Nokea
A patient arrives at the health care clinic and informs the nurse that he has consumed several aspirin tablets for a severe headache over the past 24 hours. The nurse would be alert for which of the following as a harmful effect?
- A. Gastrointestinal bleeding
- B. Breathing difficulties
- C. Visual disturbances
- D. Loss of balance
Correct Answer: A
Rationale: Aspirin is potentially harmful and can cause gastrointestinal bleeding and salicylism. Breathing difficulties, visual disturbances, and loss of balance could be due to an illness or the effects of some other drug.
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The nurse administers a prescribed medication that is supplied as an enteric-coated tablet. The patient asks the nurse about this form of tablet. When describing how this tablet is absorbed, which response by the nurse would be most accurate?
- A. The medication dissolves directly from the stomach into the body.
- B. The drug breaks up into pieces as it moves through the stomach.
- C. The medication bypasses the GI tract and goes quickly into the bloodstream.
- D. The drug dissolves into fragments after it reaches your small intestine.
Correct Answer: D
Rationale: Enteric-coated tablets disintegrate or fragment after reaching the alkaline medium of the small intestine. Tablets and capsules break up into small particles and dissolve into body fluids in the gastrointestinal tract. Liquids and parenteral drugs are quickly absorbed into the body system.
A drug may be classified by which of the following? Select all that apply.
- A. The chemical type of the drug's active ingredient
- B. The way the drug is used to treat a specific condition
- C. The generic name of the drug
- D. The trade name of the drug
- E. The nonproprietary name of the drug
Correct Answer: A,B
Rationale: A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Generic, trade, and nonproprietary refer to how a drug is named.
A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
Which of the following would the nurse identify as a factor that alters drug response in children and infants? Select all that apply.
- A. Slower gastric emptying
- B. Greater surface area
- C. Less protein binding
- D. Decreased body water content
- E. Less cutaneous fat
Correct Answer: A,B,C,E
Rationale: Children and infants are not small adults; therefore, they have altered pharmacokinetics. Factors that alter pharmacokinetics in children include slower gastric emptying, less cutaneous fat, greater surface area, increased body water content, less protein binding, and immature hepatic and renal function.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the first phase?
- A. Metabolism
- B. Absorption
- C. Distribution
- D. Excretion
Correct Answer: B
Rationale: Pharmacokinetics refers to the transportation activity of drugs in the body after administration. The first component is absorption. This is followed by distribution, metabolism, and finally excretion.