Chapter 03 - Toxic Effects of Drugs

Question 1

A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point
included by the nurse to improve compliance and safety?
A) List of pharmacies where the drug can be obtained
B) Measures to alleviate any discomfort associated with adverse effects
C) The cost of the brand name drug compared with the generic form
D) Statistics related to Phase III testing for the prescribed drug

Answer 1

B) Measures to alleviate any discomfort associated with adverse effects

Question 2

A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports
to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is
experiencing what?
A) An adverse reaction from the antibiotic
B) A drug toxicity effect of the antibiotic
C) An overdose of the drug that is damaging to more than one body system
D) A superinfection caused by the antibiotic, which has destroyed normal flor

Answer 2

D) A superinfection caused by the antibiotic, which has destroyed normal flor

Question 3

A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in
distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What
assessment findings are important in making this diagnosis?
A) Blood pressure (BP): 186/100, difficulty breathing
B) Hematocrit (Hct): 32%, decreased urine output
C) Temperature: 102º, swollen joints
D) Profuse sweating, Blood Pressure: 92/58

Answer 3

A) Blood pressure (BP): 186/100, difficulty breathing

Question 4

A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny
nose. When planning teaching for this patient, the nurse would include what teaching point?
A) Advise the patient to limit fluid intake to dry out mucous membranes.
B) Advise the patient to avoid driving or operating machinery.
C) Advise the patient to report strange dreams or nightmares.
D) Advise the patient to decrease dietary fat.

Answer 4

B) Advise the patient to avoid driving or operating machinery.

Question 5

A	nurse	is	providing	teaching	to	a	group	of	patients	who	are	beginning	drug	therapy	for	acquired
immunodeficiency	syndrome	(AIDS).	What	should	be	included	in	her	instructions	to	the	group?

A)​Take your medications as directed. Poisoning occurs with overdosage causing damage to more
than one body system.​
B)​Renal injury results from first-pass effect when the drug is excreted from the system.​
C)​A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellowish or you
experience itching.​
D)​Most drugs are metabolized in the liver and the first indication of damage is dark red papules,
which should be reported immediately.

Answer 5

A)​Take your medications as directed. Poisoning occurs with overdosage causing damage to more
than one body system.​

Question 6

The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and
how they can lead to hyperkalemia, indicated by what assessment finding?
A) Urine output of 1,500 mL/24 hours
B) Blood pressure of 98/60
C) Potassium level of 5.9 mEq/L
D) Calcium level of 11.4 mg/dL

Answer 6

C) Potassium level of 5.9 mEq/L

Question 7

An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide
antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for
the patient. What should the nurse include in her instructions regarding home care?

A) Keep the patient in a prone position when in bed.
B) Eliminate salt from the patient’s diet.
C) Provide protective measures to prevent falling or injury.
D) Monitor exposure to sunlight.

Answer 7

C) Provide protective measures to prevent falling or injury.

Question 8

Oral	antidiabetic	drugs	can	cause	alterations	in	glucose	metabolism.	Patients	who	are	taking	these	drugs
would	need	to	be	observed	for	what?
A) Increased	urination
B) Deep	Kussmaul’s	respirations
C) Thirst	and	hot	or	flushed	skin
D) Confusion	and	lack	of	coordination

Answer 8

D) Confusion and lack of coordination

Question 9

A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient
would the nurse suspect may be an adverse reaction of the medication?
A)​I have to urinate all the time.​
B)​Sometimes I have blurred vision.​

C)​I have tingling in my arms and legs.​
D)​Sometimes I feel like I am off balance

Answer 9

B)​Sometimes I have blurred vision.​

Question 10

A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to
Mexico. The nurse will encourage the patient to do what?
A) Avoid sightseeing during the hottest part of the day.
B) Discontinue the antihistamines if he becomes extremely restless.
C) Decrease the dosage of the drugs if he experiences excessive thirst.
D) Continue taking the antihistamines even if he begins to hallucinate.

Answer 10

A) Avoid sightseeing during the hottest part of the day.

Question 11

The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What
would be the nurse’s appropriate next action?
A) Ascertain the exact nature of the patient’s response to the drug.
B) Document the patient is allergic to penicillin.
C) Mark the patient’s chart in red that she has a penicillin allergy.
D) Continue to assess the patient for other allergies

Answer 11

A) Ascertain the exact nature of the patient’s response to the drug.

Question 12

A 77-year-old man is brought to the clinic by his daughter for a routine follow-up appointment. The
daughter tells the nurse that her father is only taking half the prescribed dosage of several of his
medications. What effect would the nurse explain could result from this behavior?
A) Increased risk of primary actions
B) Dermatologic reaction
C) Superinfection
D) Reduced therapeutic effect

Answer 12

D) Reduced therapeutic effect

Question 13

The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and
lists an adverse reaction of this drug as what?
A) Bronchoconstriction
B) Hyperglycemia
C) Cardiac arrhythmias
D) Severe constipation

Answer 13

B) Hyperglycemia

Question 14

The	nurse	needs	to	consider	teratogenic	effects	of	medications	when	caring	for	what	population	of
patients?
A) Older	adults
B) Patients	with	a	history	of	cancer
C) Children
D) Young	adult	women

Answer 14

D) Young adult women

Question 15

The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore
throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is
experiencing?
A) Dermatologic reaction
B) Blood dyscrasia
C) Electrolyte imbalance
D) Superinfection

Answer 15

B) Blood dyscrasia

Question 16

The	pharmacology	instructor	explains	to	students	that	adverse	effects	can	be	extensions	of	what?
A) Primary	action	of	a	drug
B) Anaphylaxis
C) Secondary	action	of	a	drug
D) Anticholinergic	responses	to	the	dru

Answer 16

A) Primary action of a drug

Question 17

A student nurse asks her study group how to define a drug allergy. What would be the peer group’s best
response?
A) A second effect of the body to a specific drug
B) The formation of antibodies to a drug protein causing an immune response when the person is next
exposed to that drug.
C) A serum sickness caused by a reaction to a drug
D) Immediate systemic reaction to the drug when exposed to the drug the first time

Answer 17

B) The formation of antibodies to a drug protein causing an immune response when the person is next
exposed to that drug.

Question 18

The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as
follows:
Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food
preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that
has been treated successfully. What information from the Kardex is likely to have the greatest
implication in educating the patient about antihistamine administration?
A) The patient’s age
B) The patient’s smoking habit
C) The patient’s profession
D) The patient’s medical history

Answer 18

C) The patient’s profession

Question 19

The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An
anticholinergic drug has been prescribed. What would be the nurse’s priority teaching point for this
patient?
A) Urinary incontinence may develop.
B) Bladder hypertonia may develop.
C) An increased dosage may be required.
D) Empty the bladder before taking the drug

Answer 19

D) Empty the bladder before taking the drug

Question 20

The nurse is caring for a patient who experienced a severe headache. When the prescribed number of
over-the-counter pain relievers did not work the patient said she took double the dosage an hour later.
The nurse recognizes this patient is at greatest risk for what?
A) An allergic reaction
B) Anaphylactic reaction
C) Poisoning
D) Sedative effect

Answer 20

C) Poisoning

Question 21

What classification of drug allergy would be described as an immune system reaction to injected
proteins used to treat immune conditions?
A) A cytotoxic reaction
B) Serum sickness
C) A delayed reaction
D) An anaphylactic reaction

Answer 21

B) Serum sickness

Question 22

The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining.
When the patient reports abdominal discomfort after taking the medication, the nurse would classify
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) 47
this discomfort as what type of adverse effect?
A) Primary action
B) Secondary action
C) Hypersensitivity reaction
D) Allergic reaction

Answer 22

D) Allergic reaction

Question 23

Why does the nurse need to be alert for any indication of an allergic reaction in patients?
A) To obtain early warning of noncompliance in drug therapy
B) To increase the effectiveness of a specific medication
C) To maintain the patient’s safety during drug therapy
D) To reduce the risk of adverse effects during drug therapy

Answer 23

C) To maintain the patient’s safety during drug therapy

Question 24

The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought
in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus.
He is somnolent and his electrocardiogram shows an arrhythmia. The boy’s friends tell you he was
taking a ​bunch of little green pills​ he got from the cupboard at his grandparent’s house. The nurse
suspects what?
A) Overdose of sleeping pills
B) Poisoning
C) Anaphylactic shock
D) Allergic reaction to Dyazide

Answer 24

B) Poisoning

Question 25

The nurse administers antipsychotic medications to the patient who has taken these same drugs for
many years. What signs and symptoms would the nurse attribute to secondary actions of the drug?
(Select all that apply.)
A) Muscular tremors
B) Drooling
C) Changes in gait
D) Yellow discoloration of skin and sclera
E) Fine red rash on the trunk

Answer 25

A) Muscular tremors
B) Drooling

D) Yellow discoloration of skin and sclera

Question 26

The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to
increase. The patient asks the nurse, ​Why does this medication make my blood sugar go up?​ What is
the nurse’s best response?
A)​The active ingredient in ephedrine is mixed with sugar.​
B)​Ephedrine is a placebo containing only sugar.​
C)​Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels.​
D)​Insulin is inactivated by ephedrine so it cannot work to control sugar levels.

Answer 26

C)​Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels.​

Question 27

The nurse is writing a plan of care for a patient who is exhibiting Parkinson-like syndrome. What
would be an appropriate intervention if, on assessing the patient, the nurse finds the patient is having
difficulty swallowing?

A) Thicken all liquids.
B) Keep the patient NPO (not taking anything orally).
C) Give only soft or pureed foods.
D) Provide small, frequent meals.

Answer 27

D) Provide small, frequent meals.

Question 28

The post-anesthesia care unit nurse is serving a patient after a right knee arthroscopy. As the patient
begins to wake up from anesthesia, the nurse assesses rigidity, involuntary movements, hyperthermia,
and tachycardia. What would the nurse suspect is causing these effects?
A) Neuroleptic malignant syndrome
B) Parkinson-like syndrome
C) Malignant tachycardia
D) Anaphylactic shock

Answer 28

A) Neuroleptic malignant syndrome

Question 29

A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient
knows that the most severe adverse effect of hyperkalemia is what?
A) Renal failure

B) Cardiac emergency
C) Liver failure
D) Respiratory distress

Answer 29

B) Cardiac emergency

Question 30

The nurse administers an anticholinergic medication to the patient. When assessing this patient, what
finding will the nurse consider a secondary effect of the drug?
A) Nasal congestion
B) Tachycardia
C) Hyperthermia
D) Profuse sweating

Answer 30

A) Nasal congestion

Question 31

Before administering a macrolide antibiotic the nurse would question the order for what patient?
A) An 82-year-old woman with hypertension
B) A 12-year-old boy with hearing loss
C) A 30-year-old pregnant patient

D) A 51-year-old man after myocardial infarction

Answer 31

B) A 12-year-old boy with hearing loss

Question 32

What	cardiac	effect	would	the	nurse	be	prepared	to	see	in	the	patient	with	an	extremely	high	potassium
level?
A) Arrhythmia
B) Tachycardia
C) Sudden	death
D) Bradycardia

Answer 32

A) Arrhythmia

Question 33

The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other
electrolyte would the nurse expect to be excreted in significant amounts?
A) Calcium
B) Magnesium
C) Potassium
D) Zinc

Answer 33

A) Calcium

Question 34

The nurse administers a medication to the patient that induces the secondary action of hypoglycemia.
What organ will be most acutely impacted by inadequate circulating glucose?
A) Brain
B) Heart
C) Lungs
D) Skin

Answer 34

A) Brain