Nokea
A nurse is reviewing the medical record of a client and notes the various orders for drug therapy. Which of the following would the nurse most likely expect to find? (Select one that does not apply.)
- A. Standing order
- B. STAT order
- C. Single order
- D. Alternate order
Correct Answer: D
Rationale: Common orders given by health care providers for drug therapy include the standing order, the single order, the PRN order, and the STAT order.
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A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct Answer: B
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
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 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.
The nurse is reviewing the results of the patient's laboratory tests. What must the nurse keep in mind when reviewing these results related to medication administration?
- A. The patient's emotional response to the disease process
- B. The timing of the last dose of medication relative to when blood was drawn
- C. The possibility of a drug-laboratory test interaction
- D. A change in the body's responses or actions related to the drug
Correct Answer: C
Rationale: The body works through a series of chemical reactions. Because of this, administration of a particular drug may alter results of tests that are done on various chemical levels or reactions as part of a diagnostic study. This drug-laboratory test interaction is caused by the drug being given and not necessarily by a change in the body's responses or actions. The patient's emotional response or timing of the last dose is not important in drug-laboratory interactions.
An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).