Nokea
A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct Answer: A
Rationale: Propranolol is contraindicated in asthma due to risk of bronchoconstriction.
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Most common indication for therapeutic monitoring of plasma levels of a drug is
- A. Hit & run drugs
- B. Drugs with irreversible action
- C. Narrow therapeutic range
- D. Failure of response
Correct Answer: C
Rationale: Drugs with a narrow therapeutic range (e.g., digoxin) require monitoring to avoid toxicity.
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 nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why can't I participate in this study? What would be the nurse's best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a phase I study.
A nurse is preparing a prescribed dose of rabeprazole for a client with gastric ulcers. The nursing drug guide does not list treatment of gastric ulcers among the recognized indications for this drug. What should the nurse do?
- A. Administer the drug as ordered
- B. Clarify with the prescriber concerning the ordered drug
- C. Document this potential error in the client's health record
- D. Ask the client whether he or she has taken this drug before
Correct Answer: B
Rationale: Rabeprazole is typically for GERD, not gastric ulcers per standard indications; clarifying with the prescriber ensures safety and appropriateness.
Which of the following two cyclooxygenase isoenzymes is constitutively expressed?
- A. COX-1
- B. COX-2
Correct Answer: A
Rationale: COX-1 is constitutively expressed in most tissues, maintaining normal functions, unlike inducible COX-2.