Chapter 09: Collaboration in Community Settings Nursing School Test Banks

Chapter 09: Collaboration in Community Settings
Test Bank

MULTIPLE CHOICE

1. During a home visit, the nurse learns that a patient has not been taking the prescribed medications. The patient reports having no insurance and tells the nurse that the drug is too expensive. After learning that there is no substitute medication, the nurse will perform which action next?
a. Assist the patient to apply for a patient-assist program.
b. Contact the pharmacy to request a reduction in the cost of the drug.
c. Determine the patients annual income.
d. Give the patient the number of a charitable organization that may be able to help.
ANS: C
Patient-assist programs may be helpful, but many are dependent on the patients income so the nurse should determine that first. It is unlikely that the pharmacy would offer a cost reduction. The patient has demonstrated an inability to navigate the system by simply not taking the medication, so only providing a phone number to the patient is not likely to be effective.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 99
TOP: NURSING PROCESS: Assessment/Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A patient calls the clinic and tells the nurse that a newly prescribed medication isnt working. What is the nurses next action?
a. Notify the provider and discuss increasing the dose.
b. Question the patient about compliance with the regimen.
c. Review the drug information with the patient.
d. Suggest the patient discuss changing medications with the provider.
ANS: C
It is important for patients to understand the therapeutic effects and expected time frame for effects to occur. The nurse should review this with the patient first to make sure the patients expectations are consistent with the drugs effects. The dose should not be increased or the drug changed until it is determined that the drug is not working as it should. Questioning the patient about compliance first assumes that the patient is doing something wrong. The nurse may question the patient about compliance after reviewing the drug information.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 99
TOP: NURSING PROCESS: Assessment/Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance

3. The parent of a school-age child tells the nurse that the child often misses the midday dose of a medication because the child forgets to take it to school. What will the nurse suggest?
a. Asking the pharmacist to divide the prescription into two labeled packages
b. Discussing a different medication with the childs provider
c. Putting the bottle of pills in the childs lunchbox
d. Requesting permission for the child to come home from school during the day
ANS: A
Patients and families should be assisted to have medications available at home, work, or school if it is necessary to take the medications in those locations. Asking the pharmacist to label some of the drug for school will allow a supply to be kept at school. It should not be necessary to take a different medication. Children should not have medications in their lunchboxes. It should not be necessary for the child to come home to take a medication.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 99
TOP: NURSING PROCESS: Planning/Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance

4. The community health nurse is teaching a group of elderly residents in an assisted care facility about medication use. The nurse will remind the residents that over-the-counter (OTC) medications
a. are not as effective as prescription medications.
b. are not recommended for older adults.
c. are safer than prescription medications.
d. should be reviewed with a provider before taking.
ANS: D
OTC medications should be reviewed as part of a medication history at every encounter with the provider to prevent food and drug interactions. OTC medications may be just as effective as prescription medications, may be used by older adults, and often have serious side effects.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 99
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance

5. The nurse is teaching a patient about a new medication that will be administered using a metered-dose inhaler. To evaluate the patients understanding about how to use the device, what will the nurse do?
a. Ask the patient to give a return demonstration using the inhaler.
b. Give the patient written instructions to review as needed.
c. Offer the patient an Internet web address with information about the product.
d. Provide information about drug effects and adverse reactions.
ANS: A
The nurse should demonstrate skills and evaluate understanding with return demonstrations. Written instructions and Internet sites are helpful but do not give information about how well the patient can perform a task.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 100
TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Health Promotion and Maintenance

6. The community health nurse is preparing to administer a medication to a patient in the patients home. The order reads amoxicillin as directed BID PO. The nurse will perform which action?
a. Administer the medication as ordered on the prescription label.
b. Ask the patient to take the medication as ordered.
c. Contact the provider to confirm the correct dose of the medication.
d. Review the drug information to verify the correct dose.
ANS: C
The home nurse must have a complete order for giving medications including name of medication, dose, route, frequency, so the nurse should contact the provider to ascertain the dose. The prescription label may be outdated if the provider has changed the regimen.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 100
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance

7. A nursing student is working as a home health aide. The patient asks the aide to give a medication, and the aide calls the nurse for permission to perform this task. Which is the correct response by the nurse?
a. I can authorize you to give this medication.
b. If you have taken a pharmacology course, you may give the medication.
c. You may assist the patient to self-administer the medication.
d. You should never assist with medications in the home setting.
ANS: C
The certified home health aide should never give medications but may help a patient self-administer a medication.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 101
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The school nurse happens to observe a child pulling a pill out of a backpack and preparing to take it. What action will the nurse take?
a. Ask the child to describe the medication, dose, and reason for taking it.
b. Ask the child to keep all pills in the nurses office.
c. Call the childs provider for a telephone order to give the medication.
d. Contact the childs parent to request a properly labeled prescription.
ANS: D
Children should bring medications properly labeled to school and should not self-administer medications without supervision.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 102
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The home health nurse learns that an immigrant family relies on folk healers when treating illnesses among family members. The nurse will perform which action?
a. Acknowledge the familys beliefs while pointing out how these are not effective.
b. Ask the family elder to explain how a prescribed regimen will be more effective.
c. Give the family a list of dangerous practices to avoid using.
d. Incorporate any safe, non-conflicting practices into the plan of care.
ANS: D
The nurse should communicate respect for families and cultures at all times. Respect for cultural diversity may be demonstrated by including traditional practices into plans as long as they are safe and do not conflict with evidence-based care.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 103
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The nurse is preparing to teach a patient who will begin taking a monoamine oxidase (MAO) inhibitor. What is most important when teaching patients about MAO inhibitors?
a. Emphasizing the importance of potassium intake
b. Giving detailed drug information
c. Reviewing dietary guidelines
d. Providing a schedule for medication administration
ANS: C
MAO inhibitors have many dietary restrictions with potentially serious adverse reactions, so this should be an important part of teaching.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 100
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The nurse is teaching a patient about taking a once daily medication that has a side effect of drowsiness. The nurse learns that the patient works a 7:00 PM to 7:00 AM shift in a hospital. The nurse will recommend that the patient take this medication at which time of day?
a. 0600
b. 0800
c. 1800
d. 2000
ANS: B
The medication should be given when the patient is at home before sleep.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 99
TOP: NURSING PROCESS: Planning/Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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