate information from one cell or cell group to another.
- Because neurotransmitters are responsible for immediately transmitting impulses between nerve cells, they are known as which of the following?
A) First messengers B) Second messengers C) Receptors D) Synapses
- A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior. The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the:
A) Tuberinfundibular dopamine pathway B) Nigrostriatal dopamine pathway C) Mesocortical dopamine pathway D) Mesolimbic dopamine pathway
- A client lives with acquired deficits in emotional control, memory, and learning. What part of this client's brain is most likely affected?
A) Basal ganglia B) Brainstem C) Limbic system D) Cerebellum
- You are caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?
A) Diencephalon B) Brainstem C) Cerebellum D) Pons
- A client who experiences dysfunction in the hypothalamus is most likely to have
A) Maintaining homeostasis B) Processing sensory input
C) Secreting melatonin D) Integrating motor activities
- Sensory deprivation in infancy and childhood has adversely affected a boy's brain development. Which characteristic of the brain was most directly involved in this process?
A) Neuroplasticity B) Reactive plasticity C) Adaptive plasticity D) Synaptic plasticity
- Rather than being 100%, concordance rates for schizophrenia in monozygotic twins are only 50%. Which of the following statements best explains this phenomenon?
A) Genetic predisposition to disease is frequently overstated. B) One twin is inherently more vulnerable in every case. C) Environmental experiences affect gene expression. D) The genetic pathway responsible for vulnerability is unrelated to being a twin. Chapter 03- Conceptual Frameworks and Theories
- A psychiatric–mental health nurse is aware of the importance of theories in the development and delivery of care. Which of the following is the best definition of a theory?
A) A group of related concepts or ideas B) A person's or group's beliefs about how something happens or works C) A prediction about two or more concepts D) A researchable question related to health care
- Which of the following explains why theories are important to psychiatric–mental health nursing?
A) Theories provide more treatment options for clients. B) Theories add professionalism to health care. C) Theories simplify treatment decisions for most clients. D) Theories lead to the expansion of knowledge.
- A client has been told by a psychologist that memories in his unconscious are contributing to his depression. This reasoning implies that the psychologist ascribes to what theory?
A) Psychoanalytic theory B) Behavior theory C) Cognitive–behavioral theory
D) The humanistic perspective
- A client's current plan of care includes interventions that are rooted in the concepts of reinforcement. Which theory of human behavior is being prioritized during this client's care?
A) Humanistic theory B) Sociocultural theory C) Behavioral theory D) Psychoanalytic theory
- A client and her therapist have been discussing the notion that her psychopathology results from the blocking or distortion of personal growth, excessive stress, and unfavorable social conditions. This discussion is congruent with what theory?
A) Humanistic theory B) Interpersonal theory C) Biophysiological theory D) Sociocultural theory
- During marital counseling, a man complains that his wife often “bombards” him with problems as soon as he settles down at home after work, which results in a prolonged argument. The wife admits that she does this but states she feels neglected and that her husband does not take the family problems seriously. She doesn't want her marriage to turn out like her parents' marriage. The wife admits that she sometimes provokes an argument in order to gain her husband's attention. How would a behaviorist most likely explain the wife's actions?
A) She has repressed painful memories about her emotionally distant father and is working out her anger at the parent in the marital relationship. B) Her thoughts about her parents' unhappy marriage are a justification for her behavior. C) She has an underlying anxiety disorder. D) The long argument in which she and her husband participate positively reinforces her behavior.
- An adult man recalls that he was teased as a child about his inability to participate in sports. He began to avoid situations in which others might evaluate his behavior. He seeks treatment now because he is an accomplished musician but cannot perform for an audience. According to behavioral theory, his behavior is an example of which of the following concepts?
A) Discrimination B) Modeling C) Generalization D) Shaping
- The nurse is working with a client who admits to having low self-esteem. The care team has determined that cognitive restructuring will likely enhance the client's self-esteem. Which of the following best describes the goals of this intervention?
A) Avoid negative self-talk B) Replace negative self-talk with positive statements C) Change distorted thinking and the subsequent behaviors D) Use adaptive defense mechanisms
- A 55-year-old woman is being treated for narcissistic personality disorder. The therapist demonstrates caring and appropriate regard for the client. The therapist's behavior is an example of which concept of behavior theory?
A) Shaping B) Discrimination C) Modeling D) Conditioning
- In a group therapy session, group members confront a 35-year-old woman about her abuse of prescription pain medications. The woman states that, because a physician has prescribed her medication, she is not a drug addict. The nurse identifies this as an example of which of the following defense mechanisms?
A) Regression B) Projection C) Denial D) Sublimation Chapter 04- Evidence-Based Practice
- The nurse demonstrates a commitment to the health, safety, and welfare of people by providing evidence-based practice. What does the term “evidence-based practice” mean?
A) Care that integrates research and clinical expertise with the client's characteristics, culture, and preferences B) Care that bases decision making on established clinical protocols C) Care based on prior outcomes from the nurse's practice D) Care based on outcomes and research conducted by the practitioner
- Many pseudoscientific practitioners function openly and market themselves as mainstream
“therapists.” Why does the public often respond favorably to unconventional therapies? A) Pseudoscientific therapies are frequently more effective than conventional therapies. B) Further advancements can be made in effective pseudoscientific treatments with continued practice. C) Malpractice is minimized because pseudoscientific treatments are not empirically supported.
D) Some clients and families are disenchanted with the outcomes of professionally approved treatments.
- Nursing is both an art and a science. Which statement best represents how evidence-based practice encompasses these two aspects of nursing?
A) The art of nursing has been replaced by evidence-based practice. B) Multiple theoretical perspectives no longer guide evidence-based nursing care. C) The art of nursing is demonstrated through carrying out the science of nursing in a skillful, knowledgeable, intelligent, and ethical manner. D) The artful side of nursing is of less value to positive patient outcomes than is the science of nursing.
- Evidence-based practice is based on the scientific method and empirical evidence. Which of the following is a principle of empirical evidence?
A) Scientific observations are subjective inferences made by the knowledgeable nurse researcher. B) Empirical studies may be designed to report the physical and mental effects of subjective experiences. C) Empirical evidence is not appropriate in the field of mental health because cognitions and emotions are subjective and unpredictable. D) Empirical knowledge is verifiable only with valid and reliable measurement instruments.
- The nurse is part of team conducting a research study that involves controlled observations. Controlled observations involve which of the following activities?
A) Putting information together to form a new understanding B) Watching something carefully and noting events C) Testing a hypothesis or prediction D) Determining whether data are reliable and supportive
- Two patients with schizophrenia have consented to be involved in clinical trials to determine the efficacy of a new antipsychotic medication. The researcher administers the new drug to one subject and a sugar pill to another subject. The patient who received the sugar pill received a treatment that is considered which of the following?
A) Sham treatment B) Unethical treatment C) Placebo D) Supplemental therapy
- A research team has been formed to study a new medication and its effects on depression. The researcher wants to use a design where neither the clients nor the research staff will know who is receiving the medication or the placebo. What type of study is this group conducting?
A) An empirical study B) An evidence-based study C) A case-control study
D) A double-blind study
- A researcher is determining whether data that were obtained in a psychiatric nursing study are reliable and whether the data support the study hypothesis. In what part of the scientific process is the researcher functioning?
A) Experimentation B) Analysis C) Synthesis D) Prediction
- The nurse is working with a 42-year-old female patient who is mildly overweight. The patient expresses a desire to “tone up” before summer and is interested in trying an over-the-counter weight loss remedy. The nurse should perform health education related to what subject?
A) To be wary of any product that claims rapid or effortless results without exercise B) The relatively low risk of using natural remedies C) The small amount of active ingredient in most over-the-counter treatments D) To choose a product that reports data indicating a high degree of effectiveness
- Many people get health care information from the Internet. Hence, evidence-based health care can be threatened by the proliferation of pseudoscientific information available to the public. Which measure is currently being taken to prevent the misinformation of the healthcare consumer?
A) Evidence-based knowledge is currently only disseminated in professional journals and publications. B) The Food and Drug Administration (FDA) has been denied the jurisdiction to prosecute unscrupulous internet marketers. C) Public education is being performed by the Federal Trade Commission (FTC) through a campaign called Operation Cure All. D) Websites publicizing misinformation on the Internet are being screened and blocked. Chapter 05- Legal and Ethical Aspects
- A psychiatric–mental health nurse has been consistently aware of the need to adhere to standards of practice during interactions with clients and their families. What is a standard of nursing practice?
A) The body of text in the state nurse practice act B) A document outlining minimum expectations for safe nursing practice C) Unwritten but traditional practices that constitute safe nursing care
D) Part of the federal nurse practice act
- Nursing students are reviewing the nurse practice act in the state where they reside. A state's nurse practice act has which of the following functions?
A) Makes recommendations for how nurses should practice B) Defines the scope and limit of nursing practice C) Defines specific situations that constitute malpractice D) Follows federal laws about nursing practice
Solution Manual for Nursing Diagnosis Handbook 11th Edition by Ackley Ackley: Nursing Diagnosis Handbook, 11th Edition Table of Contents 41 cases Lecture Notes
Problem-Based Learning/Critical Thinking
Case Study - Restless Leg Syndrome Case Scenario Abdul Malek is a 21 year old college student. He attends the local state university and is a junior studying graphic design. Three (3) weeks into his fall semester, Abdul’s professors notice that he is falling asleep in class and often looks restless. Abdul taps his foot and squirms around in his seat. Abdul, who is usually an excellent student, has failed his first test in his Graphic Design II course. His professor asks him to see his advisor because the fear is that Abdul has become chemically impaired. His advisor sends Abdul to the student health services and his case is reviewed by the nurse. Nursing Assessment Abdul is a well-developed 22 year old male with a BMI of 20. His vital signs are: blood pressure 104/78; temperature 98.4 degrees F.; heart rate – 64 BPM; respiratory rate – 16 per minute. A nutritional history confirms a well-balanced diet with the exclusion of pork products. Abdul had been working out every day at the University gym but reports that he is currently “too tired” to do so. Abdul denies drug or alcohol use and this is confirmed by serum analysis. Abdul complains about sleeping poorly and feeling as if, “I am moving all night.” He states that he often wakes up his dorm mate and feels badly about that. The nurse reclines Abdul on the examination table and checks his deep tendon reflexes (DTRs) which are all 2 . The nurse asks Abdul to relax and dims the lights while she consults with the primary care practitioner. While the nurse is out of the examination room Abdul dozes and when the nurse returns the nurse observes Abdul’s right leg jerking several times before she arouses him.
- Identify significant symptoms by underlining them in the assessment.
- List those symptoms that indicate the client has a health problem (those you have underlined).
- falling asleep in class
- often looks restless
- taps his foot
- squirms around in his seat
- failed his first test
- “too tired”
- complains about sleeping poorly
- “I am moving all night”
- often wakes up
- right leg jerking several times
- Group the symptoms that are similar.
- falling asleep in class
- often looks restless
- taps his foot
- squirms around in his seat
- failed his first test
- complains about sleeping poorly
- “too tired”
- “I am moving all night”
- often wakes up
- right leg jerking several times
| Chapter 01: Drug Definitions, Standards, and Information Sources Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th Edition MULTIPLE CHOICE 1.What is the name under which a drug is listed by the US Food and Drug Administration (FDA)?|
ANS: C The official name is the name under which a drug is listed by the FDA. The brand name, or trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic, name is provided by the United States Adopted Names Council DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 NAT: NCLEX Client Needs Category: Safe, Effective Care Environment TOP: Nursing Process Step: Assessment CON: Patient Education
- Which source contains information specific to nutritional supplements?
ANS: C United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA approved drugs; it does not include nutritional supplements. Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements. Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements. DIF: Cognitive Level: Knowledge REF: p. 2 | p. 3 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Nutrition | Patient Education 3.What is the most comprehensive reference available to research a drug interaction?
|a.||USP Dictionary of USAN & International Drug Names|
|b.||Natural Medicines Comprehensive Database|
|c.||United States Pharmacopoeia/National Formulary (USP NF)|
|d.||Drug Interaction Facts|
ANS: B First published in 1983, Drug Interaction Facts is the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with clinical and scientific expertise. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Safety | Patient Education | Clinical Judgment 4.The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug?
|a.||Drug Facts and Comparisons|
|b.||Drug Interaction Facts|
|c.||Handbook on Injectable Drugs|
|d.||Martindale—The Complete Drug Reference|
ANS: B A physician’s order would include the brand and/or generic name of the drug. The alphabetic index in the PDR would make this section the most user-friendly. Based on a physician’s order, manufacturer’s information and classification information would not be known. The Manufacturer’s section is a roster of manufacturers. The product category section lists products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and antibiotics. The product information section contains reprints of the package inserts for the major products of manufacturers. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Planning CON: Safety | Patient Education | Clinical Judgment 5.Which online drug reference makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines?
|b.||Brand and Generic name section|
|c.||Product category section|
|d.||Product information section|
ANS: C DailyMed makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines. The American Drug Index is not appropriate for patient use. The American Hospital Formulary is not appropriate for patient use. The PDR is not appropriate for patient use. DIF: Cognitive Level: Knowledge REF: p. 3 | p. 5 OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Implementation CON: Safety | Patient Education | Clinical Judgment 6.Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
|a.||American Drug Index|
|b.||American Hospital Formulary|
|d.||Physicians’ Desk Reference (PDR)|
ANS: A The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner. The Controlled Substances Act addresses only controlled substances and their categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products before marketing them. DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 6 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Safety | Patient Education | Evidence | Health Care Law 7.Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall? ANS: B Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical dependence. Schedule I drugs have high potential for abuse and no recognized medical use. Schedule III drugs have some potential for abuse. Use may lead to low to moderate physical dependence or high psychological dependence. Schedule IV drugs have low potential for abuse. Use may lead to limited physical or psychological dependence. DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 2 NAT: NCLEX Client Needs Category: Safe, Effective Care Environment TOP: Nursing Process Step: Assessment CON: Patient Education | Addiction | Pain 8:What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?
|a.||Federal Food, Drug, and Cosmetic Act (1938)|
|b.||Durham Humphrey Amendment (1952)|
|c.||Controlled Substances Act (1970)|
|d.||Kefauver Harris Drug Amendment (1962)|
|a.||List smallpox as a health orphan disease.|
|b.||Omit the preclinical research phase.|
|c.||Extend the clinical research phase.|
|d.||Fast track the investigational drug.|