Nokea
A client is diagnosed with thrombophlebitis. The nurse should tell the client that which prescription is indicated?
- A. Bed rest, with bathroom privileges only
- B. Bed rest, keeping the affected extremity flat
- C. Bed rest, with elevation of the affected extremity
- D. Bed rest, with the affected extremity in a dependent position
Correct Answer: C
Rationale: The correct answer is C: Bed rest, with elevation of the affected extremity. Elevating the affected extremity is crucial in managing thrombophlebitis as it helps reduce swelling and promotes venous return. By elevating the affected extremity, the gravitational force assists in venous blood flow back to the heart, thereby reducing the risk of complications associated with thrombophlebitis. Choices A, B, and D are incorrect because they do not address the need for elevation, which is specifically beneficial in the management of thrombophlebitis.
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The healthcare provider is evaluating the effects of care for a client with deep vein thrombosis (DVT). Which limb observations should the provider note as indicating the least success in meeting the outcome criteria for this problem?
- A. Pedal edema that is 3+
- B. Slight residual calf tenderness
- C. Skin warm, equal temperature in both legs
- D. Calf girth 1/8 inch larger than the unaffected limb
Correct Answer: A
Rationale: Significant pedal edema, indicated by 3+, suggests ongoing or worsening venous insufficiency. This can be a sign that the care provided has not been effective in managing the deep vein thrombosis (DVT) and the associated complications. Monitoring and addressing pedal edema is crucial in the evaluation of DVT treatment outcomes and overall patient care. Choices B, C, and D are not indicative of the least success in meeting the outcome criteria for DVT. Slight residual calf tenderness, skin warmth, and a slightly larger calf girth do not necessarily point towards treatment failure or lack of improvement in DVT management.
The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
- A. Propensity to go to the target receptor
- B. Biological half-life
- C. Pharmacodynamics
- D. Safety and side effects
Correct Answer: B
Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Choice B is correct because azathioprine's type D ADR (delayed) relates to its carcinogenic potential, like leukemia, emerging years after use. Choice A is incorrect as teratogenicity is a separate risk, not type D's focus. Choice C is wrong because hypersensitivity is type B, not delayed. Choice D is incorrect since it suppresses immunity, not the HPA axis directly.
An 86-year-old patient is seen in clinic for a scheduled follow-up after starting a new oral medication 1 month prior. The patient reports no change in symptoms, and a laboratory test reveals a subtherapeutic serum drug level. The NP caring for this patient should:
- A. consider ordering more frequent dosing of the drug.
- B. titrate the patient's dose upward and recheck in 1 month.
- C. ask the patient about any increased frequency of bowel movements.
- D. determine the number of pills left in the patient's prescription bottle.
Correct Answer: D
Rationale: The correct answer is D because elderly patients often have adherence issues due to cost or confusion, so checking pill count assesses compliance before adjusting dose. Choice A is incorrect as frequency isn’t the first step. Choice B is wrong since dose increase without compliance check is premature. Choice C is inaccurate as bowel changes aren’t the primary concern.
Strategies to monitor controlled substance use include:
- A. Prescription drug monitoring programs
- B. Patient education
- C. Urine drug screening
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track prescriptions, education informs risks, and urine screening detects misuse—all key monitoring tools per guidelines. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since screening is only one approach.