Nokea
A nurse is preparing a prescribed dose of rabeprazole for a client with gastric ulcers. The nursing drug guide does not list treatment of gastric ulcers among the recognized indications for this drug. What should the nurse do?
- A. Administer the drug as ordered
- B. Clarify with the prescriber concerning the ordered drug
- C. Document this potential error in the client's health record
- D. Ask the client whether he or she has taken this drug before
Correct Answer: B
Rationale: Rabeprazole is typically for GERD, not gastric ulcers per standard indications; clarifying with the prescriber ensures safety and appropriateness.
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Cruciferous vegetables may alter drug pharmacokinetics by:
- A. Enhancing absorption of weakly acidic drugs
- B. Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins
- C. Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
- D. Decreasing first-pass metabolism of drugs
Correct Answer: C
Rationale: Cruciferous vegetables (e.g., broccoli) induce CYP1A2, accelerating metabolism of drugs like theophylline, potentially reducing efficacy.
Precautions that should be taken when prescribing controlled substances include:
- A. Faxing the prescription for a Schedule II drug directly to the pharmacy
- B. Using tamper-proof paper for all prescriptions written for controlled drugs
- C. Keeping any pre-signed prescription pads in a locked drawer in the clinic
- D. Using only numbers to indicate the amount of drug to be prescribed
Correct Answer: B
Rationale: Tamper-proof paper prevents fraud, a key precaution; faxing Schedule II has restrictions, and locking pads or numbers-only are less specific.
Which diuretic is classified as a thiazide?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Mannitol
Correct Answer: C
Rationale: Hydrochlorothiazide is a thiazide diuretic, acting on the distal convoluted tubule, unlike furosemide (loop), spironolactone (potassium-sparing), or mannitol (osmotic).
A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching?
- A. Expect therapeutic effects in 24 to 48 hr.
- B. Discontinue the medication after a week of improved mood.
- C. Change positions slowly to minimize dizziness.
- D. Decrease injury from the first dose.
Correct Answer: C
Rationale: Slow position changes prevent dizziness, and chewing gum relieves dry mouth, common with tricyclics like amitriptyline.
If an agonist can produce submaximal effects and has moderate efficacy it's called:
- A. Partial agonist
- B. Antagonist
- C. Agonist-antagonist
- D. Full agonist
Correct Answer: A
Rationale: A partial agonist produces a submaximal effect even at full receptor occupancy.