Taylor is a 10-year-old child diagnosed with major depression. The appropriate first-line antidepressant for children is:
- A. Fluoxetine
- B. Fluvoxamine
- C. Sertraline
- D. Escitalopram
Correct Answer: A
Rationale: Fluoxetine is FDA-approved as a first-line treatment for pediatric depression.
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The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient?
- A. The medication history of the patient's mother and/or father
- B. The name of the patient's pharmacy
- C. Insurance, financial support, and stability for the patient and his family
- D. The last time the patient was hospitalized
Correct Answer: C
Rationale: Financial and insurance status directly impacts access to medications and care, critical for a family man, more than pharmacy name or parental history.
Patients who are beginning therapy with vitamin B12 need to be monitored for:
- A. Hypertensive crisis that may occur in the first 36 hours
- B. Hypokalemia that occurs in the first 48 hours
- C. Leukopenia that occurs at 1 to 3 weeks of therapy
- D. Thrombocytopenia that may occur at any time in therapy
Correct Answer: B
Rationale: Hypokalemia can occur early in B12 therapy as red cell production surges, shifting potassium; other effects are rare.
The nursing instructor observes several nursing students administer medications to their assigned patients. The instructor would stop what student from administering the medication until the error was corrected?
- A. The student checks the label on the medication against the administration record three times.
- B. The student enters the patient's room and asks the patient Are you Mr. Jones?
- C. The student checks the drug's brand name and generic name before taking it to the patient.
- D. The student documents the medication upon exiting the patient's room
Correct Answer: B
Rationale: Asking 'Are you Mr. Jones?' risks misidentification; students must verify identity with two identifiers (e.g., wristband).
The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?
- A. The medication is administered within 60 minutes before the morning and evening meal.
- B. The medication is withheld and the HCP is called to question the prescription for the client.
- C. The client is monitored for gastrointestinal side effects after administration of the medication.
- D. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration.
Correct Answer: B
Rationale: Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not recommended for clients taking insulin. Hence, the nurse should hold the medication and question the HCP regarding this prescription. Although options 1 and 3 are correct statements about the medication, in this situation the medication should not be administered. The medication is packaged in prefilled pens ready for injection without the need for drawing it up into another syringe.
Which of the following produced by the pancreatic beta cells:
- A. Insulin
- B. Gastrin
- C. Somatostatin
- D. Glucagon
Correct Answer: A
Rationale: Insulin is produced by pancreatic beta cells to regulate blood glucose.