A 44-year-old woman with systemic lupus erythematosus presents to her primary care physician for follow-up. She is currently being managed with an oral glucocorticoid agent. The most likely mechanism of action of this medication involves which of the following?
- A. Inhibition of erythrocytes
- B. Inhibition of macrophages
- C. Stimulation of cyclooxygenase 2 synthesis
- D. Stimulation of phospholipase A2
Correct Answer: B
Rationale: Glucocorticoids inhibit macrophages and other immune cells, reducing inflammation in conditions like lupus.
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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.
A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
- A. Vitamin k1
- B. Atropine
- C. Protamine
- D. Calcium gluconate
Correct Answer: C
Rationale: Protamine reverses heparin's anticoagulant effect in bleeding emergencies.
Which action will the nurse take if a dosage is unclear on a health care provider's order?
- A. Ask the patient what dosage was given in the past.
- B. Ask another physician to determine the correct dosage.
- C. Tell the patient that the medication will not be given.
- D. Contact the health care provider to verify the correct dosage.
Correct Answer: D
Rationale: Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse's priority action?
- A. Wash her hands before handling the medications.
- B. Consult a drug guide for compatibility.
- C. Question the patient concerning drug allergies.
- D. Identify the patient by checking the armband and asking the patient to state his name.
Correct Answer: B
Rationale: A nurse should first consult a drug guide for compatibility when two or more drugs are being given at the same time. After compatibility is determined the medication can be administered. The nurse will perform hand hygiene, check for patient allergies, and ensure the right patient receives the medication by using two identifiers.
Carbamazepine has a Black Box Warning due to life-threatening:
- A. Renal toxicity, leading to renal failure
- B. Hepatotoxicity, leading to liver failure
- C. Dermatologic reaction, including Steven's Johnson and toxic epidermal necrolysis
- D. Cardiac effects, including supraventricular tachycardia
Correct Answer: C
Rationale: Carbamazepine's Black Box Warning highlights severe skin reactions like SJS/TEN.
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