Nokea
During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy?
- A. Assessment
- B. Nursing diagnosis
- C. Interventions
- D. Evaluation
Correct Answer: D
Rationale: Evaluation assesses the effectiveness of interventions, including drug therapy outcomes, to determine if goals are met.
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Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
- A. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus
- B. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
- C. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns
- D. Clarified to include information such as safe dosages in each trimester of pregnancy
Correct Answer: B
Rationale: FDA replaced categories with risk summaries and clinical considerations for clearer, narrative-based guidance, effective 2015.
The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
Which mode of action has insulin in muscles?
- A. Decrease glucose absorption
- B. Decrease glycolysis
- C. Enhance glycolysis
- D. Decrease amino acid absorption
Correct Answer: C
Rationale: Insulin enhances glycolysis in muscles by increasing glucose uptake and utilization.
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, requiring:
- A. A need to monitor drugs metabolized by 2D6 for toxicity
- B. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
- C. Decreased conversion of codeine to morphine by CYP 2D6
- D. The need for lowered dosages of drugs, such as beta blockers
Correct Answer: B
Rationale: Ultra-rapid 2D6 metabolizers (e.g., in Asians) need higher SSRI doses due to fast metabolism, unlike toxicity , codeine issues , or lower doses .
A 25-year-old woman comes to the clinic complaining of rapid heart rate and easy fatigability. Laboratory results reveal low hemoglobin levels and microcytic red blood cells. The most suitable therapy for her condition will be:
- A. Folic acid
- B. Epoiten alfa
- C. Ferrous sulfate
- D. Vitamin B12
Correct Answer: C
Rationale: Microcytic anemia suggests iron deficiency; ferrous sulfate is the standard treatment.