Nokea
A nurse is caring for a client who has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
- A. Orthostatic hypotension
- B. Hearing loss
- C. Gastrointestinal bleeding
- D. Weight loss
Correct Answer: A
Rationale: Phenelzine, an MAOI, commonly causes orthostatic hypotension due to its effect on blood pressure regulation.
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The routine monitoring recommended for low molecular weight heparin is:
- A. INR every 2 days until stable, then weekly
- B. aPTT every week while on therapy
- C. Factor Xa levels if the patient is pregnant
- D. White blood cell count every 2 weeks
Correct Answer: C
Rationale: Factor Xa levels may be monitored in pregnancy with LMWH; routine INR or aPTT isn't needed due to predictable pharmacokinetics.
Which of the following anti inflammatory drugs is ineffective in gout?
- A. Piroxicam
- B. Tolmetin
- C. Aspirin
- D. Celecoxib
Correct Answer: C
Rationale: Aspirin increases uric acid levels, worsening gout.
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
- A. Decreased effectiveness of irinotecan in the treatment of cancer
- B. Increased adverse drug reactions, such as neutropenia
- C. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
- D. Increased concerns for irinotecan being carcinogenic
Correct Answer: B
Rationale: UGT1A1 mutations slow SN-38 inactivation, raising neutropenia risk , not affecting efficacy or activation .
Which of the following NSAIDs has greater inhibitory selectivity for COX-1 than COX-2?
- A. Flurbiprofen
- B. Indomethacin
- C. Diclofenac
- D. Celecoxib
Correct Answer: B
Rationale: Indomethacin is more selective for COX-1, whereas celecoxib is COX-2 selective; others have mixed activity.
The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
- A. Diarrhea
- B. Hair loss
- C. Chest pain
- D. Numbness and tingling in the fingers and toes
Correct Answer: D
Rationale: A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication.