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A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?
- A. Obtain a blood specimen immediately prior to administering the next dose of medication.
- B. Verify that the client has been taking the medication for 24 hour before obtaining a blood specimen.
- C. Ask the client to provide a urine specimen after the next dose of medication.
- D. Administer the medication, and obtain a blood specimen 30 min late
Correct Answer: A
Rationale: Trough levels are measured just before the next dose to assess the lowest drug concentration in the blood.
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Which of the following is CORRECT about aspirin poisoning?
- A. Is rarely seen in cases of chronic use
- B. It does not affect body temperature
- C. It is treated by administration of intravenous sodium bicarbonate
- D. The earliest sign is hypoventilation
Correct Answer: C
Rationale: Sodium bicarbonate enhances aspirin excretion by alkalinizing urine.
Janice has elevated LDL, VLDL, and triglyceride levels. Niaspan, an extended-release form of niacin, is chosen to treat her hyperlipidemia. Due to its metabolism and excretion, which of the following laboratory results should be monitored?
- A. Serum alanine aminotransferase
- B. Serum amylase
- C. Serum creatinine
- D. Phenylketonuria
Correct Answer: A
Rationale: Niacin can cause hepatotoxicity, requiring ALT monitoring.
Immunosupressive effects of glucocorticoids are denominated with:
- A. Decrease of interleukins 1,2
- B. Activation of lymphocyte proliferation
- C. Increase amount of T lymphocytes
- D. Activation of lymphocyte transport at the site of antigen stimulation
Correct Answer: A
Rationale: Glucocorticoids suppress immunity by decreasing pro-inflammatory cytokines like interleukins 1 and 2.
An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.