Nokea
A nurse is preparing to administer tobramycin. Which lab value should be monitored closely?
- A. Liver function tests
- B. BUN and creatinine
- C. Complete blood count
- D. Electrolytes
Correct Answer: B
Rationale: Tobramycin, an aminoglycoside, is nephrotoxic; BUN and creatinine monitor kidney function, critical for safe administration.
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What needs to happen to the protein-drug complex for the drugs to reach the cells where the drug can act?
- A. The protein-drug complex must break itself into smaller pieces to enter the capillaries.
- B. The binding site on the protein picks up a chemical to make it soluble in the serum.
- C. The drug must break away from the protein-binding site and float freely.
- D. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.
Correct Answer: C
Rationale: Most drugs are bound, to some extent, to proteins in the blood to be carried into circulation. The protein-drug complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the protein's binding site at the tissues. This occurs without the introduction of another chemical or by dissolving in it plasma.
The nurse would expect to see an adjusted dosage in what patients? (Select one that does not apply.)
- A. Young adult women
- B. older adults
- C. Infants
- D. Neonates
Correct Answer: A
Rationale: Infants, neonates, and older adults require dosage adjustments due to differences in metabolism and organ function.
Pentobarbitone is
- A. Long acting barbiturates
- B. Short acting barbiturates
- C. Ultra short acting barbiturates
- D. Intermediate acting barbiturates
Correct Answer: D
Rationale: Pentobarbitone (pentobarbital) is classified as an intermediate-acting barbiturate, with a duration of action between short-acting and long-acting barbiturates.
A pharmaceutical lab states that a drug causes negative side effects in 3 of every 100 patients. To confirm this affirmation, another laboratory chooses 5 people at random who have consumed the drug. What is the probability that at least two experience side effects?
- A. 0.8687
- B. 0.1313
- C. 0.00847
- D. 0.0003
Correct Answer: C
Rationale: The probability of at least two experiencing side effects is P(X≥2) = 1 - [P(X=0) + P(X=1)]. Using binomial calculations: P(X=0) = 0.8687, P(X=1) = (5 choose 1) * 0.03 * 0.97^4 = 0.1342, so P(X≥2) = 1 - (0.8687 + 0.1342) = 0.00847, matching the document.
The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action?
- A. Add ethambutol (Myambutol)
- B. Change the streptomycin to clarithromycin
- C. Change the streptomycin to kanamycin
- D. Order renal function tests
Correct Answer: C
Rationale: Kanamycin replaces streptomycin in phase I resistance; ethambutol is for INH resistance, and clarithromycin is phase II. The patient's current regimen is first-phase treatment. If resistance to streptomycin develops, the provider can change to kanamycin or to ciprofloxacin.