Nokea
Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:
- A. Apply the transdermal disk at least 4 hours before the antiemetic effect is desired.
- B. Swallow the tablet 1 hour before traveling where motion sickness is possible.
- C. Place the tablet under the tongue and allow it to dissolve.
- D. Change the transdermal disk daily for maximal effect.
Correct Answer: A
Rationale: Scopolamine patches require 4 hours for onset, making preemptive application key.
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The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action?
- A. Add ethambutol (Myambutol)
- B. Change the streptomycin to clarithromycin
- C. Change the streptomycin to kanamycin
- D. Order renal function tests
Correct Answer: C
Rationale: Kanamycin replaces streptomycin in phase I resistance; ethambutol is for INH resistance, and clarithromycin is phase II. The patient's current regimen is first-phase treatment. If resistance to streptomycin develops, the provider can change to kanamycin or to ciprofloxacin.
Which of the following does albumin have the strongest affinity for?
- A. Anionic drugs
- B. Hydrophilic drugs
- C. Hydrophobic drugs
- D. A and C
Correct Answer: C
Rationale: Albumin has the strongest affinity for hydrophobic drugs , which bind to its hydrophobic pockets, unlike hydrophilic drugs; anionic drugs may bind but less preferentially.
Which of the following adverse effects of chronic high-dose prednisone administration represents a mineralocorticoid effect?
- A. Buffalo hump
- B. Easy bruising
- C. Edema
- D. Moon facies
Correct Answer: C
Rationale: Edema is a mineralocorticoid effect of prednisone due to sodium and water retention.
Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?
- A. Reduces time that prescribing drugs takes
- B. Eliminates the need to chart drugs prescribed
- C. Decreases prescribing and transcription errors
- D. Helps keep the number of drugs prescribed to a minimum
Correct Answer: C
Rationale: Computerized provider order entry reduces errors in prescribing and transcription.
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.