Nokea
A nurse is preparing to administer a prescribed drug via an intramuscular injection. Which of the following would be most appropriate for the nurse to do? (Select one that does not apply.)
- A. Always wear gloves.
- B. Cleanse skin at injection site.
- C. Place pressure on the area after removing the needle.
- D. Recap the needle before disposal.
Correct Answer: D
Rationale: When administering an intramuscular injection, the nurse should always wear gloves, cleanse the skin at the injection site prior to administration, aspirate for 5 to 10 seconds after inserting the needle, apply pressure to the area after removing the needle, and never recap the needle.
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Carbamazepine has a Black Box Warning due to life-threatening:
- A. Renal toxicity, leading to renal failure
- B. Hepatotoxicity, leading to liver failure
- C. Dermatologic reaction, including Steven's Johnson and toxic epidermal necrolysis
- D. Cardiac effects, including supraventricular tachycardia
Correct Answer: C
Rationale: Carbamazepine's Black Box Warning highlights severe skin reactions like SJS/TEN.
Tuberculin purified protein derivative:
- A. Is administered to patients who are known tuberculin-positive reactors
- B. May be administered to patients who are on immunosuppressives
- C. May be administered 2 to 3 weeks after an MMR or varicella vaccine
- D. May be administered the same day as the MMR and/or varicella vaccine
Correct Answer: D
Rationale: TB skin test can be given same-day as MMR/varicella; prior positives or immunosuppression complicate interpretation.
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.
When taking a medication history on a patient why should the nurse ask about the use of alternative therapies?
- A. Patients who use new drugs are usually not compliant with medical regimens.
- B. Many drug-alternative therapy interactions can cause serious problems and should be avoided.
- C. Natural products may be more effective and the drug may not be needed.
- D. The cost of the drug and the alternative therapy may be too great for the patient to handle.
Correct Answer: B
Rationale: Alternative therapies can interact with prescribed drugs, potentially causing adverse effects, making this a critical assessment point.
Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
- A. Federal Food, Drug, and Cosmetic Act (1938)
- B. Durham Humphrey Amendment (1952)
- C. Controlled Substances Act (1970)
- D. Kefauver Harris Drug Amendment (1962)
Correct Answer: A
Rationale: The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety.