Nokea
A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
- A. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
- B. MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce
- C. Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate treatment
- D. All of the above
Correct Answer: D
Rationale: MAOIs have serotonergic interactions, food restrictions (tyramine), and hypertensive crisis risks.
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Prescribing less-expensive generic drugs or drugs off the 4 retail pharmacy lists:
- A. Increases the complexity of the pharmacoeconomics of prescribing for the individual patient
- B. Increases compliance by reducing the financial burden of drug costs to the patient
- C. Is not sound prescribing practice due to the inferiority of the generic products
- D. Will increase the overall cost of drugs to the system due to the ease of overprescribing less-expensive drugs
Correct Answer: B
Rationale: Generic drugs improve adherence by lowering patient costs.
What must the nurse have before administering any medication? (Select one that does not apply.)
- A. A current license to practice
- B. A medication order signed by a practitioner licensed with prescription privileges
- C. Knowledge of the medication
- D. Consultation with a pharmacist
Correct Answer: D
Rationale: Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications. Safe medication administration includes knowledge of the medication, pathophysiology of patient diagnoses, and pharmacodynamics of the ordered medication on the pathophysiology. It is not necessary for the nurse to consult with a pharmacist each time medication is to be administered to a patient.
The patient asks the nurse why generic drugs would be used and voices concerns that only the brand name product will be safe. What is the nurse's best response?
- A. Generic drugs are often less expensive.
- B. Some quality control problems have been found with generic drugs.
- C. Most generic drugs are very safe and can be cost effective as well.
- D. Although initial cost is higher for a brand name it may cost less in the long run.
Correct Answer: C
Rationale: Most generic medications are completely safe and may be identical to the brand name drug except generic medications are often less expensive, but this does not address the patient's concern about safety. Although some quality control issues have occurred in the past, this does not address the patient's concerns regarding safety or explain why generic drugs are prescribed and used. Although some doctors believe initial cost is higher but will cost less over time, this response also does not address the patient's concerns.
A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential. Under what category would morphine be classified?
- A. Schedule I
- B. Schedule II
- C. Schedule III
- D. Schedule IV
Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than II and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability.
A group of nursing students are reviewing information about the process of drug development in the United States. The students demonstrate understanding of this process when they identify that which of the following categories are assigned by the Food and Drug Administration to newly approved drugs?Select one that does not apply
- A. Metabolite
- B. controlled substance
- C. Prescription
- D. Nonprescription
Correct Answer: A
Rationale: Once drugs are approved for use, the FDA assigns the drug to one of the following categories: prescription, nonprescription, or controlled substance. Metabolite refers to the inactive form of the drug. Noncontrolled substance is a term that is not used.