Nokea
A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Weight gain
- B. Nervousness
- C. Bradycardia
- D. Constipation
Correct Answer: A
Rationale: Prednisone causes weight gain due to fluid retention and increased appetite.
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A patient requires 1,000 mL of IV fluid to be infused over 10 hours with a drop factor of 20 gtt/mL. What is the flow rate in drops per minute?
- A. 33 gtt/min
- B. 50 gtt/min
- C. 67 gtt/min
- D. 100 gtt/min
Correct Answer: A
Rationale: Flow rate = (Volume Drop factor) ÷ Time in minutes = (1,000 mL 20 gtt/mL) ÷ (10 60) = 20,000 ÷ 600 = 33.33 gtt/min, rounded to 33 gtt/min.
Bromocriptine is (select one that does not apply)
- A. A partial agonist of dopamine
- B. A partial antagonist of dopamine
- C. Used in the treatment of parkinsonism
- D. Used to reduce GH secretion in acromegaly
Correct Answer: B
Rationale: Bromocriptine is a dopamine agonist used in parkinsonism and acromegaly; all except B are correct.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
For the treatment of morphine addiction which of the following drug is substituted?
- A. Tramadol
- B. Methadone
- C. Fluoxetine
- D. Dextromethorphan
Correct Answer: B
Rationale: Methadone, a long-acting opioid agonist, is commonly substituted for morphine in addiction treatment to reduce withdrawal symptoms and cravings.
The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would the nurse consider a priority to assess to develop the most effective plan of care related to medication administration?
- A. Description of the patient's living environment
- B. Required lifestyle changes
- C. Family members in the community
- D. Compliance with therapy to reduce risk of skin breakdown
Correct Answer: A
Rationale: Living environment affects medication storage, access, and administration, critical for an elderly patient with CHF.