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A doctor orders 250 mL of IV fluid to be infused over 1 hour using microdrip tubing (60 gtt/mL). What is the flow rate in drops per minute?
- A. 100 gtt/min
- B. 120 gtt/min
- C. 150 gtt/min
- D. 250 gtt/min
Correct Answer: D
Rationale: Flow rate = (250 mL 60 gtt/mL) ÷ (1 60) = 15,000 ÷ 60 = 250 gtt/min, matching microdrip where mL/hr = gtt/min.
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A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
You are gathering assessment data from a medication history of a 38-year-old male with four children. What assessment information would be most important in providing care for this patient?
- A. The medication history of the patient's mother and/or father
- B. The name of the patient's pharmacy
- C. Insurance, financial support, and stability for the patient and his family
- D. The last time the patient was hospitalized
Correct Answer: C
Rationale: Insurance and financial stability impact access to medications and adherence, critical for a 38-year-old with family responsibilities.
A classic drug interaction resulting in an increased bleeding time, involves warfarin and:
- A. Vitamin B6
- B. Aspirin
- C. Folic acid
- D. Rifampin
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation, enhancing warfarin's anticoagulant effect and increasing bleeding risk.
Genetic polymorphisms account for differences in metabolism, including:
- A. Poor metabolizers, who lack a working enzyme
- B. Intermediate metabolizers, who have one working, wild-type allele and one mutant
- C. Extensive metabolizers, with two normally functioning alleles
- D. All of the above
Correct Answer: D
Rationale: All listed phenotypes (A-C) result from genetic polymorphisms affecting drug metabolism, making D correct.
A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion?
- A. Lorazepam
- B. Prednisolone
- C. Disulfiram
- D. Naltrexone
Correct Answer: A
Rationale: Lorazepam and diazepam manage withdrawal symptoms; disulfiram and naltrexone are for maintenance.