Nokea
A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?
- A. Name
- B. Dosage
- C. Route
- D. Frequency
Correct Answer: D
Rationale: PRN (as needed) lacks a specific frequency (e.g., every 4 hours), requiring clarification for safe administration.
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When writing a prescription for warfarin it is common to write ____ on the prescription.
- A. OK to substitute for generic
- B. The brand name of warfarin and Do Not Substitute
- C. PRN refills
- D. Refills for 1 year
Correct Answer: B
Rationale: Brand-specific warfarin ensures consistent potency; generics vary slightly, and PRN or yearly refills are impractical.
A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
- A. Coumadin, which may lead to bleeding problems
- B. Coumarin, which can cause liver and kidney damage
- C. Cinnamic aldehyde, which is toxic to the kidney
- D. Cinnamate eugenol, which is toxic to the liver
Correct Answer: B
Rationale: Cassia cinnamon contains coumarin, which can be hepatotoxic and nephrotoxic in high doses.
The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- A. Pancreatitis
- B. Diabetes mellitus
- C. Myocardial infarction
- D. Chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication.
A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient?
- A. Blood urea nitrogen (BUN) and creatinine
- B. Electrolytes
- C. Fluconazole levels
- D. Glucose
Correct Answer: D
Rationale: Fluconazole inhibits CYP450, increasing sulfonylurea levels and hypoglycemia risk; glucose monitoring is key. Patients taking sulfonylurea drugs may have altered serum glucose when taking antifungal medications.
The following drug is used for diabetic coma:
- A. Glibenclamid
- B. Long acting insulin preparations
- C. The rapid and intermediate acting insulin preparations
- D. Metformin
Correct Answer: C
Rationale: Rapid and intermediate-acting insulins are used to quickly correct hyperglycemia in diabetic coma.