Nokea
A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.
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When moving to another state, what is the nurse responsible for becoming familiar with?
- A. Local policies and procedures for controlled substance administration
- B. Local provider's Drug Enforcement Agency (DEA) number for prescribing controlled substances
- C. The agency monitoring controlled substances in the new state
- D. Board of Nursing regulations of controlled substances in the new state
Correct Answer: A
Rationale: The nurse needs to learn local policies and procedures for controlled substance administration because they can vary with some local governments more rigorous than others. Nurses do not memorize a provider's DEA numbers. The DEA is a federal agency that monitors controlled substances in all states. State boards of nursing do not regulate controlled substances but may regulate how controlled substances are administered by nurses.
A nurse is teaching a client who has Graves' disease about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?
- A. Propranolol helps increase blood flow to my thyroid gland.
- B. Propranolol is used to prevent excess glucose in my blood.
- C. Propranolol will decrease my tremors and fast heart beat.
- D. Propranolol promotes a decrease of thyroid hormone in my body
Correct Answer: C
Rationale: Propranolol reduces tremors and tachycardia in Graves' disease by blocking beta-adrenergic effects.
What is the role of calcium supplements when patients take bisphosphonates?
- A. They must be restricted to allow the medication to work
- B. They must be taken in sufficient amounts to provide foundational elements for bone growth
- C. They must be taken at the same time as the bisphosphonates
- D. They only work with bisphosphonates if daily intake is restricted
Correct Answer: B
Rationale: Calcium supports bone health with bisphosphonates but must be timed separately (not C) to avoid interference.
In which of the following patients would a nurse expect to see an alteration in drug metabolism?
- A. A 35-year-old female with cervical cancer
- B. A 41-year-old male with kidney stones
- C. A 50-year-old male with cirrhosis of the liver
- D. A 62-year-old female in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. In cirrhosis patients the drug dosage will need to be altered to ensure normal levels in the body.
The nurse learns that a drug needed by the patient is classified as an orphan drug and recognizes what as a reason for this classification?(Select one that does not apply.)
- A. The drug is rarely prescribed.
- B. The drug has dangerous adverse effects.
- C. The drug treats a rare disease.
- D. The patent on the medication is still effective.
Correct Answer: D
Rationale: Drugs are classified as orphan drugs when they are not financially viable for a drug company to produce either because of risk for lawsuits about adverse effects or because the drug is not prescribed, which is often seen in rare diagnoses. Generic drugs are not produced until the patent expires, but this has no impact on classifying a particular drug as an orphan drug. Generic drugs are often produced by companies that only manufacture drugs without conducting research, but this has no bearing on the classification of orphan drugs.