Nokea
A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but there is no pediatric dose listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?
- A. Surface area
- B. Height
- C. Birth date
- D. Age at gestation
Correct Answer: A
Rationale: Surface area, calculated via nomograms using height and weight, is the most accurate method for pediatric dosing adjustments.
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Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be:
- A. None, wait for the culture results to determine the course of treatment
- B. Ciprofloxacin (Ciloxan) ophthalmic drops
- C. IM ceftriaxone
- D. High-dose oral amoxicillin
Correct Answer: C
Rationale: Gonococcal conjunctivitis requires urgent IM ceftriaxone; waiting risks progression.
Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:
- A. Become a vegetarian because this disorder is associated with eating red meat.
- B. Stop taking the drug if abdominal cramps and diarrhea develop.
- C. Report muscle weakness or tenderness and dark urine to his provider immediately.
- D. Expect 'hot flash' sensations during the first 2 weeks of therapy.
Correct Answer: C
Rationale: Muscle symptoms and dark urine indicate rhabdomyolysis, requiring immediate reporting.
Which of the following is true regarding the Dietary Supplement Health and Education Act (DSHEA)?Select one that does not apply.
- A. The act allows for DEA enforcement of the act.
- B. The act gives the FDA power to enforce the laws governed by the act.
- C. The act permits general health claims.
- D. The act does not permit curative health claims.
Correct Answer: A
Rationale: The DSHEA defines substances such as herbs, vitamins, minerals, amino acids, and other natural substances as 'dietary supplements' and permits general health claims as long as the label also has a disclaimer stating that the supplements are not approved by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. The act gives the FDA the power to enforce the laws governed by the act.
A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next?
- A. Ask about alcohol consumption
- B. Reassure her that these are harmless side effects
- C. Tell her that this signals a worsening of her infection
- D. Tell her to go to the emergency department immediately
Correct Answer: A
Rationale: Metronidazole with alcohol causes a disulfiram-like reaction (symptoms listed); it's not infection worsening or harmless . Patients who are taking metronidazole can experience a disulfiram-like reaction when they drink alcohol.
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for to be used for an episode of status epilepticus.
- A. IV phenobarbital
- B. Rectal diazepam (Diastat)
- C. IV phenytoin (Dilantin)
- D. Oral carbamazepine (Tegretol)
Correct Answer: B
Rationale: Rectal diazepam is a rescue medication for status epilepticus at home.