(Eğitim Tanrısı) Kathryn Cadenced Colgrove, Christi Doherty - Pharmacology Success_ NCLEX®-Style Q&A Review-F. A. Davis (2018).pdf

Document Content and Description Below

Pharmacology Success NCLEX®-Style Q&A Review THIRD EDITION Kathryn Cadenhead Colgrove, RN, MS, CNS Christi Doherty, DNP, MSN, RNC-OB, CNEF.A. Davis Company 1915 Arch Street Philadelphia, PA 191... 03 www.fadavis.com Copyright © 2019 by F.A. Davis Company All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Acquisitions Editor: Jacalyn Sharp Senior Content Project Manager: Julia L. Curcio Electronic Project Editor: Sandra A. Glennie Design and Illustrations Manager: Carolyn O’Brien As new scientifi c information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. ISBN: 978-0-8036-6924-6 Authorization to photocopy items for internal or personal use, or the internal or personal use of specifi c clients, is granted by F.A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-6924-6/19 0 + $.25.Thank you to all the nursing students, nursing faculty, and nursing colleagues we have had the privilege to work with during our careers. We would like to recognize Ray Ann Hargrove-Huttel, PhD, RN, the author of this and other Success series books for her contributions to all of the books. Dr. Huttel lost her battle to cancer December 23, 2012. I would like to dedicate this book to the memory of my mother, Mary Cadenhead, and grandmother, Elsie Rogers. They always told me I could accomplish anything I wanted to accomplish. I would also like to dedicate this book to my husband, Larry; children, Laurie and Todd and Larry Jr. and Mai; and grandchildren, Chris and Melissa, Ashley and Martin, Justin C., Justin A., Connor, Sawyer, and Carson. Without their support and patience, this book would not have been possible. —Kathryn Cadenhead Colgrove This book is dedicated to my mother, Ellen Shomette, who showed me that hard work and perseverance can make dreams come true; to my mother-in-law, Clara June Doherty, RN, who lived her life with such kindness and generosity, an inspiration for self-improvement every day; and to my husband and best friend, Kevin Doherty, thank you for all the support and encouragement in all my endeavors. You make everything worthwhile. —Christi DohertyBE PREPARED FOR SUCCESS SAVE 20% + FREE SHIPPING Order today online at www.FADavis.com Use Promo Code: REVIEW20 Promotion subject to change without notice. Valid for purchases from www.FADavis.com by individuals in the U.S. only. “The most essential facts you will ever need from a trusted series.” —Amazon student reviewer Don’t have time to read your textbook? Try the Essential Nursing Content + Practice Questions series Content Review | Case Studies | NCLEX®-Prepv Beth Batturs Martin, RN, MSN Director of Nursing and Healthcare Initiatives Anne Arundel Community College Arnold, Maryland Susan Fowler, MS(N), MHS, RN Lead Nursing Instructor Tri-County Community College Murphy, North Carolina Reviewersvii 1 Basic Concepts in Medication Administration . . . . . . . . . . . .1 PHARMACOLOGY TEST-TAKING HINTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 POPULATION-SPECIFIC INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Pediatric Clients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Elderly Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Females of Childbearing Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 IMPORTANT DATA TO REMEMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Medication Memory Jogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 Neurological System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 QUESTIONS 7 A Client With a Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 A Client With Seizures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 A Client With a Cerebrovascular Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 A Client With a Brain Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 A Client With Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 A Client With Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 A Client With a Migraine Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 ANSWERS AND RATIONALES 18 A Client With a Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 A Client With Seizures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 A Client With a Cerebrovascular Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 A Client With a Brain Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 A Client With Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 A Client With Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 A Client With a Migraine Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 NEUROLOGICAL SYSTEM COMPREHENSIVE EXAMINATION 31 NEUROLOGICAL SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 35 3 Cardiovascular System. . . . . . . . . . . . . . . . . . . . . . . . . . . .39 QUESTIONS 39 A Client With Angina/Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . 39 A Client With Coronary Artery Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 A Client With Congestive Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 A Client With Dysrhythmias and Conduction Problems . . . . . . . . . . . . . . . . . . 44 A Client With Infl ammatory Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . 47 A Client With Arterial Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 A Client With Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 A Client With Deep Vein Thrombosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 A Client With Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 ANSWERS AND RATIONALES 55 A Client With Angina/Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . 55 A Client With Coronary Artery Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 A Client With Congestive Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 A Client With Dysrhythmias and Conduction Problems . . . . . . . . . . . . . . . . . . 60 A Client With Infl ammatory Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . 62 Table of Contentsviii TABLE OF CONTENTS A Client With Arterial Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 A Client With Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 A Client With Deep Vein Thrombosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 A Client With Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 CARDIOVASCULAR SYSTEM COMPREHENSIVE EXAMINATION 72 CARDIOVASCULAR SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 76 4 Pulmonary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 QUESTIONS 81 A Client With an Upper Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . 81 A Client With a Lower Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . . 82 A Client With Reactive Airway Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 A Child With Reactive Airway Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 A Client With a Pulmonary Embolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 ANSWERS AND RATIONALES 89 A Client With an Upper Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . 89 A Client With a Lower Respiratory Infection. . . . . . . . . . . . . . . . . . . . . . . . . . 90 A Client With Reactive Airway Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 A Child With Reactive Airway Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 A Client With a Pulmonary Embolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 PULMONARY SYSTEM COMPREHENSIVE EXAMINATION 99 PULMONARY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 102 5 Gastrointestinal System . . . . . . . . . . . . . . . . . . . . . . . . . .107 QUESTIONS 107 A Client With Gastroesophageal Reflux . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 A Client With Infl ammatory Bowel Disease (IBD) . . . . . . . . . . . . . . . . . . . . . 108 A Client With Peptic Ulcer Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 An Elderly Client With Diverticulosis/Diverticulitis . . . . . . . . . . . . . . . . . . . . 111 A Client With Liver Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 A Client With Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 A Child With Gastroenteritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 A Client With Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 A Client Experiencing Constipation or Diarrhea . . . . . . . . . . . . . . . . . . . . . . 117 A Client Undergoing Abdominal Surgery With General Anesthesia . . . . . . . . . 118 A Client Receiving Total Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . 120 A Client Experiencing Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 ANSWERS AND RATIONALES 124 A Client With Gastroesophageal Reflux . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 A Client With Infl ammatory Bowel Disease (IBD) . . . . . . . . . . . . . . . . . . . . . 125 A Client With Peptic Ulcer Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 An Elderly Client With Diverticulosis/Diverticulitis . . . . . . . . . . . . . . . . . . . . 129 A Client With Liver Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 A Client With Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 A Child With Gastroenteritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 A Client With Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 A Client Experiencing Constipation or Diarrhea . . . . . . . . . . . . . . . . . . . . . . 138 A Client Undergoing Abdominal Surgery With General Anesthesia . . . . . . . . . 140 A Client Receiving Total Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . 142 A Client Experiencing Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 GASTROINTESTINAL SYSTEM COMPREHENSIVE EXAMINATION 146 GASTROINTESTINAL SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 151TABLE OF CONTENTS ix 6 Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157 QUESTIONS 157 A Client With Type 1 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 A Client With Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 A Client With Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 A Client With Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 A Client With Pituitary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 A Client With Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 ANSWERS AND RATIONALES 166 A Client With Type 1 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 A Client With Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 A Client With Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 A Client With Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 A Client With Pituitary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 A Client With Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 ENDOCRINE SYSTEM COMPREHENSIVE EXAMINATION 179 ENDOCRINE SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 183 7 Genitourinary System . . . . . . . . . . . . . . . . . . . . . . . . . . .187 QUESTIONS 187 A Client With Chronic Kidney Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 A Client With a Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 A Client With Benign Prostatic Hypertrophy. . . . . . . . . . . . . . . . . . . . . . . . . 190 A Client With Renal Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 An Adolescent With a Sexually Transmitted Infection . . . . . . . . . . . . . . . . . . 192 ANSWERS AND RATIONALES 194 A Client With Chronic Kidney Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 A Client With a Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 A Client With Benign Prostatic Hypertrophy. . . . . . . . . . . . . . . . . . . . . . . . . 197 A Client With Renal Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 An Adolescent With a Sexually Transmitted Infection . . . . . . . . . . . . . . . . . . 200 GENITOURINARY SYSTEM COMPREHENSIVE EXAMINATION 203 GENITOURINARY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 206 8 Reproductive System. . . . . . . . . . . . . . . . . . . . . . . . . . . .209 QUESTIONS 209 A Client Experiencing Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 The Newborn Client Transitioning to Extrauterine Life . . . . . . . . . . . . . . . . . 214 A Client Experiencing Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 A Client Using Birth Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 A Client Experiencing Reproductive Hormone Changes. . . . . . . . . . . . . . . . . 217 ANSWERS AND RATIONALES 219 A Client Experiencing Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 The Newborn Client Transitioning to Extrauterine Life . . . . . . . . . . . . . . . . . 223 A Client Experiencing Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224 A Client Using Birth Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 A Client Experiencing Reproductive Hormone Changes. . . . . . . . . . . . . . . . . 227 REPRODUCTIVE SYSTEM COMPREHENSIVE EXAMINATION 228 REPRODUCTIVE SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 231 9 Musculoskeletal System. . . . . . . . . . . . . . . . . . . . . . . . . .235 QUESTIONS 235 A Client With Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 A Client With Renal Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236x TABLE OF CONTENTS A Client With Renal Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 A Client Undergoing Orthopedic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 ANSWERS AND RATIONALES 241 A Client With Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 A Client With Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242 A Client With Osteoporosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 A Client Undergoing Orthopedic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 MUSCULOSKELETAL SYSTEM COMPREHENSIVE EXAMINATION 250 MUSCULOSKELETAL SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 254 10 Integumentary System. . . . . . . . . . . . . . . . . . . . . . . . . . .259 QUESTIONS 259 A Client With Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259 A Client With Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 A Client With a Skin Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262 ANSWERS AND RATIONALES 264 A Client With Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264 A Client With Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 A Client With a Skin Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 INTEGUMENTARY SYSTEM COMPREHENSIVE EXAMINATION 269 INTEGUMENTARY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 272 11 Immune Infl ammatory System . . . . . . . . . . . . . . . . . . . . .277 QUESTIONS 277 A Client With an Autoimmune Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 A Client With HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 A Client With Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 A Client With Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 A Child Receiving Immunizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 ANSWERS AND RATIONALES 285 A Client With an Autoimmune Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 A Client With HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 A Client With Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 A Client With Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 A Child Receiving Immunizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 IMMUNE INFLAMMATORY SYSTEM COMPREHENSIVE EXAMINATION 294 IMMUNE INFLAMMATORY SYSTEM COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 297 12 Cancer Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 QUESTIONS 301 A Client Receiving Chemotherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 A Client Receiving a Biologic Response Modifier . . . . . . . . . . . . . . . . . . . . . 304 A Client Receiving Hormone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305 A Client Receiving an Investigational Protocol . . . . . . . . . . . . . . . . . . . . . . . 306 A Client Undergoing Surgery for Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 308 A Client With Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 ANSWERS AND RATIONALES 312 A Client Receiving Chemotherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 A Client Receiving a Biologic Response Modifier . . . . . . . . . . . . . . . . . . . . . 313 A Client Receiving Hormone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 A Client Receiving an Investigational Protocol . . . . . . . . . . . . . . . . . . . . . . . 317 A Client Undergoing Surgery for Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 A Client With Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321 CANCER TREATMENTS COMPREHENSIVE EXAMINATION 323 CANCER TREATMENTS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 328TABLE OF CONTENTS xi 13 Mental Health Disorders . . . . . . . . . . . . . . . . . . . . . . . . .333 QUESTIONS 333 A Client With a Major Depressive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . 333 A Client With Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334 A Client With Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336 A Client With an Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337 A Child With Attention Defi cit-Hyperactivity Disorder . . . . . . . . . . . . . . . . . . 339 A Client With a Sleep Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340 A Client With Substance Abuse Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 ANSWERS AND RATIONALES 344 A Client With a Major Depressive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . 344 A Client With Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346 A Client With Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348 A Client With an Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350 A Child With Attention Defi cit-Hyperactivity Disorder . . . . . . . . . . . . . . . . . . 352 A Client With a Sleep Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353 A Client With Substance Abuse Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355 MENTAL HEALTH DISORDERS COMPREHENSIVE EXAMINATION 358 MENTAL HEALTH DISORDERS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 362 14 Sensory Defi cits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367 QUESTIONS 367 A Client With an Eye Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367 A Child With an Ear Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 ANSWERS AND RATIONALES 371 A Client With an Eye Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371 A Child With an Ear Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372 SENSORY DEFICITS COMPREHENSIVE EXAMINATION 375 SENSORY DEFICITS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 378 15 Emergency Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . .381 QUESTIONS 381 A Client Experiencing Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381 A Community Facing Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382 A Client Experiencing a Code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384 A Child Experiencing Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385 ANSWERS AND RATIONALES 387 A Client Experiencing Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387 A Community Facing Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 A Client Experiencing a Code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390 A Child Experiencing Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392 EMERGENCY NURSING COMPREHENSIVE EXAMINATION 394 EMERGENCY NURSING COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 397 16 Nonprescribed Medications . . . . . . . . . . . . . . . . . . . . . . .401 QUESTIONS 401 A Client Taking Herbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 A Client Taking Vitamins/Minerals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402 A Client Self-Prescribing Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403 ANSWERS AND RATIONALES 405 A Client Taking Herbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 A Client Taking Vitamins/Minerals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406 A Client Self-Prescribing Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407 NONPRESCRIBED MEDICATIONS COMPREHENSIVE EXAMINATION 410 NONPRESCRIBED MEDICATIONS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 413xii TABLE OF CONTENTS 17 Administration of Medications . . . . . . . . . . . . . . . . . . . . .417 QUESTIONS 417 The Nurse Administering Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 The Nurse Computing Math to Administer Medications . . . . . . . . . . . . . . . . 418 ANSWERS AND RATIONALES 421 The Nurse Administering Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421 The Nurse Computing Math to Administer Medications . . . . . . . . . . . . . . . . 422 ADMINISTRATION OF MEDICATIONS COMPREHENSIVE EXAMINATION 424 ADMINISTRATION OF MEDICATIONS COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES 427 18 Comprehensive Examination. . . . . . . . . . . . . . . . . . . . . . .431 QUESTIONS 431 ANSWERS AND RATIONALES 445 Appendix A: Drug Charts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461 Glossary of English Words Commonly Encountered on Nursing Examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . 483 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4871 The nurse should never put a medication in any client’s orifi ce, man-made or natural, if the nurse does not know what the medication is, how it acts in the body, and what the safe administration guidelines for that medication are. —Ray A. Hargrove-Huttel PHARMACOLOGY TEST-TAKING HINTS The test taker must know medications, and memorization is part of administering medications safely. This chapter contains some tips to assist the test taker in learning about medications. These tips apply to all the questions in this book. First, learn the specific classification of a medication, including the actions, side effects, and adverse effects. Also, learn how to safely administer a medication in the classification. Generally speaking, medications in a classifi cation share characteristics. However, be sure not to be too broad in the classifi cation. For example, do not combine all medications administered for hypertension in the same category. Angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and calcium channel blockers do not work in the same manner and are not in the same classifi cation, even though they may all be used to treat hypertension. Similarly, medications for diabetes mellitus and diuretics fall into several classification groups, and the facts about each specific classification must be learned. This knowledge will assist the nurse in administering medications, as medications in a specifi c class will have similar safety requirements and similar effects/side effects. For example, ALL beta blocker medications require the nurse to monitor the blood pressure and apical pulse (AP) prior to administering the medication. The biggest change for a nursing student regarding learning to administer medications and being able to pass the RN-NCLEX is that the RN-NCLEX examination no longer provides the test taker with the classifi cation or the trade name of the medication. This requires the test taker to recognize the medication and its effects and side effects by memorization of the generic name. Because of this change, all medications in the stems of the questions will list only the generic names. The classification of the medication and a trade name will be provided in the answers section so the test taker will become familiar with several ways to recognize the medications. The exception to this will be when the test taker is required to use a medication administration record (MAR). In some clinical facilities, MARs contain both the generic names and trade names of the medications, so some MARs will contain both in this book. When administering medications for a group of clients, the test taker must realize that time is a realistic issue. It is not feasible for the nurse to look up 50 to 60 medications and administer them all within the dosing time frame, so it is imperative that the nurse learn about the most common medications. One tip for learning about medications is for the test taker to complete handmade drug cards. This is better than buying ready-made cards because in completing the drug cards the test taker uses more than one method of learning—reading, deciding which information to put on the card, and writing the pertinent information on the card. All of this assists the test taker in memorizing the information. Basic Concepts in Medication Administration12 PHARMACOLOGY SUCCESS When the test taker is deciding which information is the most important to write on a drug card, the following fi ve questions can be used as a guide. The test taker should always ask why an intervention is being implemented. That is the key to critical thinking. 1. What classifi cation is the medication that the nurse is administering to the client, and why specifi cally is this client receiving this medication? Many medications are categorized in one classifi cation group, but the client is receiving the medication for a different reason. For example, the medication trazodone is labeled as an antidepressant, but in reality it is prescribed as a sedative medication (sleeper) because its sedating effects are more powerful than its antidepressant effects. What action does the medication have on the body? This is known as the scientifi c rationale for administering the medication. Example #1: digoxin (Lanoxin) 0.25 mg po generic name (Trade Name) • The classification of this medication is a cardiac glycoside. • The medication is administered to clients with congestive heart failure (CHF) or rapid atrial fibrillation. • Cardiac glycosides increase the contractility of the heart and decrease the heart rate. (In heart failure, the medication is administered to increase the contractility of the heart, but in atrial fi brillation, the medication is administered to slow the heart rate.) Example #2: furosemide (Lasix) 40 mg IV push (IVP) generic name (Common Trade Name) • The classification of the medication is a loop diuretic. • The medication is administered to clients with essential hypertension or CHF or with any other condition in which there is excess fluid in the body. • This medication helps remove excess fluid from the body. • Loop diuretics remove water from the kidneys along with potassium. 2. When should the nurse question administering this medication? Does the medication have a therapeutic serum level? Which vital signs must be monitored? Which physiological parameters should be monitored when the medication is being administered? Example #1: digoxin (Lanoxin) • Is the AP less than 60 beats per minute (bpm)? • Is the digoxin level within the therapeutic range? • Is the potassium level within normal range? Example #2: furosemide (Lasix) • Is the potassium level within normal range? • Does the client have signs/symptoms of dehydration? • Is the client’s blood pressure below 90/60? 3. What interventions must be taught to the client to ensure the medication is administered safely in the hospital setting? What interventions must be taught for taking the medication safely at home? Example #1: digoxin (Lanoxin) • Explain the importance of having serum levels checked regularly. • Teach the client to take his or her radial pulse and not to take the medication if the pulse is less than 60 bpm. • Inform the client to take the medication daily and to notify the HCP if not taking the medication. Example #2: furosemide (Lasix) • Teach about orthostatic hypotension. • Instruct the client to drink a limited amount of water to replace insensible fluid loss. • Because the medication is IVP, inform the client about how many minutes the medication should be pushed, what primary IV is hanging, and whether the IV is compatible with Lasix.CHAPTER 1 BASIC CONCEPTS IN MEDICATION ADMINISTRATION 3 4. What are the side effects and potential adverse reactions? Side effects are undesired effects of the medication, but they do not warrant discontinuing or changing the medication. Adverse reactions are any situations that would require notifying the HCP or discontinuing the medication. Example #1: digoxin (Lanoxin) • Decrease in heart rate to below 60 bpm. • Signs of toxicity—nausea, vomiting, anorexia, and yellow haze. Example #2: furosemide (Lasix) • Side effects—dizziness, light-headedness. • Adverse effects—hypokalemia; tinnitus if administered too quickly in IVP. 5. How does the nurse know the medication is effective? Example #1: digoxin (Lanoxin) • Have the signs/symptoms of CHF improved? • Is the client able to breathe easier? How many pillows does the client have to sleep on when lying down? Is the client able to perform activities of daily living (ADLs) without shortness of breath? What do the lung fi elds sound like? Example #2: furosemide (Lasix) • Is the client’s urinary output greater than the intake? • Has the client lost any weight? • Does the client have sacral or peripheral edema? • Does the client have jugular vein distention? • Has the client’s blood pressure decreased? SAMPLE DRUG CARDS Front of Card Classification of Drug Route Action of drug Uses Nursing implications (When would I question giving the medication?) How will I monitor to see if it is working? Back of Card Side effects Teaching needs Drug names4 PHARMACOLOGY SUCCESS It is suggested that the test taker complete these cards from a pharmacology textbook and not a drug handbook because most test questions come from a pharmacology book. Digoxin Cardiac Glycosides PO/IV Action: Positive inotropic action, increases force of ventricular contraction and thereby increases cardiac output; slows the heart, allowing for increased fi lling time. Uses: CHF and rapid atrial cardiac dysrhythmias. Nursing Implications: Check AP for 1 full minute; hold if < 60. Check digoxin level (0.5–2.0 normal, > 2.5 = toxic). Check K+ level (hypokalemia is most common cause of dysrhythmias in clients receiving dig [3.5–5.0 mEq/L]). Monitor for S/S of CHF, crackles in lungs, I > O, edema. Question if the AP < 60 or abnormal lab values. IVP—over 5 minutes: maintenance dose 0.125–0.25 mg q day. Effectiveness: S/S of CHF improve, output > intake, weight decreases, breathing improves, activity tolerance improves, atrial rate decreases. Side Effects: Toxic = yellow haze or nausea and vomiting; ventricular rate decreases. If given along with a diuretic, increased risk of hypokalemia. Teaching needs: To take radial pulse and hold if < 60 and notify HCP. K+ replacement—eat food high in K+ or may need supplemental K+. Report weight gain of 3 lb or more. Drug names: Digoxin (generic) Lanoxin Lanoxicap Sample Card for Furosemide Furosemide Loop diuretic PO/IVP/IM Actions: Blocks reabsorption of sodium and chloride in the loop of Henle = prevents the passive reabsorption of water = diuresis. Uses: CHF, fl uid volume overload, pulmonary edema, HTN. Nursing implications: I & O, monitor K+ level, check skin turgor, monitor for leg cramps, provide K+-rich foods or supplements, give early in the day to prevent nocturia. If giving IVP, give at prescribed rate (Lasix 20 mg/minute); ototoxic if given faster. Effectiveness: Decrease in weight, output > intake, less edema, lung sounds clear. Side Effects: Hypokalemia, muscle cramps, hyponatremia, dehydration. Teaching Needs: Take early in the day. Eat foods high in K+. Drug Names: Furosemide (Lasix) Bumetanide (Bumex) Torsemide (Demadex) Ethacrynic acid (Edecrin) The test taker is encouraged to use these guidelines/test-taking hints when answering the questions about medications in the following chapters. The questions cover medications prescribed for many different disease processes. The book is intended to cover the most commonly occurring health-care problems, but it is not all inclusive. New medications are approved for use every month.CHAPTER 1 BASIC CONCEPTS IN MEDICATION ADMINISTRATION 5 In each chapter there are medication questions for specifi c disease processes and a comprehensive test that may have some questions regarding less common disease processes and the medications prescribed to treat these problems. POPULATION-SPECIFIC INFORMATION Pediatric Clients The nurse must be aware that pediatric clients have specific prescribing and drug administration needs. The weight of the child’s body directly affects the amount of medication that can safely be administered. In addition, possible effects on the liver and brain, which are not fully mature in pediatric clients, must be considered. Pediatric dosing is frequently prescribed in mg/kg. The nurse must have the mathematical ability to convert pounds to kilograms and grams to milligrams. A kilogram is equal to 2.2 pounds. Elderly Clients The nurse must be aware that as the body ages, the body processes slow and do not function as they once did. The liver and kidneys are responsible for processing medications and eliminating the excess from the body. These organs are two of the most important organs to monitor when administering medications. The client’s reaction to the medications prescribed, laboratory studies, and potential toxicities must all be carefully monitored. In the elderly, doses may need to be decreased to account for the body’s decreased ability to process and detoxify medications. Females of Childbearing Age Any time a female client is mentioned in a question and an age is given that indicates the client is of childbearing age and could be pregnant, the test taker must determine if the medication is safe to administer to two clients—the female client and a potential fetus. IMPORTANT DATA TO REMEMBER The test taker must [Show More]

Last updated: 1 year ago

Preview 1 out of 513 pages