Nokea
A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?
- A. Add extra snacks to your diet to prevent weight loss.
- B. Notify the provider if you develop breast enlargement.
- C. You may begin to have mild seizures while taking this medication.
- D. This medication is likely to increase your libido.
Correct Answer: B
Rationale: Risperidone can cause gynecomastia , a side effect to report; it often decreases libido and causes weight gain.
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A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?
- A. Body temperature varies between men and women.
- B. Muscle mass is greater in women.
- C. Percentage of fat differs between genders.
- D. Proven subjective factors exist between the genders.
Correct Answer: C
Rationale: Gender differences in pharmacokinetics are largely due to fat percentage , affecting drug distribution; muscle mass is greater in men (B is false), and temperature/subjective factors are less impactful.
Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:
- A. Fluoxetine (Prozac)
- B. Paroxetine (Paxil)
- C. Amitriptyline (Elavil)
- D. Duloxetine (Cymbalta)
Correct Answer: D
Rationale: Duloxetine addresses both depression and fatigue, unlike sedating options.
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia.
The nurse is preparing to administer an intradermal injection. The nurse would insert the needle at which angle?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: A
Rationale: When giving an intradermal injection, the needle is inserted bevel up at a 15-degree angle. The nurse would insert the needle at a 90-degree angle for an intramuscular injection or for a patient who is obese and requires a subcutaneous injection. Typically a subcutaneous injection is given at a 45-degree angle.
A nurse is assessing the patients home medication use. After listening to the patient list current medications, the nurse asks what priority question?
- A. Do you take any generic medications?
- B. Are any of these medications orphan drugs?
- C. Are these medications safe to take during pregnancy?
- D. Do you take any over-the-counter medications?
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter medications because patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs unless they too are health care providers. Safety during pregnancy, use of a generic medication, or classification of orphan drugs are things the patient would be unable to answer but could be found in reference books if the nurse wishes to research them.