Nokea
Select a drug used in the treatment of primary hyperaldosteronism that may cause hyperkalemia:
- A. Acetazolamide
- B. Mannitol
- C. Torsemide
- D. Spironolactone
Correct Answer: D
Rationale: Spironolactone, an aldosterone antagonist, causes potassium retention.
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The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
- A. It is standard practice when the patient is unable to take the ordered medication.
- B. It is acceptable if the patient agrees to the altered route form.
- C. It is preferable to having the patient miss a dose of the medication.
- D. It is contraindicated without an order from the health care provider.
Correct Answer: D
Rationale: One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber's order.
When moving to another state, what is the nurse responsible for becoming familiar with?
- A. Local policies and procedures for controlled substance administration
- B. Local providers Drug Enforcement Agency (DEA) number for prescribing controlled substances
- C. The agency monitoring controlled substances in the new state
- D. Board of Nursing regulations of controlled substances in the new state
Correct Answer: A
Rationale: The nurse needs to learn local policies and procedures for controlled substance administration because they can vary with some local governments more rigorous than others. Nurses do not memorize a providers DEA numbers. The DEA is a federal agency that monitors controlled substances in all states. State boards of nursing do not regulate controlled substances but may regulate how controlled substances are administered by nurses.
Which of the following is used for treatment of mixedema:
- A. Triiodthironine
- B. Potassium perchlorate
- C. Mercazolil
Correct Answer: A
Rationale: Triiodothyronine (T3) is used to treat myxedema (severe hypothyroidism) by replacing deficient thyroid hormone.
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
- A. Patients with kidney stones
- B. Pregnant patients
- C. Patients with heartburn
- D. Postmenopausal women
Correct Answer: A
Rationale: Calcium carbonate can worsen kidney stones; it's generally safe in pregnancy or heartburn without special caution.
Which drug has a high first pass effect
- A. Amiodarone
- B. Phenytoin
- C. Verapamil
- D. Disopyramide
Correct Answer: C
Rationale: Verapamil undergoes extensive first-pass metabolism in the liver, reducing its bioavailability when taken orally.