Chapter 11: The Nursing Process in Patient-Centered Pharmacotherapy Nursing School Test Banks

Chapter 11: The Nursing Process in Patient-Centered Pharmacotherapy
Test Bank

MULTIPLE CHOICE

1. The nurse provides teaching about the sedative side effects of a medication ordered to be given at 8:00 PM daily. The patient works a 7:00 PM to 7:00 AM shift. The nurse explores options including taking the medication at 8:00 AM instead of in the evening. Which QSEN competency do the nurses actions best demonstrate?
a. Collaboration and teamwork
b. Evidence-based practice
c. Patient-centered care
d. Patient safety
ANS: C
Patient-centered care recognizes the patient as the source of control and provides care based on respect for the patients preferences, values, and needs.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 113
TOP: NURSING PROCESS: Planning MSC: NCLEX: Management of Care

2. The nurse learns that a patient cannot afford a prescribed medication and enlists the assistance of the social worker and an outside agency to provide medications at a lower cost. Which QSEN competency do the nurses actions best demonstrate?
a. Collaboration and teamwork
b. Evidence-based practice
c. Patient-centered care
d. Quality improvement
ANS: A
Collaboration and teamwork involve interprofessional communication and shared decision-making to provide patient care.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 114
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Management of Care

3. A 5-year-old child with type 1 diabetes mellitus has repeated hospitalizations for episodes of hyperglycemia related to poor control. The parents tell the nurse that they cant keep track of everything that has to be done to care for their child. The nurse reviews medications, diet, and symptom management with the parents and draws up a daily checklist for the family to use. This is an example of the principles outlined in
a. Guiding Principles of Patient Engagement.
b. National Alliance for Quality Care.
c. Nursing Process.
d. Quality and Safety Education for Nurses.
ANS: A
Guiding Principles of Patient Engagement address the dynamic partnership among patients, families, and health care providers.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 114
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Management of Care

4. The nurse is preparing to administer a medication and reviews the patients chart for drug allergies, serum creatinine, and blood urea nitrogen (BUN) levels. The nurses actions are reflective of which phase of the nursing process?
a. Assessment
b. Evaluation
c. Implementation
d. Planning
ANS: A
Assessment involves gathering information about the patient and the drug, including any previous use of the drug.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Pages 114-115
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Management of Care

5. Which assessment is categorized as objective data?
a. A list of herbal supplements regularly used
b. Lab values associated with drugs the patient is taking
c. The ages and relationship to the patient of all household members
d. Usual dietary patterns and intake
ANS: B
Objective data are measured and detected by another person and would include lab values. The other examples are subjective data.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 115
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Management of Care

6. The nurse reviews a patients database and learns that the patient lives alone, is forgetful, and does not have an established routine. The patient will be sent home with three new medications to be taken at different times of day. The nurse develops a daily medication chart and enlists a family member to put the patients pills in a pill organizer. This is an example of which phase of the nursing process?
a. Assessment
b. Evaluation
c. Implementation
d. Planning
ANS: C
The implementation phase involves education and patient care in order to assist the patient to accomplish the goals of treatment.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Pages 117-118
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Management of Care

7. A patient who is hospitalized for chronic obstructive pulmonary disease wants to go home. The nurse and the patient discuss the patients situation and decide that the patient may go home when able to perform self-care without dyspnea and hypoxia. This is an example of which phase of the nursing process?
a. Assessment
b. Evaluation
c. Implementation
d. Planning
ANS: D
Planning involves goal-setting which, for this patient, means being able to perform self-care activities without dyspnea and hypoxia.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 115
TOP: NURSING PROCESS: Planning MSC: NCLEX: Management of Care

8. A patient will be sent home with a metered-dose inhaler, and the nurse is providing teaching. Which is a correctly written goal for this process?
a. The nurse will demonstrate correct use of a metered-dose inhaler to the patient.
b. The nurse will teach the patient how to administer medication with a metered-dose inhaler.
c. The patient will know how to self-administer the medication using the metered-dose inhaler.
d. The patient will independently administer the medication using the metered-dose inhaler at the end of the session.
ANS: D
Goals must be patient-centered and clearly state the outcome with a reasonable deadline and should identify components for evaluation.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Pages 115-116
TOP: NURSING PROCESS: Planning MSC: NCLEX: Management of Care

9. The nurse is developing a plan of care for a patient who has chronic lung disease and hypoxia. The patient has been admitted for increased oxygen needs above a baseline of 2 L/min. The nurse develops a goal stating, The patient will have oxygen saturations of > 95% on room air at the time of discharge from the hospital. What is wrong with this goal?
a. It cannot be evaluated.
b. It is not measurable.
c. It is not patient-centered.
d. It is not realistic.
ANS: D
This goal is not realistic because the patient is not usually on room air and should not be expected to attain that goal by discharge from this hospitalization.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 116
TOP: NURSING PROCESS: Planning MSC: NCLEX: Management of Care

10. The nurse is developing a teaching plan for an elderly patient who will begin taking an antihypertensive drug that causes dizziness and orthostatic hypotension. Which nursing diagnosis is appropriate for this patient?
a. Deficient knowledge related to drug side effects
b. Ineffective health maintenance related to age
c. Readiness for enhanced knowledge related to medication side effects
d. Risk for injury related to side effects of the medication
ANS: D
This patient has an increased risk for injury because of drug side effects, so this is an appropriate nursing diagnosis.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 115
TOP: NURSING PROCESS: Nursing Diagnosis
MSC: NCLEX: Management of Care

11. An older patient must learn to administer a medication using a device that requires manual dexterity. The patient becomes frustrated and expresses lack of self-confidence in performing this task. Which action will the nurse perform next?
a. Ask the patient to keep trying until the skill is learned.
b. Provide written instructions with illustrations showing each step of the skill.
c. Schedule multiple sessions and practice each step separately.
d. Teach the procedure to family members who can administer the medication for the patient.
ANS: C
Nurses should be sensitive to patients level of frustration when teaching skills. In this case, breaking the steps down into individual parts will help with this patients frustration level.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 116
TOP: NURSING PROCESS: Planning MSC: NCLEX: Management of Care

12. A school-age child will begin taking a medication to be administered 5 mL three times daily. The childs parent tells the nurse that, with a previous use of the drug, the child repeatedly forgot to bring the medication home from school, resulting in missed evening doses. What will the nurse recommend?
a. Asking the provider if the medication may be taken before school, after school, and at bedtime
b. Putting a note on the childs locker to encourage the child to take responsibility for medication administration
c. Asking the provider if 7.5 mL may be taken in the morning and 7.5 mL may be taken in the evening so that the correct amount is given daily
d. Taking the noon dose to school every day and giving it to the school nurse to administer
ANS: C
For busy families with school-age children, it may be necessary to adjust the medication schedule to one that fits their schedule. The nurse should ask the provider if a revised schedule is possible. In this case, the revised schedule would involve not taking the medication while at school. Putting a note on the locker is not likely to be effective. It is not correct to adjust the dose.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 117
TOP: NURSING PROCESS: Nursing Intervention/Planning
MSC: NCLEX: Management of Care

13. A high-school student regularly forgets to use a twice-daily inhaled corticosteroid to prevent asthma flares and is repeatedly admitted to the hospital. The childs parent tells the nurse that the child has been told that forgetting to take the medication causes frequent hospitalizations. The nurse will
a. encourage the child to take responsibility for taking the medication.
b. reinforce the need to take prescribed medications to avoid hospitalizations.
c. suggest putting the inhaler with the childs toothbrush to use before brushing teeth.
d. suggest that the childs parents administer the medication to increase compliance.
ANS: C
It is important to empower patients to take responsibility for managing medications. Putting the medication with the toothbrush can help this child remember to use it. Telling the child to take medications and reminding the child that failure to do so results in hospitalization is not working. Asking the childs parents to administer the medication does not empower the adolescent to take responsibility.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 118
TOP: NURSING PROCESS: Planning/Nursing Intervention
MSC: NCLEX: Management of Care

14. An adolescent patient who has acne is given a regimen of topical medications and an oral antibiotic that generally clears up lesions to fewer than 10 within 6 to 8 weeks. At a 2-month follow-up, the patient continues to have more than 25 lesions. The childs parent affirms that the child is using the medications as prescribed. Which evaluation statement is correct for this patient?
a. Goal of fewer than 10 lesions in 6 to 8 weeks is not met.
b. Goal that the medication will be effective is not met.
c. Goal that the patient will take medications as prescribed is not met.
d. Goal that the patient understands the medication regimen is not met.
ANS: A
All indications are that this patient is taking the medications and they are not effective. The first statement is correct because it identifies a measurable goal and a specific time frame.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 116
TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Management of Care

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