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Chapter 1: Definitions, Names, Standards, and Information Sources

MULTIPLE CHOICE 1. ____________________ ____________________ is the name under which the drug is listed by the United States Food and Drug Administration, who by federal law names the drug for human use in the United States. a. Brand name b. Nonproprietary name c. Official name d. Trademark name ANS: B DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment 2. The ____________________ contains information specific to nutritional supplements. a. USP Dictionary of USAN & International Drug Names b. Natural Medicines Comprehensive Database c. United States Pharmacopoeia/National Formulary d. Drug Interaction Facts ANS: C RATIONALE: USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide and possible future FDA approved drugs; Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; Drug Interaction Facts contains comprehensive information on drug interaction facts. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 3. Drugs may be classified according to which of the following? a. Affect on the body system b. Cost c. Generic or trade d. Chemical constitution ANS: A

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RATIONALE: Classification is according to affect on body system, therapeutic use or clinical indications, physiologic or chemical action, prescription or nonprescription, and recreational and/or drugs. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity

4.The most comprehensive reference available to research a drug interaction is: a. Drug Facts and Comparisons. b. Drug Interaction Facts. c. Handbook on Injectable Drugs. d. Martindale-The Complete Drug Reference. ANS: B RATIONALE: First published in 1983, this reference is currently the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with the clinical and scientific expertise. DIF: Cognitive Level: Comprehension TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 5. The physician has written an order for a drug with which you are unfamiliar. Which section of the Physician’s Desk Reference would be most helpful to get information about this drug? a. Manufacturer’s section b. Brand and Generic Name section c. Product Category section d. Product Information section ANS: B RATIONALE: A physician’s order would include the brand and/or generic name of the drug. The alphabetical index in the PDR would make this section the most user friendly. Based on a physician order, manufacturer’s information and classification information would not be known. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity 6. Your client states she afraid she is taking an inferior antibiotic because her insurance company pays only for generic equivalents. A reference source to refer her to is: a. Advice for the Patient (USP DI). b. Therapeutic Choices (USP DI). c. Approved Drug Products and Legal Requirements (USP DI). d. Tyler’s Honest Herbal. ANS: C

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RATIONALE: The United States Pharmacopoeia Dispensing Information is an excellent nontechnical source for patients. The Approved Drug Product and Legal Requirement section lists the therapeutic equivalent drugs when a drug is made by more than one manufacturer. Therefore, patients are able to verify therapeutic equivalence of the medication of lower cost. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Psychosocial Integrity

7. The Federal Drug Administration of the Department of Health and Human Services was given the authority to determine the safety of drug prior to its’ marketing as a result of the: a. Federal Food Drug & Cosmetic Act (1938). b. Durham-Humphrey Amendment (1952). c. Controlled Substances Act (1970). d. Kefauver-Harris Drug Amendment (1962). ANS: A RATIONALE: The Federal Food, Drug & Cosmetic Act in 1938 authorized the FDA to determine the safety of all drugs prior to marketing. Later Amendments and Acts helped to tighten FDA control and ensure drug safety. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 8. Your client is receiving IM Demerol postoperatively. You recognize that this drug is a narcotic with a high potential for physical and psychologic dependency. This drug will be locked up on your unit because it is a: a. Schedule I drug. b. Schedule II drug. c. Schedule III drug. d. Schedule IV drug. ANS: B RATIONALE: Demerol (meperidine) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychologic and physical dependence. DIF: Cognitive Level: Application TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment 9. To expedite drug development and approval for an outbreak of smallpox, a disease for which there is no known treatment, the FDA would: a. list smallpox as a “health orphan” disease. b. omit the preclinical research phase. c. extend the clinical research phase. d. “fast-track” the investigational drug. ANS: D

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RATIONALE: The FDA must ensure that all phases of the preclinical and clinical research phase have been completed in a safe manner. Once the Investigational New Drug Application has been approved the drug can receive highest priority within the agency which is called “fast tracking.” A smallpox outbreak would become a priority concern in the world. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Safe, Effective Care Environment

COMPLETION 1. Pharmacology deals with the study of drugs and their actions on ____________________ ____________________. (Your response should appear as two words, lowercase, separated by a space.) ANS: living organisms RATIONALE: Per definition. DIF: Cognitive Level: Knowledge TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity 2. Illnesses are treated by several different therapeutic methods. You are caring for a 5-yearold girl newly diagnosed with juvenile-onset diabetes mellitus. Which of the following approaches to therapeutic methods would you consider in treatment of this child and her illness? a. Therapeutic drugs b. Concentrated carbohydrate diet c. Family-centered care d. Regular daily exercise and activity e. Daily baths List the answers in uppercase, alpha order, separated by commas and spaces (e.g., X, X, X): ____________________ ANS: A, B, D RATIONALE: Therapeutic methods include drug therapy, diet therapy, physiotherapy, and psychologic therapy. DIF: Cognitive Level: Application TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity 3. As a student nurse, you are assigned to the emergency department for a portion of your clinical rotation. An 83-year-old woman experiencing shortness of breath is brought to the hospital by her daughter. You are obtaining the medication history from the patient and her daughter. Unfortunately, neither have a list of her current medications, only a weekly pill dispenser that contains four different pills. They did not bring the prescription bottles with them, but fill her prescriptions through the local pharmacy. Which of the following resources would be appropriate to use in determining the medication names and doses? a. Martindale–The Complete Drug Reference b. Physician’s Desk Reference; grey section

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c. Senior Citizens’ Center d. Patient’s home pharmacy e. Drug Identification Guide List the answers in uppercase, alpha order, separated by commas and spaces (e.g., X, X, X): ____________________ ANS: A, D, E RATIONALE: Physician’s Desk Reference; grey section, and the Drug Identification Guide have full color images of commonly dispensed tablets and capsules; Martindale–The Complete Drug Reference has written information on medication; the Senior Citizens’ Center is not likely to have specific client medication information; the client’s pharmacy would have an accurate account of all the medications the client is currently on. DIF: Cognitive Level: Analysis TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity