Nokea
A 7-year-old male fell off a wood pile while playing. He has been admitted to the ICU with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient?
- A. Adverse effects may be decreased
- B. Therapeutic effects may be increased
- C. Pharmacodynamics may be altered
- D. Pharmacokinetics remain the same
Correct Answer: C
Rationale: Trauma alters pharmacodynamics (drug effects) due to physiological stress and injury responses.
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Which advantage(s) does the unit dose drug distribution system include? (Select one that does not apply.)
- A. Credit is given to the patient for unused medications.
- B. The pharmacist is able to analyze prescribed medications for each client for drug interactions and contraindications.
- C. There is less waste of medications.
- D. The time spent by nursing personnel preparing these medications is increased.
Correct Answer: D
Rationale: Because the pharmacist has a profile of all medications for each patient, he or she is able to analyze prescribed medications for each patient for drug interactions and contraindications. This is an advantage of the unit dose drug distribution system. Less waste of medications is an advantage of the unit dose drug distribution system. Because each dose is individually packaged, credit can be given to the patient for unused medications. There is increased pharmacist involvement and better use of his or her extensive drug knowledge and nursing personnel time is decreased with this method.
Patients who are beginning therapy with vitamin B12 need to be monitored for:
- A. Hypertensive crisis that may occur in the first 36 hours
- B. Hypokalemia that occurs in the first 48 hours
- C. Leukopenia that occurs at 1 to 3 weeks of therapy
- D. Thrombocytopenia that may occur at any time in therapy
Correct Answer: B
Rationale: Hypokalemia can occur early in B12 therapy as red cell production surges, shifting potassium; other effects are rare.
During which phase of pharmacokinetics could a significant drug-drug interaction occur, resulting in one drug stimulating or blocking the metabolism of the other drug?
- A. Absorption
- B. Distribution
- C. Biotransformation
- D. Excretion
Correct Answer: C
Rationale: During biotransformation, a drug may be metabolized quicker if taken at the same time as another drug, and higher doses of the drug will be needed to achieve the desired effect. During absorption, one drug can prevent or accelerate absorption of the other drug. During distribution, one drug competes for the protein-binding site of another drug so the second drug cannot be transported to the reactive tissue. During excretion, one drug competes for excretion with the other drug, leading to accumulation and toxic effects of one of the drugs.
A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 125
- B. 120
- C. 150
- D. 110
Correct Answer: A
Rationale: Calculation: 750 mL ÷ 6 hr = 125 mL/hr, matching the answer.
Aminoglycosides lack activity against streptococci.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Aminoglycosides are effective against some streptococci (e.g., when combined with cell wall-active agents), though they are primarily used for gram-negative bacteria.