Nokea
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct Answer: A
Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
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Which of the following would the nurse identify as a factor that alters drug response in children and infants? (Select one that does not apply.)
- A. Slower gastric emptying
- B. Greater surface area
- C. Less protein binding
- D. Decreased body water content
Correct Answer: D
Rationale: Children and infants are not small adults; therefore, they have altered pharmacokinetics. Factors that alter pharmacokinetics in children include slower gastric emptying, less cutaneous fat, greater surface area, increased body water content, less protein binding, and immature hepatic and renal function.
The nurse promotes optimal drug effectiveness by doing what? (Select one that does not apply.)
- A. Incorporate basic history and physical assessment factors into the plan of care.
- B. Evaluate the effectiveness of drugs after they have been administered.
- C. Modify the drug regimen to modify adverse or intolerable effects.
- D. Minimize the number of medications administered to patients.
Correct Answer: D
Rationale: Incorporate basic history and physical assessment factors into any plan of care so that obvious problems can be identified and handled promptly. If a drug simply does not do what it is expected to do, further examine the factors that are known to influence drug effects. Frequently, the drug regimen can be modified to deal with that influence. Minimizing the number of medications administered is usually not an option because each drug is ordered for a reason of necessity for the patient.
The nurse is teaching a nursing student about the antifungal drug amphotericin B. Which statement by the student indicates a need for further teaching?
- A. Amphotericin B may be given intravenously or by mouth
- B. Patients who take this drug should have potassium and magnesium levels assessed
- C. Patients with renal disease should not take amphotericin B
- D. This drug is used for severe systemic infections
Correct Answer: A
Rationale: Amphotericin B is IV-only due to poor oral absorption; electrolyte monitoring and systemic use are correct. Amphotericin B is not absorbed from the gastrointestinal tract, so is not given by mouth.
Which of the following is not a dose related reaction:
- A. Myocardial Irritation of Quinidine
- B. Hypoglycemia of tolbutamide
- C. Digitalis induced arrythmia
- D. Drug fever of sulpha
Correct Answer: D
Rationale: Drug fever from sulfa is an idiosyncratic/hypersensitivity reaction, not dose-related.
Which of the following statements about beta-blockers is false?
- A. Beta-blockers should be avoided with non-dihydropyridine calcium channel blockers
- B. Beta-blockers increase renin secretion
- C. Non-selective beta-blockers are contraindicated in asthma
- D. Beta-blockers prolong the refractory period of the AV node
Correct Answer: B
Rationale: Beta-blockers decrease renin secretion by blocking beta-1 receptors in the kidney, making this statement false.