A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the knowledge that the aging process impacts drug therapy in what important way?
- A. Blood volume decreases
- B. Subcutaneous tissue increases
- C. Total body water increases
- D. Muscle mass increase
Correct Answer: A
Rationale: Decreased blood volume in aging affects drug distribution and concentration.
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A nurse working in radiology administers iodine to a patient who is having a computerized axial tomography (CAT) scan. A nurse working on an oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The nurse working in radiology is administering a drug to help diagnose a disease. The nurse working on an oncology unit is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is how the body acts on the drug.
A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
- A. Vitamin k1
- B. Atropine
- C. Protamine
- D. Calcium gluconate
Correct Answer: C
Rationale: Protamine reverses heparin's anticoagulant effect in bleeding emergencies.
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hr
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct Answer: C
Rationale: Hyperkalemia (5.2 mEq/L, C) is a serious side effect of spironolactone, a potassium-sparing diuretic.
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication.