Nokea
A nurse is caring for a client who has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the nurse should advise the client to do which of the following?
- A. Avoid the use of acetaminophen for headaches.
- B. Restrict intake of foods rich in sodium.
- C. Decrease fluid intake to less than 1,500 mL daily
- D. Limit aerobic activity in hot weather
Correct Answer: D
Rationale: Limiting activity in hot weather prevents dehydration, which increases lithium levels and risk of toxicity.
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Anti-inflammatory action of glucocorticoids is determined by:
- A. Inhibition of phospholipase A2
- B. Activation of phospholipase A2
- C. Inhibition of cyclooxygenase type-1
- D. Inhibition of cyclooxygenase type-2
Correct Answer: A
Rationale: Glucocorticoids inhibit phospholipase A2, reducing the production of inflammatory mediators like prostaglandins.
The nurse, working on the maternity unit, receives a call from a pregnant woman asking how she can know whether a medication is safe to take while pregnant. What is the nurse's best response?
- A. You can take any drug indicated as a Category A.
- B. No medications should be taken during pregnancy.
- C. Never take medication until you receive approval from your health care provider.
- D. Most medications are safe but you need to weigh benefit against risk.
Correct Answer: C
Rationale: The best response to a pregnant woman asking about medication usage is to talk with her obstetric practitioner because the best advice will come from someone who knows their health and pregnancy history. While Category A drugs have no known risk, they may be contraindicated by the woman's health condition or pregnancy issues and many pregnant women would not know what it means to be a Category A drug. Medications can be helpful during pregnancy if taken safely and appropriately. Although risk benefit needs to be weighed, it should occur with advice from the obstetric practitioner.
Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also be prescribed:
- A. Folic acid to prevent megaloblastic anemia
- B. Iron, to start when the epogen starts
- C. An antihypertensive to counter the adverse effects of epogen
- D. Vitamin B12 to prevent pernicious anemia
Correct Answer: B
Rationale: Iron supports erythropoiesis with epoetin alfa; antihypertensives manage side effects, not prophylaxis.
When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
Taking which drug with food maximizes it bioavailability?
- A. Donepezil
- B. Galantamine
- C. Rivastigmine
- D. Memantine
Correct Answer: C
Rationale: Rivastigmine's bioavailability is maximized with food, reducing GI side effects.