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A nurse is caring for a client who has a new prescription for Niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of Niacin?(Select one that does not apply.)
- A. Jaundice
- B. Hyperglycemia
- C. Hearing loss
- D. Flushing of the skin
Correct Answer: C
Rationale: Niacin causes hyperglycemia , flushing , and jaundice from liver effects.
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Thirty-two units of Humulin insulin is ordered for the patient. The insulin is supplied in a multidose vial that is labeled 100 units/mL. How much insulin would be needed to treat this patient?
- A. 0.032 cc
- B. 0.32 cc
- C. 3.2 cc
- D. 32 cc
Correct Answer: B
Rationale: A cc is equivalent to an mL. There are 100 units in each cc. Divide that amount by 32 units for the answer (0.32 cc).
A 66-year-old man is admitted to the hospital with confusion, nausea, and blurred vision. He is currently on digoxin for the treatment of heart failure. On physical exam, his heart rate is 120 bpm. Further evaluation reveals a digoxin level of 5.3 ng/mL (normal range: 0.5-2 ng/mL). The doctor believes his symptoms are due to digoxin toxicity. Which parameter is used to indicate the ability of digoxin to produce the desired effect relative to a toxic effect?
- A. Bioavailability
- B. Efficacy
- C. Intrinsic activity
- D. Therapeutic index
Correct Answer: D
Rationale: Therapeutic index (TI) measures the relative safety of a drug by comparing the dose required for a therapeutic effect to the dose that produces toxicity. In this case, digoxin toxicity is indicated by the elevated level, and TI is the relevant parameter.
Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
- A. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
- B. For pedal edema throughout therapy
- C. Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm
- D. For vision changes, such as red-green blindness, at least annually
Correct Answer: A
Rationale: Phenytoin hypersensitivity syndrome can occur 3-8 weeks post-initiation.
Which of the following can be used with parenteral route for the treatment of diabetes mellitus
- A. Insulin preparations
- B. Sulfonilureas
- C. Biguanides
- D. Acarbose
Correct Answer: A
Rationale: Insulin is the only diabetes medication administered parenterally (e.g., subcutaneous or IV).
When reviewing the phases of drug development, the nurse finds a discussion about the postmarketing surveillance phase. Which one of the following activities would the nurse expect to find as being carried out during this phase?
- A. Health care providers report adverse effects to FDA.
- B. Healthy volunteers are involved in the test.
- C. In vitro tests are performed using human cells.
- D. The drug is given to patients with the disease.
Correct Answer: A
Rationale: The postmarketing surveillance phase of drug development encourages health care professionals to report adverse effects of drugs to the FDA using MedWatch. Phase 1 of clinical testing involves 20 to 100 healthy volunteers. In vitro testing of the drug on human or animal cells is done in the pre-FDA phase. In Phase 2 of clinical testing, the drug is given to patients with the disease for which the drug is manufactured.