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Adams, Pharmacology for Nurses: Pathophysiologic Approach, 5/EChapter 6,100% CORRECT

Type: MCSA The nurse follows the nursing process when conducting medication education about insulin. The step of evaluation is best demonstrated by which question? 1. "Is your abdomen the best place to inject insulin?" 2. "What questions do you have about insulin?" 3. "Can you recognize when you are experiencing hypoglycemia?" 4. "Can you tell me four points you remember about how to take your insulin?" Correct Answer: 4 Rationale 1: Asking the patient what questions she has about insulin is an assessment question. Rationale 2: Asking the patient what questions she has about insulin is an assessment question. Rationale 3: Asking the patient if she can recognize when she is experiencing hypoglycemia is an assessment question. Rationale 4: The nurse is evaluating the effectiveness of medication education by asking the patient for feedback from the education provided. Global Rationale: The nurse is evaluating the effectiveness of medication education by asking the patient for feedback from the education provided. Asking the patient what questions she has about insulin is an assessment question. Asking the patient if her abdomen is the best place to inject insulin is an assessment question. Asking the patient if she can recognize when she is experiencing hypoglycemia is an assessment question. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research. NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 6-1 Compare and contrast the different steps of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 2 Type: MCMA The nurse assesses the patient with diabetes mellitus prior to administering medications. Which questions are important to ask the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Are you allergic to any medications?" 2. "Are you taking any herbal or over-the-counter medications?" 3. "How difficult is it for you to maintain your ideal body weight?" 4. "Will you please tell me about the kind of diet you follow?" 5. "What other medications are you currently taking?" Correct Answer: 1,2,4,5 Rationale 1: Questions about allergies are important during assessment. Rationale 2: Questions about herbal and OTC medications are an important part of assessment. Rationale 3: Ideal body is an important question, but does not refer specifically to medication administration. Rationale 4: Questions about normal diet help to assess health management and are pertinent to drug administration. Rationale 5: Questions about current medication are important during assessment. Global Rationale: Questions about allergies and which medications are being taken are assessment questions. Questions about normal diet help to assess health management and are pertinent to drug administration. Ideal body weight is an important question but does not refer specifically to medication administration. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 63 Question 3 Type: MCSA The physician has prescribed a nitroglycerine (Nitrodur) patch for the patient. What is the best outcome for this patient as it relates to use of the medication? 1. Patient will be able to identify the expiration date of the medication prior to discharge. 2. Patient will verbalize three side effects of the medication prior to discharge. 3. Patient will state the reason for receiving the medication prior to discharge. 4. Patient will demonstrate correct application of the patch prior to discharge. Correct Answer: 4 Rationale 1: The patient does not need to identify the expiration date of the medication in order to correctly apply the patch. Rationale 2: The patient does not need to identify side effects of the medication in order to correctly apply the patch. The patient does not need to state the reason for the medication in order to correctly apply the patch. The patient does not need to identify the expiration date of the medication in order to correctly apply the patch. Rationale 3: The patient does not need to state the reason for the medication in order to correctly apply the patch. Rationale 4: The overall goal of nursing care related to pharmacotherapy is the safe and effective administration of medication. In this instance, the most important aspect of patient teaching is that the patient be able to correctly apply the patch. If the patch is not correctly applied, the other issues are irrelevant. The patient does not need to identify side effects of the medication in order to correctly apply the patch. The patient does not need to state the reason for the medication in order to correctly apply the patch. The patient does not need to identify the expiration date of the medication in order to correctly apply the patch. Global Rationale: The overall goal of nursing care related to pharmacotherapy is the safe and effective administration of medication. In this instance, the most important aspect of patient teaching is that the patient be able to correctly apply the patch. If the patch is not correctly applied, the other issues are irrelevant. The patient does not need to identify side effects of the medication in order to correctly apply the patch. The patient does not need to state the reason for the medication in order to correctly apply the patch. The patient does not need to identify the expiration date of the medication in order to correctly apply the patch. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6-4 Identify the main components of the planning phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 65 Question 4 Type: MCSA The patient is receiving albuterol (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this medication? 1. Monitor the patient for relief of bronchospasms. 2. Monitor the patient for nausea and headache. 3. Monitor the patient's serum drug levels. 4. Provide the patient with age-appropriate education about albuterol (Proventil). Correct Answer: 1 Rationale 1: Monitoring drug effects, in this case, the relief of bronchospasms, is a primary intervention that nurses perform. Rationale 2: Nausea and headache are expected side effects, but monitoring for these side effects is not part of the primary intervention. Rationale 3: Monitoring of serum drug levels for albuterol (Proventil) is not indicated. Rationale 4: Education about medication is important but is not part of the primary intervention. Global Rationale: Monitoring drug effects, in this case, the relief of bronchospasms, is a primary intervention that nurses perform. Nausea and headache are expected side effects, but monitoring for these side effects is not part of the primary intervention. Education about medication is important but is not part of the primary intervention. Monitoring of serum drug levels for albuterol (Proventil) is not indicated. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 5 Type: MCSA The patient is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The patient's outcome is "Patient will state a key point about antibiotic treatment for cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been met? 1. "If the pain gets too bad, I can take my prescribed pain medication." 2. "If the swelling continues, I can apply an ice pack." 3. "I need to take all the pills even if my leg looks better." 4. "I must keep my leg elevated until the swelling goes down." Correct Answer: 3 Rationale 1: Taking pain medication does not address the outcome for antibiotic treatment. Rationale 2: Applying an ice pack does not address the outcome for antibiotic treatment. Rationale 3: Taking all the medication even if the leg looks better is a key point about antibiotic therapy and meets the patient's outcome. Rationale 4: Keeping the leg elevated does not address the outcome for antibiotic treatment. Global Rationale: Taking all the medication even if the leg looks better is a key point about antibiotic therapy and meets the patient's outcome. Keeping the leg elevated does not address the outcome for antibiotic treatment. Applying an ice pack does not address the outcome for antibiotic treatment. Taking pain medication does not address the outcome for antibiotic treatment. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Quality and Safety: Contribute to assessment of outcome achievement. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 6-6 Explain the importance of the evaluation phase of the nursing process as applied to pharmacotherapy. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 6 Type: MCSA The physician has prescribed quetiapine (Seroquel) for the patient with chronic auditory hallucinations. The patient has stopped taking the medication. The nurse incorrectly uses the diagnosis of "noncompliance." In which situation would this diagnosis be appropriate? 1. The patient reported a physical change as the reason for stopping the medication. 2. The patient made an informed decision not to take the medication. 3. The patient was unsure about how to order a refill for the prescription. 4. The patient did not understand why the medication was prescribed. Correct Answer: 2 Rationale 1: If the patient reports a physical change as the reason for stopping the medication, the nursing diagnosis should be related to that change. For example, if the patient reports being fatigued, the nursing diagnosis would relate to that finding. Rationale 2: Noncompliance assumes that the patient has been properly educated about the medication and has made an informed decision not to take it. Rationale 3: Being unsure of the way to obtain a refill on the medication is related to a knowledge deficit, not noncompliance. Rationale 4: Not knowing why the medication was prescribed related to a knowledge deficit, not noncompliance. Global Rationale: Noncompliance assumes that the patient has been properly educated about the medication and has made an informed decision not to take it. A lack of understanding of the reason the medication was prescribed or being unsure of how to obtain an prescription refill are related to a knowledge deficit, not noncompliance. Reports of a physical change since taking the medication would be diagnosed as pertaining to the change. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 6-3 Describe the areas of concern relating to pharmacotherapy that should be addressed during the diagnosis phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 64 Question 7 Type: MCSA The nurse is preparing for medication administration to a group of patients. What is the best overall outcome for the patients? 1. Patients will take the medications after receiving medication instruction. 2. Patients will receive the best therapeutic outcome from the medications. 3. Patients will state the reason they are receiving the medications. 4. Patients will experience minimal side effects after taking the medications. Correct Answer: 2 Rationale 1: The fact that the patient takes the medication is not the best overall outcome for the patients. Rationale 2: Outcomes should focus first on the therapeutic outcome of the medications. Rationale 3: Having the patients state the reason they are receiving the medications is the best overall outcome for the patients. Rationale 4: The treatment of side effects is not the best overall outcome for the patients. Global Rationale: Outcomes should focus first on the therapeutic outcome of the medications. The fact that the patient takes the medication is not the best overall outcome for the patients. The treatment of side effects is not the best overall outcome for the patients. Having the patients state the reason they are receiving the medications is the best overall outcome for the patients. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6-4 Identify the main components of the planning phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 65 Question 8 Type: MCSA The nurse is managing care for several patients at a diabetic treatment center. What is the primary intervention for the nurse? 1. To administer the correct medicine to the correct patient at the correct dose and the correct time via the correct route 2. To return the patient to an optimum level of wellness while limiting adverse effects related to the patient's medical diagnosis 3. To include any cultural or ethnic preferences in the administration of the medication 4. To answer any questions the patient may have about the medicine, or any possible side effect of the medication Correct Answer: 2 Rationale 1: The correct patient, dose, and time refer to the five "rights" of medication administration and, while important, is not the best, overall nursing intervention. Rationale 2: Interventions are aimed at returning the patient to an optimum level of wellness and limiting adverse effects related to the patient's medical diagnosis or condition. Rationale 3: Answering questions the patient may have is an appropriate intervention but is not the best overall intervention. While important to include cultural and ethnic preferences, this is not the best overall intervention. Rationale 4: Answering questions the patient may have is an appropriate intervention but is not the best overall intervention. Global Rationale: Interventions are aimed at returning the patient to an optimum level of wellness and limiting adverse effects related to the patient's medical diagnosis or condition. The correct patient, dose, and time refer to the five "rights" of medication administration and, while important, is not the best, overall nursing intervention. Answering questions the patient may have is an appropriate intervention but is not the best overall intervention. While important to include cultural and ethnic preferences, this is not the best overall intervention. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 9 Type: MCSA What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission? 1. Planning care 2. Teaching 3. Assessment 4. Evaluating care Correct Answer: 2 Rationale 1: Planning is important but not the most significant role of the nurse according to state nurse practice acts and Joint Commission. Rationale 2: State nurse practice acts and regulating bodies such as the Joint Commission consider teaching to be a primary role for nurses, giving it the weight of law and key important accreditation standards. Rationale 3: State nurse practice acts and regulating bodies such as the Joint Commission consider teaching to be a primary role for nurses. Assessment is important but not the most significant role of the nurse according to state nurse practice acts and Joint Commission. Rationale 4: Evaluation is important but not the most significant role of the nurse according to state nurse practice acts and Joint Commission. Global Rationale: State nurse practice acts and regulating bodies such as the Joint Commission consider teaching to be a primary role for nurses, giving it the weight of law and key important accreditation standards. Assessment, planning, and evaluation are important but not the most significant roles of the nurse according to state nurse practice acts and Joint Commission. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 10 Type: MCSA The Joint Commission documented that patient education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem and focused on what likely nursing intervention? 1. Providing educational pamphlets about medications to the patients. 2. Asking the physicians to provide medication education to the patients. 3. Discussing medications each time they are administered to patients. 4. Requesting more frequent pharmacy consults for the patients. Correct Answer: 3 Rationale 1: Educational pamphlets can be effective but are not as effective as the nurse providing education to the patient. Rationale 2: Medication education is considered to be a responsibility of the nurse, not the physician. Rationale 3: Discussing medications each time they are administered is an effective way to increase the amount of education provided. Rationale 4: Medication education is considered to be a responsibility of the nurse, not the pharmacist. Global Rationale: Discussing medications each time they are administered is an effective way to increase the amount of education provided. Medication education is considered to be a responsibility of the nurse, not the physician or pharmacist. Educational pamphlets can be effective but are not as effective as the nurse providing education to the patient. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 11 Type: MCSA The nurse has several educational pamphlets for the patient about medications the patient is receiving. Prior to giving the patient these pamphlets, what is a primary assessment for the nurse? 1. Assess the patient's readiness to learn new information. 2. Assess the patient's religious attitudes toward medicine. 3. Assess the patient's reading level. 4. Assess the patient's cultural bias toward taking medicine. Correct Answer: 3 Rationale 1: Assessing the patient's readiness to learn is important but not the primary assessment. Rationale 2: Educational pamphlets are ineffective if the reading level is above what the patient can understand. Assessing the patient's religious attitudes is important but not the primary assessment. Rationale 3: Educational pamphlets are ineffective if the reading level is above what the patient can understand. Rationale 4: Assessing the patient's cultural bias is important but not the primary assessment. Global Rationale: Educational pamphlets are ineffective if the reading level is above what the patient can understand. Assessing the patient's readiness to learn, cultural bias, and religious attitudes are important but not as important as the patient's reading level. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 12 Type: MCSA The nurse is aware that it is most important to be accurate in which portion of the nursing process? 1. Evaluation 2. Assessment 3. Diagnosis 4. Planning Correct Answer: 2 Rationale 1: While accuracy in evaluation is important, it is more important to be accurate in a different step of the nursing process. Rationale 2: Assessment is the basis for the development of the rest of the steps of the nursing process. While the nurse always strives to be accurate, inaccuracies in assessment will translate as inaccuracies in the remaining steps. Rationale 3: While accuracy in diagnosis is important, it is more important to be accurate in a different step of the nursing process. Rationale 4: While accuracy in planning is important, it is more important to be accurate in a different step of the nursing process. Global Rationale: Assessment is the basis for the development of the rest of the steps of the nursing process. While the nurse always strives to be accurate, inaccuracies in assessment will translate as inaccuracies in the remaining steps. While accuracy in evaluation, diagnosis, and planning is important, it is more important to be accurate in assessment. Cognitive Level: Understanding Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 61 Question 13 Type: MCSA The nurse is assessing a newly admitted patient's current medications. What does the best objective data include? 1. The patient's wife tells the nurse what medications the patient has been receiving. 2. The nurse checks the prescription bottles the patient has brought to the hospital. 3. The nurse asks the physician what medications the patient was currently taking. 4. The patient lists the medications that have been prescribed. Correct Answer: 2 Rationale 1: A list of medications provided by the patient's wife is subjective, not objective, data. Rationale 2: Objective data includes information gathered through assessment, and not necessarily what the patient says or perceives. The most reliable and objective assessment by the nurse is to check the patient's prescription medication bottles. Rationale 3: Asking the physician what medication the patient was receiving is subjective data, and the physician may not remember all the medication the patient was receiving. Rationale 4: A list of medications provided by the patient is subjective, not objective, data. Asking the physician what medication the patient was receiving is subjective data, and the physician may not remember all the medication the patient was receiving. Global Rationale: Objective data includes information gathered through assessment, and not necessarily what the patient says or perceives. The most reliable and objective assessment by the nurse is to check the patient's prescription medication bottles. A list of medications provided by the patient and the patient's wife is subjective, not objective data. Asking the physician what medication the patient was receiving is subjective data, and the physician may not remember all the medication the patient was receiving. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 61 Question 14 Type: MCSA The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of medication? 1. Complete blood count (CBC) and electrolytes 2. Kidney and liver function tests 3. Arterial blood gases (ABGs) and basic metabolic panel 4. Lipid panel and thyroid function tests Correct Answer: 2 Rationale 1: Complete blood count (CBC) and electrolytes are not likely to help in determining the proper drug dosage. Rationale 2: Renal and hepatic function tests are essential for many patients, particularly older patients and those who are critically ill, as these will be used to determine the proper drug dosage. Rationale 3: Arterial blood gases (ABGs) and a basic metabolic panel are not likely to help in determining the proper drug dosage. Rationale 4: Lipid panel and thyroid function tests are not likely to help in determining the proper drug dosage. Global Rationale: Renal and hepatic function tests are essential for many patients, particularly older patients and those who are critically ill, as these will be used to determine the proper drug dosage. Complete blood count (CBC) and electrolytes, lipid panel and thyroid function tests; and ABGs and a basic metabolic panel are not likely to help in determining the proper drug dosage. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 62 Question 15 Type: MCSA Which list correctly identifies and orders the primary steps of the nursing process? 1. Establish nursing diagnosis, assessment, intervene, collaborate, evaluation 2. Establish goals, assessment, intervention, planning, communication 3. Assessment, establish nursing diagnosis, planning, interventions, evaluation 4. Assessment, planning, establish objectives, communication, evaluation Correct Answer: 3 Rationale 1: Nursing diagnoses cannot be established until assessment is done. Rationale 2: Goals cannot be established until assessment is done. Rationale 3: The primary steps (in order) include assessment, establish nursing diagnosis, planning, interventions, evaluation. Rationale 4: Communication is important but is not a primary step of the nursing process. Global Rationale: The primary steps (in order) include assessment, establish nursing diagnosis, planning, interventions, evaluation. Although some steps might not be in this precise order, assessment is done first. Communication is important but is not a primary step of the nursing process. Cognitive Level: Remembering Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice and research. NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-1 Compare and contrast the different steps of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 62 Question 16 Type: Seq Place these nursing activities in the correct order of the nursing process. 1. The nurse analyzes the data collected. 2. The nurse documents the time and route of an administered medication. 3. The nurse weighs the patient. 4. The nurse writes an individualized nursing intervention. 5. The nurse changes a nursing intervention that is not working. Correct Answer: 3,1,4,2,5 Global Rationale: The order of the steps of the nursing process is assessment, diagnosis, planning, implementing, and evaluating. Weighing the patient is assessment, analyzing data occurs in the diagnosis step, writing interventions occurs in the planning step, documentation occurs in the implementation step, and revising interventions occurs in the evaluation step. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice and research. NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 6-1 Compare and contrast the different steps of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 62 Question 17 Type: FIB The nurse uses a newly admitted patient’s armband barcode to identify the patient prior to administering medications. The nurse should use ______ other means of identifying this patient. Standard Text: Record your answer rounding to the nearest whole number. Correct Answer: 2 Rationale: Even though the barcode identification system has improved safety, it is not foolproof. The nurse should use two other means of identifying the patient such as verifying name and birth date. Global Rationale: Even though the barcode identification system has improved safety, it is not foolproof. The nurse should use two other means of identifying the patient such as verifying name and birth date. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 61 Question 18 Type: MCSA Which statement about the nursing process is accurate? 1. Generally, goals are more measurable than outcomes. 2. Goals involve very specific criteria that evaluate interventions. 3. Obtaining the outcomes is essential for goal attainment. 4. After selecting the nursing diagnosis, interventions are completed. Correct Answer: 3 Rationale 1: Outcomes are generally more measurable than goals as they are more specific. Rationale 2: Goals are more general than specific. Rationale 3: Outcomes are specific, measurable criteria that are used to measure goal attainment. Rationale 4: The planning phase (including outcomes and goals) follows nursing diagnosis. Global Rationale: Outcomes are specific, measurable criteria that are used to measure goal attainment. The planning phase (including outcomes and goals) follows nursing diagnosis. Outcomes are generally more measurable than goals as they are more specific. Goals are more general than specific. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6-4 Identify the main components of the planning phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 65 Question 19 Type: MCSA Which nursing intervention would take priority following administration of a new medication? 1. Monitoring lab values 2. Monitoring the patient's respiratory status 3. Prescribing additional medications if side effects occur 4. Measuring patient weight Correct Answer: 2 Rationale 1: Monitoring lab values might be appropriate nursing interventions with some medications but would not be the priority. Rationale 2: Any time a new medication is provided to the patient, it is important to monitor for an allergic reaction. Anaphylaxis, a life-threatening allergic reaction, can impair breathing. Rationale 3: Nurses do not prescribe medications. Rationale 4: Measuring weight might be appropriate nursing interventions with some medications but would not be the priority. Global Rationale: Any time a new medication is provided to the patient, it is important to monitor for an allergic reaction. Anaphylaxis, a life-threatening allergic reaction, can impair breathing. Monitoring lab values and measuring weight might be appropriate nursing interventions with some medications but would not be the priority. Nurses do not prescribe medications. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 20 Type: MCSA A patient with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication administration? 1. Asking the patient whether he is compliant in taking his medications 2. Determining that goals were not met 3 days following medication administration 3. Administration of IV antihypertensive agents 4. Determination of the patient's baseline blood pressure Correct Answer: 2 Rationale 1: Asking about compliance would be the assessment step. Rationale 2: Evaluation is the final step in the nursing process where goal attainment is determined. Rationale 3: Administering medications is the intervention step. Rationale 4: Determining the patient’s baseline blood pressure would be the assessment step. Global Rationale: Evaluation is the final step in the nursing process where goal attainment is determined. Administering medications is the intervention step. Determining the patient’s baseline blood pressure and asking him about compliance would be the assessment step. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Quality and Safety: Contribute to assessment of outcome achievement. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 6-6 Explain the importance of the evaluation phase of the nursing process as applied to pharmacotherapy. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 21 Type: MCSA Which assessment identifies the collection of objective data? 1. The patient rates her pain a 5 on a 0–10 pain scale. 2. The patient states she is anxious. 3. The patient has a wound measured at 5 centimeters in length. 4. The patient informs the nurse that she weighs 150 pounds. Correct Answer: 3 Rationale 1: Subjective data consist of what the patient says or perceives. Rationale 2: Subjective data consist of what the patient says or perceives. Rationale 3: Objective data are gathered through physical assessment, laboratory tests, and other diagnostic sources. Rationale 4: Subjective data consist of what the patient says or perceives. Global Rationale: Objective data are gathered through physical assessment, laboratory tests, and other diagnostic sources. Subjective data consist of what the patient says or perceives. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 63 Question 22 Type: MCMA When teaching the patient about a new medication, the nurse should include which information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Adverse effects that can be expected 2. Which adverse effect to report to the health care provider 3. The drug's therapeutic action 4. Chemical composition of the drug 5. Name of the drug manufacturer Correct Answer: 1,2,3 Rationale 1: In order to help the patient identify and prevent adverse effects, the patient should be taught the adverse effects. Rationale 2: The patient should be taught when to notify the health care provider of adverse effects. Rationale 3: In order to help the patient identify and prevent adverse effects, the patient should be taught the therapeutic action of the drug. Rationale 4: It is not necessary to teach the patient the chemical makeup of the drug. Rationale 5: It is not necessary to teach the patient the name of the drug manufacturer. Global Rationale: In order to help the patient identify and prevent adverse effects, the patient should be taught the therapeutic action, adverse effects, and when to notify the health care provider of adverse effects. It is not necessary to teach the patient the chemical makeup of the drug or the name of the drug manufacturer. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 23 Type: MCMA A nurse is preparing care for a newly admitted patient with diabetes. Which information would be critical for the nurse to assess? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Medical history 2. Current lab results 3. Medication allergies 4. Use of dietary supplements 5. Number of previous hospitalizations Correct Answer: 1,2,3,4 Rationale 1: Medical history may reveal conditions that contraindicate the use of certain drugs. Rationale 2: Current lab results may reveal important information about the health of organs, such as the kidneys and liver, which would be important to metabolism and excretion of drugs. Rationale 3: Allergies to one drug may cross over to another drug and would need to be avoided. Rationale 4: Some dietary supplements can interact with drugs. Rationale 5: While this is good information, it is not critical to this admission. Global Rationale: Medical history may reveal conditions that contraindicate the use of certain drugs. Current lab results may reveal important information about the health of organs, such as the kidneys and liver, which would be important to metabolism and excretion of drugs. Allergies to one drug may cross over to another drug and would need to be avoided. Some dietary supplements can interact with drugs. While knowledge about number of previous hospitalization is good to know it is not critical to this admission. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.A.1 Integrate understanding of multiple dimensions of patient centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; and transition and continuity. AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6-2 Identify health history questions to ask during the assessment phase that are pertinent to medication administration. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 61 Question 24 Type: MCMA Which concepts should the nurse use when formulating a nursing diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Base the nursing diagnosis on the medical diagnosis 2. Focus on what the nurse needs to help the patient return to health 3. Include the patient in the identification of needs 4. Consider the patient’s response to the current health problem 5. Be certain the diagnosis is measureable Correct Answer: 3,4 Rationale 1: The nursing diagnosis is not dependent on the medical diagnosis. Rationale 2: The focus should be on the patient’s needs. Rationale 3: Including the patient in the formulation of nursing diagnoses encourages more active involvement in working toward meeting identified goals. Rationale 4: A nursing diagnosis is a clinical judgment concerning human response to health conditions. Rationale 5: Goals and outcomes need to be measureable, not nursing diagnosis. Global Rationale: A nursing diagnosis is a clinical judgment concerning human response to health conditions and should be patient focused. Including the patient in the formulation of nursing diagnoses encourages more active involvement in working toward meeting identified goals. It is not dependent on the medical diagnosis. Goals and outcomes need to be measureable, not nursing diagnosis. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 6-3 Describe the areas of concern relating to pharmacotherapy that should be addressed during the diagnosis phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 64 Question 25 Type: FIB The nurse who is writing a risk nursing diagnosis will write a ______ part statement. Standard Text: Record your answer rounding to the nearest whole number. Correct Answer: 2 Rationale: Since risk diagnoses do not have evidence to support the chosen statement, they are written in two parts. Global Rationale: Since risk diagnoses do not have evidence to support the chosen statement, they are written in two parts. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 6-3 Describe the areas of concern relating to pharmacotherapy that should be addressed during the diagnosis phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 64 Question 26 Type: MCMA A patient returns to the clinic for follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the patient makes which statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "I've been taking my medication on an empty stomach like the prescription label said to." 2. "I take my medication first thing in the morning, just like you said." 3. "I have been able to decrease my medication to every other day and that saves me some money." 4. "I switched all my medications to one pharmacy like you suggested." 5. "Did you say I need to take this medication with water or milk?" Correct Answer: 1,2,4 Rationale 1: Some medications must be taken on an empty stomach. This statement indicates the patient is following instruction. Rationale 2: This statement indicates the patient is following instruction. Rationale 3: Changing dosage schedule without direction indicates failure to follow instruction. Rationale 4: Filling all prescriptions at the same pharmacy will assist the pharmacist in comparing current and new medications for interactions. This statement indicates the patient is following the nurse’s suggestion. Rationale 5: The patient is unsure of instructions. Global Rationale: Statements about taking medication as directed indicate the patient is adhering to instructions. Changing dosage schedule without direction indicates failure to follow instruction. If the patient is unsure of instructions, it is less likely that the correct administration technique is being followed. Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Quality and Safety: Contribute to assessment of outcome achievement. Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 6-6 Explain the importance of the evaluation phase of the nursing process as applied to pharmacotherapy. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 67 Question 27 Type: MCMA Which patient outcome statements are correctly formatted? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The patient will understand the effects of the medication administered prior to discharge. 2. The nurse will administer all medications with ten minutes of their scheduled time. 3. The patient will identify two adverse effects of enoxaprarin (Lovenox) prior to self-administering the drug. 4. The patient will verbalize the storage requirements for NPH insulin prior to discharge. 5. The physician will discuss the desired effects of discharge medications with the patient the evening before discharge. Correct Answer: 3,4 Rationale 1: “Understand” is not a measureable verb. Rationale 2: Patient outcome statements are focused on what the patient will do, not on what the nurse will do. Rationale 3: “Identify” is a measurable verb, there is a specific measure to be evaluated and a time line is present. Rationale 4: “Verbalize” is a measurable verb, there is a specific measure to be evaluated, and a time line is present. Rationale 5: Patient outcome statements are focused on what the patient will do, not on what the physician will do. Global Rationale: In order to be complete, the patient outcome measure must be patient (not nurse or physician) focused, must contain a measurable verb, must have the specific circumstances to be evaluated, and must have a time line. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6-4 Identify the main components of the planning phase of the nursing process. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 65 Question 28 Type: Seq Place these methods of communicating with a non-English speaking patient in order of their desirability and usefulness. 1. Adult family member interprets 2. Health care agency interpreter is present 3. The nurse uses drawings and body language to communicate 4. Child relative interprets 5. No interpretation is attempted Correct Answer: 2,1,4,3,5 Global Rationale: In the ideal situation the nurse will contact an interpreter employed or provided by the health care agency. The next best solution is for an adult family member to interpret with the third best being a child in the family who has been assessed to be able to handle the translation. In the absence of these options, the fourth best plan is for the nurse to use drawings, body language, pictures, and nonverbal clues to communicate. Not using any kind of interpretation is not desirable and leaves the nurse in the situation of doing something “to” a patient with no explanation. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. AACN Essentials Competencies: III.6 Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care. Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6-5 Discuss key nursing interventions required in the implementation phase of the nursing process for patients receiving medications. MNL Learning Outcome: 1.2.1 Apply the five steps of the nursing process as it relates to pharmacotherapy. Page Number: 66 Question 29 Type: MCMA During evaluation, the nurse, patient, and physician determine that the goals of antibiotic therapy have not been met. What actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Review the dosage of the medication 2. Consider checking serum drug levels 3. Discard the idea that the infection is treatable 4. Consider prolonging therapy 5. Consider using a different antibiotic Correct Answer: 1,2,4,5 Rationale 1: The dosage may not be correct for the individual patient. Rationale 2: In some instances, checking serum drug levels will help identify if the dosing schedule is adequate. Rationale 3: Just because the first evaluation is that the goal is not met does not indicate that the goal is not a good one or that the therapy is not going to work. Rationale 4: The drug may work if given more time. Rationale 5: The infection may require use of a second antibiotic. Global Rationale: Just because the first evaluation is that the goal is not met does not indicate that the goal is not a good one or that the therapy is not going to work. The drug may work if the dosage is altered (which may be indicated by serum drug level) or if therapy is continued for a longer time. The antibiotic may need to be changed. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Pharmacological and Parenteral Therapies QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity o

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