Nokea
A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The nurse should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?
- A. Bursitis
- B. Brussels
- C. Depression
- D. Glaucoma
Correct Answer: D
Rationale: Oxybutynin is contraindicated in glaucoma due to its anticholinergic effects increasing intraocular pressure.
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A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select one that does not apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. You'll your provider if you develop a rash.
Correct Answer: A
Rationale: Grapefruit juice interacts, blood counts monitor toxicity, rash signals reaction, and driving caution addresses sedation.
Who defines the standards of care for the practice of nursing? (Select one that does not apply.)
- A. State boards of nursing
- B. Hospital policy and procedures
- C. Federal laws regulating health care facilities
- D. The Joint Commission
Correct Answer: B
Rationale: Standards of care are defined by state boards of nursing, federal laws regulating health care facilities, The Joint Commission, and professional nursing associations such as the American Nurses Association. Individual hospital policies and procedures incorporate federal and state guidelines into their respective policies and procedures and are often more stringent than state and federal regulations.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
What dermatological issue is linked to Amiodarone use?
- A. Increased risk of basal cell carcinoma
- B. Flare up of any prior psoriasis problems
- C. Development of plantarwarts
- D. Progressive change of skin tone toward a blue spectrum
Correct Answer: D
Rationale: Amiodarone causes blue-gray skin discoloration due to drug deposition.
A patient is using the Commit lozenge 2 mg to help quit smoking and reports nausea and indigestion. The nurse will instruct the patient to perform which action?
- A. Allow the lozenge to dissolve slowly over 20 to 30 minutes
- B. Chew the lozenge thoroughly before swallowing it
- C. Increase to 4 mg and use less often
- D. Take the lozenge with food and a full glass of water
Correct Answer: A
Rationale: Slow dissolution minimizes GI upset from nicotine lozenges; chewing worsens it. The patient should allow the lozenge to dissolve slowly.