Nokea
A client has a new prescription for phenytoin. Which of the following instructions should the nurse include?
- A. Take the medication with a full glass of water.
- B. Avoid consuming dairy products.
- C. Take the medication on an empty stomach.
- D. Expect a metallic taste in your mouth.
Correct Answer: B
Rationale: The correct instruction for a client prescribed phenytoin is to avoid consuming dairy products. Dairy products can reduce the absorption of phenytoin. Taking the medication with a full glass of water (Choice A) is generally a good practice for oral medications but is not specifically required for phenytoin. Taking the medication on an empty stomach (Choice C) can lead to gastrointestinal upset, so it is not recommended for phenytoin. Expecting a metallic taste in the mouth (Choice D) is a possible side effect of phenytoin but is not a crucial instruction for the client to follow.
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An NP prescribes an oral elixir medication for a child who is to take 1 tsp PO bid. When counseling the child's parents about administering this drug, the NP should tell them to:
- A. shake the medication well before giving each dose.
- B. mix the medication with cereal or applesauce to improve its taste.
- C. administer the medication on an empty stomach to enhance absorption.
- D. use a syringe purchased at the pharmacy to measure the medication accurately.
Correct Answer: D
Rationale: The correct answer is D because a syringe ensures accurate dosing (teaspoons vary 2.5-7.8 mL). Choice A is incorrect (elixirs don’t need shaking). Choice B is wrong (mixing risks incomplete dosing). Choice C is inaccurate (empty stomach isn’t required).
Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:
- A. After the second dose
- B. After four to five half-lives
- C. When the patient feels the full effect of the drug
- D. One hour after IV administration
Correct Answer: B
Rationale: Choice B is correct because steady state is reached after four to five half-lives, when absorption equals elimination, stabilizing drug levels for therapeutic monitoring. Choice A is incorrect as the second dose is too early for steady state. Choice C is wrong because patient perception doesn't define pharmacokinetics. Choice D is incorrect since IV timing varies and doesn't inherently match steady state.
In every state, prescriptive authority for NPs includes the ability to write prescriptions:
- A. for controlled substances.
- B. for specified classifications of medications.
- C. without physician-mandated involvement.
- D. with full, independent prescriptive authority.
Correct Answer: B
Rationale: The correct answer is B because all states grant NPs some prescriptive authority, but it’s often limited to specific drug classes. Choice A is incorrect as not all states allow controlled substances. Choice C is wrong since physician involvement is required in many states. Choice D is inaccurate as full independence isn’t universal.
A client has a new prescription for lisinopril. Which of the following findings should be reported to the provider by the nurse?
- A. Weight gain
- B. Dry cough
- C. Hypokalemia
- D. Increased appetite
Correct Answer: B
Rationale: The correct answer is B - Dry cough. Lisinopril is known to cause a persistent dry cough as a common side effect. This adverse reaction can be bothersome to the client and may necessitate discontinuation of the medication. Weight gain, hypokalemia, and increased appetite are not typically associated with lisinopril and would not be as concerning as a dry cough when assessing for adverse effects.
Herbal products that should be avoided when a patient is taking warfarin include:
- A. Ginkgo biloba
- B. Echinacea
- C. Valerian root
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because ginkgo biloba has antiplatelet effects, enhancing warfarin's anticoagulation and bleeding risk, so it should be avoided. Choice B is incorrect as echinacea doesn't significantly interact with warfarin. Choice C is wrong because valerian root's sedative effects don't notably affect anticoagulation. Choice D is incorrect since only ginkgo biloba poses a clear risk.