Nokea
A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)
- A. Cough
- B. Dizziness
- C. Increased libido
- D. Invention
Correct Answer: B
Rationale: Venlafaxine can cause dizziness , decreased libido , and hypotension ; 'invention' seems a typo.
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Which of the following is an advantage of sublingual administration?
- A. Rapid absorption
- B. Convenient
- C. Avoid harsh GI environment
- D. Avoid first pass-metabolism
Correct Answer: D
Rationale: Sublingual administration offers rapid absorption , convenience , avoids the GI tract , and bypasses first-pass metabolism ; all are true, but D is a key pharmacological advantage.
Because of their site of action, bile acid sequestering resins:
- A. Should be administered separately from other drugs by at least 4 hours
- B. May increase the risk for bleeding
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: A
Rationale: Bile acid resins bind drugs in the gut, requiring separation by 4 hours.
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?
- A. A second nurse enters the prescription into the client's medical record.
- B. Another nurse should listen to the phone call:
- C. The provider can clarify the prescription when he signs the health record.
- D. I should omit the 'read back' if this is a one-time prescription
Correct Answer: B
Rationale: Having another nurse listen ensures accuracy in transcribing verbal orders, a standard safety protocol.
The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didn't they know this adverse effect could occur? What is the nurse's best response? (Select one that does not apply.)
- A. Pharmaceutical companies sometimes underreport problems to make more money.
- B. Your response to this medication will be reported to the drug company and the Food and Drug Administration (FDA).
- C. After a drug reaches phase III testing it is considered an accepted drug and will not be recalled.
- D. The pharmaceutical company weighs the benefits of the drug with the severity of adverse effects.
Correct Answer: B
Rationale: When a new and unexpected adverse effect occurs, especially one of a serious nature, it is reported to the drug company who reports it to the FDA immediately. When a large number of people begin using the drug in phase III studies, it is not unusual to identify adverse effects not previously noted. It would be both unprofessional and inaccurate to imply that pharmaceutical companies put profit ahead of patient concern because lawsuits would remove any potential profit if a drug proves harmful. The FDA is responsible for weighing risk versus benefit in deciding whether to allow the drug to move to the next phase of testing. Drugs found to have serious adverse effects can be removed from the market at any time.
The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
- A. It is standard practice when the patient is unable to take the ordered medication.
- B. It is acceptable if the patient agrees to the altered route form.
- C. It is preferable to having the patient miss a dose of the medication.
- D. It is contraindicated without an order from the health care provider.
Correct Answer: D
Rationale: One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber's order.