Test Bank Pharmacology and the Nursing Process

Test Bank Pharmacology and the Nursing Process Related

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After being in remission from Hodgkin’s disease for 18 months, a client develops a fever of unknown origin. The physician orders a blind liver biopsy to rule out advancing Hodgkin’sdisease and infection. Twenty-four hours after the biopsy, the client has a fever, complains of severe abdominal pain, and seems increasingly confused. The nurse suspects that these finding result from:

  • A. Bleeding in the liver caused by the liver biopsy.
  • B. Perforation of the colon caused by the liver biopsy.
  • C. An allergic reaction to the contrast media used during liver biopsy.
  • D. Normal post procedural pain, with a change in the level of consciousness resulting from the preexisting fever.
Correct Answer: B

Rationale: The correct answer is B: Perforation of the colon caused by the liver biopsy. The symptoms of fever, severe abdominal pain, and confusion are indicative of peritonitis, which can result from a bowel perforation during the liver biopsy procedure. Perforation of the colon can lead to leakage of bowel contents into the peritoneal cavity, causing inflammation, infection, and systemic symptoms. This is a serious complication that requires immediate medical attention.

Incorrect options:
A: Bleeding in the liver caused by the liver biopsy would present with symptoms such as hypotension and signs of internal bleeding, not confusion and severe abdominal pain.
C: An allergic reaction to contrast media would typically present with symptoms such as rash, itching, or respiratory distress, not fever, severe abdominal pain, and confusion.
D: Normal post procedural pain would not cause confusion and a change in the level of consciousness, which indicates a more serious underlying issue like bowel perforation.

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A client with rheumatoid arthritis is being discharged with a prescription for aspirin (Ecotrin), 600mg PO every 6 hours. The nurse should instruct the client to notify the physician if which adverse drug reaction occurs?

  • A. Dysuria
  • B. Tinnitus
  • C. Leg cramps
  • D. Constipation
Correct Answer: B

Rationale: The correct answer is B: Tinnitus. Aspirin can cause tinnitus (ringing in the ears) as an adverse drug reaction, which can indicate potential ototoxicity. Tinnitus is an important side effect that should be reported promptly to the physician to prevent further auditory complications. Dysuria (A), leg cramps (C), and constipation (D) are not typically associated with aspirin use and are less urgent compared to tinnitus. Reporting these side effects may still be necessary but are not as critical as tinnitus in this scenario.

A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?

  • A. It inhibits deoxyribonucleic acid (DNA) synthesis
  • B. It inhibits ribonucleic acid (RNA) synthesis
  • C. It’s cell cycle-phase specific
  • D. It inhibits protein synthesis
Correct Answer: A

Rationale: The correct answer is A: It inhibits deoxyribonucleic acid (DNA) synthesis. Mitomycin is an alkylating agent that works by cross-linking DNA, preventing DNA synthesis and leading to cell death. This mechanism of action makes it effective against rapidly dividing cells like cancer cells.

Choice B, inhibiting ribonucleic acid (RNA) synthesis, is incorrect as mitomycin primarily targets DNA synthesis. Choice C, being cell cycle-phase specific, is incorrect as mitomycin affects cells in all phases of the cell cycle. Choice D, inhibiting protein synthesis, is incorrect because mitomycin's primary mode of action is on DNA replication, not protein synthesis.

The nurse assesses the motor functions during a neurologic examination of a client. Which of the ff steps will help the nurse perform the examination effectively? Choose all that apply

  • A. Allow the client to grasp the nurses hand firmly
  • B. Check the patient’s sensitivity to heat, cold, touch, and pain.
  • C. Ask the client to pick up small and large objects between the thumb and forefinger
  • D. Ask questions that require cognition and logic
Correct Answer: A

Rationale: Step-by-step rationale:
1. Allowing the client to grasp the nurse's hand firmly assesses grip strength and motor coordination.
2. This step helps evaluate the client's ability to follow instructions and perform a coordinated motor task accurately.
3. Assessing grip strength is essential in determining any muscle weakness or neurological deficits.
4. It also provides insight into the client's motor function and coordination abilities.

Summary:
- Choice B is incorrect because it focuses on sensory functions rather than motor functions.
- Choice C assesses fine motor skills, not grip strength and coordination.
- Choice D evaluates cognition and logic, which are not directly related to motor function assessment.

The nurse is explaining the action of insulin to a newly diagnosed diabetic client. During the teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when stating that insulin is secreted from the:

  • A. adenohypohysis.
  • B. alpha cells of the pancreas.
  • C. beta cells of the pancreas.
  • D. parafollicular cells of the thyroid.
Correct Answer: C

Rationale: Rationale:
1. Insulin is a hormone produced by beta cells of the pancreas.
2. Beta cells are responsible for monitoring blood glucose levels and secreting insulin in response to high glucose levels.
3. Insulin helps regulate blood glucose by facilitating glucose uptake into cells.
4. Adenohypophysis secretes other hormones, not insulin.
5. Alpha cells of the pancreas secrete glucagon, not insulin.
6. Parafollicular cells of the thyroid secrete calcitonin, not insulin.

Summary:
Choice C is correct because insulin is indeed secreted from the beta cells of the pancreas. Choices A, B, and D are incorrect as they do not secrete insulin or are related to other hormones.

In assisting a physician to perform a thoracentesis to Mr. Sy, how should the nurse postion a patient with pleural effusion of the left lung?

  • A. supine with the left arm extended over the head
  • B. sitting at the side of the bed with both arms resting on alocked overbed table
  • C. high fowler’s with both arms resting on pillows
  • D. semi-fowlers with both arms resting on pillows
Correct Answer: B

Rationale: The correct answer is B: sitting at the side of the bed with both arms resting on a locked overbed table. This position allows for better lung expansion and easier access to the thoracic cavity during the procedure. Sitting position helps in maximizing lung volume and facilitates drainage of pleural effusion. Arms resting on a locked overbed table helps the patient maintain a stable position and reduces the risk of movement during the procedure. Other choices are incorrect because supine position (A) may not allow for optimal lung expansion, high fowler's position (C) may not provide easy access to the thoracic cavity, and semi-fowlers position (D) may not facilitate efficient drainage of pleural effusion.

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