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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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.
Clonidine has several off-label uses, including:
- A. Alcohol and nicotine withdrawal
- B. Post-herpetic neuralgia
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Clonidine is used off-label for both alcohol/nicotine withdrawal and post-herpetic neuralgia.
An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be:
- A. Oral pseudoephedrine
- B. Oral phenylephrine
- C. Nasal oxymetazoline
- D. Nasal azelastine
Correct Answer: C
Rationale: Nasal oxymetazoline , a topical decongestant, has less systemic effect on blood pressure than oral options ; azelastine is an antihistamine.
What would be the best source of drug information for a nurse?
- A. Drug Facts and Comparisons
- B. A nurses drug guide
- C. A drug package insert
- D. The Physicians Drug Reference (PDR)
Correct Answer: B
Rationale: A nurses drug guide provides nursing implications and patient teaching points that are most useful to nurses in addition to need-to-know drug information in a very user friendly organizational style. Lippincotts Nursing Drug Guide (LNDG) has drug monographs organized alphabetically and includes nursing implications and patient teaching points. Numerous other drug handbooks are also on the market and readily available for nurses to use. Although other drug reference books such as Drug Facts and Comparisons, PDR, and drug package inserts can all provide essential drug information, they will not contain nursing implications and teaching points and can be more difficult to use than nurses drug guides.
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