Nokea
A 35-year-old woman has Graves' disease, a small goiter, and symptoms that are deemed 'mild-to-moderate.' Propylthiouracil is prescribed. Which of the following is the most serious adverse response to this drug, for which close monitoring is required?
- A. Agranulocytosis
- B. Cholestatic jaundice
- C. Gout
- D. Renal tubular necrosis
Correct Answer: A
Rationale: Agranulocytosis is a severe, potentially fatal side effect of propylthiouracil requiring close monitoring due to its impact on white blood cell production.
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A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication, the nurse will review which laboratory values in the patient's medical record?
- A. Complete blood count (CBC) with differential white cell count
- B. Blood urea nitrogen (BUN) and creatinine
- C. Potassium and magnesium levels
- D. Serum fasting glucose
Correct Answer: B
Rationale: Streptomycin risks nephrotoxicity, requiring renal function (BUN, creatinine) checks; CBC or electrolytes are less critical. Streptomycin can cause significant renal toxicity.
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
As an antacid, sodium bicarbonate has the following disadvantages EXCEPT:
- A. It causes acid rebound
- B. In ulcer patients, it increases risk of perforation
- C. It has low acid neutralizing capacity
- D. It is contraindicated in CHF
Correct Answer: C
Rationale: Sodium bicarbonate has high acid-neutralizing capacity, but it causes acid rebound, risks perforation in ulcers due to gas production, and is contraindicated in CHF due to sodium load.
Human papillomavirus (HPV) vaccine (Gardasil, Cervarix):
- A. Is a live virus vaccine that provides immunity to six strains of HPV virus
- B. Has a common adverse effect of syncope within 15 minutes of giving the vaccine
- C. Should not be given to males younger than age 12 years
- D. May be given to pregnant women
Correct Answer: B
Rationale: HPV vaccine commonly causes syncope post-injection; it's not live , is approved for males 9+ , and is avoided in pregnancy .
The use of information technology for quality improvement in pharmacotherapeutics includes:
- A. Incorporating the use of 'apps' into all patient encounters
- B. Tracking data trends within the practice via the electronic health record database
- C. Informing patients that they have access to their medication list via the Internet
- D. Using macros for individualizing patient care management
Correct Answer: B
Rationale: Tracking data trends in EHRs supports quality improvement in pharmacotherapeutics.