Nokea
A nurse is assessing a client who has taken Procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select one that does not apply.)
- A. Joint swelling
- B. Widened QRS complex
- C. Narrowed QT interval
- D. Easy bruising
Correct Answer: C
Rationale: Procainamide can widen QRS , cause bruising from lupus-like syndrome, and joint swelling .
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A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug-drug interaction. What is the nurse's first and best means of avoiding this problem?
- A. Consult a drug guide.
- B. Call the pharmacist.
- C. Contact the provider.
- D. Ask another nurse.
Correct Answer: A
Rationale: Whenever two or more drugs are being given together, first consult a drug guide for a listing of clinically significant drug-drug interactions. Sometimes problems can be avoided by staggering the administration of the drugs or adjusting their dosages. Consulting the pharmacist is not wrong, but it would not be the first action to take. The nurse holds responsibility for his or her own practice so asking a health care provider or another nurse is based on the assumption that that professional is knowledgeable about all drug-drug interactions, which is likely not the case.
A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
- A. Cardiovascular
- B. Immune
- C. Central nervous
- D. Gastrointestinal
Correct Answer: C
Rationale: Extrapyramidal effects are movement disorders caused by medications affecting the central nervous system , like antipsychotics.
Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?
- A. Platelet count
- B. Triglyceride level
- C. Complete blood count
- D. White blood cell count
Correct Answer: B
Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman 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 metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
A patient requires 1,000 mL of IV fluid to be infused over 10 hours with a drop factor of 20 gtt/mL. What is the flow rate in drops per minute?
- A. 33 gtt/min
- B. 50 gtt/min
- C. 67 gtt/min
- D. 100 gtt/min
Correct Answer: A
Rationale: Flow rate = (Volume Drop factor) ÷ Time in minutes = (1,000 mL 20 gtt/mL) ÷ (10 60) = 20,000 ÷ 600 = 33.33 gtt/min, rounded to 33 gtt/min.