| Content | Test Bank Lehne Pharmacology For Nursing Care 10th Edition Burcham
Chapter 01: Orientation to Pharmacology
Test Bank
MULTIPLE CHOICE
1. The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse
will rely on knowledge of which topic?
a
.
Clinical pharmacology
b
.
Drug efficacy
c
.
Pharmacokinetics
d
.
Pharmacotherapeutics
ANS: D
Pharmacotherapeutics is the study of the use of drugs to diagnose, treat, and prevent conditions.
Clinical pharmacology is concerned with all aspects of drug-human interactions. Drug efficacy
measures the extent to which a given drug causes an intended effect. Pharmacokinetics is the
study of the impact of the body on a drug.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. What is a desired outcome when a drug is described as easy to administer?
a
.
It can be stored indefinitely without need for refrigeration.
b
.
It does not interact significantly with other medications.
c
.
It enhances patient adherence to the drug regimen.
d
.
It is usually relatively inexpensive to produce.
ANS: C
A major benefit of drugs that are easy to administer is that patients taking them are more likely to
comply with the drug regimen. Drugs that are easy to give may have the other attributes listed,
but those properties are independent of ease of administration.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 2
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. A patient tells the nurse that an analgesic he will begin taking may cause drowsiness and will
decrease pain up to 4 hours at a time. Based on this understanding of the drug’s effects by the
patient, the nurse will anticipate which outcome?
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a
.
Decreased chance of having a placebo effect
b
.
Decreased motivation to take the drug
c
.
Improved compliance with the drug regimen
d
.
Increased likelihood of drug overdose
ANS: C
A drug is effective if it produces the intended effects, even if it also produces side effects. Patients who understand both the risks and benefits of taking a medication are more likely to comply with the drug regimen.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 2
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
MULTIPLE RESPONSE
1. What are the properties of an ideal drug? (Select all that apply.)
a
.
Irreversible action
b
.
Predictability
c
.
Ease of administration
d
.
Chemical stability
e
.
A recognizable trade name
ANS: B, C, D
In addition to predictability, ease of administration, and chemical stability, other properties include a reversible action so that any harm the drug may cause can be undone and a simple generic name, because generic names are usually complex and difficult to remember and pronounce.
PTS: 1 DIF: Cognitive Level: Comprehension REF: pp. 1-2
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. Before administering a medication, what does the nurse need to know to evaluate how individual
patient variability might affect the patient’s response to the medication? (Select all that apply.)
a
.
Chemical stability of the medication
b
.
Ease of administration
c Family medical history
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.
d
.
Patient’s age
e
.
Patient’s diagnosis
ANS: C, D, E
The family medical history can indicate genetic factors that may affect a patient’s response to a
medication. Patients of different ages can respond differently to medications. The patient’s illness can affect how drugs are metabolized. The chemical stability of the medication and the ease
of administration are properties of drugs.
PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 3-4
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
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Sample Questions
Chapter 04: Genetic Issues
Urden: Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
- What is a genetic variant that exists in greater than 1% of the population termed?
| a. |
Genetic mutation |
| b. |
Genetic polymorphism |
| c. |
Genetic deletion |
| d. |
Tandem repeat |
ANS: B
When a genetic variant occurs frequently and is present in 1% or more of the population, it is described as a genetic polymorphism. The term genetic mutation refers to a change in the DNA genetic sequence that can be inherited that occurs in less than 1% of the population. Genetic material in the chromosome can also be deleted and new information from another chromosome can be inserted or can be a tandem repeat (multiple repeats of the same sequence).
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 43
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
| a. |
Chromosome |
| b. |
Mitochondrial |
| c. |
Multifactorial disorders |
| d. |
Allele dysfunction |
ANS: C
In multifactorial disorders there is an interaction between vulnerable genes and the environment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples of multifactorial disorders that result from an interaction of genetic and environmental factors.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 46
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Prader-Willi syndrome (PWS) is a rare genetic disorder in which genes on chromosome 15 (q11.2-13) are deleted. What type of disorder is PWS?
| a. |
Chromosome disorder |
| b. |
Mitochondrial disorder |
| c. |
Complex gene disorder |
| d. |
Multifactorial disorder |
ANS: A
Prader-Willi syndrome (PWS) is a chromosome disorder as a result of several missing genes on chromosome 15. In chromosome disorders, the entire chromosome or very large segments of the chromosome are damaged, missing, duplicated, or otherwise altered.
PTS: 1 DIF: Cognitive Level: Applying REF: p. 45
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- A family pedigree is used to determine whether a disease has a genetic component. What does a proband indicate in a family pedigree?
| a. |
The disease being mother related or father related |
| b. |
The first person in the family who was diagnosed with the disorder |
| c. |
Who in the family is the xy band |
| d. |
The disease genotype including locus |
ANS: B
For nurses, it is important to ask questions that elucidate which family members are affected versus those who are unaffected and then to identify the individuals who may carry the gene in question but who do not have symptoms (carriers). The proband is the name given to the first person diagnosed in the family pedigree. Homozygous versus heterozygous determines if the disorder is carried by a gene from one or both parents. The xy band determines if the disorder is carried through the sex genes. A disease locus is the genetic address of the disorder.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 46
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Philadelphia translocation is a specific chromosomal abnormality that occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. This abnormality is associated with which disease?
| a. |
Hemophilia A |
| b. |
Chronic myelogenous leukemia |
| c. |
Obesity |
| d. |
Marfan syndrome |
ANS: B
Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality associated with chronic myelogenous leukemia. It occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with the FTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 42
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What was the goal of the Human Genome Project?
| a. |
Identifying haplotype tags |
| b. |
Exposing untaggable SNPs and recombination hot spots |
| c. |
Producing a catalog of human genome variation |
| d. |
Mapping all the human genes |
ANS: D
The Human Genome Project was a huge international collaborative project that began in 1990 with the goal of making a map of all the human genes (the genome). The final genome sequence was published in 2003. The HapMap project was to identify haplotype tags. The Genome-Wide Association Studies was used to expose untaggable SNPs and recombination hot spots. The 1000 Genomes project was used to map all the human genes.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 49
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- The patient is placed under general anesthesia for a carotid endarterectomy. During the surgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. What is a possible cause for malignant hyperthermia?
| a. |
Polymorphism in RYR1 at chromosome 19q13.1 |
| b. |
Variant in the VKOR1 gene |
| c. |
Variant in the cytochrome P450 enzyme CYP2C9 gene |
| d. |
Halothane overdose |
ANS: A
Individuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome 19q13.1 are at risk of a rare pharmacogenetic condition known as malignant hyperthermia. In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxants during general anesthesia induces life-threatening muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in the VKOR1 gene and in the cytochrome P450 enzyme CYP2C9 gene.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 53|Box 4-3
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
| a. |
Chromatids |
| b. |
Karyotype |
| c. |
Genetics |
| d. |
Histones |
ANS: C
Genetics refers to the study of heredity, particularly as it relates to the ability of individual genes to transfer heritable physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 54
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell. What is the arrangement of human chromosomes termed?
| a. |
Chromatids |
| b. |
Karyotype |
| c. |
Genomics |
| d. |
Histones |
ANS: B
A karyotype is the arrangement of human chromosomes from largest to smallest. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
| a. |
Chromatids |
| b. |
Karyotype |
| c. |
Genomics |
| d. |
Histones |
ANS: C
Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
| a. |
Chromatids |
| b. |
Karyotype |
| c. |
Genomics |
| d. |
Histones |
ANS: D
A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- To achieve a consistent distance across the width of the DNA strand, the nucleotide base guanine (G) can only be paired with what other genetic material?
| a. |
Adenine (A) |
| b. |
Thymine (T) |
| c. |
Cytosine (C) |
| d. |
Sex chromosome X |
ANS: C
Four nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprise the “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T with A and G with C. The nucleotide bases are designed so that only G can pair with C and only T can pair with A to achieve a consistent distance across the width of the DNA strand. The TA and GC combinations are known as base pairs.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 40
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
| a. |
They share an identical genome. |
| b. |
They have different sex chromosomes. |
| c. |
They have mirror chromosomes. |
| d. |
They have identical health issues. |
ANS: A
Studies of identical twins offer a unique opportunity to investigate the association of genetics, environment, and health. Identical twins are monozygotic and share an identical genome. Monozygotic twins are the same sex. Studies occur much less frequently today because tremendous efforts are made to keep siblings together when they are adopted. Genetics can be stable in a study group, but the environment and health issues are dynamic even in a controlled study group.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 48
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- The process that is used to make polypeptide chains that constitute proteins can be written as:
| a. |
RNA ® DNA ® protein. |
| b. |
DNA ® RNA ® protein. |
| c. |
Protein ® RNA ® DNA. |
| d. |
Protein ® DNA ® RNA. |
ANS: B
The nucleotides A, T, C, and G can be thought of as “letters” of a genetic alphabet that are combined into three-letter “words” that are transcribed (written) by the intermediary of ribonucleic acid (RNA). The RNA translates the three-letter words into the amino acids used to make the polypeptide chains that constitute proteins. This process may be written as DNA ® RNA ® protein.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 41
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What are the studies called that are done on large, extended families who have several family members affected with a rare disease?
| a. |
Genetic association |
| b. |
Genetic epidemiology |
| c. |
Kinships |
| d. |
Phenotypes |
ANS: C
In genetic epidemiologic research of a rare disease, it can be a challenge to find enough people to study. One method is to work with large, extended families, known as kinships, which have several family members affected with the disease. Genetic association studies are usually conducted in large, unrelated groups based on demonstration of a phenotype (disease trait or symptoms) and associated genotype. Genetic epidemiology represents the fusion of epidemiologic studies and genetic and genomic research methods. Phenotypes are different at different stages of a disease and are influenced by medications, environmental factors, and gene–gene interaction.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 48
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is an example of direct-to-consumer genomic testing?
| a. |
Genetic testing through amniocentesis |
| b. |
Paternity testing from buccal swabs of the child and father |
| c. |
Biopsy of a lump for cancer |
| d. |
Drug testing using hair follicles |
ANS: B
An example of direct-to-consumer testing is paternity testing from buccal swabs of the child and father. Genetic testing can be done through biopsies and amniocentesis, but they are performed in a facility by a medical professional. Drug testing and genomic testing are two different tests and are unrelated.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 53
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What was the Genetic Information Nondiscrimination Act (GINA) of 2008 designed to prevent from happening?
| a. |
Abuse of genetic information in employment and health insurance decisions |
| b. |
Genetic counselors from reporting results to the health insurance companies |
| c. |
Mandatory genetics testing of all individuals with certain diseases |
| d. |
Information sharing between biobanks that are studying the same genetic disorders |
ANS: A
The Genetic Information Nondiscrimination Act (GINA) of 2008 is an essential piece of legislation designed to prevent abuse of genetic information in employment and health insurance decisions in the United States. One of the paramount concerns in the genomic era is to protect the privacy of individuals’ unique genetic information. Many countries have established biobanks as repositories of genetic material, and many tissue samples are stored in medical center tissue banks. Some people who may be at risk for a disorder disease will not be tested because they fear that a positive result may affect their employability. GINA also mandates that genetic information about an individual and his or her family has the same protections as health information.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 53
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
- Which patients would be candidates for genetic testing for long QT syndrome (LQTS)? (Select all that apply.)
| a. |
Patients with prolonged QT interval during a cardiac and genetic work-up |
| b. |
Family history of positive genotype and negative phenotype |
| c. |
Patients diagnosed with torsades de pointes |
| d. |
Family history of sudden cardiac death |
| e. |
Family history of bleeding disorders |
| f. |
Family history of obesity |
ANS: A, B, C, D |
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)?
| a. |
Brand |
| b. |
Nonproprietary |
| c. |
Official |
| d. |
Trademark |
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?
| 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: 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. |
Drug Facts and Comparisons |
| b. |
Drug Interaction Facts |
| c. |
Handbook on Injectable Drugs |
| d. |
Martindale—The Complete Drug Reference |
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. |
Manufacturer’s section |
| b. |
Brand and Generic name section |
| c. |
Product category section |
| d. |
Product information section |
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?
| a. |
American Drug Index |
| b. |
American Hospital Formulary |
| c. |
DailyMed |
| d. |
Physicians’ Desk Reference (PDR) |
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. |
Federal Food, Drug, and Cosmetic Act (1938) |
| b. |
Durham Humphrey Amendment (1952) |
| c. |
Controlled Substances Act (1970) |
| d. |
Kefauver Harris Drug Amendment (1962) |
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. |
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. |
ANS: D | 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
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• We offer a free sample so you know exactly what to expect | Chapter 01: Foundations of Maternity, Women’s Health, and Child Health Nursing
MULTIPLE CHOICE
- Which factor significantly contributed to the shift from home births to hospital births in the early 20th century?
| a. |
Puerperal sepsis was identified as a risk factor in labor and delivery. |
| b. |
Forceps were developed to facilitate difficult births. |
| c. |
The importance of early parental-infant contact was identified. |
| d. |
Technologic developments became available to physicians. |
ANS: D
Technologic developments were available to physicians, not lay midwives. So in-hospital births increased in order to take advantage of these advancements. Puerperal sepsis has been a known problem for generations. In the late 19th century, Semmelweis discovered how it could be prevented with improved hygienic practices. The development of forceps is an example of a technology advance made in the early 20th century but is not the only reason birthplaces moved. Unlike home births, early hospital births hindered bonding between parents and their infants.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Safe and Effective Care Environment
- Family-centered maternity care developed in response to
| a. |
demands by physicians for family involvement in childbirth. |
| b. |
the Sheppard-Towner Act of 1921. |
| c. |
parental requests that infants be allowed to remain with them rather than in a nursery. |
| d. |
changes in pharmacologic management of labor. |
ANS: C
As research began to identify the benefits of early extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of rooming-in and finally to family-centered maternity care. Family-centered care was a request by parents, not physicians. The Sheppard-Towner Act of 1921 provided funds for state-managed programs for mothers and children. The changes in pharmacologic management of labor were not a factor in family-centered maternity care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 2 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Psychosocial Integrity
- Which setting for childbirth allows the least amount of parent-infant contact?
| a. |
Labor/delivery/recovery/postpartum room |
| b. |
Birth center |
| c. |
Traditional hospital birth |
| d. |
Home birth |
ANS: C
In the traditional hospital setting, the mother may see the infant for only short feeding periods, and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum room setting allows increased parent-infant contact. Birth centers are set up to allow an increase in parent-infant contact. Home births allow an increase in parent-infant contact.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 2 OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
- As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is
| a. |
increased hospitalization of children. |
| b. |
decreased number of children living in poverty. |
| c. |
an increase in ambulatory care. |
| d. |
decreased use of managed care. |
ANS: C
One effect of managed care has been that pediatric health care delivery has shifted dramatically from the acute care setting to the ambulatory setting in order to provide more cost-efficient care. The number of hospital beds being used has decreased as more care is given in outpatient settings and in the home. The number of children living in poverty has increased over the past decade. One of the biggest changes in health care has been the growth of managed care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 5 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The Women, Infants, and Children (WIC) program provides
| a. |
well-child examinations for infants and children living at the poverty level. |
| b. |
immunizations for high-risk infants and children. |
| c. |
screening for infants with developmental disorders. |
| d. |
supplemental food supplies to low-income pregnant or breastfeeding women. |
ANS: D
WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program provides for well-child examinations and for treatment of any medical problems diagnosed during such checkups. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the program. Public Law 99-457 is part of the Individuals with Disabilities Education Act that provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 8
OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance
- In most states, adolescents who are not emancipated minors must have the permission of their parents before
| a. |
treatment for drug abuse. |
| b. |
treatment for sexually transmitted diseases (STDs). |
| c. |
accessing birth control. |
| d. |
surgery. |
ANS: D
Minors are not considered capable of giving informed consent, so a surgical procedure would require consent of the parent or guardian. Exceptions exist for obtaining treatment for drug abuse or STDs or for getting birth control in most states.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 17 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they
| a. |
are developed and implemented by nurses. |
| b. |
are used primarily in the pediatric setting. |
| c. |
set specific time lines for sequencing interventions. |
| d. |
are part of the nursing process. |
ANS: C
Clinical pathways are standardized, interdisciplinary plans of care devised for patients with a particular health problem. They are used to identify patient outcomes, specify time lines to achieve those outcomes, direct appropriate interventions and sequencing of interventions, include interventions from a variety of disciplines, promote collaboration, and involve a comprehensive approach to care. They are developed by multiple health care professionals and reflect interdisciplinary care. They can be used in multiple settings and for patients throughout the life span. They are not part of the nursing process but can be used in conjunction with the nursing process to provide care to patients.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 7 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The fastest growing group of homeless people is
| a. |
men and women preparing for retirement. |
| b. |
migrant workers. |
| c. |
single women and their children. |
| d. |
intravenous (IV) substance abusers. |
ANS: C
Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless. People preparing for retirement, migrant workers, and IV substance abusers are not among the fastest growing groups of homeless people.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 14 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity
- A nurse wishes to work to reduce infant mortality in the United States. Which activity would this nurse most likely participate in?
| a. |
Creating pamphlets in several different languages using an interpreter. |
| b. |
Assisting women to enroll in Medicaid by their third trimester. |
| c. |
Volunteering to provide prenatal care at community centers. |
| d. |
Working as an intake counselor at a women’s shelter. |
ANS: C
Prenatal care is vital to reducing infant mortality and medical costs. This nurse would most likely participate in community service providing prenatal care outreach activities in community centers, particularly in low-income areas. Pamphlets in other languages, enrolling in Medicaid, and working at a women’s shelter all might impact infant mortality, but the greatest effect would be from assisting women to get consistent prenatal care.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 14 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
- The intrapartum woman sees no need for a routine admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take?
| a. |
Consult the family of the woman. |
| b. |
Notify the provider of the situation. |
| c. |
Document the woman’s refusal in the nurse’s notes. |
| d. |
Make a referral to the hospital ethics committee. |
ANS: B
Patients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the patient’s decision, should be notified immediately. Both professionals can work to ensure the mother understands the rationale for the action and the possible consequences of refusal. The woman herself is the decision-maker, unless incapacitated. Documentation should occur but is not the first action. This situation does not rise to the level of an ethical issue so there is no reason to call the ethics committee.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 18 OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
- Which statement is true regarding the “quality assurance” or “incident” report?
| a. |
The report assures the legal department that no problem exists. |
| b. |
Reports are a permanent part of the patient’s chart. |
| c. |
The nurse’s notes should contain, “Incident report filed, and copy placed in chart.” |
| d. |
This report is a form of documentation of an event that may result in legal action. |
ANS: D
An incident report is used when something occurs that might result in legal action, such as a patient fall or medication error. It warns the legal department that there may be a problem in a particular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’ notes should not contain any reference to them.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 18 OBJ: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
- Elective abortion is considered an ethical issue because
| a. |
abortion law is unclear about a woman’s constitutional rights. |
| b. |
the Supreme Court ruled that life begins at conception. |
| c. |
a conflict exists between the rights of the woman and the rights of the fetus. |
| d. |
it requires third-party consent. |
ANS: C |
