the tendency of a drug to combine with its receptor is called

NCLEX-PN

Nclex Questions Management of Care

1. What is the term for the tendency of a drug to combine with its receptor?

A. potency
B. efficacy
C. kinetics
D. affinity

Correct answer: D

Rationale: The correct answer is 'affinity.' Affinity refers to the close relationship or mutual attraction between a drug and its receptor, indicating the strength of the drug-receptor bonding. Potency (Choice A) is related to the dose of a drug needed to produce a specific effect. Efficacy (Choice B) refers to a drug's ability to generate the desired effect. Kinetics (Choice C) deals with forces affecting the motion of material bodies or changes in a system, which is not directly associated with the bonding between a drug and its receptor.

2. An example of a process standard on a med-surg unit is:

A. a procedure for changing IV tubing.
B. a policy for staffing.
C. the job description of the CEO (chief executive officer).
D. a procedure for checking waveforms on a client being treated with an intra-aortic balloon pump.

Correct answer: D

Rationale: Process standards define the actions and behaviors required by staff to provide care on a med-surg unit. A procedure for changing IV tubing is a critical psychomotor skill necessary for safe and effective patient care in this setting. Choice B, a policy for staffing, pertains more to organizational management rather than specific care processes on the unit. Choice C, the job description of the CEO, delineates the responsibilities of the organization's top executive and is not a process standard for frontline staff. Choice D, a procedure for checking waveforms on a client with an intra-aortic balloon pump, is more specific to a cardiac care unit and not typically performed on a med-surg unit.

3. An 80-year-old aphasic CVA client had abdominal surgery 2 days ago. Which of the following puts this client at the highest risk for inadequate pain management?

A. Inability to turn, cough, and breathe deeply
B. Inability to communicate pain
C. Inability to ambulate freely
D. Inability to use a bedside commode

Correct answer: B

Rationale: The correct answer is B: Inability to communicate pain. In this scenario, the client's aphasia prevents them from verbally expressing their pain, which can lead to inadequate pain management if the healthcare team is not vigilant. The nurse must use alternative methods to assess and address the client's pain. Choices A, C, and D, although important considerations in postoperative care, do not directly relate to the client's ability to communicate pain, which is crucial for effective pain management in this case.

4. A health care provider informs a nurse that the husband of an unconscious client with terminal cancer will not grant permission for a do-not-resuscitate (DNR) order. The health care provider tells the nurse to perform a 'slow code' and let the client 'rest in peace' if she stops breathing. How should the nurse respond?

A. Telling the health care provider that the client would probably want to die in peace
B. Telling the health care provider that if the client stops breathing, the health care provider will be called before any other actions are taken
C. Telling the health care provider that all of the nurses on the unit agree with this plan
D. Telling the health care provider that 'slow codes' are not acceptable

Correct answer: D

Rationale: The nurse may not violate a family's request regarding the client's treatment plan. A 'slow code' is not acceptable, and the nurse should state this to the health care provider. The definition of a 'slow code' varies among health care facilities and personnel and could be interpreted as not performing resuscitative procedures as quickly as a competent person would. Resuscitative procedures that are performed more slowly than recommended by the American Heart Association are below the standard of care and could therefore serve as the basis for a lawsuit. The other options are inappropriate: Option A is speculative and does not address the issue directly; Option B does not challenge the unethical practice of a 'slow code'; Option C is irrelevant and does not address the ethical concerns raised by the health care provider's request.

5. The LPN is auscultating for bowel sounds and hears between 3 and 4 bowel sounds per minute. This is a somewhat expected finding for which of these clients?

A. a 63-year-old female undergoing chemotherapy for breast cancer
B. a 56-year-old female with dementia undergoing a swallow study
C. a 34-year-old male with a PEG tube newly admitted for diabetic ketoacidosis
D. a 45-year-old male recovering from a knee replacement under general anesthesia

Correct answer: D

Rationale: When recovering from general anesthesia, hypoactive bowel sounds can be expected due to the effects of the anesthesia on gut motility. For the other clients, hearing less than 5 bowel sounds per minute would indicate an abnormal finding. In the context of the given situation, the client recovering from knee replacement surgery aligns with the expected range of bowel sounds post-general anesthesia. Therefore, choice D is the correct answer. Choices A, B, and C present scenarios where hearing less than 5 bowel sounds per minute would be abnormal, indicating potential issues that need further evaluation.