Nokea
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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Select the most appropriate drug for regular prophylactic therapy in a 10 year old child who suffers from exercise induced asthma:
- A. Oral salbutamol
- B. Oral theophylline
- C. Inhaled sodium cromoglycate
- D. Inhaled salmeterol
Correct Answer: C
Rationale: Inhaled sodium cromoglycate is preferred for prophylaxis in exercise-induced asthma in children, stabilizing mast cells to prevent bronchoconstriction; salmeterol is a long-acting option but less favored.
The term 'chemical antagonism' means that:
- A. two drugs combine with one another to form an inactive compound
- B. two drugs combine with one another to form a more active compound
- C. two drugs combine with one another to form a more water soluble compound
- D. two drugs combine with one another to form a more fat soluble compound
Correct Answer: A
Rationale: Chemical antagonism involves a direct chemical interaction rendering the drug inactive, e.g., chelation.
The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didnt they know this adverse effect could occur? What is the nurses best response? (Select all that apply.)
- A. Phase III testing involves wide-scale population testing, which can reveal rare adverse effects not seen in earlier phases.
- B. New adverse effects can lead to further study or withdrawal of the drug.
- C. Phase I testing on healthy volunteers ensures all adverse effects are identified before patient use.
- D. Even with extensive testing, some adverse effects may only appear after widespread use.
Correct Answer: C
Rationale: Phase III testing involves a large population, uncovering rare effects . Preclinical animal studies don't fully predict human responses (B is false). Phase I uses healthy volunteers, missing disease-specific effects (C is false). Rare effects emerge post-approval , potentially leading to further action .
Which of the following drugs should be avoided in a pregnant woman because of a risk of harming the fetus?
- A. Pravastatin
- B. Cholestyramine
- C. Gemfibrozil
- D. Niacin
Correct Answer: A
Rationale: Statins like pravastatin are contraindicated in pregnancy due to potential teratogenic effects.
Carbamazepine has a Black Box Warning due to life-threatening:
- A. Renal toxicity, leading to renal failure
- B. Hepatotoxicity, leading to liver failure
- C. Dermatologic reaction, including Steven's Johnson and toxic epidermal necrolysis
- D. Cardiac effects, including supraventricular tachycardia
Correct Answer: C
Rationale: Carbamazepine's Black Box Warning highlights severe skin reactions like SJS/TEN.