1. Question Name: 0001 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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.”

Correct Answer: D

Explanation/Rationale:

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) REF: p. 9

TOP: NURSING PROCESS: Nursing Diagnosis

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

2. Question Name: 0002 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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” problem

 B. “Right dose” problem

 C. “Right route” problem

 D. “Right medication” problem

Correct Answer: A

Explanation/Rationale:

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) REF: p. 13

TOP: NURSING PROCESS: Implementation

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

3. Question Name: 0003 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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

 B. Planning

 C. Implementation

* D. Evaluation

Correct Answer: D

Explanation/Rationale:

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) REF: p. 15

TOP: NURSING PROCESS: Evaluation

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

4. Question Name: 0004 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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.

Correct Answer: D

Explanation/Rationale:

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) REF: p. 11

TOP: NURSING PROCESS: Planning

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

5. Question Name: 0005 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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

Correct Answer: A

Explanation/Rationale:

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) REF: p. 11

TOP: NURSING PROCESS: Implementation

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

6. Question Name: 0006 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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?

 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.

Correct Answer: C

Explanation/Rationale:

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) REF: p. 14

TOP: NURSING PROCESS: Implementation

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:19:30 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00

 ___________________________________________________________________________________________________ 

7. Question Name: 0007 Type: MC Objective: Ch 01: The Nursing Process and Drug Therapy Item Bank: Lilley 

Pharmacology and the Nursing Process 7th Ed

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

Correct Answer: C

Explanation/Rationale:

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) REF: p. 13

TOP: NURSING PROCESS: Assessment

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

Reference/Notes:

Keywords:

Points: 1.00 Penalty: 0.00 Score Mode: Active

Date Created: 01/31/13 14:18:01 Date Modified: 01/31/13 14:18:01 Date Used:

Difficulty: Easy Discrimination: Low

Item Analysis: Last Item Analysis: Cumulative

No. of Students Responded: 0 No. of Students Responded: 0

Correct Responses (%): Correct Responses (%):

Total Group: 0.00 Total Group: 0.00

Upper 27% of Group: 0.00 Upper 27% of Group: 0.00

Lower 27% of Group: 0.00 Lower 27% of Group: 0.00

Point Biserial: 0.00 Point Biserial: 0.00

Response Frequencies (%)

A B C D

Last: 0.00 0.00 0.00 0.00

Cumulative: 0.00 0.00 0.00 0.00