Nokea
A CNM:
- A. may treat only women.
- B. has prescriptive authority in all 50 states.
- C. may administer only drugs used during labor and delivery.
- D. may practice only in birthing centers and home birth settings.
Correct Answer: B
Rationale: The correct answer is B because CNMs have prescriptive authority in all 50 states. Choice A is incorrect as they can treat partners for STDs. Choice C is wrong since their authority isn’t limited to labor drugs. Choice D is inaccurate as they practice in various settings.
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Patient education for the elderly should include:
- A. Explanation of drug purpose
- B. Instructions for safe administration
- C. Potential side effects
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because explaining purpose (improves adherence), safe administration (prevents errors), and side effects (enhances safety) are all key for elderly education, per geriatric care. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because administration is just part. Choice C is incorrect solo since side effects are only one element.
An 86-year-old patient is seen in clinic for a scheduled follow-up after starting a new oral medication 1 month prior. The patient reports no change in symptoms, and a laboratory test reveals a subtherapeutic serum drug level. The NP caring for this patient should:
- A. consider ordering more frequent dosing of the drug.
- B. titrate the patient's dose upward and recheck in 1 month.
- C. ask the patient about any increased frequency of bowel movements.
- D. determine the number of pills left in the patient's prescription bottle.
Correct Answer: D
Rationale: The correct answer is D because elderly patients often have adherence issues due to cost or confusion, so checking pill count assesses compliance before adjusting dose. Choice A is incorrect as frequency isn’t the first step. Choice B is wrong since dose increase without compliance check is premature. Choice C is inaccurate as bowel changes aren’t the primary concern.
After administering nitroglycerin to a client with coronary artery disease (CAD) who reports chest pain, what should be the nurse's next priority action?
- A. Obtain a 12-lead ECG
- B. Monitor the client's blood pressure
- C. Notify the healthcare provider
- D. Administer a second dose of nitroglycerin
Correct Answer: B
Rationale: The correct next priority action after administering nitroglycerin to a client with CAD experiencing chest pain is to monitor the client's blood pressure. Nitroglycerin can cause hypotension, so it is crucial to assess and monitor the client's blood pressure for any signs of decreased perfusion or adverse effects. Obtaining a 12-lead ECG may be important but is not the immediate priority. Notifying the healthcare provider and administering a second dose of nitroglycerin should only be considered after ensuring the client's blood pressure is stable.
Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs):
- A. A 32-year-old male
- B. A 22-year-old female
- C. A 3-month-old female
- D. A 48-year-old male
Correct Answer: C
Rationale: Choice C is correct because a 3-month-old female is at higher risk for ADRs due to immature liver and kidney function, reducing drug metabolism and excretion, increasing toxicity potential. Choice A is incorrect as a healthy 32-year-old male typically has mature systems. Choice B is wrong because a 22-year-old female also has developed metabolism. Choice D is incorrect since a 48-year-old male, unless compromised, has lower risk than an infant.
A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. What should the nurse do first?
- A. Call a code blue.
- B. Call the healthcare provider.
- C. Check the client's status and lead placement.
- D. Press the recorder button on the ECG console.
Correct Answer: C
Rationale: The correct first action for the nurse to take is to check the client's status and lead placement. This step is crucial to ensure that the alarm is not triggered by a simple issue such as lead displacement. Calling a code blue (choice A) is premature without assessing the client first. Contacting the healthcare provider (choice B) can be done after ruling out basic causes for the alarm. Pressing the recorder button (choice D) is not as urgent as checking the client's status and lead placement in this scenario.