Nokea
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. I will clean the site with an alcohol swab before I apply the patch.
- B. I will rotate the application sites weekly.
- C. I will apply the patch to an area of skin with no hair.
- D. I will place the new patch on the site of the old patch.
Correct Answer: A
Rationale: Cleaning the site with alcohol ensures proper adhesion and absorption, a key instruction for transdermal patches.
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The patient tells the nurse about a new drug being tested to treat the disease she was diagnosed with and asks the nurse whether the doctor can prescribe a medication still in the preclinical phase of testing. What is the nurses best response?
- A. The doctor would have to complete a great deal of paperwork to get approval to prescribe that drug.
- B. Sometimes pharmaceutical companies are looking for volunteers to test a new drug and the doctor could give them your name.
- C. Drugs in the preclinical phase of testing are only tested on animals and so would not be available to you.
- D. Drugs in the preclinical phase of testing are given only to healthy young men and so would not be available to you.
Correct Answer: C
Rationale: During the preclinical phase of testing drugs are tested on animals and are not available to patients. In phase I, the drug is tested on volunteers who are usually healthy young men. It is only in phase III studies that the drug is made available to prescribers who agree to closely monitor patients getting the medication.
A nurse is providing teaching to a client who has a new prescription for Buspirone to treat Anxiety. Which of the following information should the nurse include?
- A. Take this medication on an empty stomach
- B. Expect optimal therapeutic effects within 24 hr.
- C. Take this medication when needed for anxiety
- D. This medication has a low risk for dependency.
Correct Answer: D
Rationale: Buspirone has a low dependency risk , unlike benzodiazepines; it takes weeks to work, not PRN.
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
A 24-year-old female is prescribed erythromycin for gastroparesis. It is prescribed four times daily due to its short half-life. What is the rationale for such a frequent dosing?
- A. Achieve the steady-state plasma concentration of the drug
- B. Aid more complete distribution of the drug
- C. Avoid the toxicity of the drug because of its low therapeutic index
- D. Ensure that the drug concentration remains constant over time
Correct Answer: C
Rationale: Frequent dosing is required due to erythromycin's short half-life and low therapeutic index, which means a narrow margin between effective and toxic doses, necessitating careful maintenance to avoid toxicity.
Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be:
- A. Ibuprofen (Advil)
- B. Acetaminophen with hydrocodone (Vicodin)
- C. Oxycodone (Oxycontin)
- D. Oral morphine (Roxanol)
Correct Answer: A
Rationale: Ibuprofen is first-line for mild-to-moderate pain due to efficacy and safety.