Nokea
A 19-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:
- A. Bradykinesia, akathisia, and agitation
- B. Excessive weight gain
- C. Hypertension
- D. Potentially fatal agranulocytosis
Correct Answer: A
Rationale: Risperidone frequently causes movement disorders like bradykinesia and akathisia.
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Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
- A. Selective estrogen receptor modulators
- B. Aspirin
- C. Glucocorticoids
- D. Calcium supplements
Correct Answer: C
Rationale: Glucocorticoids cause bone loss, warranting bisphosphonate prophylaxis; SERMs protect bone.
A patient with a history of opioid abuse will be discharged home with buprenorphine to help prevent relapse. Which product will the nurse anticipate the provider to order?
- A. Buprenex
- B. Suboxone
- C. Subutex
- D. Vivitrol
Correct Answer: A
Rationale: Buprenex is buprenorphine with low abuse potential for maintenance; Suboxone has naloxone added. Buprenex is an agonist-antagonist opioid that can be used for detoxification and maintenance therapy because it has a low potential for abuse.
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?
- A. Administer the drug as ordered.
- B. Question the prescriber concerning the ordered drug.
- C. Ask a coworker his or her thoughts about the ordered drug for the patient.
- D. Ask the patient why the drug has been prescribed for him or her.
Correct Answer: B
Rationale: If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone's part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time
Correct Answer: B
Rationale: A history of rash suggests a possible allergy; withholding the medication and consulting the provider is safest.
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
- A. Spending large amounts of money on medications
- B. Allergic reactions to medications
- C. Drug-drug interactions
- D. Critical concentrations of medications in the body
Correct Answer: C
Rationale: It is important that all health care providers have a complete list of the patients medications to avoid drug-drug interactions caused by one provider ordering a medication, unaware of another medication the patient is taking that could interact with the new prescription. Using the same pharmacist for all prescriptions will also help to prevent this from happening. Informing the provider of all medications taken will not reduce costs of medications, which is best accomplished by requesting generic medications. Allergies should be disclosed to all health care providers as well, but this is not why it is important to provide a complete list of medications taken. Critical concentrations are desirable because that is the amount of drug needed to cause a therapeutic effect, or, in other words, to have the effect the drug is prescribed for.