Nokea
A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct Answer: B
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
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Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
- A. Selective estrogen receptor modulators
- B. Aspirin
- C. Glucocorticoids
- D. Calcium supplements
Correct Answer: C
Rationale: Glucocorticoids cause bone loss, warranting bisphosphonate prophylaxis; SERMs protect bone.
When taken with aminoglycosides, platinum chemotherapy or cyclosporin increase the risk of
- A. Kidney damage
- B. Ototoxicity
Correct Answer: A
Rationale: Platinum chemotherapy (e.g., cisplatin) and cyclosporin both potentiate aminoglycoside nephrotoxicity, increasing kidney damage risk.
The rotavirus vaccine (RotaTeq, Rotarix):
- A. Is a live vaccine that replicates in the small intestine, providing active immunity against rotavirus
- B. Should not be given to infants who are or may be potentially immunocompromised
- C. Is not given to an infant who has a febrile illness (temperature greater than 100.5°F)
- D. All of the above
Correct Answer: D
Rationale: All are true: rotavirus vaccine is live , contraindicated in immunocompromise , and deferred with fever .
The nurse is preparing a medication that is new to the market and cannot be found in the nurse's drug guide. Where can the nurse get the most reliable information about this medication?
- A. Package insert
- B. Another nurse
- C. Drug manufacturer
- D. Physician
Correct Answer: A
Rationale: The most reliable information about the drug can be found on the package insert supplied by the manufacturer because it was prepared according to strict Food and Drug Administration (FDA) regulations. Asking another nurse or the physician is not reliable and cannot be verified as accurate. It would not be realistic to call the drug manufacturer for information.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time
Correct Answer: B
Rationale: A history of rash suggests a possible allergy; withholding the medication and consulting the provider is safest.