NGN ATI CNA
COMPETENCY EXAM 2024
ACTUAL EXAM 350 AND
CORRECT DETAILED
ANSWERS (VERIFIED
ANSWERS) ALREADY
GRADED A+
After instructing a mother about nutrition for a preschool-age child, which statement by
the mother indicates correct understanding of the topic?
A."I usually use dessert only as a reward for eating other foods."
B."I will make sure my child gets at least 2,000 kcal/day."
C."I do not give my child snacks; they simply spoil the appetite for meals."
D."I know that lifelong food habits are developed during this stage of life." - ANSWERCorrect answer = D
MyPlate has a color food guide that includes the following: (select all that apply)
A.Fruits
B.Vegetables
C.Grains
D.Protein
E.Dairy - ANSWER-Correct answer = A, B, C, D, E
-ALL of them!!
These macronutrients provide the body with energy: (select all that apply)
A.Carbohydrates
B.Protein
C.Lipids
D.Vitamins
E.Minerals - ANSWER-Correct answer = A, B, C
- Vitamins and Minerals are MICROnutrients
- not for energy
While the nurse is performing a nutritional assessment, the client states, "I am on a
vegan diet. I have been a vegan for 10 years." What is the best response by the nurse?
A."Is this a religious or cultural requirement for you?"
B."It is fine; however, you may not be getting all the nutrients you need."
C."Can you tell me about the foods you eat along with any other supplements you
take?"
D."I think it is your right to be on whatever diet you would like to be on." - ANSWERCorrect answer = C
- D is not the BEST answer because we want more info
This usually contains water, glucose (depending on the client's calculated energy need),
amino acids, essential fatty acids, vitamins, minerals, and trace elements.
A.Enteral feedings
B.Lipids
C.Total parenteral nutrition (TPN)
D.Intravenous fluids (IVF) - ANSWER-Correct answer = C
-TPN = the medical term for infusing a specialized form of food through a vein
(intravenously)
What are types of drug names? - ANSWER-•Chemical name is the exact description of
the drug's chemical composition and molecular structure
•Generic (nonproprietary) name is assigned by the United States Adopted Names
Council (USAN Council) when the developing manufacturer is ready to market the drug;
this is usually similar to the chemical name, but in a simpler form
•Official name is also the generic name that is listed in publications, such as the United
States Pharmacopeia (USP) and National Formulary (NF)
•Ibuprofen is both a generic and an official name
•Brand (trade or proprietary) name is what the drug is sold as in stores; the brand name
is easily recognized because it begins with a capital letter and sometimes has a
registration mark (®) at the upper right of the name; different manufacturers of the same
medication may give it different brand names
What is a Chemical name? - ANSWER-the exact description of the drug's chemical
composition and molecular structure
What is a generic name? - ANSWER-this is usually similar to the chemical name, but in
a simpler form
-is assigned by the United States Adopted Names Council (USAN Council) when the
developing manufacturer is ready to market the drug;
What is a brand name? - ANSWER-what the drug is sold as in stores; the brand name
is easily recognized because it begins with a capital letter and sometimes has a
registration mark (®) at the upper right of the name
What is an official name? - ANSWER-Official name is also the generic name that is
listed in publications, such as the United States Pharmacopeia (USP) and National
Formulary (NF)
•Ibuprofen is both a generic and an official name
Are we expected to know everything about every drug?? - ANSWER-NO!!!
-It is important to know how to look up drug info!!
Where can you research reliable information about drugs? - ANSWER-•Pharmacopoeia
and formularies
•Electronic and Internet-based formularies/Apps
•Nursing drug handbooks
•Physician's Desk Reference (PDR)
•Pharmacology texts
•A clinical pharmacist
•Medication package inserts
•Institutional medication policies and procedures
In the US what controls laws about drug administration? - ANSWER-In the US, drug
administration is controlled by federal, state, or local laws
What role does the FDA play in drug administration? - ANSWER-- regulates the
manufacture and sale of all medications
- monitors their safety and effectiveness
- it also regulates, through controlled clinical trials, the testing of any medication that is
to be marketed and sold in the US
What is the danger of stock supplies? - ANSWER-Stock supplies require you to
measure the dose each time a client needs it, so the potential for measurement error is
present each time a dose is prepared
-however, a bulk supply of medication is often very cost-effective
What is a unit dose? - ANSWER-A unit dose is the prescribed amount of drug the client
receives at a single time
- each unit dose (usually one tablet) is individually packaged and labeled with drug
name, dose, and expiration date
What is an automated dispenser? - ANSWER-An automated dispensing system is a
computerized system similar to a unit-dose system
The locked cart contains all the medications frequently used on a particular nursing unit,
and the computer database contains records and counts of the medications, as well as
the medication prescriptions for each client on the unit
The medications are usually packaged in unit doses, but some bulk medications may
also be kept on the cart
How are medications stored within an automated dispenser? - ANSWER-The
medications are usually packaged in unit doses, but some bulk medications may also
be kept on the cart
What is self administration? - ANSWER-At times while in the hospital, clients may selfadminister medications (SAM) that the hospital does not carry
-otherwise, all personal medications must be left at home (to avoid double-dosing)
What are pharmodynamics? - ANSWER-primary and secondary effects of the drugs
What are pharmokinetics? - ANSWER-Pharmokinetics is the study of how a drug
reaches its target cell, tissue or organ in the body.
4 processes
1.Absorption
2.Distribution
3.Metabolism
4.Excretion of a drug
What is absorption? - ANSWER-Movement of the drug from the site of administration
into the bloodstream
-Rate of absorption determines when a drug becomes available to exert its action; thus,
absorption also influences metabolism and excretion.
What is Distribution? - ANSWER-Transportation of a drug in body fluids (usually the
bloodstream) to the various tissues and organs of the body
- **because blood goes to all parts of the body, theoretically a drug can produce effects
(intended or unintended) anywhere**
- The rate of distribution depends on the adequacy of local blood flow in the target area
(the site where the drug effects occur)
What is metabolism (in terms of pharmokinetics)? - ANSWER-Chemical inactivation of a
drug through its conversion into a more water-soluble compound or into metabolites that
can be excreted from the body
What is excretion? - ANSWER-For excretion to occur, drug molecules must be removed
from their sites of action and eliminated from the body
**Drugs may be metabolized completely, partially, or not at all when they are excreted**
What are the common organs of excretion? - ANSWER-•Kidneys
•Liver
•Gastrointestinal tract (GI)
•Lungs
•Exocrine glands (sweat and salivary)
What factors affect absorption? - ANSWER-•*Route of administration*
-Drugs are manufactured for a specific route of administration: oral, sublingual, buccal,
inhalant, topical, enteral, and parenteral
-Drugs are absorbed at different rates depending on the route
•*Drug solubility*
-Ability of a medication to be transformed into a liquid form that can be absorbed into
the bloodstream
•*pH/ionization*
-The pH (relative acidity or alkalinity) of the local environment also affects the
absorption of a drug
•*Blood flow*
-Medications are absorbed rapidly in areas where blood flow to the tissue is greatest
(e.g., oral mucous membranes)
-Areas with poor vascular supply (e.g., the skin, scarred areas) experience delayed
absorption
What are enteric coated drugs? - ANSWER-•Cannot be decomposed by gastric
secretions
•The coating thus prevents the medication from being diluted before it reaches the
intestines
•In this way, the coating delays the action of the medication
- It also decreases irritating effects of the medication on the stomach
What are timed released medications? - ANSWER-Timed-release (sustained-release)
medications are formulated to dissolve slowly, releasing small amounts for absorption
over several hours
how does route of administration affect absorption? - ANSWER--Drugs are
manufactured for a specific route of administration: oral, sublingual, buccal, inhalant,
topical, enteral, and parenteral
-Drugs are absorbed at different rates depending on the route
How does Drug solubility affect absorption? - ANSWER-Ability of a medication to be
transformed into a liquid form that can be absorbed into the bloodstream
How does pH/Ionization affect absorption? - ANSWER-•The pH (relative acidity or
alkalinity) of the local environment also affects the absorption of a drug
•The acid content of the stomach aids in transporting the medication across the mucous
membranes, so acidic medications, such as aspirin, are more readily absorbed in the
stomach than basic (alkaline) medications, such as sodium bicarbonate, which are
readily absorbed in the more alkaline small intestine
How does blood flow affect absorption? - ANSWER--Medications are absorbed rapidly
in areas where blood flow to the tissue is greatest (e.g., oral mucous membranes)
-Areas with poor vascular supply (e.g., the skin, scarred areas) experience delayed
absorption
What factors affect distribution? - ANSWER-•Local blood flow
•Membrane permeability
•Protein-binding capacity
How does local blood flow affect distribution? - ANSWER-•Rate of distribution depends
on the adequacy of local blood flow in the target area (the site where the drug effects
occur)
•It is also influenced by the permeability of capillaries to the drug's molecules as well as
the protein-binding capacity of the drug
How does membrane permeability affect distribution? - ANSWER-•Drug molecules must
leave the blood and cross capillary membranes to reach their sites of action
•Some capillary membranes act as barriers
•The capillary networks in some organs consist of tightly packed endothelial cells that
prevent some drugs from crossing them
How does protein binding capacity affect distribution? - ANSWER-•A drug's tendency to
bind to plasma proteins in the blood also affects distribution
•For a given amount of a drug, some molecules bind to plasma proteins, and the
remainder will be "free"
•For example, nearly all acetaminophen (Tylenol) molecules are free in the bloodstream
and are therefore pharmacologically active
•By contrast, about 99% of the anticoagulant warfarin (Coumadin) is bound in the blood;
its effects are produced by only the 1% of warfarin molecules that are free
What factors affect metabolism? - ANSWER-- Biotransformation
- Liver function
- Health/disease status
- First pass effect
How do biotransformations effect metabolism? - ANSWER-Chemical conversion of drug
How does Liver function effect metabolism? - ANSWER-•Metabolism takes place mainly
in the liver, but medications can be detoxified also in the kidneys, blood plasma,
intestinal mucosa, and lungs
•If liver function is impaired (e.g., due to liver disease or aging), the drug will be
eliminated more slowly, and toxic levels may accumulate
How does Health disease/status effect metabolism? - ANSWER-Disease states also
affect drug metabolism.
How does First pass effect effect metabolism? - ANSWER-•Oral medications are
absorbed from the GI tract and circulate through the liver before they reach the systemic
circulation
•Many oral medications can be almost completely inactivated in this way
•This inactivation is known as the first-pass effect
•*For this reason, oral medications are formulated with a higher concentration of the
drug than are parenteral medications*
How can drugs be secreted? - ANSWER-Drugs may be metabolized completely,
partially, or not at all when they are excreted
What are major organs of secretion? - ANSWER-•Kidneys - the primary site of excretion
•Liver and GI tract- some drugs broken down by the liver are excreted into the GI tract
and then eliminated in the feces
•Lungs - gases and volatile liquids (e.g., general anesthetics) administered by inhalation
usually are removed through exhalation.
3 documents
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