Nokea
The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:
- A. To take aspirin (acetylsalicylic acid) as needed for headache
- B. Drink beverages containing alcohol in moderate amounts each evening
- C. Consult with health care providers (HCPs) before receiving immunizations
- D. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct Answer: C
Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects.
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An agonist is substance that:
- A. Interacts with the receptor without producing any effect
- B. Interacts with the receptor and initiates changes in cell function, producing various effects
- C. Increases concentration of another substance to produce effect
- D. Interacts with plasma proteins and doesn't produce any effect
Correct Answer: B
Rationale: An agonist binds receptors and activates them, producing a biological effect.
The U.S. Drug Enforcement Administration:
- A. Registers manufacturers and prescribers of controlled substances
- B. Regulates NP prescribing at the state level
- C. Sanctions providers who prescribe drugs off-label
- D. Provides prescribers with a number they can use for insurance billing
Correct Answer: A
Rationale: The DEA registers those handling controlled substances , not state NP rules , off-label sanctions , or insurance numbers .
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.
Patients receiving heparin therapy require monitoring of:
- A. Platelets every 2 to 3 days for thrombocytopenia that may occur on day 4 of therapy
- B. Electrolytes for elevated potassium levels in the first 24 hours of therapy
- C. INR throughout therapy to stay within the range of 2.0
- D. Blood pressure for hypertension that may occur in the first 2 days of treatment
Correct Answer: A
Rationale: Heparin can cause thrombocytopenia (HIT) around day 4, requiring platelet checks; INR is for warfarin, not heparin.
Hypoglycemic effects of repaglinide and nateglinide is determined with:
- A. Closure of ATP sensitive K+ channels
- B. Increase numbers of insulin receptors
- C. Stimulation of PPAR-Y receptors
- D. Degradation of incretin
Correct Answer: A
Rationale: Repaglinide and nateglinide close ATP-sensitive K+ channels on beta cells, triggering insulin release.