Nokea
A nurse is preparing a presentation for a group of nurses about actions that nurses can do to help prevent drug errors. Which of the following would the nurse include? Select one that does not apply
- A. Rechecking all calculations
- B. Always administering the drug before answering any of the client's questions
- C. Avoiding distractions and concentrating on only one task at a time
- D. Confirming any questionable orders
Correct Answer: B
Rationale: In addition to following the five +1 rights of drug administration, a nurse can employ the following strategies to aid in the prevention of drug errors: confirm any questionable orders; when calculations are necessary, verify them with another nurse; listen to the client when he or she questions a drug, the dosage, or the drug regimen; never administer the drug until the client's questions have been adequately researched; and avoid distractions and concentrate on only one task at a time.
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Pharmacokinetic factors that affect prescribing include:
- A. Therapeutic index
- B. Minimum effective concentration
- C. Bioavailability
- D. Ease of titration
Correct Answer: C
Rationale: Bioavailability directly impacts how much drug reaches circulation, a key pharmacokinetic factor, unlike therapeutic index or titration ease .
The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh less than 64 kg.
- A. 5
- B. 11
- C. 15
- D. 20
Correct Answer: B
Rationale: Z-score: (64-70)/3 = -2. P(Z < -2) = 1 - P(Z ≤ 2). Using standard tables, P(Z ≤ 2) ≈ 0.9772, so P(Z < -2) = 1 - 0.9772 = 0.0228 (document says 0.02128, likely a typo). Then, 0.0228 * 500 ≈ 11, matching the document.
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
- A. St. John's wort
- B. Kava
- C. Fish oil
- D. Ginseng
Correct Answer: D
Rationale: Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John's wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.
The nurse, providing patient teaching about home medication use to an older adult, explains that even when drugs are taken properly they can produce negative or unexpected effects. What are these negative or unexpected effects called?
- A. Teratogenic effects
- B. Toxic effects
- C. Adverse effects
- D. Therapeutic effects
Correct Answer: C
Rationale: Negative or unexpected effects are known as adverse or side effects. Teratogenic effects are adverse effects on the fetus and not a likely concern for an older adult. Toxic effects occur when medication is taken in larger than recommended dosages caused by an increase in serum drug levels. Therapeutic effects are the desired actions for which the medication is prescribed.
True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
- A. Fever up to 104°F (40.5°C) after previous DTaP vaccine
- B. Family history of seizures after DTaP vaccine
- C. Adolescent pregnancy
- D. Anaphylactic reaction with a previous dose
Correct Answer: D
Rationale: Anaphylaxis is a true contraindication to DTaP/Tdap; fever , family history , or pregnancy are not.