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A nurse is preparing to administer Propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold propranolol for an apical pulse greater than 100/min.
- B. Administer propranolol to increase the client's blood pressure.
- C. Assist the client when she sits up or stands after taking this medication.
- D. Check for hypokalemia frequently due to the risk for propranolol toxicity.
Correct Answer: C
Rationale: Propranolol can cause orthostatic hypotension; assisting with position changes prevents falls.
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Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:
- A. Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case
- B. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness
- C. Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission
- D. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times
Correct Answer: B
Rationale: Warfarin's delayed onset requires heparin overlap for immediate anticoagulation; this is standard, not an error or exception .
A nurse is caring for a client who is taking oral Oxycodone The client states he is also taking lbuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings?
- A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication
- B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication
- C. An increase in the expected therapeutic effect of both medications
- D. An increase in expected adverse effects for both medications
Correct Answer: C
Rationale: Both are analgesics; combined use enhances pain relief , a therapeutic synergy, without necessarily increasing adverse effects.
A nurse is working as a member of a research team involved in exploring the unique response to drugs each individual displays based on genetic make-up. What is this area of study called?
- A. Pharmacotherapeutics
- B. Pharmacodynamics
- C. Pharmacoeconomics
- D. Pharmacogenomics
Correct Answer: D
Rationale: Pharmacogenomics is the area of study that includes mapping of the human genome. In the future, medical care and drug regimens may be personally designed based on a patients unique genetic make-up. Pharmacotherapeutics is the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. Pharmacodynamics involves how a drug affects the body. Pharmacoeconomics includes the costs involved in drug therapy.
Please select a correct statement:
- A. Steroids excreted in maximal amount in evening and night time - between 20-24 h
- B. Steroids maximal excretion is in morning time - between -4-8 h
- C. Steroids maximal secretion is in daytime- between -12-16 h
- D. Steroids decrease sensitivity of vessels and bronchus towards catecholamines
Correct Answer: B
Rationale: Steroids peak in the morning (4-8 AM) due to circadian rhythm of cortisol secretion.
All of the following adverse effects commonly occur in glucocorticoid therapy except:
- A. Osteoporosis
- B. Increased risk of infection
- C. Hypotension
- D. Emotional disturbances
Correct Answer: C
Rationale: Glucocorticoids cause hypertension, not hypotension, due to mineralocorticoid effects and fluid retention.