Nokea
A client has just been prescribed with methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?
- A. Clay-colored stool is a normal response to the treatment.
- B. Pregnancy is not contraindicated with the use of the medication.
- C. Strict hand washing.
- D. Get a daily source of sunlight during the day.
Correct Answer: C
Rationale: Methotrexate is an immunosuppressant, increasing the risk of infections. Strict hand washing and infection prevention measures are crucial. Clay-colored stools are not normal and may indicate liver dysfunction. Pregnancy is contraindicated due to the risk of fetal harm. Sunlight exposure should be limited to reduce the risk of photosensitivity reactions.
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Why is it important to monitor ins and outs with patients using ACE inhibitors?
- A. To assess for renal impairment
- B. You must make sure the patient is receiving adequate fluid intake
- C. To assess the patient for potential heart failure
- D. To assess for decreased blood pressure
Correct Answer: D
Rationale: It is important to monitor ins and outs with patients using ACE inhibitors to assess for decreased blood pressure. ACE inhibitors are known to lower blood pressure by dilating blood vessels, which can sometimes lead to hypotension (low blood pressure). Monitoring the patient's fluid intake and output helps healthcare providers evaluate the patient's blood pressure response to the medication and make necessary adjustments to prevent complications such as dizziness, falls, or fainting. Regular monitoring is crucial to ensure the patient's safety and optimize the effectiveness of ACE inhibitor therapy.
An overwhelmed nursing student asks the instructor whether there are any tips that will make learning pharmacology easier. The instructor gives an example of the anticoagulant heparin. The instructor indicates that knowing heparin and comparing other drugs to it will facilitate learning the many anticoagulants. Which approach is the instructor using?
- A. Mechanism of action approach
- B. Generic name approach
- C. Trade name approach
- D. Prototype drug approach
Correct Answer: D
Rationale: The prototype approach uses a representative drug like heparin to learn a class (anticoagulants), comparing others to its traits-mechanism, effects, side effects-simplifying study. Mechanism of action is narrower. Generic or trade names focus on nomenclature, not learning strategy. Prototype leverages a familiar example, a proven method for mastering drug groups.
If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?
- A. over 50%
- B. 50%
- C. under 50%
- D. 100%
Correct Answer: A
Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:
Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply.)
- A. Monitor the patient’s blood urea nitrogen and creatinine.
- B. Monitor the patient’s blood pressure for hypertension.
- C. Administer intravenous acyclovir over 30 minutes.
- D. Advise maintenance of adequate fluid intake.
Correct Answer: A
Rationale: Acyclovir can cause nephrotoxicity, so monitoring blood urea nitrogen (BUN) and creatinine levels is essential. Hypertension is not a common side effect of acyclovir. Intravenous acyclovir should be administered over at least 1 hour to prevent renal toxicity. Adequate fluid intake helps prevent crystalluria and nephrotoxicity.
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient™s BP. Which form of nitroglycerin is most appropriate?
- A. Sublingual spray
- B. Transdermal patch
- C. Oral capsule
- D. IV infusion
Correct Answer: D
Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.