Nokea
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
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Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
- A. Erythromycin
- B. Digoxin
- C. Cetuximab
- D. Rifampin
Correct Answer: C
Rationale: FDA requires pharmacogenetic testing for cetuximab to check EGFR status, not for erythromycin, digoxin, or rifampin.
When taking a medication history on a patient why should the nurse ask about the use of alternative therapies?
- A. Patients who use new drugs are usually not compliant with medical regimens.
- B. Many drug-alternative therapy interactions can cause serious problems and should be avoided.
- C. Natural products may be more effective and the drug may not be needed.
- D. The cost of the drug and the alternative therapy may be too great for the patient to handle.
Correct Answer: B
Rationale: Alternative therapies can interact with prescribed drugs, potentially causing adverse effects, making this a critical assessment point.
Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
- A. Vasodilate the peripheral vasculature
- B. Decrease cardiac output
- C. Increase renal vascular resistance
- D. Reduce atherosclerosis secondary to elevated serum lipoproteins
Correct Answer: A
Rationale: Alpha-beta blockers (e.g., carvedilol) vasodilate, reducing afterload in heart failure.
After a few weeks on a drug, a patient reports profound thirst and the production of large volumes of dilute urine (polyuria). Which of the following drugs is most likely responsible for the symptoms?
- A. Diazepam
- B. Fluoxetine
- C. Haloperidol
- D. Lithium
Correct Answer: D
Rationale: Lithium causes nephrogenic diabetes insipidus, leading to thirst and polyuria.
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?
- A. Obtain a blood specimen immediately prior to administering the next dose of medication.
- B. Verify that the client has been taking the medication for 24 hour before obtaining a blood specimen.
- C. Ask the client to provide a urine specimen after the next dose of medication.
- D. Administer the medication, and obtain a blood specimen 30 min late
Correct Answer: A
Rationale: Trough levels are measured just before the next dose to assess the lowest drug concentration in the blood.