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Pharmacology and the Nursing Process

9th Edition

Linda Lane Lilley, Shelly Rainforth Collins, Julie S. Snyder 

Contents

Chapter 01: The Nursing Process and Drug Therapy .................................................................................... 4

Chapter 02: Pharmacologic Principles .......................................................................................................... 8

Chapter 03: Lifespan Considerations ..........................................................................................................14

Chapter 04: Cultural, Legal, and Ethical Considerations .............................................................................20

Chapter 05: Medication Errors: Preventing and Responding .....................................................................26

Chapter 06: Patient Education and Drug Therapy ......................................................................................29

Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements .............................................34

Chapter 08: Gene Therapy and Pharmacogenomics ..................................................................................38

Chapter 09: Photo Atlas of Drug Administration ........................................................................................41

Chapter 10: Analgesic Drugs .......................................................................................................................50

Chapter 11: General and Local Anesthetics ................................................................................................57

Chapter 12: Central Nervous System Depressants and Muscle Relaxants .................................................61

Chapter 13: Central Nervous System Stimulants and Related Drugs .........................................................66

Chapter 14: Antiepileptic Drugs ..................................................................................................................70

Chapter 15: Antiparkinson Drugs ................................................................................................................76

Chapter 16: Psychotherapeutic Drugs ........................................................................................................81

Chapter 17: Substance Use Disorder ..........................................................................................................88

Chapter 18: Adrenergic Drugs .....................................................................................................................93

Chapter 19: Adrenergic-Blocking Drugs ......................................................................................................98

Chapter 20: Cholinergic Drugs .................................................................................................................. 103

Chapter 21: Cholinergic-Blocking Drugs ................................................................................................... 108

Chapter 22: Antihypertensive Drugs ......................................................................................................... 113

Chapter 23: Antianginal Drugs .................................................................................................................. 119

Chapter 24: Heart Failure Drugs ............................................................................................................... 125

Chapter 25: Antidysrhythmic Drugs .......................................................................................................... 131

Chapter 26: Coagulation Modifier Drugs .................................................................................................. 137

Chapter 27: Antilipemic Drugs .................................................................................................................. 143

Chapter 28: Diuretic Drugs ........................................................................................................................ 148

Chapter 29: Fluids and Electrolytes .......................................................................................................... 154

Chapter 30: Pituitary Drugs ....................................................................................................................... 160 

Chapter 31: Thyroid and Antithyroid Drugs .............................................................................................. 163

Chapter 32: Antidiabetic Drugs ................................................................................................................. 168

Chapter 33: Adrenal Drugs ........................................................................................................................ 177

Chapter 34: Women’s Health Drugs......................................................................................................... 181

Chapter 35: Men’s Health Drugs............................................................................................................... 188

Chapter 36: Antihistamines, Decongestants, Antitussives, and Expectorants ......................................... 193

Chapter 37: Respiratory Drugs .................................................................................................................. 198

Chapter 38: Antibiotics Part 1 ................................................................................................................... 204

Chapter 39: Antibiotics Part 2 ................................................................................................................... 211

Chapter 40: Antiviral Drugs ....................................................................................................................... 216

Chapter 41: Antitubercular Drugs ............................................................................................................. 221

Chapter 42: Antifungal Drugs .................................................................................................................... 226

Chapter 43: Antimalarial, Antiprotozoal, and Anthelmintic Drugs ........................................................... 231

Chapter 44: Anti-inflammatory and Antigout Drugs................................................................................. 236

Chapter 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs ..................... 242

Chapter 46: Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific Drugs and Miscellaneous Drugs ......... 248

Chapter 47: Biologic Response–Modifying and Antirheumatic Drugs ...................................................... 253

Chapter 48: Immunosuppressant Drugs ................................................................................................... 258

Chapter 49: Immunizing Drugs ................................................................................................................. 263

Chapter 50: Acid-Controlling Drugs .......................................................................................................... 268

Chapter 51: Bowel Disorder Drugs............................................................................................................ 274

Chapter 52: Antiemetic and Antinausea Drugs ........................................................................................ 281

Chapter 53: Vitamins and Minerals .......................................................................................................... 286

Chapter 54: Anemia Drugs ........................................................................................................................ 292

Chapter 55: Nutritional Supplements ....................................................................................................... 299

Chapter 56: Dermatologic Drugs .............................................................................................................. 304

Chapter 57: Ophthalmic Drugs ................................................................................................................. 310

Chapter 58: Otic Drugs .............................................................................................................................. 315 

Chapter 01: The Nursing Process and Drug Therapy 4

Chapter 01: The Nursing Process and Drug Therapy

MULTIPLE CHOICE

 1. The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly

diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing

diagnosis?

a. Anxiety

b. Anxiety related to new drug therapy

c. Anxiety related to anxious feelings about drug therapy, as evidenced by statements

such as “I’m upset about having to test my blood sugars.”

d. Anxiety related to new drug therapy, as evidenced by statements such as “I’m

upset about having to test my blood sugars.”

ANS: D

Formulation of nursing diagnoses is usually a three-step process. “Anxiety” is missing the

“related to” and “as evidenced by” portions of defining characteristics. “Anxiety related to new

drug therapy” is missing the “as evidenced by” portion of defining characteristics. The statement

beginning “Anxiety related to anxious feelings” is incorrect because the “related to” section is

simply a restatement of the problem “anxiety,” not a separate factor related to the response.

DIF: COGNITIVE LEVEL: Understanding (Comprehension)

TOP: NURSING PROCESS: Nursing Diagnosis

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 2. The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and

gave the medication 2 hours after the scheduled dose was due. What type of problem does this

represent?

a. “Right time”

b. “Right dose”

c. “Right route”

d. “Right medication”

ANS: A

“Right time” is correct because the medication was given more than 30 minutes after the

scheduled dose was due. “Dose” is incorrect because the dose is not related to the time the

medication administration is scheduled. “Route” is incorrect because the route is not affected.

“Medication” is incorrect because the medication ordered will not change.

DIF: COGNITIVE LEVEL: Applying (Application)

TOP: NURSING PROCESS: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control

 3. The nurse has been monitoring the patient’s progress on a new drug regimen since the first dose

and documenting the patient’s therapeutic response to the medication. Which phase of the

nursing process do these actions illustrate?

a. Nursing diagnosis

Chapter 01: The Nursing Process and Drug Therapy 5

b. Planning

c. Implementation

d. Evaluation

ANS: D

Monitoring the patient’s progress, including the patient’s response to the medication, is part of

the evaluation phase. Planning, implementation, and nursing diagnosis are not illustrated by this

example.

DIF: COGNITIVE LEVEL: Understanding (Comprehension)

TOP: NURSING PROCESS: Evaluation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 4. The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which

statement best illustrates an outcome criterion for this patient?

a. The patient will follow instructions.

b. The patient will not experience complications.

c. The patient will adhere to the new insulin treatment regimen.

d. The patient will demonstrate correct blood glucose testing technique.

ANS: D

“Demonstrating correct blood glucose testing technique” is a specific and measurable outcome

criterion. “Following instructions” and “not experiencing complications” are not specific criteria.

“Adhering to new regimen” would be difficult to measure.

DIF: COGNITIVE LEVEL: Applying (Application)

TOP: NURSING PROCESS: Planning

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 5. Which activity best reflects the implementation phase of the nursing process for the patient who

is newly diagnosed with hypertension?

a. Providing education on keeping a journal of blood pressure readings

b. Setting goals and outcome criteria with the patient’s input

c. Recording a drug history regarding over-the-counter medications used at home

d. Formulating nursing diagnoses regarding deficient knowledge related to the new

treatment regimen

ANS: A

Education is an intervention that occurs during the implementation phase. Setting goals and

outcomes reflects the planning phase. Recording a drug history reflects the assessment phase.

Formulating nursing diagnoses reflects analysis of data as part of planning.

DIF: COGNITIVE LEVEL: Applying (Application)

TOP: NURSING PROCESS: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 6. The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning

chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order. What

is the nurse’s best action? 

Chapter 01: The Nursing Process and Drug Therapy 6

a. Give the medication intravenously because the patient might vomit.

b. Give the medication orally because the tablets are available in 4-mg doses.

c. Contact the prescriber to clarify the route of the medication ordered.

d. Hold the medication until the prescriber returns to make rounds.

ANS: C

A complete medication order includes the route of administration. If a medication order does not

include the route, the nurse must ask the prescriber to clarify it. The intravenous and oral routes

are not interchangeable. Holding the medication until the prescriber returns would mean that the

patient would not receive a needed medication.

DIF: COGNITIVE LEVEL: Applying (Application)

TOP: NURSING PROCESS: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider when

deciding when to give a drug?

a. The patient’s ability to swallow

b. The patient’s height

c. The patient’s last meal

d. The patient’s allergies

ANS: C

The nurse must consider specific pharmacokinetic/pharmacodynamic drug properties that may be

affected by the timing of the last meal. The patient’s ability to swallow, height, and allergies are

not factors to consider regarding the timing of the drug’s administration.

DIF: COGNITIVE LEVEL: Understanding (Comprehension)

TOP: NURSING PROCESS: Assessment

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

 8. The nurse is performing an assessment of a newly admitted patient. Which is an example of

subjective data?

a. Blood pressure 158/96 mm Hg

b. Weight 255 pounds

c. The patient reports that he uses the herbal product ginkgo.

d. The patient’s laboratory work includes a complete blood count and urinalysis.

ANS: C

Subjective data include information shared through the spoken word by any reliable source, such

as the patient. Objective data may be defined as any information gathered through the senses or

that which is seen, heard, felt, or smelled. A patient’s blood pressure, weight, and laboratory tests

are all examples of objective data.

DIF: COGNITIVE LEVEL: Understanding (Comprehension)

TOP: NURSING PROCESS: Assessment

MSC: NCLEX: Safe and Effective Care Environment: Management of Care

MULTIPLE RESPONSE

Chapter 01: The Nursing Process and Drug Therapy 7

 1. When giving medications, the nurse will follow the rights of medication administration. The

rights include the right documentation, the right reason, the right response, and the patient’s right

to refuse. Which of these are additional rights? (Select all that apply.)

a. Right drug

b. Right route

c. Right dose

d. Right diagnosis

e. Right time

f. Right patient

ANS: A, B, C, E, F

Additional rights of medication administration must always include the right drug, right dose,

right time, right route, and right patient. The right diagnosis is incorrect.

DIF: COGNITIVE LEVEL: Remembering (Knowledge)

TOP: NURSING PROCESS: Implementation

MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control

 2. Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the

last phase. (Select all that apply.)

a. Planning

b. Evaluation

c. Assessment

d. Implementation

e. Nursing Diagnoses

ANS: A, B, C, D, E

The nursing process is an ongoing process that begins with assessing and continues with

diagnosing, planning, implementing, and evaluating.

DIF: COGNITIVE LEVEL: Applying (Application)

TOP: NURSING PROCESS: General

MSC: NCLEX: Safe and Effective Care Environment: Management of Care