Nokea
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.
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A patient who has oral candidiasis will begin using nystatin suspension to treat the infection. What information will the nurse include when teaching this patient?
- A. Coat the buccal mucosa with the drug and then rinse your mouth
- B. Gargle with the nystatin and then spit it out without swallowing
- C. Mix the suspension with 4 ounces of water and then drink it
- D. Swish the liquid in your mouth and then swallow after a few minutes
Correct Answer: D
Rationale: Nystatin should coat the mouth and be swallowed for oral candidiasis; spitting or rinsing reduces efficacy. Patients should be taught to swish the suspension in the mouth to coat the tongue and buccal mucosa and then swallow the medication.
You are gathering assessment data from a medication history of a 38-year-old male with four children. What assessment information would be most important in providing care for this patient?
- A. The medication history of the patient's mother and/or father
- B. The name of the patient's pharmacy
- C. Insurance, financial support, and stability for the patient and his family
- D. The last time the patient was hospitalized
Correct Answer: C
Rationale: Insurance and financial stability impact access to medications and adherence, critical for a 38-year-old with family responsibilities.
The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh exactly 64 kg.
- B. 5
- C. 10
- D. 15
Correct Answer: A
Rationale: In a continuous normal distribution, the probability of an exact value (e.g., P(X=64)) is 0, as probability is measured over intervals, not points. Thus, 0 students, as per the document.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
The safest drug to use to treat pregnant women with deep vein thrombosis is:
- A. Low-molecular-weight heparin
- B. Warfarin
- C. Aspirin
- D. Heparin
Correct Answer: D
Rationale: Heparin is safest in pregnancy as it doesn't cross the placenta, unlike warfarin (B, teratogenic); LMWH is also safe but not listed as 'heparin.'